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Rural Health Information Hub

Facilitators and Barriers to Unintentional Injury Prevention in Rural Areas

Rural communities face unique challenges related to preventing unintentional injuries, and they also have assets and strengths they can leverage to address unintentional injury.

Rural Assets and Strengths

Some rural assets and strengths may serve as facilitators for the success of unintentional injury prevention programming. These include:

  • Strong local leaders and partnerships
  • Close-knit communities that build lasting relationships
  • Common locations and centers for gathering and social activities where educational events can occur
  • A strong sense of civic and community engagement, especially related to volunteerism and entrepreneurship

Communities that encourage leadership and growth may be more equipped to support changes that align with the goals of unintentional injury prevention programs.

Rural Barriers and Challenges

Some of the common challenges related to preventing unintentional injuries in rural areas include:

Social determinants of health – This includes high rates of poverty in certain counties, lower educational attainment, increased exposure to environmental hazards that can cause injuries, and increased barriers related to transportation and safe housing.

Cultural norms – Cultural norms that affect risk of unintentional injury (for example, not wearing a seat belt), and increased outdoor activity, like ranch work, in comparison to urban areas.

High cost for implementing programs – Due to low population density in rural areas, there are high costs per resident for implementing programs and fixing infrastructure.

Limited control over private property – Rural areas often have less control over private property and land that might have environmental or other hazards, particularly in more remote and frontier areas.

Distance to access healthcare services – Barriers to accessing healthcare can pose challenges to preventing deaths from unintentional injuries. Rural communities are often isolated from healthcare services, making it challenging for rural communities to receive adequate care following an unintentional injury. After a fall or motor vehicle accident, emergency medical responders may have to travel long distances to provide care. In areas where opioid misuse is prevalent, there are often limited substance use disorder treatment services available to individuals.

Delayed medical care – Delays in access to care can happen both inside and outside of healthcare facilities and have an impact on prevention and treatment efforts. Rural communities often have limited availability of specialty care centers and providers. Limited resources at rural trauma centers and a lack of trained trauma providers can cause delays and long wait times, which can lead to fatal outcomes. A 2017 study about disparities in access to trauma care found that approximately 29.7 million U.S. residents lived farther than 60 minutes away from a Level I or II trauma center as of 2010.

For more information about rural barriers that may impact unintentional injury 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 and the Social Determinants of Health in Rural Communities Toolkit. Read more about rural unintentional injuries in the Rural Monitor.

Resources to Learn More

Leveraging Culture and History to Improve Health and Equity in Rural Communities
Describes how rural community assets and values can be leveraged to improve overall health and well-being in rural areas. Recommends strategies for identifying key partners, building relationships and trust, developing appropriate messaging, and engaging other organizations.
Author(s): Meit, M., Phillips, E., Rosenfeld, A. et al.
Organization(s): NORC Walsh Center for Rural Health Analysis
Date: 2/2018