Women's Health Frequently Asked Questions
Question: What
are the barriers to health care access for rural women?
Answer:
Problems specific to access to care for women in rural areas include:
- A
higher rate of uninsured and underinsured populations than in urban
areas.
- Higher rates of poverty in rural areas than in urban areas, particularly
among women.
- Access to transportation barriers, such as geographical
isolation, lack of public transportation, and lack of funds for individuals
to
pay for their own mode of transportation. This can disproportionately affect
single women with children responsible for transporting their families.
- Lack of providers, particularly obstetric providers due
to the recruitment and retention problems in rural areas in addition
to malpractice
suits, which make obstetric care particularly expensive and risky for providers.
Question: What
challenges do rural women face related to childbirth?
Answer:
A number of state-based studies have found increased rates in infant
mortality among rural residents as compared to urban residents.
Studies have also shown that the infant mortality rate increases with
rurality. This could be due to a number of reasons, including:
- More
non-metropolitan than suburban women receiving delayed or no prenatal
care, and rural women receiving less adequate care when
it is available. This is a major concern in rural areas as risk
factors for infant death include delayed or no prenatal care, contributing
to a higher rate of infant mortality in rural areas.
- More mothers
under age 20 or over age 40. Teen pregnancy rates are often
higher in rural areas and the population is aging at a disproportional
rate in rural areas as compared to the rest of the United States.
- Low
educational attainment of mother, which is correlated with poverty.
Rural poverty rates have consistently been higher than urban
poverty rates, particularly in persistent poverty areas such as Appalachia,
the Northern Plains states, the Delta region, the Southern Border Region, the Four Corners
area, and Alaska.
- Maternal smoking during pregnancy,
which is higher in rural areas.
- More than three previous births,
which is also related to poverty.
Rising malpractice insurance rates, relatively impoverished populations, lack of facilities, and too few physicians for back-up arrangements may make obstetrical practice in rural places unattractive. Lack of local care means that many women must seek prenatal care and delivery outside of their county of residence. There is some evidence that an increase in distance and travel time to prenatal care decreases the utilization of such care, leading to relatively poor outcomes.
Question: Is
finding quality child care a problem for rural women?
Answer:
Some child care problems for women in rural areas include:
- There are more working
poor in rural America than in urban areas of the country. Concerning
child care, this becomes a major social problem because most families
are either single-parent households or have two parents working to
make ends meet. This leaves children alone and there are few child
care providers in most rural communities.
- Lack of child care providers in rural communities can often be as
much or more of a problem than accessing health care providers.
For more information about rural child care issues, please see the Child
Care information guide.
Question: How
do chronic diseases and cancer impact rural women?
Answer:
Rural areas report higher rates of chronic diseases, including
heart disease and cancer, two diseases that affect women. This
is due to:
- A rural population that is older, poorer, and less educated
than metro populations.
- A lack of provider care in rural communities.
- More rural residents being diagnosed with
cancer in later stages of the disease than urban residents, including
breast and cervical cancer.
- Diabetes—risk of death is more common in women ages 45-64 (CDC).
Chronic illness persists over time, requires ongoing management, and involves major lifestyle changes and adaptations in one's environment. Most recommendations of treatment are difficult because of previously discussed barriers to access in rural areas.
Question: How does mental illness impact rural women?
Answer:
The prevalence of mental illness, in particular depression, in rural areas is high. Access barriers to treatment include lack of mental health providers, lack of transportation, lack of child care, poverty, and lack of health insurance. In addition, chronic depression is widespread among Americans age 65 and older.
Question: Is
there ethnic diversity among rural women?
Answer:
Currently, most women in rural areas identify themselves as
non-Hispanic white. However, population shifts throughout the last decade
have included changes in many communities' racial and ethnic makeup.
Many growing rural counties are also experiencing growth in
the diversity of residents. One source of increasing diversity is the
change
in immigration patterns in response to employment opportunities in rural
areas. Many immigrants, especially Hispanic and Asian immigrants, are
increasingly settling in the rural U.S. In general, minority women tend to be more economically disadvantaged and have poorer health outcomes than corresponding white women.
Question: How
many rural women are elderly?
Answer:
In general, rural areas have a higher
proportion of elderly residents. Increases in age among rural residents results in a largely female population. This trend is most dramatic in
the South and Midwest.
Like younger rural women, elderly women are more likely to suffer from higher rates of poverty, higher rates of chronic illness, less education, and lack of access to health care and transportation. In addition, more elderly women live alone as widows or care for a disabled spouse or family member at home.
Question: How
does poverty impact rural women?
Answer:
Rural areas have higher rates of poverty than urban areas. This disproportionately
affects women and children in rural areas.
- In 2000, the official poverty rate in nonmetropolitan areas was 13.4 percent, compared with 10.8 percent in metropolitan areas.
- The rates of women
in poverty are higher than those of men in rural America and this
dramatically affects the women and children’s
access to health and human services.
Question: How
can health and social services providers work together to help rural
women?
Answer:
The strong relationship between adequate
income, sufficient food, strong social networks and good health necessitates
coordination among various
health care and social service agencies. This coordination is especially
important in rural communities, where services and providers are limited
in numbers. In many rural communities, service providers often make
alliances with one another and exhibit extraordinary resourcefulness
and resilience.
This is also a concern for women as they are often either the sole
providers for their family or in charge of accessing health and social
services
for their children.
Credits
Breast and Cervical Cancer Screening: Is it Reaching Rural and
Rural Minority Women? Southwest Rural Health Research
Center, April 2003.
Last revised 04/21/2009
