Rural Illinois doesn’t have enough health workers, and the pandemic made it worse
Nearly every county in Illinois doesn’t have enough primary care, mental health and dental providers, according to a new report by the Rural Health Summit.
The issue is most acute in the state’s rural counties, including southern Illinois.
The report, produced by a consortium of health care professionals, finds the coronavirus pandemic exacerbated and illuminated the depth to Illinois' rural health worker shortage.
“It showed a lot of people that there are a lot of issues that were under the surface for a long time and they came to the surface, and it kind of caused a crisis,” said Dr. Jim Daniels, a family and preventive medicine physician with Southern Illinois University’s medical school.
Speaking at a webinar Thursday about the report’s findings, Daniels said there’s a mismatch with the pipelines medical and government institutions have developed to get more doctors into rural areas.
“We’ve spent a lot of time on how we’re going to get someone to rural health, but maybe not a whole lot of time in the rural areas talking to folks saying, ‘What keeps folks there?’” he said. “If you say, ‘We’re going to pay your medical bills off,’ and then in about four or five years you haven’t bonded with the community, [so] you leave.”
One way to combat this, according to the report, is to provide opportunities and incentives for people from rural communities who want to enter the health care field.
Part of this includes cultivating the right kind of connections with rural areas when recruiting for medical school, said Dr. Hana Hinkle, interim director for the National Center for Rural Health Professions.
“We evaluate [our students] on how rural they actually are in their upbringing,” she said. “Regardless of where they go to residency, they end up going back to practice in a rural community similar to where they’re from.”
It also helps to energize younger people about going into the health profession, Hinkle said. This includes opportunities for students — before they graduate from high school — to interact with hospitals, public health departments or other parts of the rural health care industry, she said.
Hinkle, who’s also with the University of Illinois College of Medicine in Rockford, explained that 30% of its incoming medical students had this kind of exposure before enrolling.
“That got them interested and excited and just demonstrated that they could be successful and they don’t have to go to Chicago or St. Louis,” she said. “They can be successful in their training and go back and make a huge difference in the communities that need them most like where they’re from.”
The report also points to collaboration between public health departments and health care service providers, like hospitals, as another key to revitalizing rural health care.
To Amy Fox, Tazewell County’s Public Health Department administrator, that includes everything from insurance providers to community support services like churches and food pantries.
“All the things that support a family and a healthy life have to be brought to the table,” she said. “Uniquely, public health tends to be a good convener of that.”
Fox stressed these connections need to be in place before a crisis, like COVID, hits a region.
An expanded view of health and wellness can also entice more people to consider a career that supports community’s health, said Leticia Boughton Price, the president of the Illinois Community Health Workers Association.
“A lot of times people, when they hear ‘health,’ they think doctor, nurse and some people have something against 12 years of education,” she said. “This broader definition of health and wellness will encompass different social determinants of health, like safety, education.”
Many people aren’t aware of the value of community health workers and how they fit into the health care landscape, Price said.
While the health summit report offers specific recommendations, Price said lawmakers and other policymakers need to listen to rural communities when they propose fixes.
“Oftentimes they want to come in and just take over,” she said. “When that remedy doesn’t work for the community, then they’re saying back, ‘They didn’t want it.’ And it’s because that’s not what [the rural community] wanted in the first place.”
Eric Schmid covers the Metro East for St. Louis Public Radio as part of the journalism grant program: Report for America, an initiative of The GroundTruth Project.