Healthcare Challenges in Rural Areas

Daniela Hrizo, 6/15/24

According to The World Bank, the rural population makes up 43% of the world population as of 2022. Nearly half of the world's population lives in a rural setting. Unfortunately, with this lifestyle comes many challenges. One of the main characteristics of a rural lifestyle is that individuals are dispersed and function far from the rest of society, thus isolating themselves. Due to many social and economic barriers, the rural population experiences a detrimental lack of access to healthcare.

Distance & Transportation

“Access to providers, even family physicians, is a problem. If you want to go to an OB/GYN, depending on where you live in the country, you may have to go 200 miles.”

-Gary Hart, PhD (University of North Dakota School of Medicine and Health Sciences)

As mentioned previously, rural individuals are dispersed and thus must be accustomed to traveling longer distances to reach certain resources compared to urban settings. This applies to medical facilities as well. For reference, as stated by the Pew Research Center, “Rural Americans live an average of 10.5 miles from the nearest hospital, compared with 5.6 miles for people in suburban areas and 4.4 for those in urban areas.” Thus, especially for people who may have chronic conditions and require frequent visits, it is more difficult to visit a physician consistently. On top of that, rural areas tend to lack public transit like trains and buses which are common in urban areas. This lack of rural infrastructure means that people must rely on their own transportation to go to the doctor’s office which poses another difficulty.

Workforce Shortages

In order for people to have a consistent source of healthcare, there must be a large enough workforce. However, rural areas tend to lack doctors and other medical personnel, thus making it even harder for individuals to receive medical attention. As mentioned in Vox, “The vast majority of rural America, 80 percent, is considered by the federal government to be medically underserved. About 20 percent of the US population lives in rural communities, but only 10 percent of doctors practice there.” The dire need for doctors in rural areas is well described in this excerpt from the Washington Post: “In Texas alone, 159 of the state’s 254 counties have no general surgeons, 121 counties have no medical specialists, and 35 counties have no doctors at all. Thirty more counties are each forced to rely on just a single doctor.” Even if people in rural settings can reach a medical facility, they may not even be guaranteed medical attention and struggle to find specialists for certain conditions.

Lack of Internet Access

Especially during the COVID-19 pandemic, telehealth has become a solution to provide healthcare online. This has been extremely effective because the lack of transportation or access to medical facilities would not be a problem anymore since people can have doctor visits in the comfort of their own homes, on their phone, or via a Zoom call. However, according to the Rural Health Information Hub, “Compared to their urban counterparts, rural individuals are nearly two times more likely to lack broadband access. A Peterson Center on Healthcare and Kaiser Family Foundation report, How Might Internet Connectivity Affect Health Care Access?, stated that 7% of people in metropolitan areas did not have access to the internet at home in 2019, while 13% of people in nonmetropolitan areas lacked access. This creates yet another obstacle to healthcare.

Poor Health Literacy

Health literacy is categorized as the ability to understand and comprehend healthcare information and instructions from medical personnel. Unfortunately, individuals living in rural areas tend to experience lower education levels and are more likely to be impoverished, which contributes to the low health literacy in rural areas. If individuals do not thoroughly understand their doctor, they may not be properly treated and may be deterred from getting further medical attention. Again, this further shows the seemingly never-ending disparity between individuals living in rural areas compared to their urban counterparts. This is also demonstrated in an excerpt from the National Library of Medicine: “Rural adults tend to be older, poorer, under-insured and have lower literacy compared to adults in urban areas [8–10].”

The Final Picture

Overall, the rural population is experiencing an extremely heavy burden in regards to their healthcare. Due to many disparities, it is much more difficult for these people to get consistent and specialized care. According to AAMC, “Compared with urban areas, rural populations have lower median household incomes, a higher percentage of children living in poverty, fewer adults with postsecondary educations, more uninsured residents under age 65, and higher rates of mortality, according to a 2017 report by the North Carolina Rural Health Research Program (NC RHRP) at The University of North Carolina at Chapel Hill.” In addition to the long distances to get to medical facilities and lack of internet, these challenges become difficult to overcome and severely impact healthcare access in rural areas.