We’ve recently seen a renewed recognition that the public health needs of rural and urban populations differ significantly, and this is especially true when looking through an emergency preparedness and response lens. We cannot approach every community with a single method. Different community needs necessitate different plans to support those communities after a crisis. Let’s break it down.
Urban Communities, Population Density & Public Transportation
In urban environments, residents tend to live closer together and larger groups can be accessed more easily. In addition, resources tend to be clustered similarly. Healthcare facilities, like pharmacies and urgent care centers, tend to be in closer proximity. On the flip side, urban environments have higher population density, so a serious or catastrophic event can damage a whole neighborhood more readily.
There is a higher dependence on public transportation in order to access basic needs, such as groceries and medical care in urban communities. Communities who depend on public transit are less likely to own personal vehicles, meaning that they would be dependent on government-facilitated evacuations during an extreme event. This means these populations would have challenges accessing food and other life-sustaining items after a crisis if public transportation is hindered in any way.
The Geographic Challenge of Aiding Rural Communities
Rural areas, on the other hand, have residents who live further apart. This comes with its own challenges as these communities disproportionately face health challenges due to their geographic location. This geographic challenge can make it hard to identify and access those who require support after a disaster. Rural areas also have a greater distance to medical facilities, including pharmacies and health centers. Often, there are few medical providers in the geographical region, meaning that the communities are more dependent on fewer medical professionals to administer care. With public transportation being less common in a rural community, transportation can become a major issue. With most transit happening through vehicular transport, any road damage, reliance on public transit, vehicle damage, or inability to access gasoline will complicate a resident's ability to receive support after an event.
What Does It All Mean?
While different contexts create different risks and vulnerabilities during a crisis, there are some populations that would be considered vulnerable and require additional support during a crisis in both rural and urban areas. This includes individuals with access or functional needs, such as those with mobility challenges, who would require special assistance during an event. Whether it means being carried down five flights of stairs because elevators are not operating or being transported to a local dialysis center for treatment, there are varying considerations for those who fall into the “vulnerable” category. This is just one example of a population that would be classified as “vulnerable,” which is why we must be careful when lumping large populations of people into this category.
How Do We Support These Communities?
While there are different tactics that increase resilience in rural and urban environments, there are some approaches that can work across both groups. For instance, both communities can benefit from creating a network through common places of congregation, such as places of worship or community centers that can be used as a local touch point and resource center during disasters. As planners, we must also consider how those affected will get to congregation points, which could be difficult if individuals need to travel a long distance (or through damaged roads) to reach them.
In advance of disasters, we must ensure those who are dependent on medicines in both rural and urban areas can take advantage of resources that are available to assist in advance of a disaster. This includes relaxing prescription refill laws during an emergency, which allows early refills of medication to avoid being without during disasters. Lastly, medical facilities in those communities have worked to build greater emergency response plans, with generators and diesel fuel on hand, and satellite phones on standby.
While there is certainly more work to do, understanding the varying needs of different communities is the first step in protecting patients during and after disasters and disease outbreaks.