The United States economy can be incredibly resilient, but it is not immune to failure. Like any complex economic system, it remains susceptible to a number of internal and external factors that can influence its performance, ranging from geopolitical events to monetary and fiscal policy. This year, we’re experiencing economic deceleration, mostly characterized by increasing consumer prices (U.S. Bureau of Labor Statistics). While difficult to predict, we may be heading toward a period of economic stagnation.

Economic stagnation is known as a period where economic output is declining, the stock market experiences no booms, and wages do not increase (Team, T. I.). When growth and development come to a standstill in certain areas, the associated economic challenges can have effects in various sectors, including healthcare. Rural areas already experience difficulty with healthcare access, and a period of stagnation may worsen this concern.

Rural areas are more prone to what are known as “healthcare deserts,” where there is a physician shortage and a lack of a formal healthcare infrastructure (Dougherty). Part of the lack of established healthcare is the lack of customers - smaller populations in rural areas means that healthcare facilities struggle to be sustainable. In turn, this results in 77% of rural residents not being able to consistently or easily access healthcare (Dougherty). This shortage of accessible physicians in rural areas will only be worsened by a period of economic stagnation.

Causes and Effects of Rural Stagnation

Rural areas are especially at risk of economic stagnation due to limited economic opportunities, population decline, and higher levels of poverty (AEDE). The greater rate of poverty and the smaller populations results in a lack of strong public infrastructure, which then results in less economic investment in the area. Financial investment is much lower because companies will not receive as much return on their investments in a rural area that lacks infrastructure, including healthcare systems and providers, as compared to more economically active areas like New York or Boston. A cycle of less economic opportunity is perpetuated in these rural regions, and it can only be worsened by stagnation.

As a result of these smaller, more distanced populations and a lower number of economic opportunities, rural healthcare workers are hard to attract and retain. Because of the existing rural physician shortage, healthcare workers that do situate themselves in a rural area experience an incredibly challenging workload without proper staffing (Miller, 2023). Many physicians also raise concerns about the lack of career advancement in rural opportunities, causing them to seek employment in more populated regions.

The medical care deserts in turn create critical and dangerous holes in available hospital services, especially for at-risk populations such as expecting mothers and those with a chronic condition. The shortage of healthcare services also can make it incredibly difficult to respond to traumas and emergencies at a quick enough pace, as the distance someone may have to travel to reach a medical facility might be too far (Noy, 2022). Many rural areas are spread out by poorly maintained roads due to little public infrastructure investment, and this can be a serious challenge for emergency transport to reach patients in dire need (Medicore, 2023). There is also a lack of established public transport, which makes it extremely difficult for potential patients to seek non-emergent care year-round. The effects of rural stagnation creates a challenging environment for residents in these areas. Declining industries and limited job opportunities hinder the development of healthcare infrastructure, which has significant implications for the well-being of rural communities. It’s apparent that comprehensive solutions and investments must be investigated to combat rural stagnation and the resulting presence of healthcare deserts.

Novel Interventions for Rural Healthcare Deserts

Many physicians and policyworkers are seeking to improve healthcare access in these underserved areas. The consistent growth of technology offers promising possibilities for reaching the spread out rural populations. Telehealth, the use of virtual communication to provide medical care, reduces the physician shortage by not requiring all physicians to live in these rural areas in order to serve patients there. Doctors can conduct virtual assessments and provide prescriptions and care instructions for non-life threatening conditions, reducing some of the pressure on rural hospitals and healthcare centers (Horowitz, 2023).

Mobile clinics are also rising in popularity for reaching geographically isolated areas and their residents (Rural Health Info). Smaller scale healthcare services, such as immunizations and screenings, can be conducted in a temporary clinic that can travel with needed medical supplies. While not all medical treatments can be administered in a mobile clinic, residents that are spread out across rural areas will have a much easier time maintaining their health with easier access to disease prevention methods such as vaccines. For example, the North County Health Consortium has helped to improve rural access to dental care with the establishment of their oral mobile clinic, “The Molar Express” (Notchnet). This mobile clinic not only provides dental care, but also serves to educate patients and visitors about dental health and prevention strategies to encourage long-term oral health. Mobile clinics such as The Molar Express show the potential in mobility and portable technology for reaching these previously isolated populations.

Medical schools are also adding opportunities to their curriculum for students to spend time learning and practicing in rural areas. For example, the Oregon Health and Sciences University created a program to send their residents to a general surgery rotation in rural Oregon as a way to expose them to rural medicine (Rural Health Information Hub). Providing opportunities for learning the unique characteristics of rural medicine encourages healthcare providers to consider working in these underserved areas and provides them with the needed education to adapt to the new environment.

Taking a Broader Look at Policy Recommendations

To fully address rural healthcare deserts and stagnation in the long run, policy changes will need to come into play to ensure the sustainability of any implemented strategies. A strong policy recommendation would be for the local and federal governments to increase investments in rural areas, helping to establish strong infrastructure and provide jobs to end the common cycle of poverty. Improvement of communication abilities, transportation routes, and other currently lacking elements that would better connect rural areas with their surroundings would enhance physician attraction and retainment to minimize the desert.

To reduce stagnation itself, there should also be political support for the rural workforce and rural workplace development. By boosting rural industries with increased investments and job opportunities, policymakers can encourage greater consumer spending and give the rural economies a jump. Economic volatility will not disappear, but its presence and effects on underserved groups such as rural populations can be mitigated to promote the health and well-being of all residents.

Looking Forward

Persistent stagnation, especially in lesser populated areas, only serves to amplify rural healthcare deserts. Consistent access to healthcare is critical for rural communities to ensure long lasting health and the ability to handle medical emergencies. It will take the work of rural community members, policymakers, and willing healthcare providers to combat stagnation and promote health equity across the country. As we move forward, addressing rural stagnation and healthcare deserts must be viewed as a shared responsibility, driven by a collective commitment to ensure the well-being of all citizens, regardless of their geographic location.