One in four rural households report being unable to get medical care for serious problems, due to the pandemic, according to a new poll from NPR, the Robert Wood Johnson Foundation and Harvard.



Americans living in rural areas have been struggling to get medical care during the pandemic. All the trouble of people in cities like canceled surgeries and trouble finding a test are multiplied by scarce resources and long distances of travel. People describe their concerns in a poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. Here's NPR's Will Stone.

WILL STONE, BYLINE: Even when there isn't a pandemic, finding the right doctor can be tough in eastern Ohio, where Reid Davis and his mother Crystal live. From their home, you can see hayfields and just a few neighbors.

REID DAVIS: It's a very small town, quite a few farms around. The nearest hospital, you're talking about 50 minutes to an hour.

STONE: Reid is 21 and helps out his mother, who has severe rheumatoid arthritis. When the pandemic began, her local doctor, a specialist, stopped seeing patients.

DAVIS: Literally just went, I'm not doing any in-person sessions. I will renew prescriptions and that's about it.

STONE: This was hard, Davis says, because the doctor would also do work on her swollen, inflamed joints to help relieve pain. And without that, over time, her condition got worse.

DAVIS: There have been days where she's just been unwilling to get out of bed because of pain.

STONE: They looked around for other specialists, but Davis says there were only three within a two-hour drive. None were accepting new patients. It was about six months until she could get back to her own doctor again. What happened to the Davis family is emblematic of what many in rural America have had to cope with this year. In fact, the NPR poll found 1 in every 4 rural households reported being unable to get medical care for serious problems. Of those families, more than half suffered negative health consequences as a result.

MARY GORSKI FINDLING: Which to us is really staggering. And, you know, that includes a third of rural households with chronic illnesses.

STONE: That's Mary Gorski Findling, a Harvard researcher who worked on the poll.

FINDLING: There's a very large number of rural households at risk at this point, and we haven't figured out a better way to provide care for them.

STONE: The most common reasons people reported missing out on care? They could not get appointments, find the right doctors, afford the care or physically get there. Rural Americans aren't alone with these challenges, but they are especially vulnerable. Brock Slabach is with the National Rural Health Association. He says the pandemic has hit these areas after years of hospital closures and a declining health care workforce.

BROCK SLABACH: Really widening the fractures that have already existed in rural communities.

STONE: That includes the Internet. NPR's poll found a third of rural households have serious problems even getting online.

SLABACH: Many of our rural citizens are older, poorer and sicker. And so they don't have iPads. They don't have the necessary means, perhaps, to communicate. Secondly, broadband is an issue.

STONE: More doctors are seeing patients in person again. But the wait can be long because there aren't enough providers to deal with the backlog. Unfortunately for Stephen McDonald, waiting has cost him. McDonald, who lives in a rural part of Montana, was between root canal appointments when the pandemic started. Then, his local dentist canceled the second visit. McDonald had to get by with the temporary filling.

STEPHEN MCDONALD: During that period of waiting, my tooth cracked.

STONE: McDonald had to go to another dentist an hour away, who took out part of the cracked tooth.

MCDONALD: Because of the procedures they had to follow for COVID, they weren't able to extract the rest of the tooth, so I had to go to an oral surgeon.

STONE: And the challenges of getting health care also make it harder for rural Americans to even get help with the coronavirus. When Sunshine Peebles got sick earlier this year, she suspected it might be COVID.

SUNSHINE PEEBLES: There's a lot of people who have access to free testing. Where I am right now in upstate New York, that's not an option.

STONE: She doesn't have health insurance either, and her family's construction business was shut down because of the pandemic. So she was hesitant to spend money on health care, including a COVID test.

PEEBLES: I should have gone a little sooner. I did wait a few days and then I just couldn't wait any longer. I had to go to an urgent care.

STONE: She paid out of pocket, $150. Luckily, the test came back negative. Will Stone, NPR News. Transcript provided by NPR, Copyright NPR.