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Rural Health Information Hub

Barriers and Facilitators for Chronic Disease Management in Rural Areas


Rural communities may face increased barriers in accessing healthcare, which can impact chronic disease management. Many of the barriers in rural areas are social determinants of health and include:

  • Higher rates of uninsurance and underinsurance among rural residents, which can make it challenging for individuals to afford medical appointments, medications, and medical supplies
  • Shortages of healthcare providers in rural areas, which can delay diagnoses, make it difficult to provide chronic disease education, and limit access to specialty care providers
  • Higher poverty rates, which can make it difficult to pay for services or medications and limit treatment options
  • Less access to healthy foods and physical activity options
  • Lower health literacy levels
  • Linguistic and educational disparities
  • Long distances to care and limited affordable and reliable transportation options which can make it difficult to travel to medical appointments

For more information on the key issues affecting healthcare access among rural populations, see the Healthcare Access in Rural Communities topic guide. For more information about rural barriers that may impact chronic disease prevention as well as social determinants of health that contribute to many of these barriers, see Barriers to Health Promotion and Disease Prevention in Rural Areas.


While barriers for addressing chronic disease exist, rural communities may also have social and structural factors that facilitate residents' ability to manage chronic diseases, including:

  • Social support from spouses and other caregivers for accessing healthcare, especially in facilitating transportation
  • Rural-adapted health system approaches including co-located services, after-hours telephone lines, and patient navigation services
  • High levels of social support and convenience of living in the same community as local healthcare providers
  • Strong partnerships between local organizations in rural communities that can work together to develop new solutions for helping residents manage chronic disease
  • Trusted referral sources within communities, such as local fire departments and faith-based organizations, that can help identify people with chronic conditions who can benefit from disease management

By taking these barriers and facilitators into consideration, rural communities can find innovative ways to help rural residents manage chronic diseases.