OPINION | Rural disparities


Every summer I head to the Boundary Waters to recharge my batteries and refresh my soul. This is a sacred time and space for me, with the natural beauties of Minnesota, integral to what I call home. They are as integral to my health as are the world-renowned, cutting edge medical services available here.

Even as I enjoy the outdoors in my home state and access to top-notch care, I am acutely aware of the many, many Minnesota women who do not. Especially rural women. I am reminded of this every day by our patients, the 64,000 people who turn to Planned Parenthood annually for affordable family planning services and basic gynecological care.

Most are women who live at or below 50 percent of the federal poverty level. More than half live in rural Minnesota, where the percentage of those in poverty jumps to 63 percent. Just one in three has public insurance, and one in five has private insurance. Only 3 percent can afford the full cost of their health care.

Rural women experience far greater risks to their health-simply because of where they live. Their income disparities, combined with a shortage of primary-care providers in rural Minnesota, have some dire health outcomes. For example:

• Rural women are 30 percent more likely than urban women to be diagnosed with invasive cervical cancer. They are less likely to receive recommended, preventive gynecological care, including mammograms, Pap tests, and colorectal screening.

• Teen pregnancy is endemic in rural Minnesota: 43 counties have teen pregnancy rates higher than the state average; all but two of these counties are in rural Minnesota.

•The greatest increases in the rates of sexually transmitted infections continue to occur in rural Minnesota.

National health-care reform represents the greatest single hope of eliminating these disparities. In my opinion, the Patient Protection and Affordable Care Act is the greatest advancement in women’s health since Medicare and Medicaid were signed into law nearly 45 years ago.

The reforms covered under this act will extend coverage to millions of women and families, guarantee access to cervical and breast cancer screenings, prohibit gender discrimination by private insurers and expand family planning services under Medicaid. The act also will provide funding for scholarships and loan repayment for primary care practitioners who work in rural areas. Rural hospitals will get the reimbursements they need to offer quality care and keep their doors open. Small rural businesses will get tax credits to provide more affordable insurance coverage to employees.

That’s the kind of place where I want to live. And that’s where I want all Minnesotans to live.

Sarah Stoesz is the president and CEO of 
Planned Parenthood of Minnesota, North Dakota, South Dakota. www.ppmns.org

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