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How much of this is simply a lack of healthcare availability in rural areas? We've been seeing reports for years of health clinics and hospitals closing in rura

How much of this is simply a lack of healthcare availability in rural areas? We've been seeing reports for years of health clinics and hospitals closing in rural areas. Even emergency services are becoming problematic. Consider that cardiovascular issues are one of the leading causes of death in the US. Time is of the essence. If your local hospital has been closed, your emergency services have been consolidated in your county, you're much more likely to be DOA than someone in the city. Also, didn't the opioid crises primarily occurred in rural areas? That's going to affect the stats, too.

brodouevencode 2y ago
> How much of this is simply a lack of healthcare availability in rural areas Speaking as someone who lives in a rural area - this ain't it. The lifestyle choices are the biggest problem. Availability is just addressing the problem at the end of the problem.
- taylodl 2y ago
  What do you see as the biggest lifestyle choices they're making having an impact on their health that folks from urban areas aren't making as much?
  - brodouevencode 2y ago
    Here's an anecdote: where I live the closest gym is 19 miles away. The closest park that has walking trails is a little over 12 miles away. Walking/running/cycling on the county roads is not wise. There is a seasonal farmer's market in the closest city to us (~15 miles away), but it's only open one day a week for 4 hours. The closest "healthy" grocery store (like Sprouts, Whole Foods, Trader Joe's) is 32.9 miles away (just had to look this up). For the local grocery stores, the organic, health options are rather minimal compared to the rest of the store's footprint, if they even exist at all. Organic produce doesn't exactly fit Dollar General's target market. Delivery doesn't always come through: there are some parts of my county that do not even get Amazon deliveries. Delivery from other providers can tend towards cost prohibitive. Most of my neighbors are blue collar (trades, construction), so even if they wanted better health and food options they're not about to drive to get it after spending a good part of the day on the road traveling to/from work sites when there's a Walmart nearby with super cheap unhealthy food.
    - taylodl 2y ago
      It's almost like the poor lifestyle choice they made was living in a rural area and not keeping a garden. My perspective may be skewed by my relatives who live in rural Appalachia. They keep gardens, have physical jobs, and hunt for meat. They live a few miles outside of a small town whose hospital just closed - the only one in the county. They do have a proper emergency care center that's designed to be able to get you stabilized and then transfer you to a hospital outside of the county. You're right though - the people that live "in town", population 6,000, tend to live like urban folk without the urban amenities like you mentioned. I have no idea why people choose to live like that.
      - randomdata 2y ago
        > It's almost like the poor lifestyle choice they made was living in a rural area It is more that the poor lifestyle choices were already made, so it is most convenient to live in a rural area where there isn't as much social pressure to change. You can easily hide when you live on a desolate backroad. It is hard to hide when stepping outside means immediately running into hundreds of people ready to judge your "undesirable" behaviour. > population 6,000, tend to live like urban folk The USA defines urban as a population of at least 2,000 people, so those in that place with 6,000 people don't just live like urban folk. They are urban folk!
      - brodouevencode 2y ago
        > It's almost like the poor lifestyle choice they made was living in a rural area > I have no idea why people choose to live like that. Many, if not most, times it's not a choice. Limited skills, limited education, limited drive, and limited exposure leads you to stick around where you are because you don't know any better. > and not keeping a garden I'll give you this. It was a thing, a big thing, when I was younger. It makes me think people have honestly gotten lazier - there seems to be no drive or desire to do so.
    - nradov 2y ago
      This may vary by the particular store, but Walmart doesn't seem to be any worse than other grocery stores in terms of selling unhealthy food. There's little or no evidence that "organic" food is actually healthier.
- inquisitorG 2y ago
  I suspect this is in general across the US. I have lost 35lbs so far this year and it is pretty shocking the health benefits of not over eating good tasting food. I think we all know this too but are collectively in denial because it is so boring eating chicken breast, broccoli and mustard yet again as I am right now instead of the awesome tasting dish from the incredible restaurants we have all over. That is even with not drinking, not smoking and going to the gym for years. People don't just want their cake and eat it too they want their cigarettes/vapes and smoke them too, a six pack and drink it too, a pizza to eat before the cake,all while only abstaining from physical activity.
nradov 2y ago
We should do more to expand access to healthcare in rural areas, but healthcare services beyond the basics (immunization, antibiotics, trauma care) do little to increase lifespan at the aggregate population level. Causes of death are mostly chronic diseases brought on by lifestyle factors and even the best treatments for those conditions usually only delay death by a little.
- linotype 2y ago
  Should we? Or should we put those dollars where they would help the most people, in urban areas that are also chronically underserved.
AStonesThrow 2y ago
I would suggest "not at all". Access to American health care has jack shit in common with being able to live a healthy lifestyle. You can learn the latter from personal trainers, self-help books, physical education, sports involvement, all sorts of ways. Then you summon the discipline to adhere to such a lifestyle, and there's nothing a physician can do to influence those decisions. The American health care system may be useful in cases of GSW or cardiac events or broken limbs, but people who use it exceedingly sparingly are the ones who end up enjoying health and wellness, without being inexorably steered into a pharmacy or chemotherapy. Follow the money here: look at some maps; I've found in my urban area that FQHCs open up to take Medicaid/Medicare dollars for services to the poor and vulnerable. In the affluent neighborhoods, you'll find cosmetic clinics and surgeons, along with massage, spas, and boutique concierge naturopaths and other alternative practitioners. (None of the above are proven to extend lifespans nor improve outcomes for the sick.) Don't believe me? Ask practicing physicians, who are utterly exasperated and fed up with all the patients who abused/neglected their bodies and now expect medicine to "fix them up" like the Tech Support desk. They can do nothing of the kind. Hopefully, they are compassionate and honest about those limitations.
faangguyindia 2y ago
Upward social mobility for rural women have increased as because of social media they manage to move to cities, find work, employment and a partner. The same is true for men of rural areas who are left to perish and become hopeless. You'll die faster from hopelessness than any lifestyle choice.

