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Column

Bustos: Three steps to strengthen America’s rural public health

Cheri Bustos
Cheri Bustos

An untenable situation has been simmering for decades in rural America. With the emergence of COVID-19, it threatens to boil over. 

This virus has begun to ravage our rural communities. In the congressional district I serve, Warren County has the fifth-highest number of cases per capita within Illinois, despite the fact that it has a population of roughly 17,000. In Stephenson County, the case rate doubles every 3.5 days. It has a population of 44,000.

COVID-19 knows no borders and disregards the term “rural-urban divide.” It simply attacks. And right now, our rural communities face unique health care challenges that have the potential to further exacerbate the impact of the virus. They are especially vulnerable.

The district I serve represents the heart of rural and small town America. Spanning 14 counties and 7,000 square miles across northwest and central Illinois, 85%of our towns are 5,000 people or fewer, while 60% are 1,000 people or fewer. Many of our communities face a shortage of health care access, longer wait times for care and other challenges. 

Drive times to see a doctor can be a burden for medical care. Shortages of health care specialists can mean entire communities have little or no access to some emergency care.

Many rural hospitals have few beds and patient-to-clinician ratios are concerning. In 2017, Henderson County had a patient-to-clinician ratio of nearly 7,000 patients per provider. Compare that to Cook County, which has a patient-to-clinician ratio of 1,200 to one.

The recent suspension of elective surgeries, although now lifted, has meant the loss of critical hospital income used to keep a tight operating budget afloat. 

That income loss has meant that some hospitals are even laying off staff. I heard from one rural hospital in my district that has been forced to furlough medical personnel. That means fewer staff who can help patients – but it also means that those people who are furloughed now will struggle to make ends meet and put food on the table for their families. 

A shortage of medical specialists, stressed patient-to-clinician ratios and a bleeding bottom line – this is the current situation many rural hospitals find themselves in.

These problems are the result of decades of underinvesting in rural health care, but with the consequences of COVID-19, they’re coming to a devastating head.

Last year, I introduced the bipartisan Rural America Health Corps Act alongside Sen. Dick Durbin and Congressmen Phil Roe and David Kustoff. To encourage America’s doctors, nurse practitioners and other medical professionals to bring their services to rural areas, my bill would create a $25 million program to offer student loan repayment, expand current Health Corps placements and provide funding for up to 5 years to assist with recruitment and retention efforts.

I also introduced the Social Determinants Accelerator Act, which aims to address the social factors that can impact our ability to lead healthy lives, such as health provider shortages, long drive times and loss of services. It would provide up to $25 million in grants and require that at least 20 percent of these grants be awarded to rural communities. 

Finally, I recently partnered with Congressman Lloyd Doggett and Congresswoman Susan Wild to introduce legislation that would open a special COVID-19 enrollment period under the Affordable Care Act. This bill would re-open the ACA marketplace in light of the pandemic, removing barriers to health care and allowing more people to become covered as we all grapple with the current crisis.

Those are my three steps to strengthen America’s rural public health. 

It is critical we take these steps to strengthen our health care infrastructure and address vulnerabilities within the very system meant to serve people. 

Recently, I raised the issue of rural health in a Congressional Appropriations Committee hearing with former director of the Centers for Disease Control and Prevention, Dr. Tom Freiden. He spoke to the importance of acting strategically – right now – to prevent future public health disasters. 

His opener noted, “We’re just at the beginning of this pandemic.” 

If there’s one lesson we have learned from this virus, it’s that the health of our nation depends on the health of our people – and that we cannot afford to wait. Now is the time to invest in our rural health.

U.S. Rep Cheri Bustos, D-East Moline, represents the 17th Congressional District, which covers Carroll, Fulton, Henderson, Henry, Jo Daviess, Knox, Mercer, Rock Island, Stephenson, Warren and Whiteside counties, and parts of Peoria, Tazewell and Winnebago counties.

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