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Overlooked and Underfunded: The Health Care crisis in Rural America

Joshua Onobrumen

In 2017, Sarah Scnatling, a mother from Pemiscot County, Missouri, drove 30 miles across state lines to Tennessee to give birth because her local maternity ward had closed down. Pemiscot County remains one of the poorest and most rural counties in the United States of America. According to the US Government Accountability Office, about 20% of the American population lives in rural areas and requires more attention than those who reside in urban or suburban areas. Even though healthcare evolves daily, people in places such as Pemiscot County are neglected and overlooked. When a person needs critical care, it is almost natural for them to seek out their local hospitals, but in the US alone, since 2010, over 8 percent of rural hospitals have closed, and the number of providers has been reduced as well. Additionally, people have driven an average of 20 miles to receive the medical assistance they need. Healthcare should be accessible regardless of where a person lives, yet for many rural citizens, that remains far from reality.

To understand why this trend continues to materialize, hospital funding has to be analyzed. An area of care generates an income based on the services supplied. Most rural communities are smaller compared to their urban counterparts, so there is less demand. Moreover, the average age of the population in these communities is much older, so government programs such as Medicaid and Medicare are often utilized. This is significant because these lower-density hospitals tend to accept only private insurance. Furthermore, the development led to a reduction in revenue, prompting hospitals to make the difficult decision to cut services to keep the hospitals operational. According to the Commonwealth Fund, a record of over 400 rural hospitals have stopped offering chemotherapy services. Additionally, 33 percent of American counties lacked maternal care in their healthcare facilities. It is important to note that these hospital closures do not equate to a reduction of cases; they shift the burden onto major hospitals. Since the closures, complaints of overcrowding and a lack of hospital beds have become prevalent.

The persistence of these challenges has prompted healthcare providers, policymakers, and lawmakers to explore solutions to increase access to rural care. Telehealth continues to be the number one method to bridge the gap for rural communities, but the issue of the method stems from connection problems and digital literacy. However, states such as Mississippi have created a system of Telemedicine kiosks. According to Mississippi State University, “ These kiosks function as standalone stations that offer medical services such as consultations, diagnostics, and health management through a blend of AI, IoT, and digital connectivity” (Chen et al., 2013; Velayati et al., 2022). The operation is the main distinction. Healthcare officials have placed the kiosks in public areas like local libraries. A major benefit is that a device from the patient isn’t required for use. The kiosks have proven their effectiveness, with chronic disease infections down 13 percent and non-emergency ED visits down 20 percent.

It is also important to recognize the significant role pharmacists can play in rural healthcare, as they remain underutilized despite their accessibility within these communities. Most people view them as the “Gatekeeper of the Pharmacy Counter” or as a search engine for what happens if a certain medicine is consumed. Although these descriptions are somewhat true, they can do so much more to help smaller towns. For example, the United Kingdom has a program called NHS Pharmacy First. The program allows people who have difficulty reaching their primary care provider to go to the pharmacy to obtain medical advice. According to Community Pharmacy, “You will speak to a pharmacist in a private consultation room, with some pharmacies also offering appointments online via a video consultation. The pharmacist will talk to you about your symptoms and will provide advice and, if necessary, supply a prescription medicine to treat the condition.”(Community Pharmacy Para 2). If the patient is not satisfied with the outcome, they can be redirected to a general practitioner. Since 2024, 6.2 million consultations have been completed, and nearly 90 percent of patients have had a positive experience.

Although healthcare access for rural citizens remains difficult to obtain, the path to ending that reality is viable. Based on the developments, such as those in the American South and the United Kingdom. People cannot depend on the current situation. Overcoming rural healthcare disparities requires embracing new, innovative, and localized strategies.