Newsweek Examines Health, Dental Care Outreach Efforts in Rural Regions

A Newsweek web exclusive last week examined efforts to provide access to dental care for low-income residents of Appalachia and other underserved rural regions of the U.S., where the "dire dental situation ... is emblematic of the larger health care crisis" in the nation.

Newsweek profiled the "huge annual medical and dental expedition" set up by Remote Area Medical, a not-for-profit group that provides basic care to people in underserved regions around the world. This year's program, in Wise, Va., organized more than 1,800 doctors, dentists, nurses and assistants and treated about 2,500 patients over two-and-a-half days in July. According to Newsweek, Southwest Virginia's coal-mining region trails much of the rest of the U.S. in health care, as its residents have "vastly higher" rates of diabetes, obesity and lung disease, and lower incomes.

Peter Cunningham of the Center for Studying Health System Change said the health care problems faced by the nation as a whole are worse in such rural areas. Cunningham noted that for many low-income U.S. residents, the Medicaid dental benefit is really a "phantom" because of the difficulty of finding a dentist who will accept Medicaid's low reimbursement rates. Cunningham said, "This is just where all our national health care problems converge: high costs, lack of access." A recent study, co-authored by Cunningham, found that about 20% of U.S. residents reported not getting or delaying needed medical care in the previous 12 months, a 14% increase over 2003.

Newsweek reports that other groups, such as Save the Children, set up nutrition, exercise and health education programs in schools that aim to improve both dental and overall health among children in such areas.

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Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of its Commission on Medicaid and the Uninsured, said, "We like to believe that everyone can get the care they need," but "people who are low-income, work hard and don't have coverage through a job have to make harsh economic choices about their health care." Virginia Gov. Tim Kaine (D) said, "This is a matter of political will. Other nations have a lower GDP than we do, and they've made a political decision that their people are going to have health coverage, but we keep deciding not to" (Schrobsdorff, Newsweek, 8/5).