Volume XIII | Issue 2 | Fall 2012
Involving young people in health-care educational programs is one way to promote health-care careers in rural areas. Photo: Mercy Medical Center

Keeping health care close to home

Rural communities face challenges in providing health care locally

In the early 1990s, a group of residents in Condon began exploring the idea of establishing an assisted-living center. The facilities nearest to Condon, the seat of the northeastern Oregon county of Gilliam, were more than a hundred miles away in Pendleton.

A vigorous fund-raising campaign resulted in the opening in 1995 of the Summit Springs Village, an assisted-living center that provides a home and activities for 23 elderly residents. “The basic idea was for local people to be able to keep their family members local when it came time for that type of facility,” says Cindy Hess, managing director of the center, which is organized as a nonprofit corporation.

It is no wonder physicians may not choose to live in a rural area

But Summit Springs offers much more than that — it also provides an opportunity for employment in a remote area where jobs are scarce. Two years ago, the center expanded by adding an eight-room specialized wing for memory care patients. Today, Summit Springs employs about 30 people. That makes it the largest private employer in southern Gilliam County.

Health-care facilities in rural areas are both a necessity for the good health of residents, and, as Summit Springs illustrates, a boon for the local economy. 

The health-care sector is, in fact, one of the top three employers in rural Oregon and Northern California communities. In Oregon’s rural counties, the percentage of jobs related to health care range from 0.36 percent in Sherman County to a high of 15 percent in Wasco County. In Coos and Jackson counties, these jobs constitute 14 percent of the total county labor market; 13 percent in Lane, Josephine and Deschutes counties; and 12 percent in Douglas County.


But rural areas face significant challenges when it comes to establishing these facilities, from building the necessary infrastructure to attracting and retaining the health-care professionals necessary to staff them. Consider this: About 20 percent of the U.S. population—more than 50 million people—live in rural areas, but only 9 percent of the nation’s physicians practice there. Shortages of skilled health-care workers are projected to worsen in the next decade. Rural areas, which traditionally have a harder time with attraction and retention than their urban counterparts, will feel the pinch even more.

The Oregon Healthcare Workforce Institute reports that health-care workforce shortages may not only impact access to care, but also may affect state and county economies and have an indirect effect on local businesses. Every health-care dollar that leaves a community is one less dollar supporting the local economy.

One critical aspect of the health-care conundrum that is often overlooked is a community’s ability to attract health-care professionals. “We have a health-care crisis in our country, and it’s exaggerated in the rural areas for a variety of reasons: lower median income, limited resources and fewer primary care providers,” says Chris Guastaferro, executive director of the Area Health Education Center of Southwest Oregon. “With the continued increasing workloads of clinics and small health systems in rural areas, along with the given disparity in lifetime compensation and student debt loads, it is no wonder future physicians may not choose to live in a rural area.”

A recent rural health-care study commissioned by The Ford Family Foundation recommends that rural communities develop a structured method to assess community needs, identify their strengths, and address their weaknesses in the critical areas of recruitment and retention. 

Partnerships are one way that rural communities can address these recommendations and improve rural health status and economic vitality. For example, the Area Health Education Center of Southwest Oregon (an affiliate of Oregon Health & Science University) has formed collaborations in Southwest Oregon with 14 hospitals, 12 rural clinics, and eight universities and colleges. 

Health-care education

Among its efforts to improve the health of people in Southwest Oregon, the center has worked to add a new health-care education coordinator or supplement an existing one at each area hospital. The goal is to promote health-care careers in schools and the community. Mercy Medical Center in Roseburg has piloted four health-care programs that were developed by the center: a teen volunteer program, an internship program, Diagnosis Day and a summer health-care career camp.

“Once communities graft these programs into their schools and health-care communities, they become a launching pad for potential job growth in the health-care-career pipeline and catalyze incredible student energy,” says Guastaferro.

From creating jobs and boosting economies to providing family members with care close to home, keeping health care local promotes a healthy environment on many levels.

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