Rural Health Issues in Minnesota

Author: Mary Fairbanks, DNP, RN, PHN

What does the word “rural” mean for public health nurses caring for rural communities? The Rural Health Information Hub defines rural in different ways; based on one definition, about 20% of Minnesotans live in rural communities (1.2 million out of 5.6 million). In Minnesota, residents of rural communities tend to be more white and older than their urban counterparts. However, rural communities are growing increasingly diverse, depending on the region.

Minnesotans living in rural communities experience different social determinants of health at greater rates than other Minnesotans, like a high level of poverty, lower rates of health insurance, lower levels of education, and less readily available access to health care. In isolated rural areas, there is one primary care physician per 2,715 people, compared with one physician per 965 people in metro areas, and a similar ratio for primary care nurses.

The five leading causes of mortality in Minnesota are cancer, heart disease, unintentional injuries, chronic lower respiratory disease, and stroke.

In rural Minnesota, additional factors impact morbidity: obesity, smoking, substance abuse, transportation, food deserts, physical inactivity. Mental health is a particular concern in rural Minnesota, especially for farmers struggling with crop production and sales, and for communities seeing a decrease in the number of mental health practitioners.

Public health nursing interventions to address obesity and its associated conditions can include:

  • Individual/ family: Health teaching and counseling: Provide materials on exercise and help develop a walking plan with a family whose parent has recently been diagnosed with hypertension.
  • Community: Social marketing: Create materials for a marketing campaign to decrease screen time and promote youth physical activity. Partner with youth groups to develop the materials.
  • Systems: Community organizing: Bring together interested organizations to partner in developing a community-wide active living initiative.

Public health nursing interventions to address cancer could include:

  • Individual/family: Case management: Coordinate care for a woman with breast cancer, arranging transportation, setting appointments, obtaining supplies, assisting with medication, and working with other service providers involved in the care plan.
  • Community: Outreach: Participate in annual community health fair to promote cancer screening for breast, cervical, lung, and colon cancer.
  • Systems: Collaborate: Partner with a local clinic to provide a women’s weekly health clinic with cancer screening, exams, immunizations, and health education.



Anderson, E. & MacFarlane, J. (2015). Community as partner: Theory and practice in nursing (7th ed.). Wolters-Kluwer: Philadelphia, PA

Minnesota Department of Health. (2019). Public health interventions: Applications for public health nursing practice (2nd ed.).

Minnesota Department of Health. (2017). Snapshot of health in rural Minnesota (PDF).

Rural Health Information Hub. (2019). Minnesota.