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When Claudia Perez-Favela, a mom of three in California, skilled irregular intervals and heavy bleeding, she was involved that these may very well be signs of most cancers.
She knew there was a historical past of reproductive most cancers in her household, however she could not see the physician instantly as a result of she was uninsured. After she obtained medical insurance, she tried to arrange an appointment with a gynecologist, however there have been a restricted variety of suppliers in her city, and he or she needed to wait a number of extra months to be seen.
After she lastly noticed a healthcare supplier and had a number of exams completed, Perez-Favela mentioned she was recognized with cervical dysplasia (a precancerous situation the place irregular cells develop on the cervix) from an aggressive pressure of human papillomavirus (HPV). Due to her household historical past and the dysplasia prognosis, Perez-Favela had a hysterectomy.
Perez-Favela mentioned accessing medical care is difficult in rural areas. “Preventative screenings are essential. However in small cities there should not a number of docs and specialists — and the wait instances for getting an appointment may be a number of months. If there had been any additional delays in seeing the physician, my situation may have developed into one thing a lot worse.”
Perez-Favela isn’t alone.
Healthcare deserts current challenges for preventive care
Healthcare deserts — geographical areas the place there may be restricted entry to medical care — influence thousands and thousands of People. Restricted medical services, monetary hardship and a scarcity of medical insurance and transportation to medical appointments compound the issue.
Most cancers prevention screenings may also be a big problem in rural areas. The Facilities for Illness Management and Prevention experiences that just about 93% of cervical cancers are preventable with Pap and HPV exams and HPV vaccinations. However for rural sufferers with restricted entry to screenings, there may be severe ramifications — together with larger loss of life charges from preventable cancers.
“Offering care in rural communities comes with distinctive challenges. Many sufferers stay vital distances from clinics or hospitals, that means preventive care (Pap exams and HPV testing) is commonly delayed or skipped altogether. Transportation boundaries, restricted appointment availability and fewer suppliers in these areas make it troublesome for sufferers to get well timed screenings,” mentioned Michael Schifano, D.O., a board-certified OB-GYN at Heartland Ladies’s Healthcare of Advantia, in Illinois.
Hospital closures and Medicaid exclusions influence rural communities
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Consultants report that a number of components inside the final decade — hospital closures, funds cuts, lack of specialists and post-pandemic staffing shortages — have made issues a lot worse in rural areas.
Obstetric and gynecological care has been notably impacted — 267 rural hospitals stopped offering obstetric care between 2011 and 2021 — and almost 100 rural hospitals diminished companies or shut down, impacting over 16 million individuals, previously decade.
“The scarcity of OB-GYNs limits each screening and prevention. With out sufficient suppliers, sufferers not solely miss routine Pap and HPV exams but in addition alternatives to obtain HPV vaccination, which is a confirmed method to stop cervical most cancers earlier than it begins,” Schifano mentioned.
Marginalized communities expertise healthcare disparities at larger charges
Researchers on the College of Chicago discovered that hospital closures disproportionately influence Black communities. Rural Black ladies are additionally at elevated danger for cervical most cancers. Analysis reveals that Black ladies within the Mississippi Delta face vital boundaries in accessing cervical most cancers screenings and are at larger danger of dying from this illness.
Some states have additionally made it tougher for marginalized communities to get medical insurance. Below the Reasonably priced Care Act, states had been allowed to develop Medicaid protection to adults with incomes as much as 138% of the federal poverty stage. Ten states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming) refused the enlargement, leaving round 1.6 million individuals — largely Black and Latinx People — with out entry to insurance coverage.
Clinics that function in small cities are additionally shedding funding. In 2018, Republican South Carolina governor, Henry McMaster, issued an government order barring Deliberate Parenthood from the state’s Medicaid supplier record. Deliberate Parenthood — who experiences that 76% of its clinics are situated in underserved areas — filed a lawsuit difficult the order.
Whereas some Deliberate Parenthood clinics present early terminations (abortion is banned in South Carolina at six weeks), abortions had been by no means coated by Medicaid. Deliberate Parenthood does present quite a few different medical companies, together with most cancers prevention screenings (Pap exams, breast exams), however the state blocked funding to Deliberate Parenthood for all medical companies.
On June 26, 2025, the Supreme Court docket dominated 6-3 to uphold South Carolina’s order to exclude Deliberate Parenthood from Medicaid. Consultants report this ruling may have far reaching penalties for clinics throughout the nation.
“Eradicating funding for clinics that present preventive screenings is harmful,” mentioned Heather Bartos, M.D., a board licensed OB-GYN in Texas and a member of HealthyWomen’s Ladies’s Well being Advisory Council.
Imminent federal funds cuts will considerably influence entry to care
H.R.1 — the federal spending invoice signed into legislation by President Trump on July 4, 2025 — cuts billions in Medicaid funding and important well being packages. Medical facilities, hospitals and cell clinics that serve rural communities may very well be hit the toughest.
“The federal funds cuts below H.R.1 will make issues exponentially worse for rural sufferers. These areas already battle and now with billions being lower, it raises severe issues,” Bartos warned.
Telemedicine may be an necessary instrument to extend entry, however a scarcity of funding for telehealth packages and restricted excessive pace web in some rural areas prevents sufferers from collaborating in digital appointments.
Bartos mentioned suppliers ought to supply telehealth appointments each time attainable. “Some medical appointments should be in-person, however oftentimes follow-up appointments may be digital. If the one method a affected person may be seen is nearly — and the choice is that they received’t be seen in any respect — then a telehealth go to ought to be completed.”
After most cancers remedy ends, rural sufferers expertise challenges with follow-up care
Emily Hoffman, a cervical most cancers survivor in Iowa, mentioned that after her most cancers remedy ended, entry to high quality care grew to become an excellent greater drawback.
Hoffman lives in a small city and already needed to journey about 45 minutes every method to her most cancers remedy appointments. However after her remedy ended and Hoffman was cancer-free, she felt sicker than she did throughout remedy.
Hoffman developed extreme ache in her intestines and was recognized with radiation enteritis, irritation of the gut because of radiation. She was referred to a neighborhood gastroenterologist, however the suppliers in her group didn’t have expertise treating her situation.
“Most cancers doesn’t finish when remedy ends. I spent 4 years being tossed round to completely different gastrointestinal docs. I went from physician to physician attempting to get assist and spent a number of my thirties sick in mattress,” Hoffman mentioned.
After 4 years, she was lastly referred to the Mayo clinic. At Mayo, Hoffman tried various things to deal with her situation and ultimately started IV feeding, and her signs improved considerably. Hoffman provides that she is doing higher and now works as a affected person advocate, however the limitations she skilled in getting the care she wanted had a big impact on the standard of her life.
As for Perez-Favela, she has been advocating for most cancers sufferers, particularly in rural communities. “I proceed to battle for individuals to have entry to higher healthcare and communicate out in opposition to funds cuts that may hurt sufferers. Most cancers doesn’t discriminate — it could influence anybody,” she mentioned.
This instructional useful resource was created with assist from Merck.
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