Overview of Rural Chronic Disease Management

Rural areas face higher rates of many of the most prevalent chronic diseases, with some rural residents experiencing multiple chronic conditions, and higher rates of related mortality. Depending on the disease, different types of management activities and strategies may be appropriate. Below are brief descriptions of the chronic diseases affecting rural Americans.

Cardiovascular diseases (CVDs) are diseases that involve the heart and blood vessels.
With Type 2 diabetes, which makes up 90-95% of all diabetes diagnoses, the body does not properly regulate and use glucose. This can result in blood sugar rising to levels that are too high.
Chronic obstructive pulmonary disease (COPD) is a group of chronic inflammatory lung diseases that cause obstructed airflow from the lungs, including emphysema and chronic bronchitis.
Chronic kidney disease (CKD), also called chronic kidney failure, is a condition which involves a gradual loss of kidney function resulting in kidneys that cannot filter wastes, toxins, and excess fluid out of the blood. Diabetes and hypertension, which are common causes of CKD, are more prevalent in rural areas putting residents at increased risk. If caught early through regular screening CKD progression can often be slowed, but rural residents are being disproportionately diagnosed with end-stage kidney disease.
Cancer is a large group of diseases, including breast cancer, cervical cancer, colorectal cancer, lung cancer, prostate cancer, and skin cancer, among others, which can start in almost any organ or tissue of the body when abnormal cells multiply and spread.
Arthritis refers to diseases of the joints that can result in swelling and pain which sometimes leads to stiffness and typically worsens with age.
Obesity and overweight are terms that describe weight ranges greater than what is generally considered to be healthy for a given height. Overweight or obesity can lead to increased risk for health conditions.

The Chronic Disease in Rural America topic guide provides statistics, information, and resources on chronic diseases that affect rural populations.

Chronic disease management focuses on improving the quality of care and well-being for people living with chronic diseases by improving access and coordination of healthcare services to facilitate self-management. Managing chronic diseases can involve various strategies and care approaches. The most common management activities include regular screenings, medical visits, monitoring, care coordination, managing medications, and education to improve the ability to self-manage chronic conditions. These approaches can improve quality of life while minimizing patient expenses and impacts of a disease.

Chronic disease management programs have been found to:

Improve quality of patient care including individualized support
Increase access to healthcare services
Improve patients' ability to self-manage chronic disease
Reduce hospital admissions and emergency room visits
Improve patient outcomes
Increase patient satisfaction
Reduce costs of managing chronic conditions

Resources to Learn More

Disease Management Programs: Improving Health While Reducing Costs?
Document
Introduces chronic disease management and describes some of the challenges that people living with chronic conditions face. Discusses the components of chronic disease management and the role of health plans, employers, and government in sponsoring disease management programs. Provides statistics on the benefits of chronic disease management programs.
Organization(s): Georgetown University Health Policy Institute

National Center for Chronic Disease Prevention and Health Promotion
Website
Describes the most prevalent chronic diseases, the health impacts and economic costs of chronic diseases, and provides information and resources for improving health equity in the prevention and management of chronic diseases.
Organization(s): Centers for Disease Control and Prevention

A Systematic Review of Chronic Disease Management Interventions in Primary Care
Document
Review of the evidence exploring the impact of chronic disease management programs on outcomes of adults when implemented in primary care and community care settings.
Author(s): Reynolds, R., Dennis, S., Hasan, I., et al.
Citation: BMC Family Practice, 19(11)
Date: 1/2018