 RURAL HEALTH CARE
Wyoming is a frontier state, where just over 509,000 people (according to the 2006 US Census estimates) live in 97,100 square miles. It is currently the least populated state in the US, with fewer people than even the District of Columbia. The land is high desert, criss-crossed with mountain ranges; its elevations range from 3,099 to 13,804 feet above sea level. The mean elevation is 6,700 above sea level, ranking Wyoming second highest among the 50 states. The climate is relatively cold with a normal daily mean temperature of 45.6 degrees Fahrenheit, and Wyoming records the highest average wind speed (12.9 miles per hour) of all fifty states. Although Wyoming ranked 15th in per capita income and had the highest percentage income growth of any state in 2004-2005, the estimated gross state product in 2004 ranked 48th in the nation, higher only than Vermont and North Dakota.
Like other rural/frontier populations, Wyoming’s citizens continually face problems in accessing quality health care and health education. It is well known that, relative to urban populations, rural residents generally fare worse on many key indicators of population health.[1] They have higher rates of premature and infant mortality, as well as higher death rates from unintentional injuries, suicide, chronic obstructive pulmonary disease, and cancer. They are more likely to smoke, be obese, and be arrested for driving under the influence of alcohol.
Health care accessibility is particularly problematic in Wyoming, where distance, geography, inclement weather, and isolated communities all present challenges for the state’s residents in gaining access to health care. Rural residents typically need to travel two to three times farther to see medical and surgical specialists than their urban counterparts.[2] Traveling long distances to access health care services is routine for many of Wyoming’s residents, and they often seek needed care in neighboring states because it is unavailable within the state.
CARE PROVIDER SHORTAGES IN WYOMING
A major contributor to this problem is the lack of primary care providers in the state. According to the 2006 Census estimates, Wyoming is ranked forty-fifth among the fifty states in physicians per 100,000 population,. The population dispersion in the state makes it difficult to achieve the economy of scale necessary to support adequate primary care. Nine of the state’s twenty-three counties qualify in their entirety as Health Professional Shortage Areas for primary care, while six other counties contain primary care shortage areas (http://bhpr.hrsa.gov/shortage/). A 2006 survey by the Wyoming Survey and Analysis Center (http://www.uwyo.edu/wysac) found that a majority of health care facilities in the state suffer from staffing shortages, most notably physicians and registered nurses (38% and 40% of positions in these professions, respectively, were found to be open). As rural residents tend to rely heavily on care from internists and family practice physicians, this lack of access is a particular problem in Wyoming.
Specialty care is also difficult to obtain within the state. Wyoming ranks 50th among the states in the overall number of medical specialists per 100,000 population. [3] The state also ranks well below the national average in providers per 100,000 population for several individual specialty areas, including cardiology, dermatology, gastroenterology, internal medicine, neurology, OB/GYN, and pediatrics. Access to mental health care is a particular problem in Wyoming, as it is in many other rural/frontier states . All twenty-three Wyoming counties qualify as Mental Health Professional Shortage Areas, and specialists in mental health are extremely scarce. Furthermore, the majority of mental health professionals are located in the larger cities in the state, so ssuch services are generally not available to residents in smaller communities or rural areas.
PROJECTS
The CRHRE is involved in a number of projects related to improving access to health care for Wyoming’s residents, particularly those in small, remote communities. These projects are listed under the “Projects” link in the column to the right.
RESOURCES
For more information on rural health care, including links to Web sites and various other resources, click on the “Topic Resources” link in the column to the right.
References
1 Eberhardt MS, Pamuk ER (2004). The importance of place of residence: examining health in rural and nonrural areas. American Journal of Public Health 94(10).
2 Chan L, Hart LG, Goodman DC (2006). Geographic access to health care for rural Medicare beneficiaries. Journal of Rural Health 22(2).
3 Larson EH et al. (2003). State of the Health Workforce in Rural America: Profiles and Comparisons. WWAMI Rural Health Research Center, University of Washington, Seattle USA.
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