Community Health Needs and Opportunities in Rural Central New York

Read the report.

Community Health Needs and Opportunities in Rural Central New York examines the health and social issues having an impact on people in four rural central New York (CNY) counties: Cayuga, Cortland, Madison, and Oswego. Part of the Health Foundation for Western & Central New York’s Transform Rural Health campaign, the report highlights how institutional and systemic issues relate to the health outcomes of people who live in these areas. It is a companion piece to a Health Foundation report on western New York’s Southern Tier published in 2022.

The report supports an overarching message of the Transform Rural Health campaign: Disparities in rural health often mirror the systemic barriers that lead to poor outcomes in urban areas. By addressing these issues, we can create a ripple effect that improves health equity for all.

Community Health Needs and Opportunities in Rural Central New York is based on dozens of interviews with staff at agencies serving these counties and analysis of data related to sociodemographic factors, perinatal health, oral health, behavioral health, and home health care. Some key findings are:

  • About 2 in 5 households in rural CNY have people struggling to afford basic needs. Service providers are working hard to connect people with food, transportation, housing, and health care. While each county does have pockets of affluence, they also have towns and small cities where people live in extreme poverty.
  • Many health outcomes are worse in rural CNY than in NYS overall or in urban areas. Infant mortality rates, tooth loss, and binge drinking are just a few of the indicators that are worse in Rural CNY compared to Onondaga County and/or NYS.
  • Health disparities exist for people who are low-income and people from marginalized identity groups. Economic disparities are well-known, but data also reveal extreme disparities in health outcomes for rural CNYers identifying as Black, Hispanic, multiracial, LGBTQ+, and disabled.
  • People have limited choices for health care providers, and access to care is further limited by workforce challenges and low reimbursement rates. Agencies have a hard time hiring and retaining people to work many of the jobs that are most needed to provide care to people. Safety net providers lose money on some services because reimbursement rates are so low, and this impacts their ability to build capacity to better meet patient needs.
  • Funding for rural health is unstable and insufficient. In recent decades funding for many agencies and programs has remained flat, declined, or disappeared altogether. Local partners do a good job filling gaps and meeting local needs with few resources, but they are constantly challenged to find ways to sustain programs and to provide services at the level that the community deserves.
  • Organizations need more flexible funding for capacity-building, infrastructure, and coordination. Agencies want and need stable funding streams that strengthen their ability to respond to the complex, challenging, whole-person needs that they see in their communities.

The report discusses many findings that collectively indicate that there is an urgent need to invest more in improving the health of rural communities. In addition, it highlights some examples of promising strategies for improving health outcomes and equity in rural CNY.


Focus Area: Community Health Capacity, Older Adults, Young Children Impacted by Poverty

Category: Evaluation, Infographic, Report, Toolkit

Date Published: June 19, 2024