Enrollment in federal and state government programs is substantially lower for some eligible demographic subpopulations, particularly persons living in rural areas. Barriers faced when seeking program benefits may, in part, explain such differences in enrollment. The purpose of this paper is to identify barriers faced by prospective rural beneficiaries and how they prefer to communicate with government agencies and, in doing so, inform Social Security Administration (SSA) disability programs processes and communication strategies. This paper reports the results of a scoping literature review of government program communication strategies and how knowledge of SSA and other government programs varies by sociodemographic groups and what this says about barriers facing those in rural communities. Following a robust scoping review process — the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), we identified articles that mentioned key phrases related to federal programs, communication, and rurality across four databases. English-language articles were included if published on topics related to our research questions between 2012 and 2022, reported on data collected in 2010 or later, and were about U.S. programs. Two of the authors each screened and reached consensus on 278 abstracts/titles and then 72 full texts to identify those that were in scope. As a result, we identified 16 articles for inclusion in this review. Three primary themes emerged: the knowledge and enrollment impact of changes to communication approaches; the importance of community-specific context; and barriers specific to communicating with rural residents and other underserved communities.
Barriers and Communications Preferences of Rural Populations: A Scoping Review
Published: 2023
Abstract
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Key Findings
- Rural areas of the United States warrant separate attention when considering how to communicate information about federal programs in part because their geography affects how information can be shared effectively (remoteness results in greater distance between field offices and lower level of broadband internet access) and in part because rural communities have a higher representation of many program-eligible groups (e.g., those older than 65, those who have a disability, and those who are low-income).
- Mode of program communication affects the likelihood of the information reaching the public. Traditionally, the Social Security Administration mailed statements to all workers. In addition, private-sector employers often trained new hires about funding their retirements during orientation. As both these forms of communication have been substantially reduced since 2011, the public’s knowledge of OASDI benefits has been low.
- When considering the general shift toward online information dissemination, this is a particular concern for those in rural areas, people with disabilities, and groups with low digital literacy. Broadband access is not as ubiquitous in rural areas as it is in nonrural ones. Perhaps as a result, many who reside in rural places are digitally illiterate and would have difficulty navigate online. In addition, most federal websites do not meet federal accessibility guidelines, creating a barrier for those with disabilities.
- Community context is important, particularly when considering program enrollment that may carry a stigma, such as SSI or food and energy assistance. Identifying local community partners who can provide technical assistance may help. For communities of particularly marginalized groups (e.g., the unhoused, those recently released from prison, low English proficiency individuals, and those with serious mental health disabilities), having dedicated staff trained in dealing with populations facing vulnerabilities may be particularly useful.