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Issues with rural healthcare in America

People residing in rural setups in America have a limited access to health care. This state of affairs can be attributed to a number of features characterizing the healthcare system here. Firstly, many people living in these areas lack healthcare insurance and this makes it hard for them to finance their own health services (Van 11). Moreover, American healthcare professionals have the tendency of preferring to relocate to affluent urban zones, where they do their practice. Although approximately 20% of the US population resides in the rural areas, only 9% of the country’s healthcare professionals reside here. Most of the physicians operating in rural zones are family-physicians. The more physicians get specialized, the less they are likely to settle in rural areas. As such, people residing in these areas are not given access to specialists in the event of complex health issues (Van 36).

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Studies also indicate that, although managed health care systems have the capacity of recruiting specialized health professionals in rural zones, these areas register a very slow growth of systems. As such, these professionals are of only a little use to the working poor as they lack safety nets such as Medicaid. Moreover, studies reveal that rural medical care is almost a male preserve. Female professionals in medicine tend to prefer to settle in urban areas. Traditionally, medical schools where dominated by male students. Presently, the number of female students in these schools is high. This means that, in future, rural areas may register even more shortages of physicians if the trend of females preferring to work in urban centers continues (Rosenblatt and Hart n.p).

Although managed care greatly influences the delivery of health care, its effect is yet to be experienced well in American rural setups. This form of health care delivery is a creature of the private sector. This system is lauded for having the capacity for providing organizational tools for employing and deploying health care professionals. However, it is also known to have consequences which impact rural areas negatively. Firstly, it occasions a loss of local control of health care institutions. Moreover, the private sector which manages it is usually unwilling to provide services to the uninsured. Additionally, the metropolitan organizations in-charge of these managed care systems depicts a little understanding of these zones. This state of affairs combined with the tendency of these organizations to lack empathy for rural residents make the health care services here very poor (The Rural Health Information n.p; Hub Rosenblatt and Hart n.p).

A research carried out by AHCPR exposes various other facts about the state of health care in rural America. Firstly, the body asserts that, many small rural health centers have closed and many more are in dire financial straits (Van 33). The body also argues that many rural residents experience resource as well as transportation difficulties as they endeavor to access health care services. Additionally, telemedicine has not been evaluated properly, therefore, not well utilized in delivering services to rural populations. According to this organization, rural America lacks professionals and facilities for dealing with alcoholism and drug abuse victims. As such, mental conditions which emanate from there conditions are not well treated (The Rural Health Information Hub n.p).

According to AHCPR, one in every three adults residing in rural America suffers poor to fair health. Almost half of the residents of rural America suffer at least one main chronic illness. The people residing in these areas also make fewer visits to health care centers when compared to their urban counterparts. The most common health issue is traumatic injury in rural America. Residents here are known to face relatively worse outcomes and are more likely to die when compared to their urban counterparts. Owing to economic pressures, many health centers in rural America prefer to offer outpatient care. Additionally, AHCPR asserts that, many people in these zones are either underinsured or uninsured (The Rural Health Information Hub n.p).

Population attributes contributing to poor rural health care amongst rural residents

For people residing in rural setups to have sufficient healthcare access, they need to have the ability to pay for them. As such, they must have adequate financial resources with which they can afford health insurance coverage. Moreover, the residents of rural areas must have the means required to access these healthcare services, therefore, they need to have money to pay for transport. Owing to poverty, it is estimated that 20% of the 62 million residents of rural areas do not have health insurance. Unfortunately, this number is projected to rise to 25% by the year 2019. It is certainly imperative that these people are provided with access to healthcare as well as healthcare insurance as they are known to suffer higher rates of chronic diseases compared to those residing in urban centers. About 17% of the people living in the rural areas of America are minorities, who tend to be more economically sidelined than their native white counterparts. Hartley (2004) reports that the minorities in America register higher levels of poor health as well as higher prevalence of fatal diseases such as HIV/AIDS, stroke and cancer. Owing to these high incidences of diseases amongst America’s rural residents, rural healthcare stakeholders and leaders need to treat the provision of quality health services as a priority (Hartley n.p; The Rural Health Information Hub n.p).

Although the level of education for the residents of rural areas in America has been on an upward trend over the years, their counterparts residing in the metro zones are still much ahead. Educational attainment amongst minorities is quite low. Failing to get a good education locks these populations out of employment. As such, they end up lacking the resources they require to afford a decent quality of healthcare. Statistics show that, American adults without a high school diploma have a shorter life expectancy of up to 9 years. In the year 2011, adults without a college diploma in America were found to have a 15% prevalence rate for diabetes. College graduates on the other hand registered a prevalence rate of only 7% the same year (Eberhardt and Elsie n.p; Van 99).

