For residents in rural communities, getting to healthcare is a challenge. Researchers in a new study have found it’s even more of a challenge for minority populations.
The report, from the Rural and Minority Health Research Center, looked at how close some ZIP codes were to different kinds of health care. Then they looked at what access looked like in areas with higher proportions of racial and ethnic minorities.
What the study found, said Janice Probst, lead author, was that the availability of different kinds of healthcare was worse for rural minorities.
“If you are in a rural area, you’re going to be further (from healthcare) than in an urban area just because that’s what rural is — it’s defined by being distant,” Probst said in an interview with The Daily Yonder. “And if there are certain populations for whom it is really hard (to access healthcare)… If you are further away from that access, or further away from those services, then you are less likely to take advantage of them.”
Researchers looked at rural ZIP codes in the lower 48 states to find out how many of them are within 15 or 30 miles of various healthcare services – Federally Qualified Health Center (FHQC) or a Rural Health Clinic (RHC), emergency rooms, pharmacies, trauma care, cardiac care, intensive care, substance abuse disorder treatment, and obstetrics. Then, Probst said, they went a step further and looked at how far urban and rural communities with higher proportions of minorities are from those same services.
Consistently, the researchers found that rural ZIP code areas with higher proportions of minority residents were more likely to be further away from those healthcare services.
Overall, about 10% of all ZIP codes are further than 15 miles from either a FHQC or RHC. But when researchers looked at rural ZIP codes, the percentage nearly doubled. For some rural ZIP codes with higher proportions of minorities, the percentage further away from those facilities nearly tripled.
For instance, when researchers looked at urban ZIP codes that had higher proportions of non-Hispanic White residents, only 10.5% had to travel more than 15 miles to get to an FHQC or RHC. In rural communities of non-Hispanic White residents, nearly a quarter of the ZIP code areas (23%) were more than 15 miles away.
The differences between urban communities with higher proportions of minorities and their rural counterparts also showed large discrepancies. For instance, only 2% of urban ZIP code areas with higher proportions of Hispanic residents were more than 15 miles from an FHQC or RHC, while 13.5% of those in rural areas were. The same held true for Asian residents, with 0.4% of those urban ZIP codes reporting FHQCs or RHCs more than 15 miles away, compared to more than 16% of rural ZIP codes being more than 15 miles away.
Probst said the researchers found similar results when they looked at access to everything from Emergency Rooms to pharmacies to trauma care, and for more specialized treatment like cancer care and substance use disorder treatment.
Overall, about 7% of all communities were more than 15 miles from a pharmacy. Nearly twice the percentage of rural counties (12.3%) were more than 15 miles away. For racial and ethnic communities, about a quarter of Hispanic (26.4%) and AI/AN (23%) communities were more than 15 miles from a pharmacy.
The cause, she said, is rooted in history.
Black populations in the “Old South”, she said, as well as Hispanic populations in the Southwest, are holdovers from historical settlement patterns. Similarly, she said, states in the West have higher AI/AN populations, but also have lower population density and require residents to travel greater distances.
“Across all groups, however, AI/AN populations consistently are located farthest from any source of care,” she said.
In fact, communities with higher proportions of AI/AN residents were more likely to have further to travel for every healthcare category the study looked at.
For instance, the study found that for substance abuse disorder treatment, only 9.7% of all urban zip code areas are more than 15 miles from a treatment facility, but 45.2% of rural ZIP code areas with higher proportions of AI/AN residents are. Only about a third (29.4%) of ZIP code areas across the country are more than 15 miles away from an emergency room, but nearly two thirds (63.4%) of rural AI/AN ZIP codes are. And those AI/AN ZIP code areas are more likely to report being more than 30 miles from a trauma center (45.3%), an Intensive Care Unit (45%), a cardiac care unit (53.7%) and an obstetrics unit (28.9%).
Similarly, more than a third of all rural ZIP codes with higher proportions of Hispanic residents reported being more than 30 miles away from trauma centers (42.1%), intensive care units (39.7%), and obstetrics units (29.1%) while nearly half reported being more than 30 miles from a cardiac care unit (46.3%).
The findings are important, Probst said, because the availability of care influences whether or not a patient uses that service. And without access to those services, rural residents are likely to go without the healthcare they need.
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