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21st Century Healthcare Leadership; Urban and Rural Health Care Disparities


Urban and rural healthcare disparities are a critical concern for healthcare leadership in the twenty-first century. Typically, urban areas have greater access to resources and specialized medical facilities, but rural communities may need help to obtain enough health care. This can result in inequalities between urban and rural populations in health outcomes and life expectancy. Addressing these discrepancies and ensuring that all persons, regardless of geography, have access to quality health care is essential for attaining health equity and improving overall health outcomes.


The issue of 21st-century healthcare leadership is a complex one. It is clear that the healthcare system in the United States has been struggling for years to address the growing disparity between urban and rural populations (Logan & Castañeda, 2020). The gap between urban and rural areas has become so large that it is difficult to imagine how it can be bridged. The problem with this disparity is that it makes it very difficult for both rural and urban populations to receive quality healthcare services, which is why there are growing concerns over this issue today. This paper aims to examine how these disparities have affected urban and rural dwellers and their communities and what can be done to address them.

Analysis (Literature-based)

Definition of the issue

Urban and rural health disparity can be defined as “the differences between the health outcomes of people living in urban areas compared to those living in rural areas” (Gimm & Ipsen, 2022). This disparity is often evident in healthcare delivery, with urbanites having access to more treatment centers, doctors, and other medical professionals than those living in rural areas. This can be caused by a number of factors, including income inequality, education level, and access to medical care.

There are many studies that suggest that there is a correlation between poverty and poor health outcomes (Huang et al., 2021). This is because low-income individuals often have less access to healthcare resources such as doctors and hospitals than higher-income individuals do. In addition, low-income individuals tend to have greater exposure to environmental risks associated with pollution (Lazar & Davenport, 2018). These factors can contribute to poor health outcomes for these populations.

Challenges related to the issue

There are many challenges related to 21st-century healthcare leadership in urban and rural communities. There is a need for more physicians, nurses, and other healthcare professionals in urban areas. As a result, healthcare facilities in urban areas tend to be overcrowded and understaffed. Rural areas also have a shortage of qualified healthcare workers but tend to have more physicians than urban areas.

Another challenge is the need for primary care physicians in rural areas. According to the American Medical Association, only 43 primary care physician positions are available in rural America for every 100,000 citizens (Wasserman et al., 2019). This means that many rural residents must travel long distances for health care services and often experience lengthy wait times for appointments or even doctor visits.

Finally, there are issues related to racial disparities in healthcare access and quality of care throughout the country. For example, according to data from the Centers for Disease Control and Prevention (CDC), black Americans are more likely than white Americans to suffer from high blood pressure due lack of healthcare services or early treatment of such conditions (Jack, 2021).

Ethical considerations of the issue

The ethical considerations of 21st-century healthcare leadership are complex and can be divided into two main categories: those related to urban and rural healthcare disparities.

In terms of urban healthcare disparities, there are several issues that have arisen as a result of the fact that many cities are now concentrated in areas that were previously rural but now have large populations. For example, one issue is the difficulty for physicians in rural areas who need access to specialized equipment or services such as CT scans or MRI machines. Another issue is the difficulty for patients who live in these areas because they often need more access to medical care due to financial constraints.

Rural healthcare disparities are more well-known than their urban counterparts; however, they also present a number of ethical challenges. For example, one issue is the quality of medical care provided by physicians in rural areas compared with those who work in urban settings—this can be due to an increased likelihood of insufficient training on how best to treat patients with certain conditions or diseases. Another issue is that many rural areas lack adequate infrastructure for healthcare professionals, such as doctors’ offices and hospitals (which can lead to long wait times).

Impact of the issue on the advanced nursing practice role

The issue of Urban and Rural Health Care Disparities affects advanced nursing practice roles in two important ways.

First, it affects the ability of nurses to provide holistic care to their patients. When there is a lack of access, communication, or coordination between urban and rural areas, the advanced nursing practice requires nurses to be able to adapt their approach based on where they are working (Wasserman et al., 2019). This can be difficult for nurses who have been trained in one particular area of health care that may not be an option in another location.

Second, this issue affects the advanced nursing practice role by creating an opportunity for nurses to work together with other professionals in order to solve problems related to healthcare delivery and patient care (Gimm & Ipsen, 2022). Even though nurses are often seen as independent practitioners who only work with patients while they are at the hospital or clinic, they can also work collaboratively with other healthcare providers when necessary.

