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Rural areas struggle with health care availability

Mark Robinson

Healthcare is readily accessible in urban areas and people living there have a lot of choices when it comes to the type of care they receive. That isn't the case for people living in rural communities. Dr. Alana Knudson is the program area director in the Public Health Department at NORC, an independent research institution at the University of Chicago, as well as the co-director of NORC’s Walsh Center for Rural Health Analysis.

Knudson discusses the concerns rural communities might face when it comes to accessing healthcare in their area.

Hospital closures

A major factor impacting healthcare in rural areas is hospital closures. Many of the hospitals in rural areas are the main employer of doctors for that community, so when the hospital shuts down, they lose those physicians as well as the emergency services provided by the hospital.

"Some of the other heath related services that have supported that hospital such as local pharmacies and different allied health professions," says Knudson." They too close and leave to find employment in other parts of the country so when you see hospitals closing, it is not just the loss of the hospital and access to those important emergency and acute care services."

With these hospital closures come problems with emergency medicine. Medical emergencies like heart attacks and strokes are time sensitive. When there isn’t a hospital in the area, patients could miss the window for like saving care.

Issues with transportation

The lack of transportation in these areas is also a likely reason why residents don't have access to the healthcare they need. As the population of rural areas grows older, it gets harder for them to go to neighboring areas to get the care they need. This means they are relying on friends or family who may have to take off work to get them where they need to go.

To help address some of the transportation concerns communities have come together to help remedy the problem.

"There’s a lot of rural communities that out of necessity that have been very innovative in developing for example volunteer share rides to be able to assist and address the transportation gaps that their populations face.” says Knudson.

Drawing new physicians to rural areas

While these rural communities tend to rely on nurse practitioners and physician assistants to provide primary care and support to hospitals and clinics, there still is a concern with these services closing. Fortunately, programs exist to help attract new physicians to these rural communities.

"There are physician repayment loans so that newly minted graduates have an opportunity to establish practices in rural areas and have some of their medical school loans forgiven," says Knudson. "There’s also a J-1 visa program that allows foreign medical graduates to practice in our rural communities."