Americans are living longer lives than ever before. In fact, over the past 100 years, the average life expectancy for Americans has increased by nearly 25 years.
Although life expectancies have improved on average, the same is not true throughout the United States. In rural or underserved areas, for example, life expectancies have stagnated or decreased slightly, largely due to a lack of doctors and nurses trained to properly treat and provide the best possible care for senior patients in these remote areas.
The Affordable Care Act (ACA) expanded access to Medicaid, which pivoted the way that seniors have come to cover their health care expenses. But in some cases, Medicaid expansion has done little for some of the most vulnerable populations in the country — specifically, seniors who live in rural areas.
Why is Medical Care Harder to Access for Rural Seniors?
“Right to care does not mean access to treatment,” Columbia University Psychologist Paul Appelbaum told The Guardian. For those in rural areas especially, the capacity for treatment simply may not be available.
The rural population is generally older. As Paula Span writes in the New York Times, “About 15 percent of residents are 65 or older, compared with 12 percent in urban areas, largely because many people have left in search of education and jobs in larger cities.
Professor Goutham Menon, who directs the Social Work Program at the University of Nevada, Reno, has attributed this percentage discrepancy to what he calls the rural area “brain drain,” which occurs when students from rural communities attend college and don’t return to their hometowns, opting instead to live in more metropolitan environments.
Naturally, this leaves a dearth of coverage in small towns, where people may not have access to a health professional without traveling long distances, and the consequences for the elderly not being able to access regular health treatment can be dire.
Challenges Faced by Rural Seniors and Their Doctors
A 2015 Oregon State University study of adults ages 85 and older found that rural residents have significantly higher levels of chronic disease, take more medications, and die several years earlier than those who live in more urban areas.
The research confirms the validity of unique challenges facing older populations in rural or remote areas, including less access to physicians, long distances to travel for care, lower socioeconomic and educational levels, and other issues. Although doctors in rural areas have good intentions, most simply cannot keep up with their caseload.
“Many physicians do the best they can in rural areas given the challenges they face,” researcher Leah Goeres wrote. “But there are fewer physicians, fewer specialists, a higher caseload. Doctors have less support staff and patients have less public transportation. A patient sometimes might need to wait months to see a doctor, and have to drive significant distances. Adverse effects can increase from taking multiple medications.
“These are real barriers to choice and access, and they affect the quality of care that’s available.”
How Are Local, Rural Governments Trying to Help Seniors Get Better Access to Care?
Access to health coverage has become a concern for many local governments. But attracting doctors and nurses to rural areas has proven to be difficult, especially when there is already a shortage of health care providers across the U.S.
As John Daley of Colorado Public Radio reports, one challenge is attracting young doctors to rural areas where there may be an “absence of culture, cultural events, shopping, [and] schools.”
In order to attract younger generations of doctors, rural hospitals in Colorado have begun offering specialized residency programs in order to give young doctors a new set of skills they wouldn’t receive in a typical residency environment.
“The residency piece is critical because data shows nationally that students stay within 150 miles or less of where they do their residency,” Rocky Vista University President Cheryl Lovell, who runs a rural residency program in Colorado says. “If we can increase the number of residency opportunities in Colorado, we’ll have better chance of keeping highly trained physicians here.”
Others hospitals have chosen to attract physicians through loan repayment programs which help medical professionals pay off their loans should they perform their duties in underserved rural areas for a certain amount of time.
How Technology is Helping Rural Seniors Expand Access to Healthcare
Perhaps the most successful approach, however, is to provide patients with the technology necessary to regularly consult their physicians from the comfort of their own home.
“In an increasingly patient-centric environment, homecare has clearly emerged as a win-win for participants and sponsors alike,” MD Connect author Dan Stempel writes. Technology has made it easier for patients to seek help from physicians regardless of their geographic location.
“Technology has the potential to decrease the gap in services and improve education, support, and connected between the client and the provider,” one one University of Virginia study notes. “As an alternative to traditional face-to-face contact for those in rural and geographically dispersed areas, the internet potentially can bridge the disparities in health care access for rural health services.”
For elderly patients who live in rural areas, access to care is a barrier that can significantly impact their quality of life as they age. In the future, policymakers, health care administrators, and doctors will have to come up with innovative solutions to making access to healthcare as easy as possible.
Danika McClure is a musician and writer from the Northwest who is passionate about social justice and education.