The COVID-19 pandemic had created disruptions in usual medical care delivery for cardiovascular and cerebrovascular disease (CVD) across the U.S. that could have devastating downstream effects long after COVID-19 was controlled. COVID’s “spillover” had manifested via delays in presentation, disruptions to acute care, deferral of usual outpatient care, and negative health effects of economic conditions and worsening social risk. 

Older adults living in rural areas had experienced worse CVD outcomes than their urban counterparts and may have been particularly vulnerable to each of these spillover effects, especially if they also lived in poverty or were members of racial or ethnic minority groups. Rural older adults may have also had less access to potential mitigation strategies, such as inpatient and outpatient telehealth, restarting elective procedures under new precautions, and proactively reaching out to patients to manage chronic disease. However, because the rural population was smaller and less often included in commercial and health system databases, this group had been understudied.

It had been crucial to understand COVID spillover in rural areas in order to counteract it. This project had focused on understanding the magnitude of COVID’s spillover effects on CVD in rural areas, as well as the impact of key mitigation strategies, which would enable effective responses to future waves of this pandemic, other outbreaks in the future, and challenges to rural care delivery more broadly.