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HealthConnections: Rural Health Access


Last year, a study from the Tennessee Health Care Campaign found that more than one fourth of Tennessee’s rural counties have no hospitals. The report found that 75% of Tennessee’s 25 essential access rural hospitals are at high risk of closure in the next few years. This week on HealthConnections, Dr. Carole Myers, a professor emeritus in the University of Tennessee College of Nursing, talks with Martin Vargas, the executive director at St. Mary’s Legacy Clinic, a mobile health clinic that provides primary care services to uninsured individuals for no cost in East Tennessee. You can find more information about St. Mary's Legacy Clinic here.

WUOT’s Carole Myers: Rural Tennesseans lag behind other Tennesseans in regards to access to healthcare and hospital services and health outcomes. Today, we will focus on Scott County, one of the seven rural underserved counties where St. Mary’s Legacy Clinic provides services. Please describe access and health challenges faced by Scott County residents.

Martin Vargas: There are three primary problems faced by Scott County residents. First is access. The second is affordability and the third is the social determinants of health. Tennessee has seen at least 16 hospital closures, 13 of them were rural, since 2010. That places us in the leading second position for hospital closures in the nation. Next is 97% of Tennessee’s residents don’t have access to primary care or it’s difficult. When you’re in a rural environment, you’ve got travel to deal with and things along those lines that prevent access so it is a tough environment from an access perspective. The other thing that challenges everybody these days is affordability. 124,000 Tennesseans can’t afford insurance and I mean they don’t have money to qualify for the Medicare and Medicaid programs out there so it is definitely a challenge for them. So, that leaves 13%, roughly, of Scott County’s residents uninsured. It’s tough to find a doctor when you have insurance and it’s even harder if you don’t. In Scott County, the level of income, educational attainment and job opportunities impact health and the outcomes of health. That’s where we come in. Some of the services we provide in Scott County are missing in the local environment. Access to good healthcare, primary healthcare, and that’s the void that we fill at St. Mary’s Legacy Clinic.

Let’s talk more about that. So, we have a county with a high uninsured rate and some other challenges. How is it that you address these challenges and bring primary care services to people in Scott County?

We do it through a ‘it takes a village’ approach. We bring in and recruit from the local community a wide network of folks to solve this problem because no one person can do it. How do we do it? We come up with a mobile clinic. It’s 40-foot-long. If you picture an RV built like a tank. It comes out and levels out. All the people come out and get the supplies ready. We start seeing patients and get them their primary care they need and we do it at a cost of nothing. Cost of care is free for the uninsured.

So, are there other healthcare providers or specialty providers or social services that work with the St. Mary’s Legacy Clinic?

Yes, there are many great providers in Scott County who are among one of them. We work with Ridgeview who work with mental health and they just acquired a mobile unit. So, we have what’s called a healthcare village that will come out to our site at the pregnancy center partner and you’ll sometimes see Ridgeview there or you’ll see Workforce Development which is key. We have a jobs bus that you can get into and do your resume. They have computers and people to help you. So, they overcome all the different challenges you may have in a one-stop-shop environment. So, it truly does take a village and the great partners that we have there.

Martin, how can our listeners and various community groups and counties support your efforts to improve access to healthcare and improve healthcare outcomes?

The number one way, if you are personally uninsured and you hear this message, is simply call us and we can help you meet your healthcare needs where you’re at at a cost of zero.

This transcript has been lightly edited for content.

Greg joined WUOT in 2007, first as operations director and now as assistant director/director of programming. His duties range from analyzing audience data to helping clear WUOT’s satellite dish of snow and ice. Greg started in public radio in 2000 in Shreveport, La., at Red River Radio and was, prior to coming WUOT, at WYSO in Dayton, Ohio, where he also was director of programming and operations.