Hospital closures and the pandemic hurt rural Blacks hard

Hospital closures during the coronavirus pandemic have exacerbated rural health-care inequalities, especially in Black-majority areas, where such hospitals have been more likely to close. 

"A record 19 rural hospitals closed in 2020, according to research from the University of North Carolina at Chapel Hill — more than in any other year," Olivia Goldhill reports for Stat. "Communities close to these shuttered hospitals similarly experienced disproportionate fatalities, according to a Stat analysis: Covid-19 death rates in counties where hospitals closed were 37 percent higher than in their states overall. Looking at the most rural counties — those with fewer than 50,000 residents and at least 50 miles from a major city — the death rates were 66% higher than in their states. Seven of the eight hospital closures in counties where the fatality rate was at least 80% higher than their state’s were in such rural counties."

The communities where rural hospitals close often have significant Black populations. They're also "predominantly clustered across the South and Southeast where, more than a half-century since health care segregation officially ended, plenty of hospitals outside of Black communities have yet to earn the trust of African American patients, erecting another barrier to care," Goldhill reports. Another barrier to access: some people would have to cross state lines to access the closest hospital, which can cause billing headaches and eligibility problems.

Stat illustrates the trend with the story of a Black family in Dawson, a town of 4,000 or so in southwest Georgia, and how a hospital closure, trust issues and more contributed to a local woman's death. Southwest Georgia is predominantly Black and rural, and has been hit hard by the pandemic and hospital closures. Dawson is the seat of Terrell County, where 1 in 10 have been infected.

A study done just before the pandemic said Georgia had the fourth highest percentage of rural hospitals in danger of closing, at just over 41%. Southern states and those with large rural populations make up most of the top 10, and the researchers noted that hospitals are likely in worse financial shape now. A more recent analysis found that about 40% of rural hospitals are now in danger of closing.