Educational attainment and health are closely correlated. When people are educated to high levels, they tend to be more health conscious than those who are not educated. People learn basic health tips in school and this makes them less likely to fall sick. Moreover, when people get educated, they become more likely to secure good jobs which are well paying. As such, the earnings they get assist them in procuring better health services, thereby, increasing their chances of leading a healthier life. Additionally, the low educational levels for the residents of rural areas make it harder for them to interpret the instructions contained in medical packages properly. When they fail to follow these instructions accurately, they predispose themselves to more health complications. Further, the less educated are more likely to misunderstand health messages. For instance, when there is a looming health disaster and warnings are send to them via various media, they fail to comprehend them well, therefore, making them more vulnerable to the catastrophe (Eberhardt and Elsie n.p; Van 97).

Less literate adults residing in rural setups in America are known to engage more in risky behaviors such as smoking and alcohol abuse. These practices certainly predispose them to health risks, thereby, making them prone to diseases. Moreover, people with lower educational attainment do not take healthy behaviors such as taking a good diet seriously. Consequently, they lead lives characterized by less resistance to diseases. These people do not also take the issue of taking body exercises seriously. A research conducted by the National Survey on Drug Use and Health (NSDUH) between 2009 and 2010 for instance indicated that, 35% of adults without a high school diploma in America were smokers. According to the study, only 13% of college graduates then engaged in the same character. This high prevalence amongst the less educated was attributed to their low socioeconomic statuses as well as their lack of knowledge on the risks of smoking. Education empowers people with knowledge on health and health risks (Van 42).

Adults with high levels of educational attainment are less likely to get stress attacks as they have already sorted out their economic problems. The less educated on the contrary suffer exposures to stress as they tend to be more economically deprived. Allostatic load makes individuals incapable of copying with long-term stress. This inability makes these people highly vulnerable to chronic diseases. People who are less literate also tend to have fewer buffers for reducing the impact of stress. For instance, when they lose their employment, they lack resources which can sustain them as they search for other occupations. The less literate are also known to lack the social support they highly require to cope with chronic occupational stress (Eberhardt and Elsie n.p; Van 75).

Through education, people are taught various life skills with which they can adapt to stress. The illiterate, therefore, certainly lack these skills hence stress is more likely to take a toll on them. To cope with the stress, these people end up engaging in risky behaviors such as drug abuse. In effect, these behaviors make them more prone to health complications. Owing to drug abuse also, minority communities living in rural setups become more likely to engage in crime. While practicing their criminal activities, these people clash with the police and this predisposes them to injuries. Moreover, research indicates that, minorities are more likely to get incarcerated in America. While in prison, these people get predisposed to unhealthy environments which make them more vulnerable to diseases (Eberhardt and Elsie n.p; Van 77).

A growing body of research indicates that life changes, chronic strain, traumas, and discrimination tend to be more prevalent in the less literate. These conditions are highly harmful to their physical as well as psychological health. The more literate people residing in urban setups are more likely to belong to social networks of communication and reciprocity. Through these networks, they are able to relay information, learn and understand social behavior norms and serve as models to others. On the other side, the less literate are known to lead lives characterized by lack of involvement in organizations, lack of friends, lower quality social relationships and lack of successful marriages. As a result, these people tend to be more prone to poor mental health and higher mortality rates (Eberhardt and Elsie n.p).

Arguments for bettering the rural health care system in America

To remedy the ailing rural health care system in America, various measures can be taken. Firstly, there is need to construct the system so that it selects, trains and deploys more professionals who are willing to do their practice in rural setups. As mentioned, many physicians decline to work in rural areas, preferring to go to urban centers instead (National Rural Health Association n.p). Moreover, state governments as well as the federal government can establish mechanisms of offering incentives to those who are ready to practice in rural areas. These incentives may for instance include the use of hardship allowances so that those who work in these setups can earn more than their urban counterparts (Rosenblatt and Hart n.p).

There is also need to recruit more students from rural areas into medical schools. These students would be more willing to return to their places of birth to do their practice their as they are already accustomed to rural lifestyles. Moreover, the federal government can allocate resources to establish training schools in rural setups. People who train in rural setups would be more willing to do their practice here. Research suggests that, public medical schools which train family physicians, have most of their graduates preferring to work in rural setups as opposed to graduates from research intensive private medical schools, who prefer to work in urban setups (Rosenblatt and Hart n.p).

