Rural Women in Minnesota Face Obstacles to Health Care

Andy Birkey

In Minnesota, lack of health insurance, lack of clinics, and factors like poverty, geographic isolation and even extreme winters all reduce rural women's access to health care.

Women living in rural Minnesota face poor health outcomes according
to a report released by Planned Parenthood of Minnesota, North Dakota
and South Dakota (PPMNS) on Wednesday. A lack of health insurance and
clinics, along with factors like poverty, geographic isolation and even
Minnesota’s extreme winters all impact the ability of rural women to
access health care. The organization says that as Congress debates
health care reform, the needs of rural women must be addressed.

“The data gathered by experts on the state and national level show
what [Planned Parenthood] knows firsthand — that rural women are more
likely to live in poverty, more likely to be uninsured or underinsured,
and more likely to have limited health care resources available than
are their urban counterparts,” said Sarah Stoesz, president of PPMNS.

In Minnesota, one in four women live in non-metropolitan areas, a
rate higher than states that are traditionally seen as rural, such as
Alabama, Texas and Utah. Forty percent of Minnesotans live in areas
where there is no access to primary health clinics.

Getting to a health care clinic 100 miles away in the dead of winter
can be a challenge in Minnesota. “Minnesota’s severe weather, coupled
with limited public transportation options and rural roads in
disrepair, can make accessing health care nearly impossible for rural
residents,” the report said.

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While Planned Parenthood serves low-income patients — statewide, 50
percent of patients are living in poverty — among clinics in greater
Minnesota, 63 percent are below the poverty line. At the Planned Parent
clinic in Thief River Falls, 75 percent of patients were living below
the poverty line and at Willmar clinic that number was 61 percent.

Only 3 percent of Minnesotans accessing care at Planned Parenthood’s
rural clinics could afford the care they received and half had no
health insurance. In Moorhead, 54 percent of patients lacked health
insurance; among Duluth residents, 53 percent were uninsured, and in
St. Cloud, 49 percent had no health insurance.

Due to these factors, rural women in Minnesota are 30 percent more
likely to be diagnosed with invasive cervical cancer than those living
in urban and suburban areas. Forty-three of Minnesota’s counties have
higher rates of teen pregnancy than the state average and all but two
are in greater Minnesota. While rates of gonorrhea infections among
women remained stable in urban and suburban areas, rural Minnesota was
the only place where state officials saw in increase in cases.

Rural women also have higher rates of obesity, mental illness and suicide, nicotine addiction and substance abuse.

“Geography and economic status should not determine a woman’s health
or her fate,” said Stoesz. “The demand for health care is urgent and
the value of prevention, the cornerstone of Planned Parenthood
services, is self-evident.”

Stoesz is urging Congress to include rural women’s needs,
particularly those around reproductive health, as it debates health
care reform. The group identifies three priorities to improve health
for rural women: Access to affordable health care services for all
women, including comprehensive reproductive health care, regardless of
income; coverage for basic, preventive health care services that
specifically impact women; and protections for trusted safety net
providers on whom women depend for their care, particularly given the
shortage of primary care providers in rural communities.

“The benefits of preventive care outweigh the costs from a public
health perspective and a fiscal perspective,” Kathi Di Nicola, director
of communications for PPMNS, told the Minnesota Independent. “For every
dollar invested in preventive reproductive health care, over $5 is
saved in the subsequent cost of unintended pregnancy.”

More than 90 percent of PPMNS’ patients in greater Minnesota are
women, and they access the organizations services for a variety of
reasons including reproductive health services and general health
services such as diabetes screening and cholesterol checks.

While they haven’t necessarily seen an increase in patients during
the recession, Di Nicola says they have seen “an uptick in patients
saying they’ve just lost their jobs and insurance and are returning to
us for care.”

In a press release accompanying the report, Stoesz urged local and
national leaders not to overlook the health needs of rural women as the
debate surrounding health reform intensifies.

“Improving the health status of rural women will require health
systems that adequately consider and respond to the unique needs of
rural women. As the nation discusses various models of health care
reform, it is essential that any emerging proposals comprehensively
address the complex needs faced by rural Minnesotans,” Stoesz wrote.

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