The importance of rural healthcare

Understanding rural Michigan’s healthcare challenges.

A photo of a person holding a child in a corn field watching the sun set.

According to the United States Census Bureau, about 1 in 5 Americans live in a rural area. Rural residents face unique barriers to receiving quality healthcare and health education. Rural areas face obstacles to practicing healthy behaviors that would prevent chronic illness. One such obstacle is difficult or lengthy commutes to access healthcare, in part because of higher doctor shortages. Nearly 70% of the medical health professional shortages occur in rural or partly rural areas. A 2019 survey found only 1% of medical school graduates in the United States wanted to live and work in a community of less than 10,000 people, leaving rural communities largely to their own devices when it comes to navigating healthcare-related concerns.  

What is Rural Health?

While there are varying definitions of the term “rural” depending on if geographical area or population density are being considered, the United States Department of Agriculture (USDA) defines rural as “any population, housing, or territory not in an urban area,” with an urban area being defined as having a population of 50,000 or more. The United States Census reports that while 97% of the landmass in the United States is rural, only 19.3% of the American population lives there.

What Disparities Do Rural Communities Face?

In the United States, the six leading causes of premature death are cardiac disease, cancer, COVID-19, accidental injuries, stroke, and respiratory disease, and the Centers for Disease Control and Prevention (CDC) reports that people living in rural areas are more likely to die of five of the six leading diseases than those in urban areas. These health outcomes are exacerbated by a notable gap between rural and urban access to healthcare facilities and providers. A 2020 report by the Health Resources and Services Administration (HRSA), Council on Graduate Medical Education, found that of the roughly 2,000 U.S. counties classified as rural in the U.S., more than 170 lacked an in-county hospital, health center, or health clinic, meaning that residents in those areas would need to drive over an hour to get medical care. They also found that rural hospitals are closing at more accelerated rates than their urban counterparts, and over 50% of rural counties in the U.S. do not have a single local hospital where women can receive maternal healthcare, such as prenatal care or care during labor and delivery.

Rural Michigan Island Weighs In

Beaver Island is a rural Michigan community located 27 miles off the coast of Charlevoix and home to approximately 600 year-round residents. It takes approximately two hours to reach the island from the mainland by boat, or 20 minutes by plane. The Michigan Vaccine Project at MSU Extension visited Beaver Island in April 2023 to provide vaccine education to its residents and speak with rural healthcare providers that live on the island to get a better understanding of the effort it takes to receive medical care in rural areas. Robin Veltkamp attended the vaccination presentation by MSU Extension and said, “it’s vital for rural areas especially that these teachings and these understandings be shared and that they be received by the local communities so that we can have a healthier and safer world.”

Joan Matejovsky, is a Nurse Practitioner with the Beaver Island Rural Health Center. Matejovsky explained that their clinic could provide primary care as well as first aid, x-rays, and vaccines, but cannot provide intensive emergency care. In an interview with MSUE, Matejovsky said “if someone has an emergency, they’ll come here or dial 911. In emergency situations, people get taken off the island by helicopter or by plane. Then, if absolutely push comes to shove, then we'll touch base with the Coast Guard to get people off.” Severe complications from vaccine-preventable diseases like the flu and COVID-19 can necessitate the use of life-saving technologies such as ventilators and extracorporeal membrane oxygenation (ECMO) machines that are not available in some rural areas like Beaver Island. For Matejovsky, vaccines are an essential part of the island’s preventative care strategy, saying “vaccines as a preventable care here on the island, I believe, is important. We do the influenza, COVID, tetanus, pneumococcus vaccines to name a few.” Matejovsky believes that Beaver Island Rural Health Center has been able to help maintain high levels of vaccination on the island by developing close ties to the community. Matejovsky says “the response for vaccines like the flu or COVID that I have seen has been pretty positive. We always have a waiting list. I have seen the worst prior to the vaccinations, and I have seen the best where it's now just becoming more upper respiratory, which we can take care of here versus sending them off the island for care. We are pro vaccines. It has been found with getting the vaccines that the severity of the disease has decreased over time. Where initially nobody knew what was to be expected, and now with the series of vaccines, I believe personally that it has decreased the severity, which is important for such a rural area.”

Watch the full video of MSU Extension’s trip to Beaver Island through the link.

Help Finding a Doctor:

If you need help finding a doctor, try searching for primary care physicians or gynecologists in your area that are highly recommended, search your insurance provider’s website for doctors in your network, or ask for recommendations from friends and neighbors. There are also search engines such as that can help you narrow your search based on region and specialty needed.

Where Can You Find Vaccines?

To find a vaccine, check with your primary care physician, local health departments, pharmacies, and clinics. You can also visit to locate a vaccine clinic near you.

If you would like to learn more about vaccines, check out Michigan State University Extension’s partnership with the Michigan Vaccine Project to find links to event schedules, podcasts, publications, webinars, and videos relating to vaccine education at

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