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IMA Influences AMA Rural Health Policy
Inequitable rural health trends are alarming—and unacceptable
Dec 13, 2024
By: Andis Robeznieks, Senior News Write
People who live in rural areas of the U.S. are at greater risk of dying from heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke than their urban and suburban counterparts.
Rural residents also tend to be older and sicker and have higher rates of cigarette smoking, obesity and high blood pressure, according to the Centers for Disease Control and Prevention.
“The health trends in rural America are admittedly alarming,” AMA President Bruce A. Scott, MD, wrote in a Leadership Viewpoints column earlier this year.
“Our nation seems to expect that health outcomes will be worse—a lot worse—for people living in small towns, farming and ranching communities, and other places far from city lights and suburban sprawl,” added Dr. Scott. “Rather than accept this status quo, the AMA is working on multiple fronts to reduce these inequities, promote greater access to care, and significantly improve the health of people regardless of ZIP code.”
This commitment to end rural health inequity was demonstrated at the 2024 AMA Interim Meeting in Lake Buena Vista, Florida, where the AMA House of Delegates took several actions aimed at attacking this issue from several different angles.
Adopted at the meeting was a Board of Trustees report addressing shortcomings in a federal program designed to encourage primary care physicians and others to consider practicing in locations designated as health-professional shortage areas (HPSAs).
“Many HPSAs do not seem to receive scores that reflect their actual need and health indicators do not adequately measure health status” of residents, the report says. “These problems can lead to significant negative impacts on underserved populations.”
The potentially inaccurate scores can weaken the effectiveness of a federal program that offers vital scholarships and loan repayment in exchange for a commitment to practice medicine in underserved areas, according to the report, which was spurred by a resolution introduced at last year’s Interim Meeting by the Idaho Medical Association.
Delegates agreed that the actionable changes recommended in the report “can lead the way to better outcomes,” and called on the AMA to:
- Support the Health Resources and Services Administration’s effort to conduct a comprehensive reevaluation and assessment of the effectiveness and equity of the Health Professional Shortage Area scoring criteria to meet the physician-workforce needs of rural communities and underserved areas.
- Urge increased federal and state resources to improve the accuracy of the data used to determine HPSA scoring used by the National Health Service Corps loan repayment program to help meet physician workforce needs for the neediest rural communities and underserved areas.
"The primary care physician shortage is hitting rural areas hard, and it’s projected to get worse,” said AMA Trustee Alexander Ding, MD, MS, MBA. “Rural areas continue to face substantial challenges in getting scores that meet federal thresholds, and we urgently need to increase data accuracy and revamp the scoring system to ensure rural communities have access to health care they desperately need.”
This new policy reinforces the AMA’s long-standing commitment to bolstering rural health care access and follows past calls from the AMA urging Congress (PDF) to raise funding to strengthen the scholarship aspect of the National Health Service Corps loan repayment program.
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