Toward Optimal and Equitable Rural Health

The stay-at-home orders and recommendations and the complete lockdown of significant parts of the economy (including self-imposed and guidance-based limits to elective medical services) have had a detrimental economic impact on ambulatory care practices, specialty and diagnostic care, oral health care, and hospital-based care, and, arguably, detrimental health effects on individuals and communities [ ]compared with persons living in the nonrural United States, those in the rural United States, in general, are older and have lower household income, lower overall educational attainment, a higher burden of chronic disease risk factors and chronic disease, and less access to medical care because of a lack of availability, long distances to care, and inadequate health insurance status The deficiencies in public health and clinical care (primary care and hospital care, in particular) infrastructure and systems existed in the rural United States before SARS-CoV-2;however, COVID-19 clusters and hot spots have made visible to many the weaknesses in rural public health and the limitations of sparse clinical care capacity to optimally conduct testing and contact tracing, on the one hand, and to deliver quality medical care to all (including adequate intensive care unit bed and staff capacity and availability of ventilators), on the other