Rural residents are less likely to describe themselves as being in good health than their urban and suburban counterparts, and they face more challenges when accessing health care, according to a national consumer survey by the Transamerica Center for Health Studies.

Rural America is becoming a medical desert, with more than 125 U.S. rural hospitals closing in the last decade, the report states. And the COVID-19 pandemic is exacerbating the situation and raising concerns about the accessibility of health care in rural areas.

"Even before COVID-19, many rural residents faced health and health care-related risks. The pandemic greatly magnifies these risks. At a societal level, more can and should be done to enhance the accessibility and affordability of health care," Christopher Wells, national program manager for TCHS, said in a press release. "At an individual level, it is extremely important that rural residents be hypervigilant in safeguarding their health and follow the CDC's recommendations for taking precautionary measures, such as social distancing, wearing a mask, and frequent hand washing."

According to the report, 69% of rural residents describe their health as excellent or good, compared to 80% of urban residents and 78% of suburban residents. Another 69% of rural residents have been told by a health care provider that they have a health condition such as depression, high blood pressure, arthritis or obesity, a rate higher than urban residents (66%) or suburban residents (64%). And 31% of rural residents have been told they have a mental health condition, compared to 24% of suburban residents and 29% of urban residents.

Of concern, the report states, is the 19% of rural residents who have no health insurance, a rate far greater than the 10% of urban residents and 11% of suburbanites. And three in four rural residents, 75 percent, say they are able to afford routine health care expenses such as insurance co-pays, deductibles and out-of-pocket expenses, which is lower than reported by urban (82%) and suburban residents (85%).

Rural residents also report making fewer health care visits, with 70% visiting a doctor's office in the past year, compared to 75% of urban residents and 74% of suburban residents. And fewer rural residents are saving for health care in flexible spending accounts, health savings accounts or bank accounts, 24%, compared to 38% of urban residents and 34% of suburban residents.

Despite the significant divide, there is plenty that can be done to close the gap, according to the report's authors, both by employers and policymakers.

"Employers across all regions of the country play a crucial role in providing workers with health insurance coverage and workplace wellness programs, but in rural areas, this is happening to a lesser extent," Wells said.

Employers in rural areas should ensure that they're offering the best possible health care plans and prices for their workers and offering a number of plan options, and take steps to encourage enrollment. They should also make an effort to offer and encourage participation in wellness programs and activities and create an employee culture that emphasizes health and healthy behaviors.

The report's recommendation to policymakers include addressing the lack of medical facilities and medical professionals in rural areas by revisiting the distribution of federally qualified health centers and introducing better incentives for medical professionals to train and practice in those areas. And the report called for providing and subsidizing more broadband internet access and expanding telemedicine services in low-income and rural communities.

Health care can be improved in rural areas by addressing transportation barriers with pooled or subsidized transport, according to the report. It also called for revisiting the implications of Medicaid expansion and its potential association with viability of rural hospitals.

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Rural residents continue to fall behind on health and health care access

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