在農(nóng)村地區(qū)獲得醫(yī)療保健已經(jīng)很困難了。流行病使情況變得更糟

在農(nóng)村地區(qū)獲得醫(yī)療保健已經(jīng)很困難了。流行病使情況變得更糟

Even when there isn't a pandemic, finding the right doctor can be tough in rural eastern Ohio. Reid Davis, 21, and his mother Crystal live in Jefferson County, which hugs the Ohio River near West Virginia. Their home is surrounded by farms, hayfields and just a few neighbors.

即使在沒(méi)有流行病的情況下，在俄亥俄州東部的農(nóng)村地區(qū)，找到合適的醫(yī)生也很困難。21歲的里德·戴維斯和他的母親克里斯托住在杰斐遜縣，該縣靠近西弗吉尼亞州的俄亥俄河。他們的家周?chē)寝r(nóng)場(chǎng)、草地和幾個(gè)鄰居。

"To the nearest hospital, you're talking about 50 minutes to an hour," Reid Davis says.

“到最近的醫(yī)院，大約需要50分鐘到一個(gè)小時(shí)，”里德·戴維斯說(shuō)。

Davis' mother has rheumatoid arthritis, a severe autoimmune condition, for which she sees a specialist. That doctor prescribes an injectable medication and also works on her joints to ease inflammation and pain, he says.

戴維斯的母親患有類(lèi)風(fēng)濕性關(guān)節(jié)炎，這是一種嚴(yán)重的自身免疫性疾病，她為此去看了專(zhuān)家。他說(shuō)，那位醫(yī)生會(huì)給她開(kāi)了一種注射的藥物，還對(duì)她的關(guān)節(jié)進(jìn)行了治療，以緩解炎癥和疼痛。

But when the pandemic began, that doctor stopped seeing patients. Nearly six months went by, and only recently was Crystal Davis able to resume in-person visits.

但當(dāng)流行病開(kāi)始時(shí)，那位醫(yī)生就不再診治病人了。將近六個(gè)月過(guò)去了，直到最近，克里斯托·戴維斯才重新親自去看醫(yī)生。

In the meantime, her condition got worse.

與此同時(shí)，她的情況更糟了。

"There have been days where she's just been unwilling to get out of bed because of pain," Davis says.

戴維斯說(shuō):“有些時(shí)候，她因?yàn)樘弁炊辉敢庀麓病?rdquo;

There were only a few other rheumatologists within a two-hour drive and none of them were accepting new patients at the time.

在兩個(gè)小時(shí)的車(chē)程內(nèi)，只有少數(shù)幾個(gè)風(fēng)濕病專(zhuān)家，他們當(dāng)時(shí)都不接受新病人。

Even before the pandemic, the health care systems that serve rural Americans were in decline: rural hospitals were closing their doors, and the medical workforce was shrinking. This year, as the coronavirus outbreak has made its way from major cities to rural America, threats to the rural health care infrastructure have only increased.

甚至在流行病之前，服務(wù)于美國(guó)農(nóng)村地區(qū)的醫(yī)療保健系統(tǒng)就已經(jīng)在走下坡路:農(nóng)村醫(yī)院紛紛關(guān)門(mén)，醫(yī)療隊(duì)伍也在萎縮。今年，隨著冠狀病毒的爆發(fā)從主要城市蔓延到美國(guó)農(nóng)村，對(duì)農(nóng)村醫(yī)療基礎(chǔ)設(shè)施的威脅只增不減。

A new nationwide poll shows that one in every four rural U.S households have been unable to get medical care for serious problems. Among those households that had trouble getting care, more than half reported that a family member experienced negative health consequences as a result.

一項(xiàng)新的全國(guó)性民意調(diào)查顯示，每四個(gè)美國(guó)農(nóng)村家庭中就有一個(gè)因?yàn)閲?yán)重的問(wèn)題而無(wú)法得到醫(yī)療照顧。在那些難以獲得照料的家庭中，一半以上報(bào)告說(shuō)，家庭成員因此遭受了負(fù)面的健康后果。

The poll was conducted by NPR, the Harvard T.H. Chan School of Public School and the Robert Wood Johnson Foundation.

這項(xiàng)調(diào)查是由美國(guó)國(guó)家公共廣播電臺(tái)(NPR)、哈佛T.H. Chan公立學(xué)校和羅伯特·伍德·約翰遜基金會(huì)進(jìn)行的。

"The crisis is really widening the fractures that have already existed in rural communities," says Brock Slabach, senior vice president of the National Rural Health Association, based in Kansas.

堪薩斯州的全國(guó)農(nóng)村衛(wèi)生協(xié)會(huì)高級(jí)副會(huì)長(zhǎng)布洛克·斯拉巴赫說(shuō):“這場(chǎng)危機(jī)確實(shí)擴(kuò)大了農(nóng)村社區(qū)已經(jīng)存在的裂痕。”

Rural Americans contacted for the NPR poll — from Montana to Georgia to upstate New York — discussed problems getting treatment for many types of health problems, including the virus.

從蒙大拿州到喬治亞州，再到紐約州北部，參與NPR民意調(diào)查的農(nóng)村美國(guó)人討論了包括病毒在內(nèi)的多種健康問(wèn)題的治療問(wèn)題。

In the U.S., one of the biggest obstacles to getting health care is the simple fact of not having health coverage, and people living in rural areas are more likely to be uninsured compared to other Americans. Not having insurance can also mean higher out-of-pocket payments for treatments or medications, on top of other pandemic-related financial stresses.

在美國(guó)，獲得醫(yī)療保健的最大障礙之一就是沒(méi)有醫(yī)療保險(xiǎn)，而生活在農(nóng)村地區(qū)的人比其他美國(guó)人更有可能沒(méi)有醫(yī)療保險(xiǎn)。沒(méi)有保險(xiǎn)還意味著，除了其他與流行病相關(guān)的財(cái)務(wù)壓力之外，還要為治療或藥物支付更高的自付費(fèi)用。

But the poll also revealed many non-financial obstacles. In interviews with NPR, rural respondents talked about being forced to cancel surgeries, waiting months for appointments, putting mental health care on hold. Because of these problems, many were experiencing increased pain, anxiety or financial hardship.

但調(diào)查也顯示了許多非財(cái)務(wù)方面的障礙。在美國(guó)國(guó)家公共電臺(tái)的采訪(fǎng)中，農(nóng)村受訪(fǎng)者談到被迫取消手術(shù)，為預(yù)約等待數(shù)月，暫停心理健康護(hù)理。由于這些問(wèn)題，許多人經(jīng)歷了更多的痛苦、焦慮或經(jīng)濟(jì)困難。