While the recent overturn of Roe v. Wade thrust women’s health into the spotlight, longstanding structural issues are contributing to a decline in maternal health outcomes for moms everywhere. However, the effects are conspicuously more pronounced in rural communities—and more so among their residents of color.
As the maternal mortality rate continues to climb, especially among moms of color, it’s clear that we’re at an inflection point. Rural moms are 60% more likely to die from childbirth, and rural Black and Brown women are three times more likely to die from maternal health complications than rural white women. But with rising costs, hospital closures, and a national shortage of OB-GYNs, all signs point to a continued decline in the health of rural communities. Fortunately, the advent of telehealth during the COVID-19 pandemic shows us that high quality care can be delivered with the push of a button—and that might just be our ticket to helping rural communities.
What are the challenges with rural healthcare?
Rural communities, which are by nature smaller and more distributed than urban areas, tend to have lower income per capita and consequently lower tax bases—meaning funding for services for things like maternity care and mental health is scarce, if not non-existent. Since 2005 over 181 hospitals in rural communities have closed, all the while a national doctor shortage persists.
According to the National Rural Health Association, “the patient-to-primary care physician ratio in rural areas is only 40 physicians per 100,000 people, compared to 53 physicians per 100,000 in urban areas.” Consequently, over 50% of U.S. counties are considered maternal care deserts, lacking a single OB-GYN. In these communities, people have to travel further for lower-quality care: rural families travel twice as far for emergency medical care, and more than 50% of rural women have to travel 30 minutes or more for OB-GYN services. The result is fewer people seeking, accessing, and receiving care—and worse outcomes.
All of these challenges are amplified for people of color through both structural issues and the social determinants of health. Whereas some people may be able to afford the gas money and time off work to travel 30+ minutes to see an OB-GYN, historically marginalized groups like Black and Indigenous women are less likely to be able to. Likewise, many rural people of color are low income and reliant on medicaid for insurance coverage, which can lead to worse outcomes because of the difficult choices they’re forced to make in light of limited coverage and a smaller network (e.g. do I use my gas to go to work or see a doctor?). Consequently, low income women, especially in rural areas, are less likely to seek help when sick and less likely to take medication—which is especially challenging for new and expecting parents.
“Maternity care fails all people in the U.S.,” says Dawn Godbolt, Director of Health Equity at Maven. “But when you add in dimensions like geographic location, income, and race, then you see the additive effect that leads to worse outcomes.” With so many challenges and uphill battles to face, it’s no wonder that so many rural families are simply not receiving or seeking necessary care.
.jpeg)
.svg)
