A lack of specialized health services takes a toll on rural communities across the country, four-part series concludes

Part of Lanai City, Hawaii (Cory Lum/Honolulu Civil Beat)

A lack of specialists in rural communities as diverse as remote Hawaiian islands to the rugged mountains and forests of far Northern California are straining local health-care resources and forcing local residents to rely on telehealth services or faraway providers. So say the last two stories in a four-part series by The Daily Yonder, the Institute for Nonprofit News, Carolina Public Press, Honolulu Civil Beat and Shasta Scout, with support from the National Institute for Health Care Management Foundation.

The Hawaiian island of Lanai, which has a population of just over 3,000, no longer has in-person psychiatric care, reports Brittany Lyte of Honolulu Civil Beat. In 2020, the state agency that offers mental-health services to uninsured or underinsured adults no longer staffed a professional on the island and switched to telehealth services from a provider in Michigan. A report from a local health-care nonprofit surveyed residents of Lanai and a nearby island found that nearly 70% of the health care that residents of the two islands receive require trips off the island, "which is arduous and expensive," the report said.

California's North State
(California Economic Development Dept.)

A lack of health-care specialists also plagues Shasta County and the other 10 counties that make up California's rural North State, an official economic development region of the state, reports Annelise Pierce for the Shasta Scout. The largely remote area, which has about a fifth of the state's geographic area but relatively little population, has a dearth of doctors who specialize in lung care and only one neonatal intensive care unit, in Redding. But still, the families of babies in need of intensive care may struggle to come up with the gas money necessary to drive from one county in the area to Redding or Sacramento or southern Oregon where the other closest NICUs are. The lack of specialists is due in part to a lack of state central planning, Pierce reports. There's a statewide acknowledgement of a lack of specialists but "no one Shasta Scout spoke with knew exactly which or how many specialist doctors are missing in Shasta County."