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Rural Healthcare Crisis: Why 136 rural hospitals closed during the epidemic?
Many areas of the United States have been described as medical deserts, lacking adequate access to one or more medical services. It is estimated that approximately 30 million Americans live at least 60 minutes’ drive from a hospital without trauma care services. According to the report, areas with scarce medical resources and higher rates of Medicaid and Medicare patients are less likely to live within an hour of an emergency room. While the phenomenon is primarily concentrated in rural areas, medical deserts are also a problem in urban and suburban areas, especially in predominantly black communities such as Chicago, Los Angeles, and New York City.
According to data between 2010 and 2021, 136 rural hospitals closed because they could not tolerate worker shortages, low patient volumes and the financial pressure caused by the COVID-19 epidemic.
In 2019, the federal government assessed that nearly 80% of rural America was defined as "medically underserved areas," lacking skilled nursing facilities, rehabilitation, psychiatric and intensive care units. Rural communities have lower life expectancies and higher rates of diabetes, chronic disease, and obesity. Faced with a lack of medical resources, rural residents often have to miss work to go to medical institutions.
Research shows that from 1999 to 2014, the main causes of death in rural counties have increased compared with urban counties, with accidents, heart disease and chronic respiratory diseases being the main causes of death. Inadequate medical facilities are one of the major factors affecting the health of residents in these areas.
In a 2019 study, rural hospitals that participated in Medicaid expansion were shown to have a 62% lower chance of closing.
Because seniors make up a higher proportion of the rural population, medical deserts disproportionately affect them. Facing higher rates of chronic disease, older adults living in medical deserts have reduced access to necessary treatments. In states that refuse to expand Medicaid, rural Americans have more limited options.
Doctor shortage problem
Although approximately 20% of Americans live in rural areas, only 9% of physicians actually practice in these areas. As young doctors' willingness to work in rural medicine declines, the retirement problem of older doctors becomes more serious. It is expected that the number of rural doctors will decrease by 23% by 2030.
Only 4% of hospitalists want to work in communities with fewer than 25,000 people, illustrating the difficulty of recruiting new physicians.
Many newly graduated doctors prefer to work in hospitals rather than in home medicine in rural areas, making the demand for medical services more difficult to meet.
Impact on Native Americans and Alaska Natives
Under federal law, the U.S. government has the responsibility to provide medical services to Native Americans and Alaska Natives. However, access to medical care in Aboriginal communities is severely affected by insufficient government funding for the Indian Health Service (IHS). Aboriginal people living on reserves face greater health problems, including higher rates of chronic diseases such as heart disease and diabetes.
Health inequalities in urban areas
According to a 2019 study, African-American communities in large cities experience a lack of medical resources several times more often than white communities. Particularly in Los Angeles, 89% of African-American communities are identified as having no access to trauma care.
The COVID-19 epidemic has had a more serious impact on communities of color in cities. The African-American population has a significantly higher death rate from the epidemic than white communities.
Solution
In response to this series of issues, some people advocate the idea of implementing a national single-payer medical system to promote medical equity. This system will alleviate health care inequalities by allowing comprehensive health care for all without worrying about high costs.
But opponents argue that implementing Medicare for All could lead to greater operational difficulties for medical providers. Additionally, there has been talk of incorporating a public option into the Affordable Care Act to enhance access to care.
How can these health care inequalities be fundamentally addressed to ensure that every American has access to timely and effective treatment when facing a health crisis?
