Rural Americans Often Struggle To Access Care

Access to care remains a major burden for Americans in rural areas, according to recent media reports. The Texas Tribune reports: "Across much of rural Texas, emergency or trauma care is simply nonexistent, or limited to one ambulance and a part-time EMS crew. ... Roughly half of the state is covered by the trauma centers in El Paso and Lubbock. In remote counties in West Texas, South Texas and the Panhandle, residents are often more than an hour from any trauma care at all."

"These isolated areas come with their own brand of injuries: hunting and ranch accidents, four-wheeler crashes. Most common are the car wrecks: late-night rollovers on highways with 80 mph speed limits. While just a third of the country's motor vehicle accidents occur in rural areas, two-thirds of deaths attributed to these accidents happen on rural roads" (Ramshaw, 1/5).

The Columbia Missourian reports on physician shortages in rural Missouri areas and the state-funded programs encouraging medical professionals to serve there. "Eighty percent of Missouri's counties don't have enough physicians. Many of those counties are rural, according to the Missouri Department of Health and Senior Services. One of the ways MU's School of Medicine has sought to draw more physicians to rural areas is through the Rural Track Pipeline Program. It began in 1995 and continues to educate medical students about the importance of practicing in rural areas."

Big factors in the shortage are an increase in aging patients and the retirement of older physicians: "According to the Office of Social and Economic Data Analysis, the population of people age 65 to 74 has increased in many rural counties in Missouri. ... That means that over the next 20 years, there will be an extreme need for physicians, especially in rural areas, to better serve the aging population. ... Despite cuts to the Missouri Area Health Education Center budget, which assists the Rural Track Pipeline Program, it continues to give medical students firsthand experience in rural medicine by sending them to rural areas to live and learn" (Matteson, 1/5).

Meanwhile, BusinessWeek/HealthDay News reports that many depressed adults go without treatment: "Most depressed adults in the United States don't get the minimum recommended treatment, and the vacuum is especially dramatic among minority populations." A study in the January issue of Archives of General Psychiatry found that "only a paltry one in five U.S. adults gets guideline-recommended treatment, with the number dropping to one in 10 for Mexican Americans and African Americans. ... Whereas previous research lumped different ethnic groups into one broad category, Latinos, these researchers looked at individual subgroups, revealing that Mexican Americans, African Americans and Caribbean blacks were even less likely to receive adequate care than others. ... Health insurance and access to care — or lack thereof — did not fully explain the differences" (Gardner, 1/4).

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