In parts of rural Colorado, where cattle and antelope often outnumber people, doctors are few and far between.
To help bridge this gap in health care coverage, the federal government began a program more than five decades ago that serves rural residents, one free screening at a time.
the Colorado District Health Education Center It conducts community outreach events across the state, including free health screenings at National Western Stock Show During its two-week run this month.
The program was founded in Colorado in 1977. “We’ve been going since then,” said Josena Romero O’Connell, state director of AHEC.
The federal government began the comprehensive AHEC program six years ago in an effort to address health care disparities in rural areas of the United States and has expanded it state by state.
Rural Colorado makes up about 12% of the state’s total population, with 47 of the 64 counties considered rural or “borderline”—a designation that indicates they have six or fewer residents per square mile—according to 2022 Snapshot of Rural Health in Colorado.
The 2022 Snapshot Report reported that adults in rural areas are almost twice as likely to lose teeth as those in urban areas. Of the 64 counties in Colorado, 24 are considered “maternity care deserts,” as there are no obstetrical care providers, hospitals, or birthing centers with obstetric care.
There is even a dearth of intensive care beds in 37 provinces.
This is where the Colorado AHEC comes in. The program is operating in its most recent grant cycle, which runs from 2022 to 2027. It is attached to the University of Colorado Anschutz Medical Campus, and students are placed in clinical courses for convenient services to rural areas.
The program divides the country into Six regional centersSince each area contains different demographics with different needs, O’Connell said.
During her stock fair presentations, students from medical schools, such as Colorado State University, serve as facilitators, with licensed physicians on site to supervise them.
The screener reviews patients’ health issues, immunizations, and dental care, and then connects them to their primary care providers if needed.
“These are such proven successes that, in this new grant, we are launching an initiative to conduct these health screens at least once a year in six different Colorado regions, bringing them closer to the communities there,” said Romero O’Connell. Phone interview.
They also develop serious health problems. Romero O’Connell recalls one case when a student could not keep track of the pulse of a patient with very high blood pressure. He was suffering from atrial fibrillation, or an irregular heartbeat that can lead to blood clots, and they rushed him to nearby emergency medical technicians.
Colorado AHEC has partnered with the Stock Show for more than 15 years, with over 400 volunteers at the program booth at a time, said Patty Jo Wagner, senior program and administrative specialist.
She added that the team checks between 1,000 and 1,800 people a year at the stock fair, with some patients, including event sellers, taking the opportunity to do their annual checkups. “Many of them do not know where to go for health care in their area.”
Wagner spoke to patients who said, “I’ll only go to the vet because it’s cheaper.”
The Denver event allows them to serve residents from all over Colorado and other states, with the typical age group being 50 and beyond.
Sam Hanson, IT coordinator and Colorado AHEC resident, notes that patients often “find the students really friendly.” Not only does the experience give students an opportunity to learn bedside manners, but it also allows them to debunk any myths or urban legends about medicine.
The program plans to take the health screens on the road, hitting every Colorado area at least once a year.
Obstacles around rural health care
Romero O’Connell, a physician, described two typical groups of her patients as either the “urban poor”—often uninsured or undocumented immigrants in the Denver area—or people in rural communities.
“The countryside is its own culture,” she said, with a range of healthcare-related challenges, including access to doctors. “I know a couple whose daughter had cancer, and they would travel six hours four times a week for treatment.”
Rural providers need to take care of every aches and pains, but this lack of specialization does not appeal to all physicians. Romero O’Connell emphasized the need for greater training that would allow providers to build their careers and reside in rural areas, which would mean recruiting more community residents to join the medical field.
Romero O’Connell knows her rural patients trust less in the medical profession, and she is “seeing more of that mistrust globally” after the COVID-19 pandemic.
Ranchers, farmers, and other self-employed rural residents often live without health insurance. “The last thing they want to think about is, I should spend money to go to the doctor when I need money to maintain my farm.” “
As immigrants settle in rural areas, cultural and language barriers develop.
While telehealth is now an option, it is being affected by a lack of reliable broadband, knowledge of the technology, and access to necessary devices, such as iPads.
Colorado ranks No. 25 of the 50 states for broadband access, said the 2022 Snapshot of Rural Health in Colorado. The six counties with the worst coverage include Ouray, Lincoln, Washington, Park, Jackson and Kiowa.
Wagner spent 20 years in Canyon City, struggling herself with broadband. “Even if we did get the internet, it was very spotty,” she said.
Rancher Janie Vanwinkel, former president of the Colorado Cattlemen’s Association, considers herself an outsider because she resides in Grand Junction, a regional medical center.
But she is frustrated by the paucity of health insurance options, noting that only one company covers clients in western Colorado.
Between VanWinkle and her husband, they’ve had four knee replacements, using a doctor at Front Range. “But right now, our insurance doesn’t cover that.”
For many rural residents, it is ultimately a matter of anxiety.
“When you have to drive 80 to 100 miles, but can’t get a date for two to three months, it makes life difficult,” Vanwinkel said. And the worry is always, ‘Well, what if something happens? “
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