Poor Rural Communities Need More Access To Health Information

Main Category: Public Health
Article Date: 14 May 2008 - 5:00 PDT

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Residents of low-income, rural communities need better access to health information and health care, finds a new study that focuses on one of the poorest counties in South Carolina.

"We found that lack of economic advantages and lack of availability of health care resources are the most pressing problems in Allendale County," said study co-author Lillian Trettin of the Medical University of South Carolina Library in Charleston.

Seventy-one percent of Allendale County residents are African-American and about 71 percent over age 25 have a high school education or less.

"The county supports few doctors and dentists, so making local appointments becomes difficult. And since few doctors will accept Medicaid, low-income people have even fewer choices," Trettin said.

The study appears in the May issue of the Journal of Health Care for the Poor and Underserved.

From 2004 to 2006, the researchers collaborated with community leaders and regional health professionals to conduct the study. Local students surveyed residents to learn which kinds of health services they needed and how they preferred to receive health information. They collected 513 completed surveys (about 5.5 percent of the total county population of 11,000).

Cancer was highest among health concerns, followed by diabetes. HIV/AIDS also ranked high, especially in young adults.

Twenty percent of residents said they considered transportation a problem to get to a medical office, and 16 percent said they visited the hospital emergency room routinely for care.

The authors also found that although nearly 60 percent of the respondents used the Internet, more than 40 percent said they used it "only rarely" as a resource for health information.

"This finding did surprise us somewhat since national rates of people using the Internet for health information is higher," Trettin said. "However, people in rural communities have had less experience finding these resources. They are unlikely to have reliable Internet access and seldom have high-speed access."

Over the three-year study period, 454 Allendale residents participated in a series of 12 workshops. These events included Internet training sessions, and workshops on major health problems (diabetes, cancer, heart disease), prenatal healthcare and HIV screening.

The authors concluded that the outreach effort was successful in reaching targeted audiences and that partners in the county will continue it.

Michael E. Samuels, a scholar in rural health policy at the University of Kentucky College of Medicine in Lexington, expressed some concerns about the study, for example, how information was gathered. The students conducted the surveys in public places like local grocery stores and on post office grounds.

"I wonder about the interviewing sites that might have biased the study away from those with serious health problems and those who lack access to transportation," he said. "I also felt that the researchers were in the mode of bringing what they thought the community needed. It did not appear, despite the committee, that there was a real attempt to listen to the community."

Samuels added, however, that he does "applaud the efforts of the researchers and believe that the interaction between community and academia can benefit both."

McKeehan N, Trettin L, May J. Improving access to health information in rural South Carolina. Journal of Health Care for the Poor and Underserved 19(X2), 2008.

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