The shortages in rural America

Recent studies have shown that there is a shortage of doctors in rural America. However, doctors aren’t the only professionals missing in rural America. There is also a shortage of both teachers and lawyers in these areas.

As someone who grew up in small town which some may argue was at least slightly rural, the headlines were no surprise. There are no lawyers in my small town. There is and for as long as I can remember has been a shortage of teachers. Most teachers commute into our town from bigger cities, some even driving an hour each way. The largest health center in town has one M.D. and two physician’s assistants. Thus, I wasn’t surprised to read that rural areas are experiencing a shortage of professionals in these three fields. Nevertheless, one may wonder, how bad is the shortage? What causes it? Is there anything being done about it?

Roughly 20% of the U.S. population live in rural areas, yet only 11% of physicians practice in these areas. In addition, of the more than 7,000 “federally designated health professional shortage areas, 3 out of 5 are in rural regions.” The shortage of physicians in rural America is a pressing problem. Rural Americans have “disproportionately higher healthcare needs” and “are less likely to receive preventative services.” This means that the shortage of physicians in rural areas is incredibly dangerous for an already vulnerable population.

However, it’s not all about the number of current doctors. The number of rural students pursing a medical degree is also playing a role in the shortage. According to researchers, “growing up in a rural setting is a strong predictor of future rural practice for physicians.” Thus, the shortage of physicians in rural areas indicates that there is also a pipeline problem. The number of rural students entering medical programs decreased by 18% between 2002 and 2017 while the number of urban students increased by 59% during the same period.

In sum, the research would seem to indicate that increasing the number of physicians in the U.S. wouldn’t necessarily address the shortage in rural areas. Rather, an increase in the number of rural students going to medical school and returning to their communities might a better solution.

The shortage of teachers in rural areas is equivalent or worse to the shortage of doctors. More than nine million children, or one in five, attend public schools in rural America. Despite the high number of students in rural areas, there aren’t enough teachers in these areas. The state of Montana, which has the highest share of rural schools, reported that “65% of rural schools in remote settings reported difficulty filling vacancies, compared with 35% of non-rural schools.” So, what’s causing the teacher shortage? Well, it’s hard to pinpoint the exact reason but it may have something to do with the fact that rural teachers are paid less than their urban counterparts. Some rural teachers were found to make almost $12,000 less than teachers in urban areas. The lower salaries make it difficult to both attract and retain new teachers. Rural areas have higher turnover rates than urban areas when it comes to both teachers and principals. Furthermore, new teachers and people going into the teaching industry are becoming scarce. In Colorado, there has been a decline of 24.4% in the number of graduates from teacher preparation programs. Some states have gotten creative and have upped their loan forgiveness programs, provided more scholarships for students going into teaching and have expanded programs that promote teaching. The state of Colorado which has been severely impacted by the shortage of teachers passed a bill allowing “retired teachers to be rehired without affecting their pensions.” Although rural areas are working hard to address the shortage, there is still much work to be done.

Like doctors and teachers, lawyers can also be difficult to find in rural areas. Despite being home to “about a fifth of the nation’s population,” rural America “[is] home to only 2% of small law practices.” Again, there are many reasons offered as to why this shortage exists. Similar to rural teachers, rural lawyers are often paid less than urban lawyers. In an attempt to motivate lawyers to practice in rural areas, South Dakota has created a program which offers an economic incentive to lawyers if they practice in a rural area. Alaska has also attempted to address the lawyer shortage through their newly-created medical-legal partnership program. This program has “embed[ded] legal services attorneys in six hospitals.” The health care professionals recommend their patients to the lawyers if the patient turned client has legal issues such as matters relating to housing. However, not many states have followed South Dakota or Alaska’s unique approaches. As this article recommends, it would be wise for states to offer similar programs to incentivize lawyers into rural areas and reduce the disparities in the access to justice.

To summarize, rural areas are struggling with doctor, teacher and lawyer shortages. Although states have begun to implement various policies and programs to address the issue, the shortages persist.