What do Telluride, Colorado, Sedona, Arizona and Kennebunkport, Maine all have in common? They’ve all been included in various lists naming the best — and often most beautiful — small towns in the United States. Each town also is inhabited by fewer than 15,000 residents.
These scenic small towns can be found across the U.S. Apart from tourism, they’re typically less crowded and offer residents more privacy. Only about 15 percent of the total U.S. population — approximately 46 million individuals — live in rural areas.
Apart from the tranquility and lower pollution many of these rural areas boast, there are certain challenges. High poverty, opioid and methamphetamine misuse and lack of public transportation are just a few.
Residents of rural communities also face a lower life expectancy and worse health outcomes. Compared to Americans living in urban and suburban areas, they are more likely to have chronic health problems and suffer from heart disease, chronic lower respiratory disease, unintentional injury, stroke and cancer. That doesn’t take into account the fact that these rural residents have higher rates of cancers related to modifiable risks (tobacco use, human papillomavirus and lack of preventive colorectal and cervical cancer screenings).
Issues Affecting Rural America
There’s a reason rural residents face more of these types of issues: less access to healthcare. It’s not just primary care, either. Types of healthcare services frequently difficult to access in rural areas include:
- Home health
- Hospice and palliative care
- Substance use disorder services
- Reproductive, obstetric and maternal health services
- Oral health services
- Mental health services
That last item is especially notable considering that opioid overdose deaths are 45 percent higher in rural areas. Or, when finding out from a study from the Centers for Disease Control and Prevention (CDC) that children in rural areas with mental, behavioral and developmental disorders face more community and family challenges than children in urban areas with the same disorders.
Why the lack of access to healthcare in these rural areas? There are many explanations, but some of the most common are healthcare workforce shortages, low health literacy, a lack of transportation, longer distances to providers, little or no health insurance coverage and social stigma. We’re providing a little more insight into each of these factors and how they affect rural Americans.
Healthcare Workforce Shortages
As we’ve mentioned in previous blogs, both the physician and nursing career fields are experiencing a shortage, one that’s not expected to improve anytime soon. Healthcare staff shortages are projected for every state by 2026, when the U.S. will lack an estimated 3.2 million healthcare workers.
There’s also an increasing scarcity of healthcare facilities in rural U.S. communities. More than 130 rural hospitals have closed in the past decade, and those still in business have trouble recruiting and retaining providers. An estimated eight percent of all physician practices nationally (about 16,000 total) — many of which were located in rural communities — closed in 2020 due to the financial strain of the COVID-19 pandemic.
Only 12 percent of doctors practice in rural areas. One in five Americans lives in a rural community. That means limited access to both primary and specialty care. The numbers for mental health treatment are worse: about 60 percent of rural residents live in a designated mental health professional shortage area.
Low Health Literacy
Low health literacy doesn’t necessarily correspond with a lack of higher education. It occurs when patients can’t obtain, process and understand basic health information to make appropriate healthcare decisions. It’s probably more common than you think — roughly 80 million adults in the U.S. are estimated to have either limited or low health literacy.
Consequences of low health literacy include medication errors, low rates of treatment compliance, unnecessary emergency department visits, higher mortality and other negative effects. Rural communities often have lower health literacy rates and experience limited resources to address the issue.
Distance and Lack of Transportation
Road trips aren’t always for leisure. Rural Americans often have to travel two to three times farther to see medical and surgical specialists and about 30 minutes to get to the nearest acute care facility. Their trips to routine care take an average of 17.5 minutes.
It’s not only the time that costs them. In addition to taking off work and procuring childcare, rural residents have to find a reliable means of transportation. Public transportation is far less accessible in rural areas.
Lack of Health Insurance
Rates of unemployment are higher in rural areas. Because of this, rural residents are less likely to have affordable healthcare coverage. The results are delays and gaps in care, less preventive care, more unpaid medical bills and worse overall health outcomes.
Living in a small town has its positives. There’s typically a slower pace of life with less crime and a lower cost of living. Rural residents also know most of the members of their community.
The problem with healthcare in rural areas is just that: rural residents know most of the members of their community. They therefore might be less likely to seek care, especially for mental and behavioral health.
Digital Health Technology: Part of the Solution
Just as the problems that prompted obstacles to quality healthcare for rural Americans didn’t come on the scene all at once, they’re not going to be solved immediately. However, by employing advancements in technology, individuals living in rural communities can improve how — and when — they access healthcare, even when living many miles from the nearest specialist.
A prime example is telehealth, which uses technologies like remote patient monitoring, video conferencing and mHealth (mobile health) to provide healthcare services to patients, especially those living in rural areas. In addition to promoting continuity of care through real-time communication, responsive concern and reduced hospital admissions, it’s convenient, cost-effective and minimizes the spread of infectious diseases.
Telehealth also benefits patients living in rural communities by offering 24/7 access to healthcare, improved emergency care, enhanced understanding of post-hospitalization care plans and better access to mental health resources. Through remote monitoring, these individuals have the capability to better manage their health in their home setting. This technology provides an additional layer of privacy and security for rural patients accessing treatment for mental and behavioral health problems.
A solution to speed up care when a patient living in a rural area does visit his or her physician in office is digital healthcare. Through tools such as digital check-in, they can enter necessary data at home using their smartphone or other mobile device. They can even complete health-risk screenings that can help prioritize care for their appointment, making visits more efficient.
Some rural healthcare providers achieve increased convenience and accessibility in patient education by offering information about patient services within the check-in workflow. Using a dual opt-in method, patients determine if they would like to see any patient services. As services are presented, they have the choice to opt-in or skip.
Epion Telehealth enables rural healthcare providers and clinicians serving rural residents from a distance to give personalized care. Using secure, high-quality video and audio, it allows patients to experience the familiar steps of an office visit from the comfort of home. Schedule a meeting with us to learn more!