A vast majority of Americans, both Democrats and Republicans, consider access to health care in rural communities an important issue, according to a new poll released by the Bipartisan Policy Center (BPC) and the American Heart Association (AHA).

At the same time, people in rural communities say they have difficulty getting quality health care due to a lack of available medical facilities, a shortage of doctors and other factors.

The issue is so important in the minds of voters that it could play a significant role in the 2020 election, with three in five surveyed saying they would vote for a candidate in the 2020 election who prioritized rural health in the campaign.

The BPC and AHA called this finding “encouraging.”

60 million people at risk

Some 60 million Americans living in rural communities. Statistics from the Centers for Disease Control and Prevention show that they are at a greater risk of dying from heart disease, cancer, stroke, and chronic lower respiratory disease. These communities also face alarming rates of hospital closures, health care worker shortages, and geographic challenges to getting timely care compared to those living in urban areas.

The survey, conducted by Morning Consult, polled nearly 2,000 registered voters online, including an additional 200 interviews with rural adults in each of the following states that will play an important role in the 2020 election: Iowa, North Carolina, and Texas.

Among the findings:

• Ninety-two percent of Democratic voters and 93 percent of Republican voters agree that access to health care in rural communities is important; and three in five voters say they would be more likely to vote for a candidate in the 2020 election who prioritized access to health care in rural America.
• More than half of rural voters (54 percent) say access to medical specialists, such as cardiologists or oncologists, is a problem in their local community compared to 33 percent of voters in non-rural areas, and more than one-quarter (27 percent), say it is difficult to access behavioral health professionals, compared to 16 percent of non-rural voters.
• Forty-seven percent of rural voters agree quality health care is a challenge in their community compared to 34 percent of non-rural voters.
• Rural voters are more likely than urban and suburban voters to agree that availability of appointments (56 vs. 50 percent) and the distance to receive care (50 vs. 37 percent) are barriers.
• One in five rural voters in Texas say it is difficult to access hospitals, urgent care facilities, primary care physicians, and medical specialists in their local community. Since 2010, 17 hospitals have closed in Texas.
• One in three rural adults in North Carolina and 46 percent in Iowa agree that access to medical specialists and quality health care are problems in their communities.
• Rural adults in Iowa, North Carolina, and Texas felt most comfortable using information technologies to reach their doctor or to receive medical care remotely, and half of rural adults in Texas said they are likely to use a “mobile app” if it were available to them.

“Timely access to quality care can mean the difference between life and death for someone suffering from a major cardiac event or stroke,” said Eduardo Sanchez, chief medical officer for prevention at the AHA.

“Addressing the barriers to delivering high-quality health care to rural communities is long overdue,” said Walter Panzirer, a trustee of the Helmsley Charitable Trust. “It’s time to give rural health care the national attention it deserves.”

Over the next year, BPC’s rural health task force will build on BPC’s 2018 report, Reinventing Rural Health Care: A Case Study of Seven Upper Midwest States. The report identified key areas for reform that could apply nationally to all rural communities: 1) allow rural communities to adjust their own health care services to better fit the community’s needs, 2) create appropriate payment models and value-based care programs that account for low patient volumes, and a reliance on Medicare and Medicaid, 3) build and retain the rural workforce, and 4) expand telemedicine services.

Task force members include: David Blair, chairman, Accountable Health Solutions; former Rep. Henry Bonilla of Texas; former Sen. Kent Conrad of North Dakota; Georges Benjamin, executive director, American Public Health Association, and former secretary, Maryland Department of Health and Mental Hygiene; Chris Jennings, BPC fellow and founder and president, Jennings Policy Strategies; Jennifer McKay, M.D., medical information officer, Avera Health; Keith Mueller, director, Rural Policy Research Institute Center for Rural Health Policy Analysis; Karen Murphy, former Pennsylvania secretary of health; Ronnie Musgrove, former governor of Mississippi; former Rep. Tom Tauke of Iowa; and Gail Wilensky, senior fellow, Project Hope, and former administrator of the Health Care Financing Administration (now CMS) under President George H.W. Bush.

This work is supported by The Leona M. and Harry B. Helmsley Charitable Trust.