Rural areas of the U.S. face unique barriers to healthcare that must be approached with a systematic framework. One access issue is a lack of primary care practitioners (PCPs) in rural areas: despite existing incentive structures for PCPs to complete residencies in rural areas, there is still a provider shortage, leading to limited access to providers for rural residents. A lack of providers in a given area could manifest itself in fewer appointment slots or longer wait times, for example. Poor access to primary care has been found to be both an effect of poverty and a cause of further health disparities.
A study of barriers to preventative screenings in Appalachia found that “lack of knowledge about prevention and cost” were the primary obstacles, impacting 51% and 36% of participants, respectively. In Graham County, NC, a county in Appalachia that is 100% rural, the local Department of Public Health asked key informants about healthcare issues in their community. When asked how much they believed physical environment and social determinants of health contribute to health problems in the county, most ranked social determinants (such as alcohol/drug abuse, economy, and education) as a major contributor. However, their top health priority was access to care. This suggests that residents are aware of the importance of primary care as an upstream factor impacting their overall ability to access healthcare. To address this issue, we cannot overlook the socioeconomic barriers that individuals face to access, as well as the other challenges happening in their lives simultaneously.