It’s all about access

Rural healthcare solutions focus on connecting patients and providers

By Ben Goldfarb

The allure of endless skies, vast tracts of land, and delicious solitude has drawn people to the American West since the days when covered wagons constituted innovative technology. Self-reliance and access to the outdoors remain entrenched in the ethos of rural Western life. Love thy neighbor, sure, but also cherish the ability to escape him, to vanish into the hills or fields when the spirit catches you. Seclusion is a perk.

Too often, however, the epic distances and luxurious privacy that make the rural West so appealing impede the provision of healthcare. Patients who could see a doctor immediately in urban settings find themselves driving hours for simple services in rural ones. The need for emergency care necessitates life-saving helicopter flights that cost tens of thousands of dollars. Rural counties struggle to attract top-notch doctors, nurses, physician assistants, and other providers, and the grinding poverty that pervades many remote areas bankrupts hospitals and clinics — even as it contributes to more, and more serious, illness and injury. Access to mental and behavioral healthcare is particularly lacking: According to the National Rural Health Association, men — and, increasingly women — in rural areas suffer far higher suicide rates than their urban counterparts.

In New Mexico and Colorado, these interrelated challenges are particularly vexing. In 2015, America’s Health Rankings rated New Mexico 37th in overall health nationwide — a four-spot downgrade from its 2014 performance. The data is especially troubling at a granular level: The state ranked 40th nationally in diabetes rates, 43rd in the percent of children living in poverty, and 49th in violent crime. Even worse, New Mexico has just one primary care provider for every 1,099 residents, far below the national average.

This month, the Small Towns, Big Change project tackles health care — both the challenges created by lack of access, and the innovative people and institutions striving to bridge the gaps. You’ll read about New Mexico’s burgeoning telestroke program, a promising new approach that allows doctors to care for stroke sufferers in local hospitals rather than flying them to Albuquerque. You’ll encounter Hidalgo Medical Services, a public health clinic that’s creating a new model for patient-centered care, as well as a rural medical network that’s increasing the purchasing power of cash-strapped hospitals. You’ll hear a radio story about Project ECHO, a nationally recognized program for demonopolizing medical knowledge. You’ll learn about everything the U.S. Department of Veterans Affairs is doing in New Mexico to improve vets’ wait times for appointments — and why those efforts haven’t yet been enough. Finally, you’ll travel to Alamosa, Colorado, where a so-called Crisis Living Room is treating mental health patients without costly and counterproductive trips to the emergency room.

Explore the West’s rural health challenges with Small Towns, Big Change. As always, we welcome your comments, questions, and feedback. Thanks for sharing, and we hope you read these stories in good health!

Warm wishes,

Ben Goldfarb
Solutions Journalism Network