Ohio’s rural health care access gap can seem more like a chasm, but that’s not stopping people from trying to fill it, often by thinking creatively.
In interviews by The Dispatch across Ohio’s rural health landscape, the phrase “getting creative” popped up dozens of times to describe the ways rural health advocates must approach getting rural communities access.
Hundreds of thousands of rural Ohioans live in some form of a health care desert, a geographic area where health needs can go partially or completely unmet due to a lack of facilities and providers, transportation barriers, high costs and more.
While urban health care deserts also exist, for years, health outcomes and mortality rates for rural communities in Ohio have been in many ways worse than their urban counterparts, according to the Health Policy Institute of Ohio. The solutions or the means to implement them often differ from urban counterparts, too.
Here’s a look at how some health systems, organizations and local residents are “getting creative” to ensure health care access for their communities.
Meeting people where they are
The largest barriers to health in rural communities are time and transportation. While many families have cars, driving times to access basic care like dental and primary doctors can be upward of an hour, depending on where you are in the state.
Some rural counties have fewer than 20 state medical board-registered physicians to serve tens of thousands of people.
So, in a full-size RV, outfitted with lab equipment, two exam rooms, medicine storage and even a small reception area, Adena Health’s mobile clinic takes care of the schools in the Chillicothe community and surrounding counties.
While they primarily serve students to help with colds, the flu, ear infections, physicals and more, they also see plenty of faculty and parents seeking care at some point in the school day. The ease of access to care at a place where the community gathers daily means healthier kids and fewer missed school days, said Matt Unger, Adena Local Schools superintendent.
In partnership with Nationwide Children’s Hospital, Adena Health plans to open five school-based clinics later this year. Like the current mobile clinic, patients will be billed through insurance, though options are available for those who don’t have insurance.
Nationwide Children’s has spearheaded the school-based clinic model for years, offering primary care services, mental health counseling, asthma therapy care, vision care, dental care and more in dozens of schools across the state.
“Schools are often providing other wraparound services. When you can provide health care, you can also be talking with the school social worker, or the school nurse, the teacher,” said Mary Kay Irwin, senior director of School Health Services at Nationwide Children’s “So when a patient comes to the doctor’s office at a school and we find out that maybe there’s some challenges with stable housing, or access to food is a challenge, then we can work with the school and the resources that they provide to connect those families.”
Finding funding in unlikely places
In urban areas, hospitals and medical services are primarily financed through private insurance or government programs, private donations and the patient population. It’s roughly the same model for rural areas, but because fewer people have private insurance in these areas, and simply fewer people, some systems have had to seek alternate methods of funding to pay for health care.
In October 2024, Marietta-based Memorial Health System broke ground in Belpre on the first-ever women and children’s hospital in southeastern Ohio. Funding came from donations, a partnership with Akron Children’s Hospital and a whopping $30 million from the state.
More:Ohio is investing $30 million into a rural, Appalachian hospital. Here’s why
State funding of that size for a hospital is unprecedented in Ohio, not just due to the amount, but to the state making room in the budget for a hospital at all. Once it’s completed, women and children in southeastern Ohio will have specialized care closer than 50 miles away for the first time.
On a smaller, local level, the M&M Fire Department of Morgan County, located in McConnelsville, hosts barbeques, pancake breakfasts and gun raffles to help keep their ambulances running for all 14,000-plus residents. In a county with no state medical board-registered physicians, their emergency services team is often the first line of primary care.
While the department gets money from various city and county tax levies, it’s often not enough. Over the past few years, the levy hasn’t gone up, but costs have. Prior to the COVID-19 pandemic, a second-hand ambulance may have cost around $80,000. Now, it could be upward of $200,000, not to mention all the medical equipment that has to go inside it.
While pinching pennies is a common pastime for the department, the emergency services team is grateful for a supportive community.
“It takes a lot of people, and the more people you can get to do it, the better you are,” Fire Chief and McConnelsville Mayor John W. Finley said. “Without that team effort, it won’t work.”
Samantha Hendrickson is The Dispatch’s medical business and health care reporter. She can be reached at [email protected]
This is by no means a comprehensive list of the ways organizations are helping bridge the gap in rural health care. This is also not the last story The Dispatch will write about rural health care. If you have story tips, ways your organization or community is helping rural health infrastructure, or questions, please reach out.
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