Rural Health

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When Health Care Is Far From Home

Richard Sandor, 65, of Hayfork, took the hour long bus ride to Mad River Clinic to pick up his medication for chronic pain. (Heidi de Marco/KHN).

Richard Sandor, 65, of Hayfork, took the hour-long bus ride to illad River Clinic to pick up his medication for chronic pain. (Heidi de Marco/KHN).

The biggest barrier to treatment for residents of a tiny town in the mountains of Northern California isn’t insurance coverage — it’s distance.

By Daniela Hernandez, Kaiser Health News

HAYFORK, Calif. — It’s Tuesday morning, half past eight and already hot, when the small bus pulls up to the community clinic. Most of the passengers are waiting in front — an old man with a cane, two mothers with four kids between them, packed lunches in hand.

Two more arrive. A gray-bearded man with a pirate bandana steps from the shelter of his Subaru. A sunken-cheeked woman rushes up on her bike.

“Woohoo! We have a full car!” the driver says brightly after they’ve all climbed aboard. The riders smile back, some with a hint of resignation. It’s time for the weekly trip to the clinic in Mad River, about 30 miles down a winding mountain road. The tight twists and turns are hard on the stomach, but even harder on the joints — especially if you have chronic Lyme disease, as more than a few of these riders do.

Jeff Clarke is one of them. He acquired Lyme long ago from deer ticks that dwell in the region’s sprawling forests. But today he’s going to ask about a lump that’s been growing in his left breast. It’s starting to hurt, and he’s worried. His fellow riders list their own ailments matter-of-factly: asthma, dental decay, diabetes, drug addiction, heart disease and much more. Continue reading

Distance a Barrier for Rural Californians with Health Problems

If you live in a small far-northern California town like Susanville, seen here, you may need to travel more than one hundred miles for health care. (ceiling/Flickr)

If you live in a small far-northern California town like Susanville, seen here, you may need to travel more than one hundred miles for health care. (ceiling/Flickr)

Editor’s Note: The barriers to getting health care can be bad enough in urban areas, where poverty, lack of insurance and cultural divides are serious barriers to care. But if you live in rural parts of California there’s a serious barrier of a different kind: distance. As part of our first-person series “What’s Your Story?” we hear from Kelly Frost of Redding about how the care you need may be hours away from your home.

Being on dialysis is tough enough without having to travel two or three hours each way just to get to the clinic. But when you live in the far reaches of Northern California, that is exactly what you must do. I sometimes sit with my wife when she does her dialysis treatment. We are lucky because we live only about 10 minutes away from the clinic in Redding. But every morning, the “remotes,” people who live on farms or in rural towns, climb into the mini-vans and come from Trinity County to the west; Mount Shasta, Weed, and Alturas to the North; and some from as far away as Susanville, near Reno.

They get up in the middle of the night, travel several hours, sometimes in bad weather, sit for treatment for three hours, and go home. Then in two days they do it all over again. When the weather turns, or there is an accident which closes the interstate, the problem compounds. Sometimes, they can’t get to Redding, or worse yet, they get here and can’t get home. Packing a lunch and three days of meds is standard fare for most. You’ve got to think ahead. Have a plan, a place to stay until the roads open. The dialysis center has some funds to help with a motel or a meal, but not much. Not for everyone, and not for more than a day. Continue reading

Rural California Hospitals Slow to Digitize

By Eve Harris

Fall colors in Quincy. (Somesh Kumar: Flickr)

Fall colors in Quincy. (Somesh Kumar: Flickr)

High in the Sierra in the town of Quincy, doctors at Plumas District Hospital are using iPads in the clinic. Technicians and nurses are also getting better acquainted with their new electronic health records (EHR) system. This 25-bed hospital has gone digital.

Plumas District joins a digitizing trend at least partially sparked by financial incentives in the federal health care law. Plumas District CEO Doug Lafferty was recruited just nine months ago to get the EHR up and running. In a recent interview he said his adopted community is full of “wonderful people.”

But in contrast to his own prior experience in major, urban hospitals, Lafferty said most of the Plumas District staff have never worked anywhere else. Sure, the iPads are welcome, but when it comes to the nitty-gritty of implementing an electronic system of medical records, change can be painful. The culture of “consistency” leaves no doubt that he is “a change agent,” Lafferty said.

While Plumas District has been fortunate to have the capital and leadership to make this change, other California towns are not so lucky. A recent nationwide report confirmed the widely-held concern that small, nonteaching and rural hospitals are lagging behind their urban counterparts in adoption of electronic health records.

Continue reading

Humboldt County – Amid Stunning Beauty, Sad Health Profile

By Richard Kipling, Center for Health Reporting

(Ben Ramirez: Flickr)

(Ben Ramirez: Flickr)

I don’t want to beat up on Humboldt County. I’ve driven through it a few times and it’s quintessential far northern California — beautiful, alluring, with Redwoods everywhere (the county motto is The Home of the Redwoods), a scenic coastline, pretty towns, friendly folk. The kind of place that sets an urban mind to wondering:  Could I live in this lush green paradise?

I’d like to spend more time there, for sure. But after a close look at the latest California Department of Public Health statistics, I might want to remain a visitor and not a resident. The county’s astounding beauty and apparent serenity disguise some truly disturbing health numbers.

The department recently released its County Health Status Profiles 2012, which provides a fascinating look at the leading causes of death for the years 2008-2010 for each of the state’s 58 counties. I just slalomed through 19 categories of death rates and Humboldt was a blinking neon sign. Let me take you on a tour. Continue reading