Medical deserts in America: Why we need to advocate for rural healthcare

In July 2015, H.R. 3225, the Save Rural Hospitals Act, was introduced in the House of Representatives. The goal of this bill was to help stabilize rural hospitals through financial relief and to halt the recent healthcare spending cuts that had led to rural hospital closures across the nation. When sequestration and Medicare cuts began to hit hospitals, the rate of rural hospital closures increased six-fold between 2010 and 2015. Currently, 673 additional rural medical facilities are at risk of closure. This means that one-third of rural hospitals in the United States may shut their doors, tens of thousands of jobs will be lost in rural communities, and 11.7 million Americans will lose access to local healthcare. Despite the significant detrimental impact that hospital closures have on rural communities, H.R. 3225 has yet to be passed.

The lack of proper attention to the rural healthcare crisis is resulting in “medical deserts” throughout the country: regions of rural America where healthcare is limited or non-existent. The National Rural Health Association reports that 77% of rural counties are considered “Primary Care Health Professional Shortage Areas” and 9% have no physicians at all. This neglectful climate around rural healthcare contradicts the clear needs of the rural population. There are stark disparities in health outcomes between our nation’s urban and rural areas. The Rural Health Information Hub reports that rural communities experience lower life expectancies and higher rates of diabetes, chronic disease, and obesity. Additionally, there is a critical shortage of OB/GYN providers, mental health professionals, and other medical specialists in rural areas, leaving women and those with certain conditions without access to proper care. Public health challenges are also rampant, with rural areas facing higher rates of tobacco use, drug and alcohol abuse, and teenage pregnancies. With tailored health policies and increased healthcare funding, many of these disparities could be reduced. Rural America could finally have a chance at a higher quality of life.

I founded the Harvard College Rural Health Association (HCRHA) to address some the issues facing rural communities today. Throughout my years at Harvard, I have delved into population health from a variety of avenues, trying to learn more about disparities that exist in healthcare, how health policymakers are currently targeting these issues, and how I can help find solutions to these challenges. I quickly noticed that my courses and conversations covered a variety of issues relevant to urban healthcare and global health, but that the salient inequalities that exist in domestic rural healthcare were scarcely mentioned. Having grown up in a rural Michigan town of 1,100 people, I was familiar with the struggles of attaining quality, specialized healthcare, especially in impoverished areas.

 

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It is now 2017, and the Save Rural Hospitals Act still hasn’t passed. So, where do we stand on rural health today? The current statistics on rural healthcare funding can seem bleak, but they don’t have to be. This was the lesson that I took from the 2017 National Rural Health Policy Institute, which I attended in Washington D.C. this past February. Hearing from the dozen U.S. senators and representatives who spoke at the conference, I was heartened to hear that rural health policy does have a place in current congressional discussions. What makes rural health promising is that it truly is a bipartisan issue. Members of Congress – both Republicans and Democrats – from states with rural populations are invested in this issue and will fight for the ability of their constituents to keep their local hospitals. While government subsidization of healthcare has been a point of political contention, the availability of quality medical services in every U.S. community is a basic expectation for our country. People should be able to access healthcare when they need it instead of having to drive past closed-down hospitals to reach a physician two hours away.

Despite discussions of reducing healthcare spending through the repeal of the Affordable Care Act and decreased funding to Medicaid, rural communities are hoping the new administration stays true to the promise of providing for their health care needs. By passing the Save Rural Hospitals Act, they would be doing just that.

 

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SASahar Ashrafzadeh ’17 served as President the Harvard Global Health Institute Student Advisory Council and is currently the Founder and President of the Harvard College Rural Health Association. She studies Molecular and Cellular Biology with a secondary field in Global Health and Health Policy and a citation in Spanish. Sahar previously served as President of the Harvard Forum for International Development and is passionate about reducing health disparities both in the United States and worldwide.