The Healthcare Crisis of Rural America

If you live in a metropolitan area, the chances of finding a doctor are high. There are many specialists and general practitioners at your fingertips with a single search.  However, in rural parts of the U.S., residents are hard-pressed to find a family doctor, yet alone a pediatrician or an obstetrician.

Access to healthcare is fundamental to the health of a community, but residents of rural areas face challenges that block their ability to receive adequate care. Some of these challenges include the cost of health care, lack of transportation, communication barriers, social stigma, privacy concerns, shortage of healthcare workers and/or a complete lack of healthcare facilities.

Healthcare and Transportation Costs

Statistically, citizens in rural areas are less likely to have health insurance than those in metropolitan areas. Without insurance, people living in rural areas have increased difficulty paying for adequate healthcare. In 2016, a report from the Office of the Assistant Secretary for Planning and Evaluation, found that 43.4% of rural residents without insurance did not have a physician for regular health care.

Furthermore, the cost of transportation to healthcare facilities can also be a deterrent since many rural areas lack specialists and hospitals. Unlike more densely populated areas, rural communities rarely have cost effective public transportation. Therefore, residents must take time away from work and spend extra money on gas to keep an appointment.

Communication Barriers and Health Literacy

A patient’s understanding of healthcare information or a doctor’s recommendation and diagnoses is referred to as their health literacy. Yet, poverty and low educational levels hinder some residents’ ability to grasp information given to them by their doctors. Such a communication barrier can often cause animosity toward physicians due to frustration from a patient.  This may increase the chance that this patient will avoid seeking healthcare in the future.

Social Stigmas and Privacy Concerns

Small communities can rarely keep secrets. Everyone knows each other and their business. This can become especially concerning for rural residents who fear that their private health information may become public knowledge. Those seeking care for their sexual health, mental health, pregnancy, or substance abuse may have an increased fear due to community stigmas.

Lack of Healthcare Facilities and Workers

A November 2018 report by the Bureau of Health Workforce Health Resources and Services Administration found that over 59% of the areas that lacked primary healthcare were rural areas. Such areas are not popular career destinations for healthcare professionals and even residents of rural areas who are trained in the health field often relocate to more populated areas. Many states are thinking out of the box when it comes to attracting and retaining health professionals. Some communities in Vermont, the most rural state in the country, are offering assistance repaying student loans to attract more doctors and healthcare workers. Other states such as

However, even if rural areas manage to attract doctors and healthcare workers, health professionals still face challenges when it comes to medical supply shortages and a lack of proper health facilities. If the closest hospital is 50 miles away, rural residents often need to travel a great distance to see a specialist – potentially putting their lives in danger.

As an OB-GYN, the lack of healthcare in rural communities is especially concerning.  Thousands of women do not have access to proper treatment or care during pregnancy. In 2017, the the American College of Obstetricians and Gynecologists found that half of the country’s counties do not have an obstetrician-gynecologist. Furthermore, by 2020, “there will be up to 8,000 fewer OB-GYNs than needed.”  This is a problem that is worsening for America.

Although the cost of health insurance and medical procedures are complaints that are widely heard, the fact that Thousands of Americans face life without adequate healthcare is barely a whisper. Many doctors are adding small communities to their workload.  Yet the lack of healthcare facilities, and the cost of treatment makes their jobs and the care they can provide a lot more difficult.

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