Challenging terrains: socio-spatial analysis of Primary Health Care Access Disparities in West Virginia

Abstract

Existing measures of health care access were inadequate for guiding policy decisions in West Virginia, as they identified the entire state as having limited access. To address this, we compiled a comprehensive database of primary health care providers and facilities in the state, developed a modified E2SFCA tool to measure spatial access in the context of West Virginia’s rural and mountainous nature, and integrated this with an index of socio-economic barriers to access. The integrated index revealed that the rural areas, especially in the southern part of the state, have especially limited access to primary health care. 1. Introduction. An emerging public health issue which has been exacerbated by the COVID-19 pandemic, is that of healthcare deserts , which are places where basic affordable health care is not accessible for residents. This problem has become worse in rural areas as rural hospitals close. In these areas, including West Virginia, scattered populations suffer from limited access to primary healthcare services. Uneven geographic and socio-economic barriers to accessing primary health care are major contributing factors to these health disparities. West Virginia’s unique rural and mountainous settlement patterns, aging population, and economic crisis over the past two decades have resulted in unequal access to the primary healthcare services for its residents. The rural nature of the state makes it difficult to maintain medical facilities accessible to much of the population, especially as rural hospitals have been closing, such as the one in Williamson, WV (Jarvie, 2020 ). The mountainous terrain slows down travel across winding roads, lengthening travel times to the nearest hospital, while an aging population has increased health care needs. Lastly, an economic crisis and higher poverty rate makes West Virginians less able to pay for health care. As a result, West Virginians are confronting a health crisis. According to a recent report by the West Virginia Health Statistics Center ( 2019 ), West Virginians rank first in the country for heart attacks, have the second-highest obesity rate and prevalence of mental health problems in the country, along with the fourth-highest rate of diabetes and fifth-highest rate of cancer. An issue faced by West Virginia’s policymakers is the limitations of tools for identifying and assessing healthcare deserts, as they are poorly suited for the unique challenges in West Virginia. Academic research has not analyzed comprehensive primary healthcare accessibility in WV, although previous studies have focused on Appalachia (e.g., Behringer & Friedell 2006 ; Smith & Holloman, 2011 ; Elnicki et al., 1995 ; Donohoe et al., 2015 , 2016a , 2016b ), and others focus on access to more specialized services (Valvi et al., ...

Call For Interdisciplinary Collaboration in Clinical Anatomy Education in WV

“…Another frequently-asked student question-often posed just after observing an advanced pathology in the anatomy lab--that deserves contemplation on educators' part is "why didn't the patient seek help sooner?" This question provides a key opportunity to discuss the need to see our population clearly and compassionately in the context of a spate of potential obstacles to care (e.g., geographical isolation, fear, availability of financial resources, childcare, information, insurance, and food, workplace hazards, and exposure to pollution), a combination of which is ultimately unique to our region of the world in a way that bears consideration as students begin to interact with our population (e.g., Hong et al 2023, Krometis et al 2017). If we hope to train clinicians who can critically assess a patient's wellbeing and provide people with the care they need, we are remiss if we don't consider the socioeconomic and environmental factors that dictate frequency and severity of presenting cases, patient access to care, and how to ensure feasibility of follow-up care.…”

Developing, implementing, and evaluating the visiting Neighbors’ program in rural Appalachia: A quality improvement protocol

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Effect of Coal Mining on Health Outcomes Between Male and Female Miners in Southern West Virginia: A Brief Report

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