美国农村的医疗保健怎么样? 我们要近距离观察

五分之一的美国人生活在农村地区有很多原因.

从最基本的开始:可能是他们出生和长大的地方, 就像他们的父母，也许是他们的父母. 也许他们喜欢他们的邻居. 或者节奏. Or they enjoy open spaces, especially those framed by some of nature's most beautiful sights. 见鬼，也许这只是因为生活把他们安置在那里.

Whatever the reason, and wherever the location, far 太 many of the roughly 66 million people who 2020年人口普查数据 show live in rural America share a disturbing reality: They lack access to quality health care.

研究 conducted before the COVID-19 pandemic shows the life expectancy of rural Americans overall is about 2.与城市居民和农村居民相比，平均寿命缩短了5年 更有可能早死 远离心脏病和中风.

Shorter life spans and more illnesses are byproducts of accumulated risk factors that also stack up more for rural folks compared to urban and suburban dwellers. 其中包括较高的烟草使用率, 缺乏身体活动, 肥胖, 糖尿病和高血压.

为什么?

从根本上说，这是一个数字游戏. There are fewer doctors and hospitals in rural areas (and those numbers are spiraling down), 这意味着更少的专业护理.

So, 获得护理可能需要行驶很多英里, 哪一个当然要花很多沙巴足球体育平台-哪一个, 紧急情况下, 是宝贵的沙巴足球体育平台. 而且是在天气好的情况下. The expanse of miles also brings challenges of getting people enough food, much less healthy food.

当然，没有单一的解决办法. 这些问题就像这些地方本身一样复杂多样.

The 美国心脏协会 has long worked with people in rural America to level the playing field. 几年前，该组织把事情推上了一个台阶.

A "presidential advisory" is a rare step taken to address a topic of special importance. 这是一种让每个人都知道有问题需要额外关注的方式. 美国心脏协会发布了一份名为“行动呼吁:农村健康”的总统咨询报告." 它强调有必要增加获得保健的机会, 提高保健质量，采取更有针对性的办法减少风险因素.

它于2020年2月发布. 几周后，COVID-19大流行来了. 就像病毒暴露了社会问题中的系统缺陷一样, 美国农村受到的影响尤为严重, 太. 本来就是危机的事情变得更糟了.

“我四年前的评论在今天和2020年一样具有现实意义。. 罗伯特·哈林顿, the dean of Weill Cornell Medicine in New York City who was the AHA president at the time of the advisory. ”,, 当然, 大流行继续突出了这些健康差距, 尤其是当我们目睹美国农村医院关闭的时候."

针对这一大流行病暴露的许多问题, 美国心脏协会制定了2024年影响目标，旨在改善所有人的健康公平, 包括查明和消除妨碍获得保健和提高保健质量的障碍. 美国农村地区的健康问题是这些障碍之一.

2022年，美国心脏协会发起了一项 帮助农村医院和临床医生提供高质量服务的三年倡议, 一致的, 及时和适当的循证护理. 该组织还创建了 HeartCorps该项目让有服务意识的成年人到农村社区改善心脏健康. 去年夏天, the AHA announced a $20 million investment into scientific research of health challenges in rural areas.

这些举措是许多正在进行的项目的补充，例如扩大 使命:生命线, which has been shown to reduce response time and improve outcomes for patients in need of acute care for heart problems and stroke since 2010. 该组织还在继续推动政策改革, 比如让数百万人获得医疗补助和远程医疗.

当然，还有一些重要的生活质量领域是农村社区的亮点.

从强调“社区”这个词开始.“即使在隔壁邻居可能相隔一英里的地方, folks pitch in for barn raisings and potluck dinners; when major life events occur – happy or sad – folks gather quickly and rare is the person who goes away hungry. In some cases, these powerful bonds generate higher levels of social connectivity and engagement.

这篇介绍并不是深入探讨美国农村健康的复杂性. It's also not meant to paint a doom-and-gloom portrait; quite the opposite, it's meant to be a reminder of the importance of improving and extending the lives of this sometimes-overlooked segment of the country.

最终, this single story is merely an overview of health in rural America – the proverbial 10,000英尺的风景.

A better understanding of the challenges and triumphs requires being down on the ground, 在最激烈的时候, 和那些把美国乡村称为“家”的人们交谈."

所以美国心脏协会的记者, 摄影师和摄像师走访了五个以农村为主的州. 一周又一周，一个州又一个州，我们将公布他们的发现. 每张照片都附有展示人物的图片和视频, 这些地方的问题和美丽.

• 来自北达科他州, a look at how health care professionals are turning to telemedicine and community education to cope with health care challenges.
• 从堪萨斯州, a look at the Iowa Tribe of Kansas and Nebraska's efforts to improve healthy food access and cultivate food sovereignty to help feed residents of their community, 那里离最近的杂货店大约半小时车程. It's part of the Ioway's shift to regenerative agriculture after realizing contaminants in their soil were killing their … bees.
• 来自西弗吉尼亚州, 这是美国慢性病发病率最高的一个州, a look at how community health workers step in to provide home-based medical support and so much more; and the challenges of breaking a generational cycle of heart disease by slowly shifting families away from culturally entrenched, 不健康的饮食习惯, 这个故事是通过萨布丽娜·福特和莎拉·沃德这对母女团队讲述的, 两名医护人员在阿巴拉契亚小镇的唯一一家诊所工作,200人.
• 从肯塔基, 看看如何在丘陵地带航行, 绕组, GPS-unfriendly roads that strain the emergency response system; and how state legislation and the efforts of local emergency medical services led to an improved system of care for heart patients.
• 来自阿拉斯加, a look at how all the challenges 到处都是 in rural America are compounded by the extremes of being in such a big, 冷, remote state in which half the population is bunched in one spot and the other half is spread across incredibly vast distances, plus the fact there are two health care systems: the standard conglomeration of public and private options for about 80% of residents, 另一个是阿拉斯加原住民和居住在阿拉斯加的美国印第安人的制度.

回到总统顾问的话题, the AHA writing group stressed three topics to consider: urban-rural disparities in health outcomes, 健康的社会决定因素的差异(城市与农村), 以及城乡地区复杂的卫生服务系统差异.

"Addressing the unique health needs of people in rural America is critical to the 美国心脏协会's mission to create a world of longer, 更健康的生活,哈林顿在咨询发布时说道.

“而且，”他最近说，“今天仍然如此!"