Rural Oklahoma hit harder by COVID-19
When residents of Greer County 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 under 3,000 people. They handled arrangements for 15 people who died of the coronavirus over the course of the pandemic.
“We’re a small town,” VanZant said. “These are our friends. These are our family. They’re not just a number.”
In a bigger city, the toll might’ve been more anonymous. But 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.
While their local death tolls may be smaller, Oklahomans in rural communities have been hit harder by COVID-19. Data from OSU’s Center for Rural Health shows rural Oklahomans have been dying of COVID-19 at disproportionate rates compared to their urban counterparts during the pandemic, reflecting long standing health disparities in rural areas.
Rural populations are often older, poorer and less-insured than their urban counterparts, said Allison Seigars, executive director of Rural Health Projects, a nonprofit 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, so it’s not surprising that it’s hit rural harder.”
It may also be harder for rural residents to access health care, she said. Outside of 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 Oklahoma State Department of Health’s investigated COVID-19 death toll, which the state recently acknowledged has fallen out of date — by about 2,500 deaths — as health care providers and state workers struggled to keep up in the height of the pandemic.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 now 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 impacts death rates in rural and urban communities.
While the provisional death count does include county-level data, it refers to the county where someone died, while the state’s toll provides information about someone’s county of residence before their death.
Dr. 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 to their urban counterparts.
COVID-19 case counts in some rural counties also can be illuminating, he said.
Alfalfa County, for example, where the population is under 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. Those concerns aren’t unfounded: according to Kaiser Family Foundation polling, 3 in 10 rural U.S. residents said they will either “definitely not” get vaccinated or will “only do so if required.”
Hubach and Seigars said they hope an awareness of how COVID-19 has highlighted existing health disparities for rural populations could lead to a reinvestment in public health infrastructure.
“I’ve been hearing, especially from local community organizations in rural areas, they’re saying this shines a light on conversations that we’ve had, and maybe this will bring additional resources into our communities,” Hubach said.
For Seigars, she is hopeful that could be the case. For now, the conversation is still in “reaction mode,” as the pandemic hasn’t stopped and many more Oklahomans are awaiting vaccinations.
“I do think that this unfortunate disease is highlighting some of those disparities and disadvantages for the rural population,” Seigars said. “I don’t think that those conversations are being held quite yet, but I think that we will get there.”