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Rural & Underserved Populations

The Center for Rural Health was formed in 1989 on the recommendation of the Governor's Rural Health Task Force. The goal of the center is to improve access to primary health care in rural and underserved areas of Illinois and to encourage community involvement in health issues. The center also serves as an information clearinghouse on rural health issues.

Center for Rural Health staff perform a number of services for local health care consumers and providers. Among these are consultation and technical assistance, which are offered to community-based organizations and health care providers to help them to identify health care issues, to discuss potential solutions, and to develop and implement plans of action.

The center is a vocal advocate, both in Illinois and nationally, that endeavors to educate policy makers and the public about the problems rural communities experience in their efforts to maintain and enhance health care access. Center staff also participate on a number of boards and task forces that address rural health issues.

The Center for Rural Health administers a number of scholarship programs for students in the health professions. The Center for Rural Health administers the State Loan Repayment Program (SLRP), the J-1 Visa Waiver Program for Illinois and supports the federal National Health Service Corps (NHSC) programs.

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“I get to the point where I look forward to Joan calling me on Wednesday afternoons. You know three o’clock comes and I know I have to be near the phone and be ready for her call, and then I give her all my numbers. She’ll check with me to see if I have any pain, how the week went and so forth, which I find is good,” explained rural Veteran Oscar Bourbeau. Bourbeau participates in a new home-based cardiac rehabilitation program offered by the U.S. Department of Veterans Affairs (VA).

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Scientific studies show that people who complete a cardiac rehabilitation program following a heart attack or bypass surgery can increase their life expectancy by up to five years, and have:

  • 27 percent lower cardiac death rates
  • 25 percent fewer fatal heart attacks
  • An improved quality of life

Cardiac rehabilitation occurs in three phases. Phase 1 begins during inpatient hospitalization under physician management. Phase 2 is a medically supervised outpatient program that begins following discharge to slow or even reverse the progression of the underlying hardening and narrowing of the arteries due to plaque. Phase 3 is a lifetime maintenance program with periodic follow-up.

Rural Veteran patient participation in sustained Phase 2 rehabilitation is a challenge due to limited transportation options, geographic barriers and lack of proximity to specialized cardiac facilities. To reduce these Veterans’ barriers to care, VA piloted a home-based cardiac rehabilitation program which recently earned the distinction of being a VA Office of Rural Health (ORH) Rural Promising Practice, and is being rolled out nationwide due to patients’ health outcomes and satisfaction.

This Rural Promising Practice enables Veteran patients to first meet in-person with a specialist to safely learn rehabilitation exercises, with subsequent sessions conducted at home. This model eliminates the need to travel multiple times a week to a rehabilitation facility for a sustained time frame, and enables patients to tailor the location and schedule of their ongoing 30-minute rehabilitation exercise sessions. Regularly scheduled phone calls with the rehabilitation specialist are dedicated to review curriculum that addresses risk factors, such as smoking cessation and proper nutrition. Other discussions focus on exercise, medication adherence and stress management.

“The weekly calls are very beneficial because I have a plan and goals that really allow me to focus on getting my health back on track,” stated program participant and rural Veteran Richard Howe.

Joan Walsh, a program nurse at Manchester VA Medical Center explained, “I’ve had some Veterans say I’m the devil on the shoulder or others you know, say I’m the angel on the shoulder.” She added, “I hold them accountable for them taking control of their health, and making it better. I’m very proud of the Veterans and their dedication to this program, and to making their lives healthy.”

To evaluate the success of a 12-week remote, home-based Phase 2 cardiac rehabilitation program compared to a traditional on-site program, researchers: reviewed its reach, effectiveness and implementation; compared clinical measures; and compared cost data. Results showed both health outcomes and costs were comparable with no negative impacts from remote care. In fact, rural Veteran patients who used home-based rehabilitation reported higher levels of satisfaction and were more likely to complete the program.

The Office of Rural Health oversees Rural Promising Practices as part of its portfolio of enterprise-wide initiatives. These 40+ initiatives help increase access to care for the 3 million Veterans living in rural communities who rely on VA for health care. To learn more, visit www.ruralhealth.va.gov or email rural.health.inquiry@va.gov.

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If you have any questions or would like additional information about ORH, contact ORH Communications.

The U.S. Department of Veterans Affairs’ (VA) Office of Rural Health (ORH) implements a targeted, solution-driven approach to increase access to care for the 3 million Veterans living in rural communities who rely on VA for health care. As VA’s lead advocate for rural Veterans, ORH works to see that America’s Veterans thrive in rural communities. To accomplish this, ORH leverages its resources to study, innovate and spread enterprise-wide initiatives through partnerships. To learn more, visit www.ruralhealth.va.gov.

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