The United States exhibits the most significant geographic health disparities among developed nations, with rural-urban gaps in health outcomes being less common in Canada, Norway, and the Netherlands, according to a study. Researchers recommend that the US reflect on the health policies of these countries to achieve similar results. Factors contributing to disparities include limited healthcare providers in rural areas and higher rates of chronic illness among rural residents. Access to care is a major challenge in the US, Canada, and Sweden, while the Netherlands excels in care access.
According to a study supported by the Commonwealth Fund, the United States exhibits the most significant geographic health disparities among developed countries. The research, published in JAMA Network Open, highlights notable differences in health outcomes between rural and urban areas.
In contrast, Canada, Norway, and the Netherlands emerged as leading performers in achieving geographic health equity. The study suggests that the US should examine the health policies implemented in these nations to attain similar outcomes domestically.
Geographic health disparities refer to variations in clinical outcomes across different geographic locations within a single country. In the US, such disparities are prevalent due to the scarcity of healthcare providers in rural areas. Moreover, individuals residing in rural regions tend to be older and have a higher prevalence of chronic illnesses.
This study compared the US to ten other similarly developed nations, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the UK. Researchers utilized data from the 2020 Commonwealth Fund International Health Policy (IHP) Survey, which surveyed adults on healthcare experiences across ten indicators in three domains: health status and socioeconomic risk factors, affordability of care, and access to care.
Across all countries analyzed, researchers identified 21 instances of geographic health disparities. Rurality was found to be a protective factor in 13 of those instances, indicating better outcomes for individuals living in rural areas. However, for the remaining eight instances, rurality was a risk factor.
This finding puzzled the researchers, as previous studies had associated rural areas with increased health risk factors. They proposed that a plausible explanation could be an underdiagnosis of mental health conditions in rural areas, leading to an apparent lower rate of mental illness prevalence.
On average, each country faced 1.9 geographic health disparities, but this varied significantly by nation. The US exhibited the poorest performance, with health disparities observed in five of the ten indicators assessed. Notably, the US displayed substantial disparities in health status, including high rates of multiple chronic conditions, mental health conditions, and material hardship. Conversely, Germany had the lowest rates of chronic conditions, mental health issues, and material hardship.
In terms of care access, rural residents in the US were most likely to forgo necessary medical and dental care due to cost, while Norway and Sweden reported the lowest rates of such instances. The US, Canada, and Sweden experienced the most significant challenges in care access for rural residents.
The researchers noted that given the large geographical size of the US and Canada, it is not surprising to find disparities in medical personnel availability across regions. This is evident from the low rates of people having a regular source of care and limited access to same-day or after-hours appointments.
The Netherlands excelled in care access compared to other countries.
Although the US demonstrated the most pronounced rural-urban health disparities, Canada, Norway, and the Netherlands were recognized as exemplary performers with fewer disparities. However, the researchers acknowledged that previous studies have identified rural-urban disparities in Canada and Norway, despite the absence of such disparities in this particular analysis. Further investigation is recommended to gain a deeper understanding of rural-urban health disparities in these countries.
Nonetheless, highlighting these three nations as role models in achieving geographic health equity could provide a valuable roadmap for improving equity in the US. The researchers concluded by suggesting that US health policymakers evaluate the models employed in Canada, Norway, and the Netherlands to promote better outcomes in both rural and urban settings.
