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Abstract An Examination of the Health Care Needs and Barriers Of Twenty Rural South Dakota Counties Victoria M. Christopherson 2001 Lack of adequate access to health care in rural areas, throughout the United States, is a well known fact to most policy makers and those involved in the practice and delivery of health care. Because health care access problems inevitably result in high socioeconomic costs, it is essential that we identify the health care needs and barriers of our communities. Only then can we begin to optimally utilize resources to adequately ameliorate the access problems to help meet the socioeconomic needs of rural Americans. The purpose of this study was two-fold: it was to examine the actual and perceived care barriers and health care needs of twenty medically underserved rural counties in Eastern South Dakota. As a background to this study, the following literature was researched: 1) Information on regional rural health care barriers throughout the world; 2)prior studies on health care barriers and needs of rural South Dakotan’s and 3) information pertaining to various instruments used to measure such barriers and needs. The research was conducted through the utilization of a population-based survey. The intent of the survey was to amass data not only regarding demographics but also concerning perceived and actual health care barriers and needs of rural Eastern South Dakotans. Additionally, epidemiological data, collected from federal, state and local agencies, was combined with results of the above to create an all-encompassing picture of health care needs within those counties surveyed. The results revealed some interesting findings concerning perceptions of the barriers and needs of the residents within each of the counties studies. In regards to demographics, the respondents primarily consisted of low-middle and middle income rural, Caucasian, female residents, a majority of whom were living in households consisting of two people. Most had a minimum of a high school education and a majority of the primary wage earners were either employed in farming or were retired. On the subject of medical care, a majority of respondents utilized more than two sources for the payment of health care: 51 percent had private insurance. In addition, most of the respondents and their household members utilized local health care practitioners however, for most of their health care needs, they traveled over 33 miles. A large majority of the respondents have seen a health care provider within the last year. Predominating health care disorders included musculoskeletal disorders and hypertension in adults and lung disorders in children. The respondents overwhelmingly recognized an educational deficit in farm first aid and, to a lesser degree, programs in substance abuse, family planning and sexually transmitted diseases. Moreover, stress, the growing number of elderly, lack of insurance and the decay of the nuclear family were recognized as growing health problems. Noted obstacles to health seeking behaviors were cited as expense, weather, and lack of specialized services. Residents also cited a lack of time in terms of driving times, waiting times in health care provider’s office, and the length of time waiting for an available appointment as deterrents to seeking a health care provider. The respondents cited a specific shortage of local services in the following areas of health care: physician specialists; cardiac rehabilitation services; respiratory care services; mental health services and services in women’s health. The following study entails information regarding commonly cited barriers and needs in rural health care. Methodology for the study is discussed and the findings have been translated into specific needs and recommendations for health education and health care services within the twenty eastern South Dakota counties included in the study.
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