Changing How We Approach Rural HealthCare

Edited by Lillian McKenna

The distribution of healthcare facilities lacks equality in all areas. Healthcare in the United States is a market, and access to care is determined based solely on the digits in someone’s account. Those in rural areas are posed with two options: receiving care at the low-funded healthcare facility in their area that might not specialize in that patient’s needs or traveling to the nearest healthcare facility in the next big city. Rural areas often don’t have access to specialists despite these communities being more prone to dying earlier from heart disease, cancer, stroke, and lung disease. There are many different ideas that come to mind when considering basic human rights. Many would argue the most basic human right is living. The livelihood of our world is highly dependent on individual access to resources. The disparity in healthcare quality based on geographic location is an injustice that needs urgent attention.

My grandfather lives in rural Georgia and has one Walmart in his town. The local hospital is known for malpractice, a lack of resources, and an overall lack of quality in care. He was in need of emergency care after finding out he had a burst blood vessel causing internal bleeding. The negative rep of his local hospital led to him and my grandmother driving to a hospital in Jacksonville, Florida, the nearest big city, in hopes of better care. My grandfather was not only dismissed during his stay, but the doctor performed the wrong procedure on him. He was then forced to wait extra days while internally bleeding on a doctor who had time in their schedule to perform the procedure.

My grandfather’s story is a perfect example of the importance of having access to healthcare in rural areas. Not only does the lack of healthcare cause disparities in these regions, it also increases the wait times in already densely populated larger cities. It led me to question what are we doing wrong as a country, when we produce the best doctors in the world, and have the resources to allocate.

This prompted me to explore healthcare practices in rural South America, focusing on regions with larger rural populations. I decided to look into regions with larger rural populations in South America and how they were doing with access to care in rural areas. In 2020, approximately seventy-seven million people lived in rural South America, and the pandemic’s disproportionate impact on rural communities highlighted existing disparities. The coronavirus pandemic disproportionately impacted rural communities and this is seen in the countless denials of care during this time.

Dr. Jerry Jailall, a citizen from Guyana, wrote to the Stabroek News detailing the holes in Guyana’s healthcare system. “Government must stop putting everything in New Amsterdam. We need equal services in the Upper Corentyne, Central Corentyne and New Amsterdam. What is the Government’s plan for the current Skeldon Hospital?” [3]. He states that there are “two Guyana’s” The Guyanese healthcare system provides primary healthcare free to all citizens, but most healthcare systems lack quality resources. These hospitals have outdated equipment and often cannot offer outpatient care such as radiology, laboratory services, and dental care facilities. The hospitals that are available are placed in touristy areas that accumulate the most money instead of in places that would benefit most locals.

The graphic below shows the prevalence of shortages in the United States healthcare system. “As of September 2022, 65.6% of Primary Care Health Professional Shortage Areas (HPSAs) were located in rural areas.” [5]. This graph brings truth to the disproportionate horrors our rural regions face in the United States.

So What Now?

Are we going to allow rural communities to continue suffering in silence due to the pure irresponsibility in allocation of resources? Creating an opportunity for these regions to have accessible affordable care needs to be a growing mission for global public health, but is slow in progress. As of February 21, 2023, Mark Green sponsored the introduction of a new hope for rural regions. The Rural Health Care Access Act of 2023 is a section of the Social Security act that would “permit states to designate without any mileage limitations facilities that are located in rural areas as critical access hospitals.” The Bill would create the possibility for access in so many communities that desperately need it. The enactment of the bill is unlikely as only 11% of Bills made it past the committee and only 2% were enacted between 2021–2023. It is unlikely that the Bill will be passed, but it is a glimmer of hope for many. In hopes of change, a few suggestions moving forward include: implementing more urgent care facilities in communities that can’t afford to build hospitals, reimagining the cost of healthcare services in hopes of reallocating resources to make building healthcare facilities more affordable, and creating a policy that mandates the government to have healthcare facilities that are equipped for both emergent and primary care services within a 25-mile radius of every town center.

Works Cited

1. Avery, K, Finegold, K, Tia, X. Impact of the Affordable Care Act Coverage Expansion on Rural and Urban Populations. (2016, June 10). https://aspe.hhs.gov/sites/default/files/private/pdf/204986/ACARuralbrief.pdf
2. GovTrack.us. (2023). H.R. 1128–118th Congress: Rural Health Care Access Act of 2023. Retrieved from https://www.govtrack.us/congress/bills/118/hr1128
3. Jailall, J. (2022, July 24). Govt.’s plan to modernise health care system commendable but equity in rural areas essential. Kaieteur News. https://www.kaieteurnewsonline.com/2022/07/24/govt-s-plan-to-modernise-health-care-system-commendable-but-equity-in-rural-areas-essential/
4. Nunes, F. G. da S., Santos, A. M. dos, Carneiro, Â. O., Fausto, M. C. R., Cabral, L. M. da S., & Almeida, P. F. de. (2022). Challenges to the provision of specialized care in remote rural municipalities in Brazil. BMC Health Services Research, 22(1), 1–14. https://doi.org/10.1186/s12913-022-08805-6
5. Rural Healthcare Information Hub. (July 2024). “Health Professional Shortage Areas: Primary Care.” https://www.ruralhealthinfo.org/rural-maps/mapfiles/hpsa-primary-care.jpg?v=392
6. Stabroek News. (2022, July 24). Gov’t’s healthcare programme lacks equity in rural areas. https://www.stabroeknews.com/2022/07/24/opinion/letters/govts-healthcare-programme-lacks-equity-in-rural-areas/