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This report, “Limited Access: Health Care for the Rural Poor” by Laura Summer, published by the Center on Budget and Policy Priorities in March 1991, examines the challenges rural residents, especially those with low incomes, face in accessing health care services.
The report highlights several key issues:
- Poorer Health Status in Rural Areas: Rural residents generally have poorer health and report more fair or poor health status than their urban counterparts. Low-income rural residents are in even worse health.
- Lower Use of Health Care Services: Despite poorer health, rural residents, particularly the poor, use health care services less frequently than urban residents. This includes routine physician care, prenatal care, and pediatric care.
- Scarcity of Providers: There is a significant shortage of physicians, especially primary care, obstetrical, and pediatric specialists, in rural areas. Many non-metropolitan counties have no physicians or specialists.
- Vulnerability of Rural Hospitals: Rural hospitals are facing financial viability threats, leading to closures. This impacts access to care and the ability of communities to attract and retain health care professionals.
- Financial Barriers and Lack of Insurance: Rural areas have higher poverty rates and lower health insurance coverage rates compared to urban areas. Employer-sponsored insurance is less common, and Medicaid eligibility rules tend to be more restrictive in rural states.
- Limitations of Federal Programs: While programs like the National Health Service Corps and Community and Migrant Health Centers are crucial for rural areas, their effectiveness has been diminished by funding cuts.
- Recommendations: The report recommends substantial increases in funding for the National Health Service Corps and Community and Migrant Health Centers. It also suggests federal and state actions to expand Medicaid eligibility, streamline application processes, increase services covered, and improve provider participation, particularly for obstetricians and pediatricians in shortage areas.
