Regular access to health care is essential for ensuring the health and wellness of a population. Unfortunately, health care is not readily available to all populations — even within developed nations like the United States. Setting aside concerns about insurance coverage — which is a major concern for many Americans — health care isn’t accessible in all regions across the U.S. When enough health care providers are not available to serve a population, that region is considered a health care desert.
What Constitutes a Health Care Desert?
America boasts roughly 6,146 hospitals, 7,100 urgent care centers and around 2,000 retail clinics offering health care, in addition to a large number of private practices in cities around the country. Unfortunately, all these care facilities only serve about 166 million Americans — roughly half of the nation’s population — leaving the other half underserved when it comes to medical access.
A health care desert is any region that is 60 minutes or more from an acute-care facility, which is any medical provider that can offer inpatient care. For the most part, health care deserts exist in rural regions around the U.S.; in fact, estimates suggest that nearly 80 percent of rural America is medically underserved. However, health care deserts can and do exist in urban environments, especially those primarily populated by BIPOC. In urban areas, neighborhoods that are more than five miles from an acute care facility are considered medical deserts, largely because it still takes residents more than an hour to reach the facility and receive treatment.
Why Should We Care About Health Care Deserts?
Health care deserts are dangerous for dozens of reasons. Here are the top two:
Health care deserts de-incentivize patient engagement with health. When visiting a health care provider requires hours of travel time, most patients are less interested in making appointments for routine care. As a result, minor health concerns can quickly develop into serious conditions that reduce quality of life and even cut lives short. Even healthy people need regular access to medical professionals, and having health care providers within reasonable reach is imperative for encouraging preventative care.
Health care deserts make emergency medical treatment essentially impossible. In instances where a patient requires immediate medical attention, health care deserts are the most disastrous. When paramedics and other emergency providers cannot reach a patient faster than 60 minutes, they cannot administer life-saving aid when it is called for. As a result, patients within health care deserts are essentially powerless against medical crises.
Worse, because health care deserts disproportionately affect BIPOC — because rural regions are largely populated by Indigenous Americans and underserved urban environments are principally Black and Brown neighborhoods — this issue is one that results from systemic racial inequality. Thus, neglecting to resolve the issue of health care deserts is perpetuating a system in which non-white Americans continue to suffer unjustly.
How Should Residents in a Health Care Desert Cope?
Health care deserts are generally the result of two issues: the high costs of building and operating health care facilities and a shortage of qualified health care providers. For-profit health care institutions rarely want to set up shop in areas of low population because the low demand from patients is unlikely to cover their expenses. Likewise, trained physicians often aren’t interested in working in underserved regions, where the pay is lower and the work more exhausting.
Experts have proposed a number of solutions to fix the ongoing problem of health care deserts. Single-payer health care or some other universal health care system in the United States would certainly be a boon, as it would allow a centralized health care service to identify underserved areas and send medical professionals to work in them. Other politicians have recommended expanding the public option of the Affordable Care Act, which might have a similar effect on health care deserts as so-called Medicare for All.
Revolutionary changes to the U.S. health care system do not have the widespread support necessary to enact them. In the meantime, some have recommended incentivizing the creation of rural care facilities through tax credits and medical reimbursements. Similarly, some advocate for motivating skilled professionals to relocate to underserved regions through improved employment perks, like low-interest home loans or student debt repayment plans.
Currently, residents within health care deserts have one viable solution: telehealth. Online services like everydaydoctor.com allow those who lack convenient or ready access to medical professionals to seek direct, face-to-face communication with qualified care providers. Fortunately, more insurance providers are covering telehealth solutions, and as technology improves to supply remote care, health care deserts may begin to shrink.
The U.S. Constitution states that the government should promote the general welfare of the American people — but allowing so much of the population to lack reliable health care access is certainly not in the population’s best interest. The sooner we pay attention to the issue of health care deserts, the sooner we can find a viable solution that improves the health and wellness of millions of lives.