Complexity of the healthcare crisis in rural America

Abstract

Because osteopathic physicians coinprise 15.3% of all physicians in small rural counties, while making up only 5.1% of the nation's physicians, the solutions to the healthcare crisis for rural America are of special interest to them. The authors explore the incredible diversity of rural communities and the difficulty with defining the term ''rural.'' They give the background of efforts to address rural health problems and the reasons accessible healthcare-available, acceptable and affordable-has been so elusive in rural settings. The authors also explain the relative success of the osteopathic medical profession and address the role osteopathic physicians can play in the future. Finally, they explore the exciting new possibilities that telemedicine offers.

The impact of arthritis in rural populations

“…Based on previously published studies and data presented here, we believe the answer is probably "yes." From national surveys, it is certainly clear that nonmetropolitan areas are home to sociodemographic groups at increased risk of arthritis, disability, and poor health outcomes (1)(2)(3)5,8,. Rural dwellers may also be at increased risk because of the physical demands of rural occupations (19,(21)(22)(23)(24).…”

“…Despite regional differences among rural areas that may be obscured by crude national estimates, certain demographic groups are generally overrepresented in nonmetropolitan areas. These include children, older persons, those with low educational attainment, the unemployed or underemployed, and the poor (1)(2)(3)5,8,(10)(11)(12)(13)(14). Approximately 157" of the nonmetropolitan population is aged 65 years or older, compared to about 1 2 % in metropolitan areas (4).…”

“…Approximately 157" of the nonmetropolitan population is aged 65 years or older, compared to about 1 2 % in metropolitan areas (4). Racial distributions vary widely by region of the country, but rural areas tend to lack the ethnic diversity of urban areas (8,13). Thirtysix percent of rural dwellers have less than 1 2 years of formal education, compared to about 25% of urbanites (3).…”

“…In addition, a higher percentage of rural residents had received medical care for life-threatening and for degenerative conditions in 1987. Regardless of age, rural dwellers are more likely to experience limitations of physical activities, self-care, and work activities than their metropolitan counterparts, and are less likely to have health insurance (3,5,8).…”

Prevention Research in Rural Communities: Overview and Concluding Comments

“…For the latter, rural areas are defined on a county-by-county basis as nonmetropolitan statistical areas (Non-MSAs) of 50,000 or fewer people. Under this latter definition, it is estimated that between 24 and 25% of the U.S. population live in rural areas (Simpson & Simpson, 1994).…”