Older rural New Yorkers are sicker, more disabled, and have less access to health care and high-speed internet than those living in urban and suburban areas.
And as the population of rural New York grows older with the aging of the Baby Boom generation and an influx of retirees, younger residents leave for jobs elsewhere.
These trends pose significant challenges and demand solutions, according to a new research report and policy paper released by AARP New York during a recent virtual event moderated by Rex Smith, editor of The Upstate American and editor emeritus of the Albany Times Union.
Disrupt Disparities: Addressing the Crisis for Rural New Yorkers 50+ is the latest in AARP New York’s multi-year initiative Disrupting Racial and Ethnic Disparities: Solutions for New Yorkers 50+, which began in January 2018.
“The pandemic has exacerbated the disparities rural New Yorkers have long faced, such as greater social and geographic isolation and less access to health care, nutritious food and increasingly critical high-speed internet,” said AARP New York State Director Beth Finkel. “This report not only documents these and other disparities, it provides achievable solutions. AARP New York fully supports these efforts to make rural New York a more livable place for the 50-plus and residents of all ages.”
“As this new report from our collaborators at AARP New York demonstrates, older adults in rural areas across New York continue to face inequities in health care, food, transportation, and other social determinants of health, and those conditions are linked to poorer health outcomes,” said Dr. Nora OBrien-Suric, president, the Health Foundation for Western & Central New York. “This insightful research underscores the continued need for policies, investments and programs that strengthen the health of rural communities and improve the lives of older adults and caregivers across New York State.”
“My recent report shows over a million New York households are not connected to broadband,” said State Comptroller Thomas P. DiNapoli. “A stark digital divide persists in rural parts of the state and among older New Yorkers. Residents age 65 and over lack access at almost three times the rate of New Yorkers ages 18 to 64. This affects their ability to work, access telehealth services, and communicate with loved ones. I want to thank AARP for keeping these issues at the forefront of our conversations here in the state and across the country. Rural New Yorkers deserve the same opportunities as everyone else.”
“Rural and underserved; these terms go together, and are made all the more complicated by how fast healthcare is changing,” said Dr. John Rugge of Hudson Headwaters Health Network, which serves about one third of rural New York. “Now as much as ever, our people need food, pharmaceuticals and transportation. But they also need computers and broadband along with caregivers at the bedside.”
The new report focuses on health, caregiving, telehealth and broadband as they impact rural New York, a sprawling area with over a million residents - more people than six states and Washington, D.C.
The report’s chief findings:
Rural areas lose residents 4 to 5 times faster than more urban Upstate areas do;
Rural residents are more likely than urban residents to die prematurely from the five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke;
Rural New York lost 3.1 physicians per 100,000 population from 2010 to 2017; there were just 83 primary care doctors per 100,000 patients in the Mohawk Valley and 89 in the Southern Tier, compared with 148 on Long Island in 2018;
There are half as many critical access hospitals for every rural New Yorker than there are for every New York City resident;
Hudson Headwaters, serving a third of rural New York, has the largest proportion of Medicare patients among federally qualified health centers in the nation — 24%;
Diabetes prevalence is 17% higher in rural areas than urban areas;
Rural residents 65+ are 1.6 times more likely to lack home high-speed internet than their non-rural counterparts. In fact, New York recently ranked 46th in the nation in “digital equity”;
99% of people living in Manhattan and in Albany, Monroe and Erie counties have access to high-speed internet vs. just 24% in Hamilton County, 73% in Yates County and 77% in Alleghany County;
Only 52% of rural Medicare beneficiaries said their provider offered telehealth vs. 67% in urban areas.
To address these and other problems, the new report proposes solutions that include:
A state tax credit for family caregivers, who spend on average over $7,200 on caregiving annually;
Tax credits and grants to help retrofit rural homesand link themto emergency medical services (EMS);
Provide mobile adult day care respite;
Increased access to telehealth technology, equipment and training;
Increased funding for in-home healthcare workersand home and community-based services, pay for family caregivers, and creation of adult foster care programs, all of which help avoid even costlier, taxpayer-funded nursing home placements;
Increased pay for first responders to address emergency medical services shortages in rural New York, and potentially incorporating nurses, nurse practitioners, physician assistants and social workers into the EMS team to avoid unnecessary emergency room visits;
Increased funding for nutrition programs including rural senior farmers markets and home grocery and meal delivery;
Extend to rural New York “PACE” (the Program of All-Inclusive Care for the Elderly), which mainly supports people dually eligible for both Medicare and Medicaid;
A strategy to equalize home high-speed internet utilization across all ages and geographies by 2025;
Empower local organizations and entities to analyze and audit high-speed internet access maps and pricing, and implementation agreements;
Subsidies for low-income older rural New Yorkers to help them afford devices - and state funding for local demonstrations to help older rural New Yorkers learn how to use new internet technology;
Subsidies for companies and/or municipalities to build and operate high-speed internet services where private investment is prohibitive, including replacing and upgrading utility poles;
Turn some senior centers into community centers, and increase taxi or shuttle service administered through senior centers across rural areas.
AARP New York will make the case for those recommendations and more at the State Capitol when the 2022 state legislative session begins in Albany in January.
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