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Healthcare in Rural Areas: Access, Improvement and Comparison to Urban Healthcare

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According to the U.S. Census Bureau, there are more than 46 million Americans who live in rural areas, which equates to about 15% of the U.S. population. Studies from the CDC are now drawing attention to the gap in health between urban and rural America. However, in urban areas, there are still plenty who find it difficult to access the primary or specialty care they need. Delays and longer wait times are often the case in these areas as well.

Though there’s an urge to discover whether people in cities or the countryside have it better when it comes to access to medical professionals, differences between states and the way people in both areas use healthcare to make a definitive winner-loser comparison impossible.

What we can do is look at a few telling aspects of how rural medical care compares to that of cities.

Rural Healthcare in America

Before we compare urban and rural healthcare, it is important we understand both. Rural simply refers to a geographic area that is located outside of towns and cities. An urban area is the opposite – an area that is built-up with a high population of people and a dense infrastructure.

Access to Healthcare in Rural Communities

The major issue that the rural healthcare system faces is workforce shortage problems. Since fewer people live in these areas, the pools of qualified nurses, doctors, specialized school professionals are drastically smaller than their urban counterpoint. According to the National Rural Health Association (NRHA), “The patient-to- primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas.”

Additionally, the average household income in rural areas is generally less than in cities. When it comes to healthcare, that means fewer people can afford coverage in the first place. The NRHA also points out that the average income in rural areas is about $10,000 less than the average income in the United States.

Rural Americans also make up a greater population of those who are in need of healthcare services in the first place. The CDC explains that “Rural Americans are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than their urban counterparts.”

Insurance becomes an issue in rural areas as well. Less competition among insurance companies in rural areas and fewer employers who have healthcare plans (a larger percentage of rural residents are self-employed) means that in many states, it will cost you more (up to 25% more) to get insured in the country than in the city.

Improving Access to Healthcare in Rural Areas

Although there are many drawbacks to rural healthcare, the problem doesn’t go unnoticed. Rural doctors are often much more aware of the problem on an individual basis and are more willing and flexible to work with patients to come up with payment plans they can handle.

 The doctors who do work in rural communities also tend to be general practitioners instead of specialists. They are more interested in making a difference in the community than getting the highest pay, and tend to stay in the community longer than doctors stay at an urban practice. To improve the accessibility of healthcare in rural areas, there are several things that can be done:

  • The use of telehealth visits is increasing rapidly
  • Educate rural Americans on healthy practices through public health campaigns
  • Implement government policies to increase accessibility
  • Utilize staffing companies to place medical professionals in hard-to-reach places 

Healthcare in Rural vs Urban Areas

While healthcare and rural areas both face many of the same socioeconomics challenges within the healthcare system, there is still a disparity across the board. Rural Americans also face unique challenges that urban Americans do not such as the additional 22% greater risk of an injury-related death or having to travel greater distances to reach a doctor or hospital. Even not having access to highspeed internet, something commonplace in metropolitan areas, greatly affects the rural healthcare system.

Rural vs Urban Nursing

Urban and rural nurses still receive the same degree, a nurse in rural Texas still needs the same credentialing and licensure in downtown Texas. However, the main difference between the two is the type of injuries and disease they see on a daily basis. While diabetes, tobacco use, and car accidents happen everywhere, these detriments are significantly more common in rural areas. For example, according to the NRHA, “More than 50 percent of vehicle crash-related fatalities happen in rural areas, even though less than one-third of miles traveled in a vehicle occur there.” 

One positive is that nursing is a career that more commonly sees its professionals travel. Travel nursing allows a constant influx of trained and specialized nurses such as ER, OR, or ICU nurses to these areas that are way outside the city limits.

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Contributor Patrick Dotts

Patrick, who’s grown with Soliant over the past 8 years, was promoted to the managing director of the healthcare division in January of 2018. Before that, Patrick was the division director for Soliant’s nursing and allied health division. Patrick has worked very closely with not only hospitals and other healthcare facilities but also the healthcare professionals that make up their workforce. This experience has given Patrick a unique insight into the ins and outs of the medical field, especially regarding its workforce. Before Soliant, he graduated from Bowling Green University and cherishes his free time with his wife, daughter, and son. Make sure to read more of Patrick’s other blogs on nursing and allied health.