Rural hospital closures in the last decade affected Blacks and Hispanics more than in the two previous decades

"A new study found that over the last decade, rural counties that had a hospital shut its doors had a higher share of Black and Hispanic residents and greater shares of income inequality compared to prior decades," Robert King reports for Fierce Healthcare. "The study, recently released by the University of North Carolina Cecil G. Sheps Center for Health Services Research, explored socioeconomic, demographic and other health system characteristics for rural counties that had and did not have facility closures from 1990 to 2020. The research comes as the Biden administration is pressing to address sources of health equity gaps."

Between 1990 and 1999, rural counties whose hospital closed had an average Black population of 0.4%. From 2000 to 2009, that rose to 0.7%. From 2010 to 2020, it leaped to 5%. That suggests that hospital closures in the past decade were more likely to affect Black residents than in previous decades. "Researchers found that a higher share of Hispanic residents were also more impacted by hospital closures over the last decade," King reports. "From 2010 to 2020, the percentage of U.S. Hispanic residents in a county that faced a closure was 3.9% compared with 1.6% from 2000 to 2009 and 0.7% from 1990 to 1999."

Over the past three decades, rural counties whose hospital closed were increasingly likely to see shortages in primary-care providers and dentists first, King reports.

Drivers of the race-related trends "include the high clustering of rural hospital closures in the South from 2010 to 2020, a region where most of the states did not expand Medicaid after passage of the Affordable Care Act," King reports. "Another driver was the 'growing concentration of closures in rural counties that neighbor metro counties,' the study said."

The findings dovetail with a recent Chartis Group report on rural health-care systems, which it found were disproportionately shuttering in states that had not expanded Medicaid.