Commentary

Walking to promote rural health

Rural hospital closuresWalking not only has individual health benefits, but this exercise can impact the health of an entire community. For the second straight year, Mayor Adam O’Neal of Belhaven is walking to save lives. While Belhaven is home to approximately 1600 people, Vidant Pungo Hospital provided critical care to people throughout Beaufort County and other rural eastern NC counties. Without the hospital, people face additional barriers to accessing care such as taking time off work to travel close to 60 miles round-trip to see a medical provider.

Beaufort County residents are not the only people in rural communities that have difficulty accessing care as 48 rural counties in NC have shortages in primary care. The closings of rural hospitals is a national issue – The Sheps Center at UNC notes that since January 2010, 50 rural hospitals have closed and nearly 300 more rural hospitals around the country are in danger of closing in 2015.

This year’s walk to DC is even more critical as our state faces many decisions that impact rural health –one of which is whether to repeal NC’s “Certificate of Need/ CON” law to allow for a “free market” and to “reduce costs” associated with accessing health care. However, research has shown that residents in rural communities have fewer resources to pay for health care, so it is unlikely that in a “free market” the need for health care services would go to rural counties where residents are more likely to be uninsured. Thus, there is more likely a duplication of services in urban counties. Further, there is research suggesting that states with CON laws report less hospital inefficiency and can even help reduce the length of stay in emergency departments. This new legislation will create more barriers to accessing quality health care in rural communities.

A second hot topic regarding health care is Medicaid expansion. There are many states that have expanded Medicaid either as outlined in the ACA or that have tailored expansion to meet their state’s needs through waivers. Even though states like Kentucky, West Virginia and Arkansas are seeing health and financial benefits, Gov. McCrory has delayed taking action on this issue until a decision has been made on King v. Burwell by the Supreme Court. The longer lawmakers take on extending health care to 500,000 North Carolinians, the more a financial and health hit our state takes. This is especially true for the rural counties in NC. In Beaufort County, over 1500 individuals would gain access to health care if Medicaid is expanded. However, with the hospital in Belhaven closed, where will the residents go to establish a medical home? Will hardworking residents in our rural counties seek primary and preventative care if there are too many barriers to accessing coordinated care or will they wait for more costly emergency care? Just like repealing or tweaking NC’s CON law, refusing to expand Medicaid affects hospital closures and thus increases health disparities.

If you can, please join Mayor O’Neal and walk for the health of Belhaven and all residents in rural communities whose health is negatively impacted by hospital closures. If you are unable to walk, call our Governor to push for Medicaid expansion and keeping our CON law.

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