Rural Cancer Health During the COVID-19 Pandemic
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LETTER TO THE EDITOR
Rural Cancer Health During the COVID-19 Pandemic Soumya J. Niranjan 1 & Claudia Hardy 2 & Tara Bowman 2 & Joseph Bryant 3 & Molly Richardson 3 & Meghan Tipre 3 & Monica L Baskin 3
# American Association for Cancer Education 2020
To the Editor, On March 11, 2020, the World Health Organization (WHO) announced that COVID-19 was a global pandemic [1]. Responses to combat it are robust in urban communities. However, rural communities and those largely populated by racial/ethnic minorities have received inadequate attention despite their higher death rates, increased risk, and are least likely to effectively manage a pandemic due to limited public health infrastructure [2] and rural hospital closures [3]. This letter discusses the impact of COVID-19 in rural Alabama and our efforts to eliminate cancer health disparities through education and outreach activities. It is especially important considering that this journal’s readership has consistently investigated cancer health disparities and sought to address them through education in cancer prevention and survivorship. [4, 5] The O’Neal Comprehensive Cancer Center (O’Neal CCC) uses a community-based infrastructure to elevate cancer prevention messages via the Community Health Advisor (CHA) model which reaches Alabamians most at risk. [6, 7] Toward this goal, the Office of Community Outreach and Engagement (OCOE) has trained more than 1700 CHAs who are “natural helpers” in their communities. In Alabama, 17% of the population lives in poverty [8] and most counties are considered non-metropolitan [9]. Many rural counties have at least 50% African-Americans with per capita income at around $35,000 [10]. They tend to be older,
* Monica L Baskin [email protected] 1
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
2
Office of Community Outreach and Engagement, O’Neal Comprehensive Cancer Center University of Alabama at Birmingham, Birmingham, AL, USA
3
Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 618, 1717 11th Avenue South, Birmingham, AL 35205, USA
have multiple comorbidities [11], are characterized by disproportionate lack of access to health services [8], and a predominately agricultural economy [12]. Additionally, 25% of Alabamians live without internet access [13] an important factor associated with telemedicine usage [14]. The Alabama Department of Public Health (ADPH) has confirmed more than 81,000 cases of COVID-19, 1400 deaths, and less than 1% of the state’s population tested. [15] Counties with the highest mortality rates are all rural with high rates of co-morbidities that increases the risk of becoming severely ill if infected [16]. COVID-19 has had a deep impact on our rural communities. The consequences of new physical distancing restrictions are most dramatically felt by church congregations, often the bedrock of social and spiritual life in the rural south and in African American communities. While some comply with the new mandates of dis
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