Addressing Barriers and Improving Access to Cancer Screenings in Rural America
Many factors, including where a person lives, have a direct impact on their health and quality of life. More than 46 million Americans live in rural areas. Unlike urban residents, people living in rural communities are more likely to have lower incomes, higher poverty rates, and less access to health services, leading to significant health disparities. Two conditions where these disparities are present are in the leading types of cancer: breast and lung cancer.
Cancer Rates and Screening
Rural health disparities in cancer are particularly stark as reports show that there are higher death rates in rural areas when compared to nonmetropolitan urban and metropolitan counties. This difference in death rates is also shown to be increasing over time, as advances in treatment are not benefiting populations equally. Cancer death rates have decreased at a rate of 1.6% in urban America compared to only 1% in rural America, a statistically significant rate according to researchers. It is also important to note that people of color and of minority backgrounds have even poorer health outcomes and lower rates of cancer screenings.
While rural residents have risk factors making them more susceptible to lung cancer such as higher rates of smoking and obesity, there are also significant and growing challenges in access to care, including the fact that between 2010 and 2021, 136 rural hospitals closed. The closure of hospitals is of particular concern when looking at breast cancer rates as mammography services are less available after a hospital closure, in addition to follow-up services in cancer care. Over 50% of the women who lived in rural areas in 28 states report they do not have easy access to mammograms.
Screening and early detection are key to cancer survival, as people who’s breast cancer is detected at an early stage have a 93% or higher survival rate in the first five years, highlighting why the lack of access to screening is of such great concern in rural communities. In fact, only 5.6% of the country’s oncologists provide care in rural areas, resulting in patients delaying care or having to commute long distances to seek treatment.
Initiatives to Address Cancer Screenings in Rural America
Investing in mobile health clinics (MHC) can increase access to cancer screening services. MHCs can come in many forms, but overall, they are a customized motor vehicle that travels to communities to provide a myriad of healthcare services. MHCs provide urgent care, preventative health screenings, and initiate chronic disease management. The MHCs are set up at convenient and familiar locations within the community, contributing to an increase in trust among patients and the healthcare sector.
MHCs are less costly than a regular health clinic – with a return on investment of $22 to $1. Furthermore, studies show that the implementation of MHCs results in a decrease in 600 visits to the emergency department. For example, within its first year one MHC in Tennessee and Georgia visited 104 sites and screened over 500 patients that otherwise likely wouldn’t have been screened.
In October 2022, President Biden signed the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act. This bipartisan law allows a health center that currently receives funding through a Health Resources & Services Administration Health Center Program grant to use and set up mobile health clinics regardless if there is a permanent health care delivery site. The new program will be implemented in 2024.