Relevance of issue to selected rural and/or urban populations

The issue of 21st-century healthcare leadership and urban and rural healthcare disparities is relevant to a variety of populations. For example, the Urban Institute’s (2010) study of rural health care disparities estimated that the average African-American patient in rural areas has over four times the probability of being given a diagnosis for a serious condition than an average patient in urban areas (Caraballo et al., 2020). The same study found that African-Americans in rural areas are also more likely to be denied needed medication for their conditions, which can lead to greater health complications later on down the line.

In addition to these differences between urban and rural populations, other factors are also at play. For example, some people may be more likely to live in poverty than others; this means they will have less access to resources like healthcare, food, or shelter that are necessary for good health (Caraballo et al., 2020). Additionally, some people may live in areas where there is less access to affordable housing or clean water, meaning they may need help getting proper medical care when they need it most. This issue is important because it addresses some of our nation’s most pressing issues—health inequality among different groups—and it helps us understand how we can address these problems to make things better for everyone.

Suggested Plan

  • Overcoming the challenges

The following plan can be used to address the challenges of 21st Century Healthcare Leadership; Urban and Rural Health Care Disparities.

First, we need to look at the socioeconomic status of rural areas. These areas tend to have less access to healthcare and better access to healthcare in urban areas. This is a problem because rural areas have a large number of people who are very poor or uninsured, while urban areas have fewer people with low incomes but more people with high incomes (Logan & Castañeda, 2020). The solution is simple: we need more resources for rural hospitals so that they can provide better care for their patients.

Next, we need to address the issue of political power. The medical community has too much power over politicians, which means that sometimes proposals for improving healthcare are met with resistance from doctors who fear change will jeopardize their positions within hospitals (Logan & Castañeda, 2020). We need to work on making sure that doctors feel confident enough in their organizations’ leadership plans that they will approve them without reservations.

Finally, we should focus on lowering costs for all sides involved in healthcare reform: patients should be able to choose cheaper options if they want them; doctors should not feel threatened by changes happening in other fields; and hospitals should be able to compete with other providers based on quality instead of price alone.

  • Advancing health or healthcare delivery

The most effective approach to advancing health or healthcare delivery would be to establish a system that prioritizes urban and rural healthcare disparities by seeking out the needs of those areas and working to meet them. This can be done through a combination of policy initiatives, research, and education. The goal would be to reduce disparities in access to quality care for all patients, regardless of where they live.

The first step would be identifying the underlying causes of health disparities between urban and rural areas. These could include socioeconomic factors such as income level or education level or environmental factors such as environmental pollution or temperature extremes. The second step would be implementing policies that address these causes in order to reduce healthcare disparities between urban and rural areas (Li et al., 2018). For example, one policy could be increasing federal funding for public transportation systems in urban areas so that doctors have more access to their patient’s homes. Another policy could be a reduction in regulations on medical dispensaries so that they can serve more people who live far away from large cities with high concentrations of patients who need medical marijuana treatments.

The third step would involve researching why these policies effectively reduce healthcare disparities between urban and rural areas while also improving the overall quality of life for all Americans living in urban and rural areas.


The urban and rural health care disparities are important to address. This can be done by creating more equitable access to healthcare by tackling disparities in rural areas where there is a lack of resources available to rural communities. We must invest in these areas by providing them with healthcare workers and other resources. This will help make sure that everyone has access to healthcare services, regardless of where they are located in the country or even across different states within the same country.


Caraballo, C., Massey, D., Mahajan, S., Lu, Y., & Annapureddy, A. R. (2020). Racial and ethnic disparities in access to health care among adults in the United States: A 20-Year national health interview survey analysis, 1999–2018. PubMed Central (PMC).

Gimm, G., & Ipsen, G. (2022). Examining rural-urban disparities in the perceived need for health care services among adults with disabilities. Frontiers.

Huang, S., Hsing, S., Sun, C., Chung, C., & Tsao, H. (2021). Inequality in health: The correlation between poverty and injury—A comprehensive analysis based on income level in Taiwan: A cross-sectional study. PubMed Central (PMC).

Jack, L. (2021, August 6). Advancing health equity, eliminating health disparities, and improving population health. Centers for Disease Control and Prevention.

Lazar, M., & Davenport, L. (2018). Barriers to Health Care Access for Low-Income Families: A Review of Literature. PubMed.

Li, J., Shi, L., Ding, G., & Xu, r. (2018, February 9). Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011. BioMed Central.

Logan, R. I., & Castañeda, H. (2020). Addressing health disparities in the rural United States: Advocacy as caregiving among community health workers and Promotores de Salud. PubMed Central (PMC).

Wasserman, J., Palmer, R. C., Gomez, M. M., & Berzon, R. (2019). Advancing health services research to eliminate health care disparities. PubMed Central (PMC).


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