New report explores barriers to health care access in rural Ohio

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Ohioans living in rural, Appalachian counties are dying early at a higher rate than the rest of the state, according to a new report. 

Early deaths (under 75) have increased statewide in the past decade. Per 100,000, there were 378 early deaths in Ohio between 2008-2010 and 454 between 2019-2021. There were 428 early deaths in rural Appalachia from 2008-2010 and 527 from 2019-2021. 

The Health Policy Institute of Ohio recently published a report titled “Health in rural and Appalachian Ohio.” They used the county types developed for the Ohio Rural Health Improvement Plan.  

“The health of rural and Appalachian Ohioans matters for the health of the state overall,” said Hailey Akah, vice president of operations and strategy for Health Policy Institute of Ohio. “One thing that’s really clear from the data is that access to health care is a significant challenge in rural parts of our state.”

The report shows how people in rural areas experience barriers to health care — from lack of broadband access to transportation.

Nearly one-fifth (18%) of households in rural Appalachia had no access to the internet from 2018-2022. 14% of rural non-Appalachian households also had no access to the internet compared to 12% of Ohio. 

The Ohio Capital Journal reported last year that about 75% of people and about a third of households in Ohio’s 32 Appalachian counties don’t have access to the Federal Communications Commission’s bare minimum internet speed. 

Ohioans living in rural Appalachia were more likely to live in a zero-vehicle household between 2018-2022 — 8% compared to 7% overall in Ohio. 

“We know that in order for Ohioans to reach their full health potential, Ohio communities need timely and affordable access to care as well as reliable transportation, employment opportunities and other community conditions that support health,” Akah said.

While most people in rural areas have health insurance, there are fewer health care providers per capita in Ohio’s rural counties. In 2021, there 42 primary care providers per 100,000 in rural counties compared to the statewide average of 75. 

There were 41 dental providers per 100,000 in rural Ohio counties in 2022 compared to 65 for the state. The Ohio Capital Journal reported last year that 10 of Ohio’s Appalachian counties have less than 10 dentists. 

Last year, there were 236 mental health providers in rural counties — 100 fewer than Ohio overall.   

School based health centers that provide health care services to students and their families at school can be a helpful way for people in rural areas to access care, Akah said.

Increased support for federally qualified health centers is another thing that would help people in rural areas, she said. FQHCs provide primary care services in underserved communities in Ohio. 

The number of people who died from a drug overdose or suicide was higher in rural Appalachia in 2023 (59 per 100,000) than Ohio overall (53 per 100,000). 

A quarter of rural Appalachian adults smoked in 2021 — higher than Ohio’s overall percentage (19%). 

Poverty rates were higher in rural Appalachian counties. 17% of rural Appalachians’ income in the last 12 months was below the federal poverty level in 2018-2022. Ohio’s overall was 13%.

Follow OCJ Reporter Megan Henry on X.