Exploring the health care challenges rural Americans face across 5 states

From life expectancy to maternal mortality, Americans living in rural regions face some of the greatest health care challenges in the country.

In a new series called Rural RX, PBS NewsHour correspondent William Brangham and producer Caleb Hellerman of the Global Health Reporting Center work with a team of reporters to explore the forces that shape rural health care in America. Brangham and Hellerman spoke with PBS NewsHour digital anchor Nicole Ellis about what they discovered while reporting from Alabama, Texas, Colorado, New York and West Virginia to better understand how health care works outside of major cities across the U.S.

For Hellerman, Rural Rx begins its reporting in West Virginia for a reason. In towns across the country, Hellerman says, “there is a common thread of people really struggling in terms of access to health care, quality of health care,” and battling social determinants that affect health outcomes for rural Americans. Those outside factors can range from local pollution to food insecurity to lack of health care services. We start the series in West Virginia because I think it epitomizes a lot of these challenges,” Hellerman says. In many health categories, West Virginia ranks dead last. For Brangham, the confluence of factors contributing to West Virginia’s health care crisis demonstrates another common thread in rural areas across the country: there is no “one-size-fits-all,” solution. “You can’t just apply one particular fix to this. It is a whole slew of societal factors that make it very, very difficult,” he explains.

For Brangham, the lionshare of health care, “is about all of the days and weeks and months before you get to a doctor’s office,” which allows you to determine how healthy you are before you need medical services — services that can be exceptionally difficult to access in rural areas. This rang true in West Virginia when a doctor shared that some of his patients had never visited a doctor until they reached their 60s and 70s.

With more segments to come, the series will tackle the effects of poverty, gender, race, class and climate change on health care in rural communities across the country. Hellerman explains “It’s not monochromatic. It’s not people from one certain place or background. I think there’s a lot more diversity in rural America than we usually think of from the perches in the main media centers. And, you know, we wanted to capture that.”

For Brangham, many of the issues facing rural Americans stem from having a market driven health care system. “America is still the center of so much pharmaceutical innovation, medical innovation, new procedures that are designed and developed here in the United States and then get spread around the world.” That innovation, Brangham says, is an undeniable benefit of the U.S. system. “But that market driven system, which has a profit motive embedded into it, also leaves a good deal of people out, resulting in an unclear path towards improving health care for rural Americans Across the country”.

Rural Rx identifies key fissures in America’s health care system, but Hellerman says the series isn’t about doom and gloom, it’s about community. “When we’re out reporting, I think that what you see the most is neighbors helping neighbors,” and the resilience rural Americans demonstrate against all odds.

Explore more of the series here:

Diabetes a major factor behind declining life expectancy in rural areas

Rural healthcare access at risk as public health efforts become politicized

Wider access to Narcan helps rural communities fight overdose deaths

West Virginia doctors work to bridge healthcare gap in rural areas