Financial insecurity, health care deficits plague rural Americans

National Public Radio reported today on rural Americans financial precarity and health care access woes.  The story, by Joe Neel and Patti Neighmond, reports on on a poll of rural Americans conducted by Harvard's T.H. Chan School of of Public Health and the Robert Wood Johnson Foundation.  It's the second such poll conducted by these partners in less than a year.  The first was last fall, and the results are the focus of this blog post.  This second poll focused on rural Americans' access to health care, which in theory has improved with the passage and implementation of the Affordable Care Act, as well as on economic security.  Here's a summary of the findings, which are reported in greater detail (and with some cool graphs) in the NPR story:

A substantial number (40%) of rural Americans struggle with routine medical bills, food and housing. And about half (49%) say they could not afford to pay an unexpected $1,000 expense of any type.

This latter finding and the question on which it is based seems linked to this story, which is not limited to the rural, from several years ago, as well as this one from early 2019.

The findings regarding health care access are also telling, not least because they speak to the practical realities of getting care--as in getting to the health care provider when material spatiality gets in the way.  Here's a breakdown of the survey's findings: 

Of those not able to get health care when they needed it, the poll found that 45% could not afford it, 23% said the health care location was too far or difficult to get to, and 22% could not get an appointment during the hours needed.  (emphasis added)

On rural hospitals in particular, Neighmond and Neel report that rural America has lost 106 rural hospitals since 2010.  The current census of rural hospitals is 1,860, of which more than a third, 673, are at risk. 

Finally, the story reports on sense of community, a topic oddly absent from the lede:

Yet even with the high levels of financial insecurity that we found, there is abundant optimism and satisfaction with the quality of life in rural America. Almost three-quarters (73%) of rural Americans rate the overall quality of life in their local community as excellent or good. And a majority (62%) are optimistic that people like them can make an impact on their local community. 

The story quotes Dee Davis of the Center for Rural Affairs regarding his observations of rural Kentucky; he makes his home in Whitesburg:

People may be living a more hardscrabble existence than folks in the suburbs or a lot of the folks in cities, but it doesn't mean they're not living a decent life.  Most people are pretty happy with it; they've got friends and neighbors they rely on and they're where they want to be.

NPR quotes a Whitesburg resident and activist, whose husband was recently hospitalized, regarding this phenomenon: 

My neighbors come and mow my grass, feed cattle, get eggs every day for the last few weeks.  That says so much to me. [It] makes me feel the emotion now of what it feels like to have such warm, wonderful support and I know that's the blessing of living in rural America.  

The survey found that 49% of rural Americans volunteer with an organization that works "to make their local community a healthier place to live."

N.B.  "Rural" was defined for purposes of this survey as not living in a metropolitan area, and on that definition, don't miss this piece.