Programs aimed at the provision of direct services to underserved zones can also come in handy. These programs may for instance include the National Health Service Corps and the Community Health Centers. Research already indicates that, these two programs provided by the federal government serve as the most effective health safety nets for rural America (Hartley n.p). According to the Rural Health Research Centers in Chapel Hill, NC, and Settle, 1 out of every 4 physicians recruited and deployed in regions characterized by shortages in the late 1980s was courtesy of the National Health Service Corps. Additionally, studies show that, 1 in every 5 private practitioners in rural America was brought there by the National Health Service Corps (Rosenblatt and Hart n.p).

The federal government can also consider a resolution of the professional licensure regulations so as to allow health care professionals practicing in urban areas to avail their expertise in rural areas across state boundaries. Moreover, there is need for clear protocols for a common technologic infrastructure to lower costs and permit practitioners in rural setups to communicate with multiple providers of far fledged services. Presently, these providers seem to be held captive by a single provider of information. Additionally, to ensure the provision of health care services in distant places, there is need for a reasonable reimbursement by third party payers (Rosenblatt and Hart n.p).

Telemedicine is a new technology capable of mitigating the existing misdistribution of physicians in rural America. Although this technology is already legitimate, it is currently highly uncoordinated, inaccessible and expensive. In other jurisdictions, the use of this technology is even illegal. As such, there is need for more research and support so as to empower the technology to make it effective in sorting out the physician crisis characterizing rural America (Rosenblatt and Hart n.p).

To improve the provision of health care services in rural America, partnerships are also essential. A study conducted in the year 2014 in Kansas involving the interviewing of 76 administrators, community and hospital representatives drawn from both urban and rural settings attests to this claim. The interview aimed at investigating about community health assessment and enhancement activities. Rural administrators reported less confidence in using these initiatives while their urban counterparts reported a high degree of their usage. According to rural administrators, rural America lacks the capacity to deploy such activities. These findings certainly indicate that the use of broad, cross-cutting partnerships can play a very pivotal role in enhancing the health outcomes of rural populations (Hale n.p).

America can also extrapolate the tremendous success registered in the use of extension services in farms to the healthcare sector. These centers were established in America about a century ago to facilitate the modernization of American farms through the application of research and technology. Universities and colleges have traditionally concentrated on agriculture, home economics, and youth development. The establishment of a national Health Care Cooperative Extension Service can assist primary health care practitioners to create models for the treatment of chronic illnesses, advanced access scheduling, group checkup visits as well as other potentially good innovations (DeLeon n.p).

As mentioned earlier, lack of good education is also a factor contributing to poor health outcomes in rural America. As such, to remedy this, there is need to support the populations residing in these areas to gain easy access to higher education. This can be done through the use of community colleges as well as through reducing the tuition fee charged by universities. Many poor people living in rural America fail to join institutions of higher learning owing to their inability to afford the huge fees charged. Many of those who join them end up completing with a huge debt in loans to pay after completion. These factors discourage many rural poor citizens from joining these institutions. The federal government can consider reducing the interest rates on student loans also to encourage more participation (Zhang n.p).

America needs to enhance competition in the insurance sector so that people can have a wide spectrum of firms from which to select. As already mentioned, many rural residents are poor and cannot afford the high cost charged by the few firms offering health insurance. By increasing the number of players in this sector through lowering the entry thresholds, competition can be occasioned. The effect of competition will be to lower the insurance costs. In fact, one in every five farmers in rural America faces medical debt. Moreover, studies show that, on average, families in this zone pay close to half of their health care costs out of their own pockets. As such, for this state of affairs to be changed, the charges involved need to be dramatically reduced. Liberalizing this market would lead to a situation where Americans living here are able to compare the available players in terms of their benefits, quality and premiums (US Department of Health & Human Services n.p; Eberhardt n.p).

Lastly, campaigns aimed at educating rural residents on the dangers of behaviors such as smoking and drug abuse need to be enhanced. As seen, those living in these areas are more likely to smoke and use drugs compared to their urban counterparts. If these habits could be reduced, people could be able to lead healthier lifestyles, thereby, lowering their chances of falling ill. Moreover, civil education needs to be improved to educate less literate rural Americans on the benefits of certain diets and exercises (US Department of Health & Human Services n.p).

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Works cited

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