Luján, Eshoo Call on President Biden to Create National Institute of Rural Health to Address Longstanding Rural Health Disparities

Washington, D.C. – As rural America continues to grapple with high numbers of COVID-19 related deaths, U.S. Senator Ben Ray Luján (D-N.M.) and Congresswoman Anna Eshoo (D-Calif.) called on President Joe Biden to create a National Institute of Rural Health (NIRH). In a letter to the President, Luján and Eshoo argue that a comprehensive, coordinated rural health strategy across federal agencies can better address longstanding disparities and improve health outcomes for rural Americans.

“Prior to the COVID-19 pandemic, rural Americans were more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than their urban counterparts. A recent CDC study found that children in rural areas with mental, behavioral, and developmental disorders face more community and family challenges than children in urban areas with the same disorders. With about 15% of all Americans living in rural areas, more needs to be done to address the structural barriers they face when trying to live healthy and prosperous lives,” wrote the Members of Congress. “There is no question the federal government has committed significant resources and consideration to address rural health, but its segmented and siloed approach has not yielded the results that reflect the effort. We have a historic opportunity to better leverage our commitment by creating a centralized NIRH to better serve rural Americans.”

Full text of the letter is available HERE and below:

Dear President Biden,

Today in the midst of an unprecedented global pandemic, the unique burdens rural communities have endured as a result of long standing systemic, health and social inequities are at the forefront. As you continue to respond to the COVID-19 pandemic, we urge you to consider an innovative approach to address rural health disparities by establishing a National Institute for Rural Health (NIRH) within the U.S. Department of Agriculture (USDA) and Health and Human Services (HHS) that convenes federal leaders across sectors to create a holistic approach to improving the health outcomes and quality of life for the 46 million Americans living in rural communities. The mission of NIRH will be to create “a state of complete physical, mental, and social well-being for one and all and not merely the absence of disease or infirmity.”

Prior to the COVID-19 pandemic, rural Americans were more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than their urban counterparts. A recent CDC study found that children in rural areas with mental, behavioral, and developmental disorders face more community and family challenges than children in urban areas with the same disorders. With about 15% of all Americans living in rural areas, more needs to be done to address the structural barriers they face when trying to live healthy and prosperous lives.

There is no question the federal government has committed significant resources and consideration to address rural health, but its segmented and siloed approach has not yielded the results that reflect the effort. We have a historic opportunity to better leverage our commitment by creating a centralized NIRH to better serve rural Americans. Currently, there are hundreds of programs that are available to rural communities for economic and rural development across 13 departments, 10 agencies, and 50 subagencies. These programs must be coordinated and streamlined through a NIRH to assemble the expertise, eliminate redundancies, and identify gaps to build a strategic plan.

We ask that you convene rural program leaders across disciplines to identify partnerships and build the infrastructure between leaders to create a delivery model for rural research and programming. Once these delivery models have been developed, we request that these models are shared with state, regional, Native, and local community leaders for their input and consultation. With that input, a comprehensive action plan should be generated and operationalized so that USDA and HHS can implement it.

The NIRH should identify and assess all rural-focused programs within the federal government, as well as other civic, educational, philanthropic/not-for-profit entities and business/labor organizations that are working in rural-focused domains, including health, health care, environment, agriculture and primary industry, community/economic development, and technology. NIRH has the potential to enhance and transform existing federal programs, partner with innovative state, county, municipal, private sector, and civic initiatives, and serve as a focus for relevant research and programming to benefit rural peoples and communities. It can serve as an advocate for the health of rural Americans and serve as a clearinghouse for rural-specific research and programming throughout the federal government, as well as the leading voice for America’s rural populations through research, leadership, education, and service.

Rural America represents a rich cultural diversity but also faces unique challenges in reaching the full height of its potential. Geographic distance from specialty care, more economic inequality, and long-standing structural barriers to full wellness are all challenges we must face head-on in the 21st Century. In overcoming the COVID-19 pandemic, we have an opportunity to integrate and maximize rural health resources. Creating the National Institutes for Rural Health is our chance to bring innovative solutions to rural America and increase opportunity for one and all.