County Health Rankings Expose Rural Maryland Health Disparities

Lack of local primary care doctors and specialty treatment services in conjunction with high poverty and unemployment rates contribute to communities in rural Maryland to be ranked the least healthiest in the state according to the national 2014 County Health Rankings. As reported on Capital News Service:

In the national 2014 County Health Rankings released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, five of the 10 least healthy jurisdictions in Maryland are considered partially or completely rural by federal standards. Three others in the bottom 10 — Allegany, Cecil and Wicomico counties — fall under the state’s broader definition of rural.

The annual rankings, released in March, are based on health outcomes that incorporate the length and quality of life for residents of each jurisdiction.

In rural Caroline County, which ranks second-to-last in health outcomes, ahead of only Baltimore City, life expectancy is seven years shorter than in top-ranked suburban Montgomery County, according to the most recent Maryland Vital Statistics Annual Report, released by the Department of Health and Mental Hygiene in 2012.

Rural health experts and advocates link the disparities to the scarcity of health care providers in rural areas and the decreased access to care that is a result.

The ratio of primary care providers to residents in Caroline County is 1-to-2,915, according to the Department of Health and Mental Hygiene. That ratio, the worst in the state, amounts to just 11 primary care providers for the entire county.

Maryland as whole has one primary care provider for every 1,647 residents.

While rural Talbot County boasts the best ratio, with 35 primary care providers lending the jurisdiction a rate of 1-to-1,056, six of the 10 worst ratios belong to federally designated rural counties. Caroline, Somerset, Dorchester and Garrett counties — all rural — hold the bottom four spots.

The article further notes that an increase in newly insured Maryland residents through the federal Affordable Care Act will increase demand in these disparate rural locations. Advocates in turn are pushing for incentive programs to entice providers to practice in these rural areas and aggressive educational campaigns to inform residents of the health services available to them.

“Having insurance is not the only thing that’s needed to have access to care,” [Dr Claudia] Baquet said. “You have to have the providers, the physicians, the nurse practitioners. You have to have the facilities.”

For more information, read the full article on Capital News Service.

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