While I mentioned previously that I am not Pennsylvania-born, I have lived in PA most of my life and have made it my home. Also, as someone who has traveled across much of this country, I can say definitively that the countryside in our region is one of the most beautiful landscapes in the US.
That being said, when it comes to healthy living, Pennsylvania is not without its challenges. While Pennsylvania enjoys a robust healthcare infrastructure in its cities, residents of rural communities often face unique challenges that contribute to significant health disparities.
To most outsiders, Pennsylvania consists of Philadelphia and Pittsburgh, with nothing in between. But for those lucky enough to live in the other 90% of the state, it is farmland and vegetable stands, hiking trails, and fishing streams. It is everything country living should be and more. The problem is that people living in rural communities still need the same access to healthcare as those in urban areas, and we just aren’t getting it.
Major cities can boast numerous hospitals, specialty clinics, and a much higher ratio of primary care providers to residents. In addition, people living in cities have greater proximity to academic medical centers and advanced healthcare technology. Conversely, rural communities face a major shortage of healthcare professionals, including doctors, nurses, mental health providers, and dentists. The closure of rural hospitals due to financial strain has increased travel times for residents seeking care, sometimes forcing them to drive for hours for basic medical services. This has also created areas known as deserts for services such as maternal care and other specialties. Limited public transportation is another factor that has exacerbated these challenges, especially for the elderly and those with chronic conditions.
Health data consistently reveals that rural Pennsylvanians experience higher rates of chronic diseases such as heart disease, diabetes, and obesity compared to their urban counterparts. Factors contributing to these outcomes include limited preventive care, delayed diagnosis due to lack of nearby facilities, and higher rates of poverty and unemployment. While urban areas face their own health challenges, they generally offer more and better public health programs that promote early detection and management of chronic illnesses.
Mental health is another major concern for people living in rural Pennsylvania, as anyone who has ever tried to find a provider knows. This severe shortage of mental health professionals has led to long wait times and very limited treatment options. Also, stigma surrounding mental illness is often greater in small towns, discouraging individuals from seeking help. In addition, urban areas also benefit from greater integration of mental health care within primary care settings, improving early intervention and outcomes.
Another subject that I have often written about is the social determinants of health. These include income, education, employment, and housing, and they play a pivotal role in shaping health disparities. Rural Pennsylvania deals with higher rates of poverty, lower educational attainment, and fewer employment opportunities. These factors contribute to food insecurity, lower-quality housing, and limited access to health-promoting resources, such as nutritious foods and recreational facilities. Urban areas may also experience poverty and housing insecurity; however, they offer more food banks, better public transportation, and more community programs that help offset these challenges.
The opioid crisis is another health issue that has hit rural Pennsylvania especially hard. The combination of economic decline, limited access to addiction treatment, and high rates of prescription opioid use has led to increased overdose deaths in rural counties.
Rural mothers and children also face distinct challenges, including fewer prenatal care providers and limited access to pediatric services. Rural hospitals often lack specialized maternity units, forcing expectant mothers to travel long distances for delivery and care. This can lead to higher rates of maternal and infant mortality, premature births, and complications.
So, what can be done? One possible solution to bridge the healthcare gap is telemedicine. By leveraging technology, rural patients can consult with specialists, receive follow-up care, and access mental health services remotely. However, disparities in broadband internet access and digital literacy remain obstacles to widespread adoption in some rural areas.
Another possible solution to addressing health disparities in rural communities may be to coordinate policy efforts and community engagement among state and federal programs. Some of these programs have aimed to bolster rural healthcare by funding critical access hospitals, expanding Medicaid, and incentivizing healthcare providers to serve rural communities. In addition, community organizations play a vital role in providing outreach, education, and support services tailored to local needs.
Innovative solutions such as mobile clinics, school-based health centers, and collaborative partnerships between urban and rural providers are helping to narrow the gap. However, sustained investment and attention are necessary to ensure equitable health outcomes for all Pennsylvanians.
By leveraging existing technology and strengthening public and private health initiatives, healthcare providers and social service professionals can make a difference in communities. As individuals, we can also make a huge impact by making a concerted effort to eat well and stay active. These efforts would include eating whole foods, particularly food grown locally and in season. Staying active can include walking as much as possible, strength training at any age, and working outside often, among other things, as all of these activities support healthy minds, bodies, and spirits. In the end, public health is everyone’s responsibility.
