Rural Okla. hit hard by COVID-19

More difficult to access care in small towns

OKLAHOMA CITY – When residents of Greer County in southwestern Oklahoma started dying of COVID-19, they weren’t strangers to Staci Vanzant.

She and her husband own Greer Funeral Home in Mangum, a city of less than 3,000 people. They handled arrangements for 15 people who died of the coronavirus.

“We’re a small town,” Vanzant said. “These are our friends. These are our family. They’re not just a number.” Vanzant knew each one, she said. “I guarantee you, there’s not one person that hasn’t been affected by somebody that passed away from COVID here,” she said.

Though their death tolls may be smaller, Oklahomans in rural communities have been hit harder by COVID-19. Data from Oklahoma State University’s Center for Rural Health shows rural residents die of COVID-19 at disproportionate rates to their urban counterparts, reflecting longstanding health disparities.

“What you’re seeing is a lot of these communities have been disproportionately impacted.” Randolph Hubach Associate professor of rural health at Oklahoma State University

Rural populations are often older, poorer and less insured than their urban counterparts, said Allison Seigars, executive director of Rural Health Projects, a nonprofit group that aims to improve health care access for rural Oklahomans.

“We also have usually higher incidences of chronic disease and obesity,” Seigars said. “Those things are all risk factors for COVID.”

It may be harder for rural residents to access health care, she said. Outside urban areas, most of the state is recognized as health professional shortage areas, Seigars said.

The data from OSU’s Center for Rural Health uses the state Department of Health’s investigated COVID-19 death toll, which the state acknowledged has fallen out of date – by about 2,500 deaths – as health care providers and state workers struggled to keep up in the height of the pandemic. The state primarily points to a provisional death count from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and researchers are working to see how that affects death rates in rural and urban communities.

Though the provisional death count includes county-level data, it refers to the county where someone died; the state’s toll provides information about someone’s county of residence.

Randolph Hubach, associate professor of rural health at Oklahoma State University, said once the data is reconciled, the rural-urban divide may be less pronounced, but he still expects to see higher mortality rates for rural areas compared with their urban counterparts.

Alfalfa County, along the Kansas border, which has a population of less than 6,000, has one of the highest infection rates for cumulative cases in the state: about 19,600 per 100,000, which means about one in five residents have been diagnosed with COVID-19, Hubach said.

“What you’re seeing is a lot of these communities have been disproportionately impacted,” he said. “They don’t have a large population, so that raw number isn’t high. But when you put that into comparison to how many people live there, it’s pretty telling . ... Raw numbers sometimes don’t capture the true impact.”

He said he feared that if vaccine uptake was lower in rural areas, divides in COVID-19 outcomes could worsen. According to Kaiser Family Foundation polling, 3 in 10 rural U.S. residents say they would either “definitely not” get vaccinated or would “only do so if required.”