Healthcare Inaccessibility in Rural Indiana: A Scoping Review

Abstract

The majority of Indiana residents live in rural areas and suffer from significantly lower access to healthcare than their urban counterparts, leading to decreased longevity and in many cases a lower quality of life. The challenges faced among this cohort include generally poor health, high poverty rates, geographical impediments, healthcare worker shortages, and great distances to healthcare facilities. As poor health among rural residents drives higher demand for healthcare, the low number of practitioners in rural areas are unable to cope with patient needs. At the same time, access to reliable transportation prevents many from gaining access to healthcare facilities. Based on a literature review, including published academic, state, national, and governmental articles regarding disparities between urban and rural healthcare access in Indiana, this study explores the general health conditions of rural Indiana residents, disparities in healthcare worker and healthcare facility access among rural and urban Indiana populations, and an assessment of many proposed solutions. Although some solutions have resulted in incremental improvements, most have yet to yield meaningful results. The most promising recommendations for lasting improved access to healthcare for rural Indiana residents involve rapidly increasing the number of healthcare workers and facilities through the expansion of mid-level provider roles, including nurse practitioners and physician assistants, to augment physician care. Concurrently, increasing awareness of the availability of healthcare by these types of providers will result in improved access and better health for patients.