Health care in rural Indiana must accommodate everyone

The caliber of Indiana’s health care system has been called into question.

An IU study led by Michael Reece, director of the Center for Sexual Health Promotion in the University’s School of Health, Physical Education, and Recreation, found that medical providers in rural areas of Indiana felt impeded in their ability to offer quality care to some of their patients: those who suffer dually from HIV and substance abuse or a mental disorder due to significant stigma and discrimination in the rural medical referral system.

The study involved conducting semi-structured interviews with health care providers throughout Indiana. It revealed a multidimensional stigma in the medical referral network and reports of verbal stigma in the form of insults, loss of respect and global loss of resources such as poorer quality of health care or no health care provided.

Over the past decade, the number of residents with HIV has been disproportionately increasing in rural areas relative to urban areas. However, this study indicates that many rural areas still lack the necessary services for residents living with HIV.

The discovered stigmas can be a factor in preventing referrals of rural HIV patients to urban care centers, in addition to other problems such as transportation. Moreover, other studies have found that patients with higher levels of perceived stigmas are less likely to access care services.

Ultimately, this reflects a major problematic trend in rural health care.

“The findings of this study demonstrate inefficiencies in our public health care system and our inability to link people easily to a range of health care providers in rural areas,” Reece said. “This also has an important economic impact given that our investments in the public health system may not be achieving the outcomes we need, such as improvements in health status.”

As medical experts, rural as well as urban physicians and specialists are expected to uphold a certain standard of professionalism within the health care community. We are entrusting these people with the well-being of our neighbors and communities.

When treating illnesses as serious as HIV, substance abuse or mental disorder, there is no room for the inefficiencies created by stigmas and personal insults.

All residents of Indiana, including those living with devalued physical conditions, deserve the best medical care that our system is capable of providing.