Rural Areas Across The United States

One area where access to care is a problem is in the rural communities. Healthcare professionals including physicians, nurse practitioners, and nurses all affect the quality and cost of care (Derksen, & Whelan, 2009). Going forward importance needs to be placed on using recourses more efficiently and effectively; these resources include but are not limited to tests, prescriptions,

Transportation is one of the largest barriers to health care access in rural communities. Fortunately, many interventions

A variety of challenges including personal, social, economic, and environmental factors can determine the health of an individual as well as its community. Others determinants of health include genetics, access to medical care, and socioeconomic measures such as education and poverty. Any interference among these factors can often lead to health disparities, which are health gaps that exist between different communities and populations. Health disparities can affect communities based on gender, age, race, social status, economic status, or special care needs. Therefore to understand which factors affect the health of a community, it is necessary to examine the social and economic conditions in which people live in, as well as the rates of diseases

Health disparities in populations and population subgroups deal with differences in overall health and the spread of disease and death (Almgren, 2013). There are several characteristics of a population or subgroup that make them more vulnerable to disparities in health and healthcare. These include race, ethnicity, sex, age, education, income, employment, and geographic location among other characteristics. Many of which are linked to social inequality within communities. On the other hand, healthcare disparities include access to care, quality of care, equity, and health care outcomes (Almgren, 2013, p.243). Disparities in both categories can be explained by the social determinants of health that affect many people’s health status and include environmental factors present in communities (Patel & Rushefsky,2014). All these factors are interrelated and seem to affect minority and low-income groups more disproportionately. Meyer et.al. (2013), use the World Health Organizations explanation of social determinants of health as being “mostly responsible for health inequities—the unfair and avoidable differences in health status seen within and between countries” (p. 3). This explanation is applicable to communities and population groups within the U.S. as

The US Department of Health and Human Services (HHS) defines medically underserved area as ranking low on a scale that involves physicians per 1000 people, infant mortality rate, percentage below poverty level, and population >65 years old. 9 The HHS defines medically underserved population as that which includes “economic barriers (low income or Medicaid-eligible populations or cultural/linguistic access barriers to primary medical care services.” 9 According to the American Pharmacist Association, approximately 85% of US states have 61-100% of counties with medically underserved areas. 11 “28% of poor, 23% of near poor…[lack] health insurance coverage,” which is much higher than the national percentage of 13%.6 When reviewing the risk factors for vaginitis such as lack of health insurance, tobacco use, lack of bachelors degree, Hispanic origin, etc., many of the women suffering from the condition fall under the category of the underserved population as defined above. This means that clinics with the purpose of treating underserved areas and populations must have a heightened awareness of the prevalence and significance of vaginitis and must be interested in staying up to date on the most efficient medical practice strategies given the patient population.

When assessing the current state of healthcare in the United States, properly forming an answer requires the separation of healthcare by geography, demographics, and economics. These factors influence the quality and availability of services and resources available to clients and professionals. The urban areas will usually have greater access to an array of services and resources, whereas the rural areas will see limitation in this regard. The rural community is normally a place with an eclectic collection of self-reliant people many of whom have never been exposed, within the context of healthcare, to the complexities contained within the healthcare organizations in urban environments. This factor does not eliminate or alleviate, for that

The landscape of health care is changing, however despite the adoption of the ACA, Americans are struggling to obtain quality healthcare services due to their geographic and psychographic limitations. The geographic disparity is due to the historic state-by-state coverage variation of low-income adults through government sponsored health care programs leaving an estimated 10 million adults with limited to no health insurance coverage and limited services in some rural areas of America (Gabow, 2013). Furthermore, as the age of the population increases and the fertility rate decreases the physiological maker of menarche where sociological determents of reproduction behavior, marriage, sterilization, infertility and sociological patters such

The socioeconomic determinants include: education, income and employment. People living in rural and remote living people are disadvantaged regarding education and employment opportunities, income and access to goods and services, therefore are more likely to work on farms, transportation or mines and can lead to lower health literacy. Environmental determinants include: geographical location, access to health services and technology. In rural and remote areas, have a lower number of GP’s employed than in major cities, which limits access to standard health services. The use od health services is also poorer than in major cities, which includes some cancer screening programs such as bowel cancer.

