Healthcare Access in Rural Communities

Access to healthcare services is critical to good health, yet rural residents face a variety of access barriers. A 1993 National Academies report, Access to Healthcare in America, defined access as the timely use of personal health services to achieve the best possible health outcomes. A 2014 RUPRI Health Panel report on rural healthcare access collects additional definitions of access, along with measures that can be used to determine access.

Ideally, residents should be able to conveniently and confidently access services such as primary care, dental care, behavioral health, emergency care, and public health services. According to Healthy People 2020, access to healthcare is important for:

  • Overall physical, social, and mental health status
  • Prevention of disease
  • Detection and treatment of illnesses
  • Quality of life
  • Preventable death
  • Life expectancy

Rural residents often experience barriers to healthcare that limit their ability to obtain the care they need. In order for rural residents to have sufficient healthcare access, necessary and appropriate services must be available and obtainable in a timely manner. Even when an adequate supply of healthcare services exists in the community, there are other factors to consider in terms of healthcare access. For instance, to have good healthcare access, a rural resident must also have:

  • Financial means to pay for services, such as health insurance coverage that is accepted by the provider.
  • Means to reach and use services, such as transportation to services which may be located at a distance, and the ability to take paid time off of work to use such services.
  • Confidence in their ability to communicate with healthcare providers, particularly if the patient is not fluent in English or has poor health literacy.
  • Confidence in their ability to use services without compromising privacy.
  • Confidence in the quality of the care that they will receive.

This guide provides an overview of barriers to healthcare access in rural America and how communities and policymakers can help improve healthcare access for rural residents. The guide includes information on barriers to care, including workforce shortages, health insurance status, distance and transportation, poor health literacy, and the stigma of certain conditions such as mental health or substance abuse issues for those in rural communities.

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