Rural Health Issues

Superior Essays
Rural areas face various obstacles in their health delivery systems. In some ways there are major differences between rural and urban health systems. Rural areas tend to have less practicing physicians with a shortage of specialists. Lower pay to primary care physicians is deterring many from choosing the field. Rural areas tend to be poorer and residents have a harder time obtaining health insurance coverage. Rural residents face various economic, social and cultural factors that influence how they receive health care. The Affordable Care Act provides a method to increase access to care through Medicaid expansion and tax credits; however, many of the rural residents that would benefit, live in states that declined to expand. Cost, access, and quality all affect residents of rural areas in different ways. Rural residents tend to be poorer than other parts of the nation and many are uninsured. This poses an issue with costs for these residents. Blankenau, Bailey, and Hudson (2009) state that rural residents have the ability to obtain coverage the same way urban residents do. Within the study, both relied on employers as the main source of insurance. The difference; however, was that in rural areas there was a higher employment percentage from small businesses. It was found that 50% of rural employees work for small businesses (Blankenau et al., 2009). Small businesses were found twice as likely not to offer coverage. This was found true for the 33% of rural residents that were self-employed as well. A reason for this is the rising costs to offer coverage and low wages. Residents interviewed discussed how full-time with minimum wage was inadequate to pay insurance premiums and business owners stated cost as a main determinant in not offering coverage (Blankenau et al., 2009). The study continues in discussing why it’s not always financially feasible for a business to offer coverage. One large reason is the aging workforce. Older employees come with higher premiums to pay for more health care needs. Blankenau et al. (2009) explains that a small business with only a few employees would only need one person with health problems to significantly increase the costs to provide coverage. Many of these small business utilize seasonal and part-time staff and with a lack of full-time of employees disqualifies many businesses from group insurance plans as well. Another issues found was that limited insurance competition gave businesses few options (Blankenau et al. 2009). Blankenau et al. (2009) also discusses underinsurance and its effects on health care costs. This is when an individual or family has insurance, but the selected plan does not reasonably assist with high health care costs. The survey taken showed that rural non-adjacent communities experienced the greatest challenge with underinsurance. 17% of privately-insured residents spent more than one thousand dollars out-of-pocket on …show more content…
A lack of preventative services is an example of this. The South Carolina Rural Health Research Center (2009) did a study on these disparities with preventative services. Rural minorities experience marked disparities in health and health care access (SC RHRC, 2009). These minorities are more likely to report poor health status, obesity, and limitations in activity. Rural adults; in general, are less likely to receive appropriate preventive services. Lack of access to primary care and being uninsured are some reasons for this (SC RHRC, 2009). This brief further discuss preventive services in physical exams for adults over the age of 40. Only 83.8% or rural residents were likely to have an exam by a physician. Among those without insurance only 59.3% received an exam. African Americans in rural areas were much more likely to have an exam than other rural residents. Hispanics and other ethnic groups had even lower rates. The study further states how rural residents also were less likely to receive other preventative services, such as mammography, pap tests, and colorectal cancer screenings. Ziller and Lenardson (2009) back these claims up and discuss a lack of preventive services as well. Although, there is a higher likelihood of having a primary care physician, rural adults tend to receive less preventative care services. Only 80% of rural adults under the age of 65 have had a physical exam in the past five years and 69% of rural adults report receiving a cholesterol check as compared with urban

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