One observation that seems to be common for both rural and urban underserved areas is the relatively low physician to patient ratio. Accessing care is often difficult when there are few doctors to be seen. These physicians are often overworked and burned out. Finding an empathetic doctor willing to take the time to listen is not easy. This often leads to mistrust or resentment toward doctors. The second common thread is the lack of education the community experiences as a whole. Many members of these communities often have no college education and many times little or no high school education. This has a two-fold effect, high unemployment and little understanding of complex medical jargon. With likely little or no medical coverage, even less purchasing power, and little ability to make sense of prescribed treatment you can see how the odd are not in anyone’s favor. Last, but certainly not least, are the hours in which the clinic operates. Often, clinics are open during normal working hours. If a person was fortunate enough to be employed, they

Rural Americans face an exclusive combination of issues that create disparities in health care that are not found in urban areas. Many complications met by healthcare providers and patients in rural arears are massively different than those located in urban areas. Financial factors, cultural and social variances, educational deficiencies, lack of acknowledgement by delegates and the absolute isolation of living in remote rural areas all combined to hinder rural Americans in their struggle to lead a normal, healthy life. Rural hospitals located in rural areas faces many disadvantages, such as; minimum resources, shortcoming or unprepared professionals, and financial disparities. Although many of these challenges could be solved

Despite overall improvements in breast cancer survival in the past 10 years, significant disparities persist which result in inequitable delivery of healthcare. Women with invasive breast cancer from lower socioeconomic statuses (SES) are more likely diagnosed at later stage, receive suboptimal treatments, and have higher rates of breast cancer mortality than their less deprived counterparts1–3. Less is known regarding disparities related to levels of rurality or urbanization in breast cancer. One study has found that, after adjusting for socioeconomic status, white women with breast cancer living in rural areas had marginally higher mortality rates than those living in urban areas2. Moreover, several studies have demonstrated differences in breast cancer management between rural and urban hospitals4,5. Although SES is correlated with rural-urban residency, few studies have accounted for both factors in their assessment of breast cancer disparities.

In Hollowing Out the Middle by Carr and Kefalas, the discussion regarding the decline of rural America is brought to the forefront. This decline is not usually discussed due to the inane ability of society to deem it relevant; the decrease in rural communities is causing a devastating effect on the socioeconomic stability of America. Carr and Kefalas move to a small, rural community in eastern Iowa they name Ellis, to evaluate the cause of this decline and attempt to create a solution. Through residency and interaction with the community as well as present and past high school graduates, they evaluate the reasons why youth are leaving rural communities at such a high rate. They determined youth fall into five categories growing up in small towns: stayers, seekers, achievers, boomerangs, and returners. The different categories these individuals fall into are influenced by socioeconomic statuses and are characteristic of segregation, deviance, stereotyping, and social stratification.

The article discusses the changes in the rural West that caused it to move from agricultural to a more urbanized domain and how these changes effected the socio-economic and ecological landscape of the West.

Access to health care refers to the individual’s ability to obtain and use needed services (Ellis & Hartley, 2008). Access to health care affects a multitude of people. Uninsured, underinsured, elderly, lower socioeconomic class, minorities, and people that live in remote areas are at the highest risk for lack of access to health care. There are also economical and political roles that complicate access to health care. Access to health care is a multi-faceted concept involving geographic, economics, or sociocultural issues. With my extensive research on access to health care, I hope to provide influences regarding; who is affected by lack of access, geographic, economic, sociocultural access, and

National equitable access to healthcare is an ongoing dilemma. The problem is exacerbated in Appalachia by the large population of individuals that are underserved due to geographic isolation, lack of public transportation, lack of physicians, and a shortages of medical facilities (Network, 2009). Statistically, 39% of Appalachian counties are lacking the minimum number of primary care providers compared to non- Appalachian counties that lack 30% (HRSA, 2007). 19% of Appalachian counties are lacking the minimum number of dentists compared to the 16% of non- Appalachian communities (HRSA, 2007). Furthermore, an overwhelming 63% of Appalachian counties are lacking the minimum number of mental health providers, versus 53% of non- Appalachian