In America, rural residents are generally less healthy than urban residents. Analysts cite numerous reasons, and state and federal governments are pursuing remedies.
- Several factors contribute to poorer health in rural places.
Authorities cite several reasons for the rural disparities. They include greater poverty; less access to health insurance and nutritious foods; the closure of many rural hospitals; higher rates of smoking and obesity; lower rates of exercise; and greater addiction to certain drugs such as oxycodone and methamphetamine.
- States are trying various remedies.
Ideas being tried include creating private-public partnerships to increase access to care; deploying mobile medical units to rural areas; expanding telemedicine; and encouraging young rural residents to enter health professions. Pennsylvania, to cite one state, gives rural hospitals certainty about their budgets by guaranteeing the revenue they will receive in the coming year.
- A century ago, rural residents typically were healthier than urban dwellers.
In the 19th and early 20th centuries, urban dwellers had a higher mortality rate than did rural residents. Scientists said the causes included contagious diseases that spread in densely populated neighborhoods, poor water quality and inadequate sewage disposal. In the early 20th century, large public works projects greatly improved water quality and sanitation. Vaccines helped tame contagious diseases. By the 1940s, the scenario had flipped, and urbanites had a lower mortality rate than rural residents.
- Indian reservations also have health care deficiencies.
“Native American communities face significant inequity in health care and health status compared to other U.S. populations,” says a study by the American Bar Association. “American Indians and Alaska Natives born today have a life expectancy that is 4.4 years less than the United States’ all races population,” the study found, “and they continue to die at higher rates than other Americans in many categories of preventable illness, including chronic liver disease and cirrhosis, diabetes, and chronic lower respiratory diseases.” A shortage of medical personnel on Indian reservations is a key reason.
- Congress is weighing ways to improve rural health care.
Pending measures include one that would create a five-year pilot program to fund up to 100 Federally Qualified Health Centers (FQHCs) and Rural Health Clinics. The goal is “to boost capacity in specific areas of medical need within their communities, enhancing skills in these areas and expanding access to care.” The bipartisan bill, called the Improving Access to Health Care in Rural and Underserved Areas Act (S.3194), is sponsored by Sens. Jacky Rosen (D-NV) and Lisa Murkowski (R-AK).