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Lemme tell you about RURAL health.
In 2019 over 62% of all federally designated primary care Health Professional Shortage Areas were in RURAL areas
Yet, MD schools don't accept a lot of rural med students.
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In 2019 over 62% of all federally designated primary care Health Professional Shortage Areas were in RURAL areas
Yet, MD schools don't accept a lot of rural med students.
Short thread 1/
Rural areas compose approximately 20% of US Population, yet only about 4% of Medical School (allopathic MD) students are from rural areas and that number declines every year.
The year I was accepted, 2015, I was one of n=850 rural med students in United States.
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The year I was accepted, 2015, I was one of n=850 rural med students in United States.
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There was n=97 underrepresented in medicine (URM) minority students from RURAL areas accepted into allopathic medical schools in 2017.
Think about that. 97 people of color from RURAL areas were accepted in medical school in 2017. That's a LOW number. NINETY SEVEN!!!!
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Think about that. 97 people of color from RURAL areas were accepted in medical school in 2017. That's a LOW number. NINETY SEVEN!!!!
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"the matriculant pool has dropped more extensively than the applicant pool over time suggesting that there is a growing mismatch between the qualifications of rural applicants and medical schools’ admissions priorities."
Aka: medical schools value "traditional" experiences
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Aka: medical schools value "traditional" experiences
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So why do I care so much about this?
Well, for a few reasons.
1) I come from a rural background. (<5% of med students)
2) I came from the lowest SES quartile (<4.3% of med students)
Health of my family depends on rural physicians. And few people want to work there.
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Well, for a few reasons.
1) I come from a rural background. (<5% of med students)
2) I came from the lowest SES quartile (<4.3% of med students)
Health of my family depends on rural physicians. And few people want to work there.
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We can't escape variation of rural vs. urban health.
"2016 the age-adjusted all-cause mortality rates were higher in rural areas than in urban areas. VA, FA, and CA had the largest rural-urban differences, with rural mortality as much as 30% higher than urban mortality."
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"2016 the age-adjusted all-cause mortality rates were higher in rural areas than in urban areas. VA, FA, and CA had the largest rural-urban differences, with rural mortality as much as 30% higher than urban mortality."
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And even more striking, though not surprising, is that Black and brown people living in rural areas have the highest mortality.
Due to:
1) Lack of access to food
2) Racism
3) Lack of access to healthcare.
Unemployment + lack of food + lack of doctors = mortality.
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Due to:
1) Lack of access to food
2) Racism
3) Lack of access to healthcare.
Unemployment + lack of food + lack of doctors = mortality.
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"Rural counties with a majority of Black or AI/AN residents had elevated rates of premature death based on 2017 data. Those differences can be partially, but not fully, explained by the sociodemographic, economic, and structural characteristics of these communities."
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IMPORTANT: "This analysis also found increased rates of premature death in rural counties with more children and higher unemployment, and lower premature death rates in counties with higher median incomes and more primary care physicians per capita."
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"Only 11 percent of the physician workforce practices in rural communities."
Over past two decades, students interested in rural practice have declined.
Multiple studies have demonstrated that students from rural backgrounds are MUCH more likely to work rurally."
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Over past two decades, students interested in rural practice have declined.
Multiple studies have demonstrated that students from rural backgrounds are MUCH more likely to work rurally."
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Main point: when we accept students from rural backgrounds, they have higher likelihood of practicing in rural areas. This has direct result in health of community and decreases rural area mortality.
So why don't more med schools care about rural students?
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So why don't more med schools care about rural students?
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The barriers to medical school for rural applicants cannot be over-stated. I grew up without internet until high school. The same physician delivered my sister, brother, and I and practices in a two-county area as only PCP. This is 2020 in America for MANY rural places.
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Please, think about WHO is represented in med school. Please consider that DO schools supply many rural apps and then are stigmatized in residency selection. Please consider privilege of medical students.
Rural areas need doctors. But med schools aren't accepting us.
/FIN
Rural areas need doctors. But med schools aren't accepting us.
/FIN
Sources:
1) Decline in Rural Med Students
https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2019.00924
2) Higher US Rural Mortality Rates Linked to SES, Physician Shortages, Lack of Insurance
https://www-healthaffairs-org.ezp3.lib.umn.edu/doi/full/10.1377/hlthaff.2019.00722
3) Rural Counties w/ Majority Black or Indigenous Suffer Highest Death
https://www-healthaffairs-org.ezp3.lib.umn.edu/doi/pdf/10.1377/hlthaff.2019.00847
1) Decline in Rural Med Students
https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2019.00924
2) Higher US Rural Mortality Rates Linked to SES, Physician Shortages, Lack of Insurance
https://www-healthaffairs-org.ezp3.lib.umn.edu/doi/full/10.1377/hlthaff.2019.00722
3) Rural Counties w/ Majority Black or Indigenous Suffer Highest Death
https://www-healthaffairs-org.ezp3.lib.umn.edu/doi/pdf/10.1377/hlthaff.2019.00847
