When someone says the word “rural”, it can quickly elicit thoughts of farmland, isolation and abandoned towns with low population density. And with large towns and cities like Chapel Hill, Charlotte and Raleigh, it’s hard to imagine North Carolina having a significant rural citizenry.
Although it may not seem like it, over 40% of North Carolina’s population lives in one of the state’s rural counties, where residents generally have a more difficult time accessing health care due to a lack of physicians, hospitals and medical infrastructure.
What's especially concerning is that rural populations in North Carolina have had a significantly higher mortality rate over metropolitan areas in the last decade. Infant mortality in particular is 16 percent higher than the national average in 29 counties in the Appalachian region of the state.
Additionally, a large portion of national rural community consists of minority populations, and closures of hospitals have disproportionately affected residents living in poverty and in areas with a lack of transportation systems. Individuals living in rural areas also tend to be older and sicker than their metropolitan counterparts, with higher rates of smoking, obesity, heart disease and chronic diseases.
According to recent research, it is more dangerous to deliver a child in the United States today than it was twenty years ago, and this risk is compounded if you are African or Native American, living in a rural area, or are female or under the age of 18. For much of rural North Carolina, nearly all of these boxes are checked.
It’s no secret that rural health initiatives take a backseat for most medical students. Many of them choose to pursue higher-impact and higher-paying subspecialties, such as oncology, cardiovascular care and critical care medicine. This leads rural areas of North Carolina to suffer from a lack of medical personnel; 20 counties do not have a pediatrician, 26 do not have an OB-GYN, and 32 are without a licensed psychiatrist.
Without a consistent influx of employees, it’s difficult to maintain medical and health infrastructure in these rural areas. About 40 percent of hospitals in rural areas have been operating at a loss, and four have closed since 2010 alone, causing huge distress to the local economy and patients.
As a result, many hospitals in Eastern North Carolina have been cutting down on the care offered to patients.
For example, in early September the Quorum Health Hospital announced a plan to discontinue maternity, labor and delivery services on Oct. 21. Although there are three birth centers within a 35 mile radius of Quorum, EMTs have cautioned that, in an emergency, adding 35 minutes could be dangerous and potentially life-threatening.
