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BPC Poll Shows 46 Percent of Rural Iowans Agree Access to Medical Specialists and Quality of Care is a Problem

Headshot of Joann Donnellan
Joann Donnellan

Washington, D.C. – While presidential candidates crisscross Iowa talking about their rural policy proposals, a recent national poll by the Bipartisan Policy Center and American Heart Association shows a majority of Americans, both Democrats and Republicans, consider access to health care in rural communities an important issue. Additionally, 60 percent of voters think it is so important, they would vote for a candidate in the 2020 election who made rural health a priority in the election.

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“We are pleased to see that our poll shows rural health is an issue of concern for rural, urban, and suburban Americans, and transcends political parties,” said former Senate Majority Leader Tom Daschle, BPC Rural Health Task Force co-chair. “Rural health has never been a top tier issue on the campaign trail. However, these findings show that it could be a powerful topic in the 2020 election. It should prompt every candidate and policymaker to address the challenges of rural health and take action.”

Members of BPC’s new Rural Health Task Force are in Des Moines today hosting a special event at UnityPoint Health with Sen. Chuck Grassley (R-IA), local physicians, patients, and hospital and rural health clinic leaders, to discuss the barriers and opportunities to securing quality healthcare in rural areas. The task force will produce policy recommendations to help improve the health and health care of the 60 million Americans living in rural communities.

“Iowans from rural communities often tell me about the challenges they face in accessing quality health care,” said Grassley. “Ensuring that everyone living in remote areas of the state is able to receive the health services they need is a priority. I’ve worked for more than 25 years to improve rural access to care, and events like today’s are vital to staying apprised of new challenges and identifying solutions. I want to thank UnityPoint and the Bipartisan Policy Center for hosting this event and for their commitment to helping residents of rural communities in Iowa and throughout the nation get the quality care they need and deserve.”

“We are thrilled to host Senator Grassley and the Bipartisan Policy Center to discuss access to health care services, a topic top of mind to our rural communities,” said Sue Thompson, senior vice president of integration and optimization at UnityPoint Health. “Rural Iowa is changing, and our systems of care need to evolve along with it.”

Statistics from the Centers for Disease Control and Prevention show those living in rural areas face a greater risk of dying from heart disease, cancer, stroke, and chronic lower respiratory disease. They also face greater challenges in accessing high-quality healthcare than those living in urban and suburban areas.

Since 2010, more than 100 rural hospitals have closed in the United States, and an additional 647 are at risk of folding, including 17 in Iowa.  As hospitals continue to close, residents often travel long distances for health services. Nearly half (46 percent) of the rural Iowans polled for the survey said they believe that access to medical specialists such as cardiologists, oncologists, and gynecologists was a problem in their community, as was access to quality healthcare generally.

“These communities face alarming rates of hospital closures, health care worker shortages, and geographic challenges to getting timely care compared to those living in urban areas,” said Marilyn Serafini, BPC health project director. “We need to create a rural health system that best suits the needs of the local community and ensures its residents have access to affordable, quality care.”

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 3 in 5 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-six percent of rural adults in Iowa agree that access to medical specialists, and quality healthcare are problems in their communities.
  • Forty-seven percent of rural voters agree quality health care is a challenge in their community compared to 34 percent of non-rural voters.
  • A majority of rural adults in Iowa agree the cost of health care (71 percent) and cost of prescription drugs (67 percent) are barriers to accessing medical services or treatment.
  • 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.

Read Survey Details

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 StatesThe 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.

BPC’s Rural Health Task Force is co-chaired by former Sens. Tom Daschle of South Dakota and Olympia Snowe of Maine; and former Govs. Ronnie Musgrove of Mississippi and Tommy Thompson of Wisconsin. Task force members include: Georges Benjamin, executive director, American Public Health Association, and former secretary, Maryland Department of Health and Mental Hygiene; David Blair, chairman, Accountable Health Solutions; former Rep. Henry Bonilla of Texas; former Sen. Kent Conrad of North Dakota; Karen DeSalvo, M.D., BPC fellow, and former acting assistant secretary of health and national coordinator for Health Information Technology at HHS; former Sen. Bill Frist, M.D.; 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; 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.

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