A Tale of Two Worlds: Urban vs. Rural Medical Care


The difference between urban and rural living is something of an “apples to oranges” comparison. Day-to-day life can differ tremendously, and there are critical circumstances that highlight the disparity. Chief among them is healthcare.

In study after study and survey after survey, the story remains the same: Rural populations don’t have the same access to quality medical care as their urban counterparts.

Rural healthcare by the numbers

Decades of research reveals rural residents receive a different standard of medical care than urban populations. From accessibility and affordability to quality of care and ultimate patient outcomes, rural populations statistically and consistently end up with notable disadvantages.

According to one extensive study from Georgetown University, conducted in the late 1990s and early 2000s:

  • 19% of rural residents under age 65 are uninsured, and 25% of those have been uninsured for 3-plus years.
  • Rural residents pay roughly 29% of their medical costs out of pocket.
  • Fewer than 11% of physicians in the United States practice in rural areas.
  • The provider-to-patient ratio in rural areas, at 1:3500, significantly exceeds the recommended 1:2000.

These figures are nearly 25 years old, but they draw attention to problems that persist today, despite being well known and well understood at the highest levels of both government and healthcare.

In 2020, the Centers for Medicare and Medicaid Services published a report detailing the quantifiable disparities between rural and urban healthcare and the obstacles that prevent equalizing them. The 202-page report concludes accessibility is paramount and quality of care is essential — and both hinge on advances in medical technology.

Gaps are growing

Infrastructure plays a critical role in perpetuating healthcare disparities in rural areas. Lack of reliable high-speed internet, for instance, reduces the opportunities for mobile and virtual solutions (e.g., telemedicine) to bridge gaps. One 2018 study examined how a lack of internet access even affects healthcare decision making: “There may be structural barriers that make it harder for rural residents to access health information, especially those with limited health literacy.”

But infrastructure is just one of several key systemic gaps hindering rural healthcare. Delivery of care, qualified medical staff, census-based budgets, financial insecurity, and specialty care or equipment access are just some of the barriers to consistent, high-quality healthcare in rural areas. Barriers frequently stem from disproportionate evaluation standards, such as census population data. A rural hospital may receive less funding support than an urban one because of census demand — and despite serving an equal population over a larger area.

It is unrealistic to judge rural healthcare by urban metrics and standards, but these flawed comparisons continue to contribute to growing gaps in quality and availability of care.

Bridging the gaps

How can rural providers improve accessibility and deliver a higher standard of care to rural patient populations? The answer lies in medical technology and the digitization of healthcare.

Lack of access to information can have detrimental effects on a patient’s decision to seek proactive screening, but technology, like Electronic Health Records (EHR), can offer patients a direct connection to their health information, access to test results, and physician insights and recommendations. By digitizing information and removing accessibility barriers, EHR helps to create fairer, more equal conditions for everyone.

There’s still a long way to go in bridging the gap in healthcare accessibility and quality between rural and urban populations, but there are positive forces making significant progress. Innovations in medical technology, such as integrated EHR, are at the forefront of healthcare equity.