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Rural Research Focus:
Minorities in Rural America

by Michael E. Samuels, DrPH, Janice Probst, PhD, and Saundra Glover, PhD

A new report on rural minority poverty by the South Carolina Rural Health Research Center stresses that individual poverty (low incomes) and community poverty (limited economic resources overall) work together to limit economic opportunity and health care access. Policymakers must understand this reality in order to devise well-tailored solutions.

Public perception often tends to associate rural poverty with whites and urban poverty with minority populations, particularly African Americans and Hispanics. In reality, African Americans, Hispanics, and Native Americans who live in rural areas are not only more likely than rural whites to be poor but also more likely to live in communities that have tighter constraints on total economic resources.

Understanding this combination of individual and regional poverty is absolutely critical, according to a new report by the South Carolina Rural Health Research Center at the University of South Carolina in Columbia. The report, "Minorities in Rural America: An Overview of Population Characteristics," which is the first offering in a series that will address minority health issues, was prepared with the help of a grant from the Federal Office of Rural Health Policy.

Using existing data sources to create a profile of rural minority populations, the authors report that total community economic resources are more constrained when minority groups represent over half of the population. Counties with high concentrations of minorities typically have income and assets that are two-thirds of the national average. This suggests how difficult it is for rural communities to improve their economic status--and that it is nearly impossible for individual residents to improve their own status without leaving their communities.

Rural Minorities: Limited Economic and Health Care Resources

The report notes that, with the exception of Asian/Pacific Islanders, rural minorities are geographically concentrated in certain areas of the country: African Americans in the South, Hispanics in southwestern States, and Native Americans in the western States. Poverty is a more prevalent problem for these three groups than it is for whites.

While 13 percent of the rural white population is poor, the numbers are two to almost three times higher for rural minority populations: 34 percent for African Americans, 25 percent for Hispanics, and 34 percent for Native Americans. (Asian/Pacific Islanders are an exception to this trend.) Furthermore, in counties where minorities make up more than half the population, economic resources are more constrained. For example:

  • African Americans: When African Americans are the majority population, average total county income is 67 percent of the national value, and bank deposits average 56 percent of the value for majority white counties.
  • Hispanics: In majority Hispanic counties, the average total county income is 66 percent of the average for all rural counties, and total bank deposits are 56.2 percent of the average for these counties.
  • Native Americans: When Native Americans are the majority, total county income is 48 percent of the average for all rural counties, and total bank deposits are less than a quarter (24 percent) of the average for these counties. This is the greatest disparity in resources that the researchers observed.

The authors also looked at disparities in access to health care resources, again finding that the minority populations, with the exception of Asian/Pacific Islanders, are more severely affected. They report that three of five rural white Americans live in Health Professional Shortage Areas (HPSAs), while roughly three out of four rural minority Americans do (71 percent of African Americans, 76 percent of Hispanics, and 73 percent of Native Americans). In fact, counties where minorities make up the majority population are more likely to be HPSAs than majority white counties.

Furthermore, African Americans, Hispanics, and Native Americans are more likely than whites to live in counties that fall into the bottom quartile for physician-to-population ratio, and less likely to live in counties with the highest physician-to-population ratios. Whereas 12.2 percent and 43.6 percent of rural whites live in counties in the bottom and top quartiles, respectively, the numbers for rural minorities are worse: 14.8 percent and 38 percent for African Americans; 15.5 percent and 32.8 percent for Hispanics; and 17.6 percent and 34.5 percent for Native Americans. While bed-to-population ratios tend to favor minority counties, the researchers note that, without providers, it is likely that the bed capacity remains unused.

Thus, rural minorities are not only more likely to be affected by individual poverty and community-wide economic constraints but also to have more limited access to health care resources. According to the report, "poverty and health care are intertwined: persons without resources cannot afford health services, and communities without resources have difficulty attracting and retaining health care providers."

Implications for Policy and Planning

The report's authors assert that policymakers and government programs must understand that rural minority poverty is both an individual and a regional problem. It is very difficult for an individual to improve his or her economic status in a community that faces severe economic constraints--just as it is difficult to get adequate health care.

The authors also point to the results of a U.S. Department of Agriculture analysis which showed that while rural counties tend to exceed metropolitan counties in funds received for income security (such as Social Security, public assistance, and medical benefits), funding for community resource development--business assistance, community and regional development--flows principally to metropolitan counties. The authors note that this trend will have to change if rural communities and rural health infrastructures are to survive, and they make a number of recommendations to assist in meeting the needs of these communities and their residents.

To receive a copy of "Minorities in Rural America: An Overview of Population Characteristics," contact the South Carolina Rural Health Research Center at (803) 251-6317.



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