Living with Heart Failure in a Rural Community
Joan Grant Keltner, PhD, RN
Urban/rural differences have continued across America for the last four decades, with rural residents more likely to die from major diseases such as heart failure (Abrams et al., 2021; Faridi et al., 2025). These individuals also experience higher rates of smoking, diabetes, and hypertension associated with their heart failure (Pierce et al., 2025). Lower finances, limited access to and variability in their medical treatment, and lower distances to travel are just a few issues. These patients also experience difficulties in managing signs and symptoms, completing daily activities, taking multiple medications and daily weights, and adhering to dietary regimens. Inadequate community support adds to the complexity of this chronic disease, for both patients and their care partners. Inadequate socializations, depression, and anxiety are other outcomes (Celano et al., 2018).
Despite these barriers, rural nurses can explore innovative solutions for addressing heart failure in rural communities. These include:
- Providing incentives (e.g., loan forgiveness, professional development) to attract primary care medical professionals and cardiology experts;
- Build partnerships between rural healthcare providers and academic medical centers;
- Establish more outreach clinics in underserved or poorly resourced rural communities;
- Partner with academic medical centers in developing rural provider training programs;
- Expand and improve telemedicine offerings, developing community wide cardiovascular disease prevention programs;
- Offer virtual consultations for primary care, mental health, and specialist’s services;
- Merge funding with efforts to measure tangible health outcomes from mobile health clinics with diagnostic tools and preventive and focused services;
- Offer remote monitor of common chronic diseases, such as hypertension and diabetes mellitus;
- Provide training of rural individuals to be community health workers and increase heath literacy efforts;
- Offer transportation financial assistance;
- Expand health insurance coverage in rural areas, with continued government support of rural hospitals; and
- Offer state-of-the-art strategies to address rural factors such as poverty, food insecurity, unemployment, housing instability, and limited access to education (Javed, 2025; Pierce et al., 2025)
References
Abrams, L. R., Myrskylä, M., & Mehta, N. K. (2021). The growing rural−urban divide in US life expectancy: Contribution of cardiovascular disease and other major causes of death. International Journal of Epidemiology, 50(6), 1970–1978. https://doi.org/10.1093/ije/dyab158
Celano, C. M., Villegas, A. C., Albanese, A. M., Gaggin, H. K., & Huffman, J. C. (2018). Depression and anxiety in heart failure: A review. Harvard Review of Psychiatry, 26(4), 175-184. https://doi.org/10.1097/HRP.0000000000000162
Faridi, B., Davies, S., Narendrula, R., Middleton, A., Atoui, R., McIsaac, S., Alnasser, S., Lopes, R. D., Henderson, M., Healey, J. S., Ko, D. T., & Shurrab, M. (2025). Rural–urban disparities in mortality of patients with acute myocardial infarction and heart failure: a systematic review and meta-analysis. European Journal of Preventive Cardiology, 32(4), 327–335. https://doi.org/10.1093/eurjpc/zwae351
Javed, A. (2025). Bridging the health care gap in rural populations: Challenges, innovations, and solutions. The American Journal of Medicine, 138(5), 761 – 762. https://doi.org/10.1016/j.amjmed.2025.01.008
Pierce, J. B., Ng, S. M., Stouffer, J. A., Williamson, C. A., & Stouffer, G. A. (2025). Rural/urban disparities in cardiovascular disease in the US—What can be done to improve outcomes for rural Americans? The American Journal of Cardiology, 248, 10–15. https://doi.org/10.1016/j.amjcard.2025.03.033
