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Chapter 5: Rural Health CareRural does not necessarily equal smaller or less critical. The differences between rural and urban go far beyond smaller buildings and fewer people. This is especially true when it comes to health care. There are a myriad of obstacles faced by health care professionals and patients in rural settings that in combination create greater disparities in comparison to non-rural locations. These obstacles have been further magnified by the current economic climate.
Rural economy is often dominated by small businesses and self-employed individuals many of whom do not have access to employer-based health care coverage. Rural areas tend to be poorer. Rural residents have higher prevalence rates of smoking, obesity, hypertension, and depression[1][2].
In rural areas, a primary barrier is lack of access to care. Nationally, only ten percent of physicians practice in rural areas. Additionally, rural areas tend to have a higher percentage of physicians nearing retirement than non-rural areas further highlighting the challenge of recruitment and retention.[3]
This chapter of the 2009 Quality Report summarizes VPQ’s role in two activities involving rural health care in Vermont. The first involved a study to measure the economic impact that two health care service entities had on the community of Lamoille County, Vermont. The second is a summary of the Rural Hospital Flexibility Program established by the Balanced Budget Act of 1997 whose purpose is to ensure the best available healthcare to Vermonters in rural areas, by supporting the availability of high quality, coordinated health services and to maintain access to acute and emergency care.
[1] Center for Rural Affairs. Why Rural America Needs a Public Health Insurance Plan. www.cfra.org/newsrelease/2009/07/23/why-rural-america-needs-public-health-insurance [3] WWAMI Rural Health Research Center. Aging of the rural generalist workforce. Seattle, WA: WWAMI Rural Health Research Center, University of Washington; in press.
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