Rural areas in New York are grappling with a severe deficit of healthcare professionals.
The New York State Comptroller's Office has issued a report in August 2023, highlighting the shortage of healthcare providers in rural counties across the state. The report reveals that approximately 27% of residents in these areas are on Medicaid, and some counties, such as Hamilton County, have no dentists at all.
To address this growing crisis, several measures are being proposed. These include workforce development and recruitment incentives, expanding transportation access, strengthening rural healthcare facilities, and adopting a systemic and multi-professional approach.
Workforce development and recruitment incentives aim to increase the number of healthcare professionals in rural areas by expanding loan forgiveness programs and other incentives. However, recent federal policy changes have made some loan forgiveness less effective.
Improving transportation linkages is another proposed solution to help patients access care despite long distances and limited public transit options in rural areas.
Strengthening rural healthcare facilities is critical, as many operate on tight margins or at a loss. Efforts to stabilize their finances could prevent closures that would worsen shortages.
Given the shortage spans primary care, dental health, mental health, and specialty providers like pediatricians and OBGYNs, a comprehensive approach to workforce development and access tailored to rural community needs is necessary.
The New York State Comptroller's report emphasizes that addressing healthcare gaps in rural counties will not only improve health outcomes but could also create jobs and strengthen rural economies.
These proposals are designed considering the unique challenges of rural healthcare, such as low population density, limited broadband availability, and transportation barriers.
Pediatric care is particularly scarce, with only 0.5 pediatricians per 10,000 residents in rural areas. The report found that rural areas have just 4 primary care doctors per 10,000 people, less than half the state average. For OB/GYNs, the ratio is 0.4 per 10,000 residents, meaning women often travel long distances for maternal care.
In some rural counties, there are no pediatricians or OB/GYNs at all. Every one of the 16 counties is designated a Mental Health Shortage Area. The average number of nurse practitioners in rural counties is 10.5 per 10,000 people, which is below the state level.
Dentist access is equally dire in rural counties, with an average of 3.6 dentists per 10,000 people, compared to 8.3 statewide. The average number of physician assistants in rural counties is 4.2 per 10,000 people, which is also below the state level.
Six rural hospitals in New York are among the top 10% nationally for Medicaid reliance. Across the board, the number of healthcare providers in rural areas falls well below state and national averages.
Mental health services are in the worst shape in rural areas, with only 6.9 practitioners per 10,000 residents, far short of the state average of 16.1. The report reviewed healthcare access across 16 rural counties and found that basic care is not available in some places.
Five other rural hospitals in New York have posted losses for three straight years. Another fix suggested is offering more rural-specific training and loan forgiveness to attract and retain healthcare workers. Most loan forgiveness programs are geared toward nonprofit or public sector work, which may not always reach rural clinics.
The report's findings underscore the urgent need for action to address the rural healthcare crisis in New York. The proposed measures, while not exhaustive, represent a step towards addressing the unique challenges faced by rural healthcare providers and patients.
- The report suggests workforce development and recruitment incentives to increase healthcare professionals in rural areas.
- Limited broadband availability is one of the unique challenges faced by rural healthcare.
- Mental health services are in worse shape in rural areas, with significantly fewer practitioners available.
- Improving transportation linkages could help patients access care in rural areas with limited public transit options.
- Rural areas have fewer primary care doctors compared to the state average, with only 4 per 10,000 people.
- Rural hospitals often depend heavily on Medicaid funding, as six rural hospitals in New York are among the top 10% nationally for Medicaid reliance.
- Solving the rural healthcare crisis in New York will not only improve health outcomes but also create jobs and strengthen rural economies.
- Loan forgiveness programs are being expanded to increase the number of healthcare professionals in rural areas.
- One of the reasons rural clinics may not be reached by existing loan forgiveness programs is that most are aimed at nonprofit or public sector work.
- The report found that rural areas have just 0.5 pediatricians per 10,000 residents, making pediatric care especially scarce.
- Healthcare access is insufficient in some rural places, as the review found in the 16 counties.
- Adopting a systemic and multi-professional approach is necessary to address the shortage in primary care, dental health, mental health, and specialty providers like pediatricians and OBGYNs.
- The average number of nurse practitioners in rural counties is below the state level, with 10.5 per 10,000 people.
- Rural healthcare facilities are often operating on tight margins or at a loss, and efforts to stabilize their finances are crucial.
- The report emphasizes the urgent need for action to address the rural healthcare crisis in New York, proposing measures that represent a step towards addressing the unique challenges.
- In some rural counties, there are no pediatricians or OB/GYNs at all, making it difficult for women to receive maternal care.
- The report reviewed eye health, hearing, respiratory conditions, digestive health, cardiovascular health, neurological disorders, skin conditions, and other medical conditions in rural areas.
- Supporting online education and self-development can contribute to skill-building and career development, which are essential for personal growth and success in various sectors like politics, policy-and-legislation, and job-search.
