When examining the big picture of our society, rural America is grossly under-represented in many ways. While areas defined as “rural” comprise 80% of the total US land area, its inhabitants comprise only 20% of the US population. In other words, rural communities span vast stretches of land, but there simply aren’t many people living there. The relative lack of population has very real consequences in terms of the healthcare available, and the effects are somewhat disastrous and certainly worrisome.
In rural areas, there are estimated to be only 30 specialists per 100,000 residents – this is compared to approximately 263 specialists for every 100,000 people in urban areas. The small number of healthcare providers overall means that they are literally and physically spread very thin, creating logistic impediments for people seeking healthcare. It is not uncommon for rural residents to have zerohealthcare providers within an hour drive of their home. The inevitable result is that people are required to devote significant amounts of time just to visit the doctor. This often means taking off an entire day of work to attend an appointment, or even staying overnight in a different town just to see a specialist. For instance, depending on where you live, you may have to travel over 200 miles to see an OB/GYN (54% of rural counties don’t have a hospital with obstetrics services). These statistics shed some light on why it is that the US has very poor maternal mortality rates, which politicians and healthcare experts have recently qualified as a “crisis.”
Other specific challenges exist in the rural setting that make the delivery of adequate healthcare even more problematic. Rural residents have lower incomes and there are fewer adults with postsecondary education, resulting in significantly higher rates of uninsured residents. On top of that, rural residents are still smoking cigarettes at the same rates or higher than 10 years ago (whereas the rest of the country has drastically reduced smoking rates), and opioid use and addiction are rampant. Finally, because healthcare is logistically so difficult to receive, individuals are generally only seeking treatment once disease presentation is much farther along and therefore less treatable. Whereas an urban resident would likely seek treatment at the first sign of disease or ailing health, rural residents significantly delay their first doctor visit because they simply cannot get there.
While the rural healthcare crisis continues to progress – at least 80 rural hospitals have closed since 2010 - healthcare experts are examining ways to combat the situation before it becomes an emergency our nation can no longer ignore. Our next post will examine these efforts and the ways some providers are taking steps to serve those that have historically been neglected.