Resources Needed to Implement Rural SDOH Programs

Rural programs addressing social determinants of health (SDOH) may need specific resources to support program implementation.

Funding

SDOH initiatives will benefit from long-term, flexible, sustainable funding sources, but this type of funding can be difficult to secure. Many SDOH grants are structured as short-term funding opportunities, funding specific activities such as pilot efforts, demonstration programs, or specific project work. Some funding opportunities only support specific priorities and activities, rather than the cross-cutting work required to address SDOH. In addition, the measurement frameworks that accompany funding opportunities do not always align with SDOH outcomes. This highlights the need for programs to develop long-term plans for funding and sustainability.

Staff

In some rural areas, especially those designated as provider shortage areas, it can be challenging to find staff with the appropriate skills and credentials to deliver programs that address SDOH. Each program addressing SDOH is different, and so the specific types of skills, experience, and credentials that programs require of staff will differ depending on the SDOH focus area and the services provided by the program.

For example, programs that focus on addressing SDOH through individual asset building and other approaches targeting economic stability may want to hire staff with a background in personal finance, such as knowledge and expertise in providing financial literacy counseling and education, or staff with specialized financial literacy certifications from accredited programs. Staff with other types of financial backgrounds and degrees in business and accounting may also be appealing. Rural programs focused on improving transportation access to address SDOH may consider hiring people with a background in customer service, human resources, and staff trained to drive and operate different types of vehicles for the public. Rural programs connecting people to healthcare services to address SDOH may use community health workers (CHWs), patient navigators, and other types of healthcare professionals.

Rural programs may need to explore innovative staffing models, such as training professionals to provide support, leveraging telehealth for specialized services, building strong partnerships to share expertise and personnel across organizations, and identifying flexible and innovative funding sources to support program staff and maintain services.

Meeting Support

Addressing SDOH often involves bringing together leadership, community members, and representatives from multiple sectors and organizations for in-person meetings and other convenings. To support these meetings and convenings, programs may require adequate meeting space that allows for regular opportunities for engagement. Considerations for adequate meeting space include cost, location, capacity, accessibility, and equipment. If virtual meetings are necessary or preferred, rural programs should consider accessibility. Virtual meetings may be difficult for some community members due to a lack of broadband access or difficulty navigating technology.

Partnership and Coalition Assistance

Engaging in multi-sector collaborations can be challenging. Partners may have differing priorities, levels of commitment, and experiences with collaboration. Many rural communities have sought technical assistance and training on building effective and sustainable coalitions and collaborations. External coaches and consultants can help rural communities gain skills in meeting facilitation, consensus building, and co-creation of strategies.

Rural communities may also need legal assistance to advance or formalize partnerships and collaborations. For example, several rural coalitions have incorporated as nonprofits, which allows them to receive and manage their own funding. Rural communities seeking 501(c)(3) status for their coalitions or collaborations may require legal assistance to review applications for tax exemption.

Transportation

In many rural areas, providing sufficient transportation is important to fostering community health. However, transportation comes at a large cost for many small, remote areas. For example, some remote areas may only be accessible by boat or plane — which can create financial barriers to programs that include transportation services. Securing funds for transportation may improve program success and outcomes. Because transportation is often the largest operating cost for SDOH programs, programs must calculate expected transportation costs and allocate sufficient funds in their annual budgets.

For more information about transportation-related implementation considerations, see the Rural Transportation Toolkit.