brodouevencode 2y ago

> How much of this is simply a lack of healthcare availability in rural areas Speaking as someone who lives in a rural area - this ain't it. The lifestyle choices are the biggest problem. Availability is just addressing the problem at the end of the problem.

taylodl 2y ago
What do you see as the biggest lifestyle choices they're making having an impact on their health that folks from urban areas aren't making as much?
- brodouevencode 2y ago
  Here's an anecdote: where I live the closest gym is 19 miles away. The closest park that has walking trails is a little over 12 miles away. Walking/running/cycling on the county roads is not wise. There is a seasonal farmer's market in the closest city to us (~15 miles away), but it's only open one day a week for 4 hours. The closest "healthy" grocery store (like Sprouts, Whole Foods, Trader Joe's) is 32.9 miles away (just had to look this up). For the local grocery stores, the organic, health options are rather minimal compared to the rest of the store's footprint, if they even exist at all. Organic produce doesn't exactly fit Dollar General's target market. Delivery doesn't always come through: there are some parts of my county that do not even get Amazon deliveries. Delivery from other providers can tend towards cost prohibitive. Most of my neighbors are blue collar (trades, construction), so even if they wanted better health and food options they're not about to drive to get it after spending a good part of the day on the road traveling to/from work sites when there's a Walmart nearby with super cheap unhealthy food.
  - taylodl 2y ago
    It's almost like the poor lifestyle choice they made was living in a rural area and not keeping a garden. My perspective may be skewed by my relatives who live in rural Appalachia. They keep gardens, have physical jobs, and hunt for meat. They live a few miles outside of a small town whose hospital just closed - the only one in the county. They do have a proper emergency care center that's designed to be able to get you stabilized and then transfer you to a hospital outside of the county. You're right though - the people that live "in town", population 6,000, tend to live like urban folk without the urban amenities like you mentioned. I have no idea why people choose to live like that.
    - randomdata 2y ago
      > It's almost like the poor lifestyle choice they made was living in a rural area It is more that the poor lifestyle choices were already made, so it is most convenient to live in a rural area where there isn't as much social pressure to change. You can easily hide when you live on a desolate backroad. It is hard to hide when stepping outside means immediately running into hundreds of people ready to judge your "undesirable" behaviour. > population 6,000, tend to live like urban folk The USA defines urban as a population of at least 2,000 people, so those in that place with 6,000 people don't just live like urban folk. They are urban folk!
    - brodouevencode 2y ago
      > It's almost like the poor lifestyle choice they made was living in a rural area > I have no idea why people choose to live like that. Many, if not most, times it's not a choice. Limited skills, limited education, limited drive, and limited exposure leads you to stick around where you are because you don't know any better. > and not keeping a garden I'll give you this. It was a thing, a big thing, when I was younger. It makes me think people have honestly gotten lazier - there seems to be no drive or desire to do so.
  - nradov 2y ago
    This may vary by the particular store, but Walmart doesn't seem to be any worse than other grocery stores in terms of selling unhealthy food. There's little or no evidence that "organic" food is actually healthier.
inquisitorG 2y ago
I suspect this is in general across the US. I have lost 35lbs so far this year and it is pretty shocking the health benefits of not over eating good tasting food. I think we all know this too but are collectively in denial because it is so boring eating chicken breast, broccoli and mustard yet again as I am right now instead of the awesome tasting dish from the incredible restaurants we have all over. That is even with not drinking, not smoking and going to the gym for years. People don't just want their cake and eat it too they want their cigarettes/vapes and smoke them too, a six pack and drink it too, a pizza to eat before the cake,all while only abstaining from physical activity.

nradov 2y ago

We should do more to expand access to healthcare in rural areas, but healthcare services beyond the basics (immunization, antibiotics, trauma care) do little to increase lifespan at the aggregate population level. Causes of death are mostly chronic diseases brought on by lifestyle factors and even the best treatments for those conditions usually only delay death by a little.

linotype 2y ago
Should we? Or should we put those dollars where they would help the most people, in urban areas that are also chronically underserved.

AStonesThrow 2y ago

I would suggest "not at all". Access to American health care has jack shit in common with being able to live a healthy lifestyle. You can learn the latter from personal trainers, self-help books, physical education, sports involvement, all sorts of ways. Then you summon the discipline to adhere to such a lifestyle, and there's nothing a physician can do to influence those decisions. The American health care system may be useful in cases of GSW or cardiac events or broken limbs, but people who use it exceedingly sparingly are the ones who end up enjoying health and wellness, without being inexorably steered into a pharmacy or chemotherapy. Follow the money here: look at some maps; I've found in my urban area that FQHCs open up to take Medicaid/Medicare dollars for services to the poor and vulnerable. In the affluent neighborhoods, you'll find cosmetic clinics and surgeons, along with massage, spas, and boutique concierge naturopaths and other alternative practitioners. (None of the above are proven to extend lifespans nor improve outcomes for the sick.) Don't believe me? Ask practicing physicians, who are utterly exasperated and fed up with all the patients who abused/neglected their bodies and now expect medicine to "fix them up" like the Tech Support desk. They can do nothing of the kind. Hopefully, they are compassionate and honest about those limitations.

faangguyindia 2y ago

Upward social mobility for rural women have increased as because of social media they manage to move to cities, find work, employment and a partner. The same is true for men of rural areas who are left to perish and become hopeless. You'll die faster from hopelessness than any lifestyle choice.