Examining Health Inequities in Three Distinct Rural Regions
The lack of rural health services takes a toll on both patients and practitioners. This series looks at health-equity issues in three diverse rural communities in Hawaii, Western North Carolina and Northern California. The series is a collaboration of The Daily Yonder and three other nonprofit news organizations: Carolina Public Press, Honolulu Civil Beat and Shasta Scout. The Rural News Network of the Institute for Nonprofit News initiated the project, with support from the National Institute for Health Care Management Foundation.
Chronic health conditions and distance to medical services mean rural residents need more healthcare specialists and better telehealth. But they are less likely than urban areas to get it. In Hawaii, California, and North Carolina, communities look at ways to change that equation.
For the first time since 1990, the state agency that provides care to adults diagnosed with a serious mental illness has no staff on Lanai, an island of about 3,000 residents where one person owns 98% of the land. Health-care access issues there are a microcosm of a growing mental health-care crisis in rural America.
In Shasta County, California, with vast swaths of sparsely populated land, patients who need local, specialized health care may be out of luck. That strains primary-care clinics, increases use of ERs, lengthens travel times for those who must find care in urban areas, and creates worse patient outcomes. A local response to the problem shows promise.