In most U.S. cities, urgent medical care is just a few minutes away.
But for a growing number of Americans in rural areas, emergency and even routine medical care is getting harder to find.
"It is definitely a life-and-death situation. Lives will be lost because of lack of emergency rooms in rural communities," said Cumberland River Hospital owner Johnny Presley.
Presley owns the small hospital in Celina, Tennessee. Facing huge financial hurdles in 2020, he was forced to close the doors, leaving the town's 1,400 residents without a nearby emergency room.
"It's really catastrophic for the local individuals in the communities not having an ER. It's usually, at best, a 45-minute to an hour trip to an ER. And by the time you summon EMS and make the 45-minute transfer, you're at least an hour away from any acute setting that you can get in to take care of true emergencies," Presley told Scripps News in 2021.
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Since 2005, 192 hospitals have shut down in rural America, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. That area is home to 15% of the U.S. population. Sixty percent of all U.S. counties are considered "medically underserved," according to the U.S. Department of Health and Human Services.
Officials say lower access to health care and insurance are reasons rural Americans are more likely to die from preventable causes than city dwellers.
"Many of the trends that have caused rural hospital closures over the past decade, they will continue," said Geroge Pink, deputy director of the North Carolina Rural Health Research Program. "Most of them are in small or declining markets. They've got high rates of unemployment, high rates of uninsured patients, high proportions of Medicare, Medicaid patients."
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The newly elected president of the American Medical Association says it all adds up to a crisis.
"The entire rural health care system is teetering on the brink," said Dr. Bruce Scott.
Nearly 40% of rural hospitals lost money last year. But new bipartisan legislation in the U.S. Senate would permanently change the way those hospitals are paid by Medicare. If passed, it would throw patients like Stephen Headrick, injured in 2020, a lifeline.
"It means everything it really does to a small community like this," Headrick said in 2021. "There'll be so many lives that won't make it because this hospital won't be here. And that's sad."
