Rural healthcare a challenge in Alabama
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Bridging the Divide
Chuck Bradley
Think about this, 55 out of 67 of Alabama’s counties are considered rural; 42.3% of the entire Alabama population lives in rural areas.
The average percentage of uninsured Alabama residents aged 18 to 64 who live in rural areas is 16.4%, compared to 14.1% of residents who live in urban areas.
There are less than 54 rural county hospitals that serve residents in 42 out of the 55 rural counties in Alabama with less than 15 rural counties in Alabama having labor and delivery units, resulting in 28% of women in Alabama having no birthing hospital within 30 minutes of their residence. In rural areas throughout Alabama, 89.8% of women live more than 30 minutes from a birthing hospital compared to 26% of women living in urban areas.
The average response time from call to arrival to the scene for the state is less than 7 minutes. The average response time for urban counties is 0-5 minutes, and the average response time for rural counties is 11-15 minutes. However, it can take up to 30 minutes for some rural counties such as Perry and Clarke. Coosa County is fortunate to have an awesome volunteer ambulance service, as well as a county-wide ambulance service.
In rural counties, there are 3.2 dentists per 10,000 residents, compared to 5.5 dentists per 10,000 residents in urban counties in Alabama. Alabama currently has three counties (Coosa, Greene and Lowndes) with no full-time dentists in the entire county.
Hospitals in rural Alabama counties where available have 21.4 general hospital beds per 10,000 residents compared to 34.6 general hospital beds per 10,000 residents in urban counties.
Life expectancy at birth for rural Alabamians is one-half of a year lower than that for urban Alabama residents and 3-and-a-half years lower than that for the nation. Life expectancy for residents of Wilcox County is 9 years lower than that for the nation.
More than one in every five rural residents is eligible for Medicaid. Nearly one half (47%) of all rural children are eligible for Medicaid. There are 14 rural counties in Alabama that have between 10 and 16% of all households with no vehicle.
Only two of Alabama’s 54 rural counties (Coffee and Pike) are not entirely or partially classified as primary care shortage areas.
There are 4.1 primary care physicians per 10,000 population in Alabama’s rural counties compared to 7.9 for urban residents.
All of Alabama’s 54 rural counties are classified as dental shortage areas for the delivery of service to the low-income population. Only Shelby County and a portion of Madison County are not currently classified as dental care shortage areas.
Coosa does not have a practicing physician in the entire county.
All of Alabama’s 54 rural counties are classified as mental health care shortage areas for providing mental health care to the entire or low-income populations. Only Madison County is not currently classified as a mental health care shortage area.
In 1980, 45 of Alabama’s 54 rural counties had hospitals providing obstetrical service. Today less than 16 of the 54 counties offer this basic service.
In 1980, 10 of the 12 Black Belt Region counties had hospitals providing obstetrical service. Today only one still offers this service.
More than one-fourth of all births to rural Alabama women involve mothers who received less than adequate prenatal care during their pregnancy. Thirteen rural Alabama counties do not have a dialysis clinic. Many rural counties like Cleburne, Coosa, Henry, Lamar, Lowndes, Macon, and Perry, and others do not have a hospital.
Having healthy population growth is a basic requirement for attracting and keeping adequate health care services. Between 1910 and 2010, 24 of Alabama’s 54 rural counties actually lost population.
Looking ahead, 39 of the 54 rural counties and two of the 13 urban counties are projected to lose population between 2010 and 2040.
Obesity is a major risk factor for numerous serious health conditions. There are 10 rural Alabama counties with between 40 and 49% of the adult population being obese, which may contribute to the mortality rate for rural Alabama residents being more than 10% higher than that for urban residents.
The chronic lower respiratory diseases mortality rate for rural Alabama residents is nearly 38% higher than that for urban residents and nearly 57% higher than that for the nation.
It is crucial that rebuilding health care in rural Alabama and rural America must be a top priority for every level of government.
Please send your questions or comments to bradleychuck92@gmail.com.