Events Calendar

The general audience will be invited to leave after the presentation and Q & A session.

Title: Dynamic Landscape of Healthcare Access in the United States: Evaluating Rural-Urban Differences in Availability, Accessibility, and Utilization

Abstract: Receiving health care in the U.S. is complex. Not only does a patient have to find a doctor but may also have to consider if the doctor takes the patients insurance, ensure the care need can be provided by this doctor at this facility, and can the patient get to the hospital or clinic the provider is located. Navigating such factors become more difficult when hospitals close, providers are scarce, or a patient has no insurance, more likely to occur in rural areas compared to urban areas. This complexity often hits rural areas differently than cities, where services and specialists are more available. Just as it is complicated to navigate the health care system to receive care, it is also difficult to analyze all the changes that the health care industry is undergoing because data is often not shared or compatible with one another. Because of these challenges, I studied how changes in availability of providers and services impacts a patient’s ability to access and receive care using three examples of health care that patients may receive 1) hospital based cardiac care, 2) breast cancer screening using mammograms, and 3) treatment for diabetic foot sores.

Hospital surveys showed that the number of hospitals offering full cardiac care is dropping nationwide, with rural areas losing more, causing rural patients to drive further to hospital cardiac care. Data from Iowa private insurance reports show that most women in Iowa should be able to receive an annual mammogram within 30 minutes of driving, however, less than half of insured women aged 40-64 got screened. Rural and younger women were less likely to receive a mammogram than urban, older women. Private insurance reports also show that rates of diabetic foot sores in Iowa are increasing among people with diabetes. Patients who live in urban areas are receiving more diabetic foot care from foot specialists, while rural patients saw more primary care doctors for diabetic foot care, potentially delaying care.

These findings highlight how changes in health care availability shape who can access and use health services. My work suggests we need better solutions, like mobile clinics, more rural doctor, or more integrated care networks between rural and urban providers to ensure health care is accessible for everyone.