Kelcy Wiley posted Jun 23, 2021 2:53 Health disparities can exist in several factors which need attention in the US: inequality ofhealth coverage, access to care and quality of care received (Wasserman et al., 2019). There are ways to address each of these for rural areas. Inequality of health coverage may relate to the fact that the US does not have a one-payer system as some European systems incorporate. While the Affordable Care Act has been shown to help with gaining access to care, there has been few studies to show its results with regard to income related inequality. One such study by Wasserman found that states that expanded Medicaid saw a decline in income related inequality (Wasserman et al., 2020). Some clinics offer a sliding fee or for certain incomes, they allow for reduced deductible or even free care through programs operated through the HRSA health center program (Health Center Program Compliance Manual, 2018, Chapter 9). Access to care can be from cultural perspectives, especially in rural settings, some patients may be reluctant to seek care in their community due to seeing their provider as a neighbor, or a friend rather than as a health professional (Douthit et al., 2015). Access to care may also be heavily influenced by lack of transportation as well as lack of internet access for virtual visit technology(Renna et al., 2020). For more rural areas, there may also be a lack of services available: lack of imaging facilities, lack of primary care clinics and even lack of hospital facilities. While virtual visits have been utilized more with the emergence of Covid 19, some rural communities lack substantial internet resources and one study indicated that one quarter of US households lack access to the internet (Douthit et al., 2015). On a personal note, this author provides care at an FQHC that has a mobile program for mental, dentaland primary care. As providers, we are able to utilize satellite phones/technology for internet access and can chart “in the field” which has revolutionized our migrant health program. References Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural usa. Public Health, 129(6), 611–620. https://doi.org/10.1016/j.puhe.2015.04.001 Health Center Program Compliance Manual (Last Updated August 20, 2018). (2018). HRSA.https://bphc.hrsa.gov/programrequirements/compliancemanual/chapter-9.html Renna, F., Kosteas, V. D., & Dinkar, K. (2020). Inequality in health insurance coverage before and after theaffordable care act. Health Economics, 30(2), 384–402. https://doi.org/10.1002/hec.4195 Wasserman, J., Palmer, R. C., Gomez, M. M., Berzon, R., Ibrahim, S. A., & Ayanian, J. Z. (2019). Advancing health services research to eliminate health care disparities. American Journal of Public Health,109(S1), S64–S69. https://doi.org/10.2105/ajph.2018.304922 Reply to Thread