Barriers to Accessing Quality Care in Rural Communities

By Adrianne J. Lane EdD, RN, CNE, President of the Rural Nurse Organization

Improving the quality of health care in rural communities has been the focus of my nursing practice for more than 40 years.  Growing up and living in rural communities has provided me the opportunity to personally know and be aware of many rural residents who truly lack access to high quality health care.   Rural residents are often more than an hour’s drive from cutting edge healthcare in urban areas.  Further, they may lack adequate transportation to get to urban healthcare facilities, may truly fear going into urban areas, and often lack the necessary insurance and/or money to seek high quality care.  The authors of Rural Healthy People 2020: New Decade, Same Challenges report little has changed in rural healthcare since 2010 and the number one priority continues to be access. 

Economic factors, cultural and social differences, educational shortcomings, lack of recognition by legislators, and isolation of living in more remote areas combine to impede quality healthcare for rural populations.  For many years my colleagues and I focused our efforts on reducing barriers to quality healthcare for rural residents.  We built programming on addressing the barriers of cost, distance, and fear.  In both rural and urban areas, nurses are often the point of contact between the patient and the health care system and it is nurses who should be the advocates for quality healthcare services that address cost, distance, and fear. 

Providing nurses with the best evidence available is important to insuring rural health needs are being addressed.  Numerous resources and organizations exist that provide such evidence.  As found on the Rural Nurse Organization (RNO) website (, RNO is an organization dedicated to recognizing, promoting, and maintaining the unique specialty of rural nursing practice. RNO represents all types of rural health care providers from individual rural nurses to healthcare agencies, academia, and government programs.  RNO offers grants for rural nursing projects and research, a regularly published newsletter, a refereed journal focused on rural nursing practice, an international conference with scholarship support available, and an ongoing opportunity to connect with other healthcare providers in rural communities across the globe. 

As president of RNO, I encourage you to visit the Rural Nurse Organization website to learn more about our organization. Also, if you have not yet read Rural Healthy People 2020, do take time to read and reflect on how findings from this report can be incorporated into your practice.   

Adrianne J. Lane EdD, RN, CNE, President of the Rural Nurse Organization

Adrianne Lane is a Professor Emeritus from Northern Kentucky University.  She was co-founder of the Trinity Health Clinic and the Southeastern Indiana Cancer Health Network.  For many years she and her colleagues provided no cost breast health services and primary healthcare to residents in rural communities; these programs have since been sustained through community integration. 


Bolin, J.N.; Bellany, G.R.; Ferdinand, A.O.; Vuong, A.M.; Kash, B.A., Schulze, A.; & Helduser, J.W. (2015). Rural Healthy People 2020: New decade, same challenges.  The Journal of Rural Health, 31, 326–333.

Lane, A. & Martin, M. (2015). Ten year profile of a best practice program aimed at rural women.  Online Journal of Rural Nursing and Health Care, 15(2), 26-48.  doi:

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