This article was contributed by Jon M. Bailey, former Rural Policy Program Director at the Center for Rural Affairs.
The question is based on a finding that many of the health issues that plagued rural America a decade ago are still prevalent, and in many cases getting worse. Over the past several years the Center for Rural Affairs has documented these issues in a series of reports.
The most acute health issues vary by region of the country, but they all have an underlying issue of access. There simply are not enough rural health care providers and not enough economic wherewithal in rural America to adequately address the health care issues facing rural people, despite heroic efforts to address rural health care concerns.
A new Rural Healthy People 2020 report from the Texas A&M School of Public Health highlights these challenges, including, nutrition and weight status, diabetes, substance abuse, and access to mental health services as well as closure of rural hospitals. This last challenge has been exacerbated by the failure of many states with large rural populations to expand their Medicaid programs as allowed by the Affordable Care Act, worsening the financial difficulties faced by many rural hospitals.
All these health issues play out in an environment also containing a host of economic and social issues – generally higher poverty rates, older population, lower educational attainment, and a lack of well-paying jobs - which have a direct influence on health. These circumstances are not just. Americans should expect better from their health care system, and from policymakers, no matter where they live.
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