In the US, the majority of the country is considered rural. Researchers and policy officials employ many definitions to distinguish rural from urban areas, using rural-urban classifications adopted by NCI. An estimated 15% of the U.S. population and approximately 74% of the area is considered rural.

Residents of rural areas face serious challenges related to socioeconomic disadvantages, limited access to quality healthcare, long travel times, and low recruitment to clinical trials, all of which affect quality of care and health outcomes. Health disparities are exacerbated by the lack of health insurance, shortage of primary care physicians, oncologists and other cancer care specialists. Moreover, largely because of systematic marginalization (eg, historical segregation, and immigration laws), higher cancer incidence and mortality are observed in racial and ethnical minoritized groups. Collectively, these and other factors are associated with delayed cancer detection, more severe disease outcomes, and increased cancer mortality.

Rural areas often have fewer primary and specialty care physicians as well as fewer home- and community-based service providers compared to urban areas

Although an estimated 17%-20% of the U.S. population lives in rural areas, only 3% of medical oncologists practice in rural communities, and over 70% of counties in the U.S. do not have medical oncologists.

A recent study by the Centers for Disease Control and Prevention (CDC) reported that in the most recent period for which the data were available, rural counties had lower cancer incidence rates but higher death rates for all cancer sites combined. In addition, the study showed that the differences in death rates between rural and urban areas are increasing over time.

Stephanie Walker and Martha Carlson, this episode’s co-hosts and producers, take a closer and more intimate look at how geographical location, age, and ethnicity affect healthcare and quality of life. They speak with four women who share how their location in rural and remote areas impact the decisions on their care.

First, they interview Dr. Denise Belle. Dr. Belle serves as the Development Director with Rural Health Group, Inc. and has been a public health professional for 20+ years . Her research focuses on Black women living in rural, isolated areas and finding ways to cope with breast cancer.

Past episodes featuring non-profits which are serving rural communities:

Meet the Guests of the Episode