Report: Many rural women in Minnesota lack access to basic health care

Photo: Dobak, Flickr

Women living in rural Minnesota face poor health outcomes according to a report released by Planned Parenthood of Minnesota, North Dakota and South Dakota (PPMNS) on Wednesday. A lack of health insurance and clinics, along with factors like poverty, geographic isolation and even Minnesota’s extreme winters all impact the ability of rural women to access health care. The organization says that as Congress debates health care reform, the needs of rural women must be addressed.

“The data gathered by experts on the state and national level show what [Planned Parenthood] knows firsthand — that rural women are more likely to live in poverty, more likely to be uninsured or underinsured, and more likely to have limited health care resources available than are their urban counterparts,” said Sarah Stoesz, president of PPMNS.

In Minnesota, one in four women live in non-metropolitan areas, a rate higher than states that are traditionally seen as rural, such as Alabama, Texas and Utah. Forty percent of Minnesotans live in areas where there is no access to primary health clinics.

Getting to a health care clinic 100 miles away in the dead of winter can be a challenge in Minnesota. “Minnesota’s severe weather, coupled with limited public transportation options and rural roads in disrepair, can make accessing health care nearly impossible for rural residents,” the report said.

While Planned Parenthood serves low-income patients — statewide, 50 percent of patients are living in poverty — among clinics in greater Minnesota, 63 percent are below the poverty line. At the Planned Parent clinic in Thief River Falls, 75 percent of patients were living below the poverty line and at Willmar clinic that number was 61 percent.

Only 3 percent of Minnesotans accessing care at Planned Parenthood’s rural clinics could afford the care they received and half had no health insurance. In Moorhead, 54 percent of patients lacked health insurance; among Duluth residents, 53 percent were uninsured, and in St. Cloud, 49 percent had no health insurance.

Due to these factors, rural women in Minnesota are 30 percent more likely to be diagnosed with invasive cervical cancer than those living in urban and suburban areas. Forty-three of Minnesota’s counties have higher rates of teen pregnancy than the state average and all but two are in greater Minnesota. While rates of gonorrhea infections among women remained stable in urban and suburban areas, rural Minnesota was the only place where state officials saw in increase in cases.

Rural women also have higher rates of obesity, mental illness and suicide, nicotine addiction and substance abuse.

“Geography and economic status should not determine a woman’s health or her fate,” said Stoesz. “The demand for health care is urgent and the value of prevention, the cornerstone of Planned Parenthood services, is self-evident.”

Stoesz is urging Congress to include rural women’s needs, particularly those around reproductive health, as it debates health care reform. The group identifies three priorities to improve health for rural women: Access to affordable health care services for all women, including comprehensive reproductive health care, regardless of income; coverage for basic, preventive health care services that specifically impact women; and protections for trusted safety net providers on whom women depend for their care, particularly given the shortage of primary care providers in rural communities.

“The benefits of preventive care outweigh the costs from a public health perspective and a fiscal perspective,” Kathi Di Nicola, director of communications for PPMNS, told the Minnesota Independent. “For every dollar invested in preventive reproductive health care, over $5 is saved in the subsequent cost of unintended pregnancy.”

More than 90 percent of PPMNS’ patients in greater Minnesota are women, and they access the organizations services for a variety of reasons including reproductive health services and general health services such as diabetes screening and cholesterol checks.

While they haven’t necessarily seen an increase in patients during the recession, Di Nicola says they have seen “an uptick in patients saying they’ve just lost their jobs and insurance and are returning to us for care.”

In a press release accompanying the report, Stoesz urged local and national leaders not to overlook the health needs of rural women as the debate surrounding health reform intensifies.

“Improving the health status of rural women will require health systems that adequately consider and respond to the unique needs of rural women. As the nation discusses various models of health care reform, it is essential that any emerging proposals comprehensively address the complex needs faced by rural Minnesotans,” Stoesz wrote.