If Iowa is serious about strengthening rural health, it must be serious about helping older adults age at home. In rural Iowa, adults 65 and older make up 43% of the population, according to the U.S. Census Bureau. They are the backbone of their communities — and any serious rural health strategy should reflect that reality.
Iowa’s Healthy Hometowns proposal, backed by $209 millionawarded through the federal Rural Health Transformation Program, is a major opportunity. But it needs to include a crucial piece: home- and community-based services that help older adults stay safe, healthy, and independent where they want to be — at home.
These services matter. They prevent falls, manage chronic disease, reduce isolation, and connect older adults to healthy food. So do broadband for telehealth, reliable transportation, and support for family caregivers — the unpaid workforce propping up rural health care every day. If Iowa wants better outcomes, it should put these supports at the center of its plan.
Healthy Hometowns also emphasizes partnerships, which are essential to reaching people in their communities. Iowa should bring in the aging network: senior centers, area agencies on aging, and community-based organizations that have supported older adults for decades. These groups know where the gaps are, which services work, and how to help people before a crisis sends them to the ER.
The return on investment is clear: When older adults can stay safely at home, emergency visits and hospital readmissions decline, nursing home placement is delayed, and public dollars go further through prevention instead of costly institutional care. A falls prevention class reduces fractures and head injuries that would otherwise strain small rural hospitals. In fact, if we invested $45 million per year nationally in falls prevention programs, we could save $1 billion in health care costs.
These supports are not nice-to-haves. They are core infrastructure for rural health. A home-delivered meal is also a wellness check. A falls prevention class can avert a fracture, a hospital stay, a traumatic brain injury, or worse. In 2020, 158,000 older Iowans reported experiencing a fall. That is not a side issue. It should be a policy priority.
Iowa’s leaders should fully integrate the aging network into Healthy Hometowns planning and funding. Hospitals and clinics cannot do this alone, and they do not need to.
By linking health care with community support, Iowa can help ensure that every older adult — regardless of ZIP code — can age with dignity, independence, and real access to care.
The strength of rural Iowa depends on whether this plan gets that right.
Ramsey Alwin is president and CEO of the National Council on Aging. Alan Morgan is CEO of the National Rural Health Association.
This article originally appeared on Des Moines Register: Iowa Healthy Hometowns must include help for aging at home | Opinion
Reporting by Ramsey Alwin and Alan Morgan, Guest columnists / Des Moines Register
USA TODAY Network via Reuters Connect
By Ramsey Alwin and Alan Morgan, Guest columnists | USA TODAY Network
