Texas has a rural health care disparity.
This means that 75 percent of our counties are federally designated health professional shortage areas. There simply aren’t enough doctors and nurses. Sixty-four of our counties lack a hospital, and 25 counties have no primary care physician. In short, rural health care disparity in our state means some 3 million Texans struggle to access the care they need.
Addressing the health gap facing our medically underserved areas would start with increased education about the benefits of checkups and procedures, better health care access, and expanded affordability. We also must find ways to combat the persistent, systemic disadvantages that often serve as a barrier to quality care.
This is an enormously complex problem without an easy solution. The best approach is to focus on one health care issue at a time where progress can be made. Improving our ability to screen more Texans for cancer is one issue we can address now. After all, this disease is the number two killer in the Lone Star State and rural Americans suffer from it disproportionately.
According to the Centers for Disease Control, the rate of cancer cases is lower in rural areas of the country compared to urban areas. However, the cancer death rates among rural residents is higher and the gap has grown over time. Some of this disparity can be attributed to lower cancer screening rates.
The data is clear on the benefits of screening. If you catch cancer early, before it spreads throughout the body, the five-year survival rate is close to 90 percent. That’s why tests like pap smears, colonoscopies, and mammograms are critical – and routine – for men and women at certain points throughout their lives. We are always looking for ways to improve access to available cancer screenings for rural Texans.
But even that would only get us part of the way to catching cancer early. There are many types of cancer people are at risk for, and we only have screening for five of them. This explains why 71 percent of all cancer deaths result from forms lacking early detection tests. There is good news on the horizon.
Multi-cancer early detection screenings are showing promise in clinical trials. These could represent a breakthrough in cancer screening technology – and a particularly important development for people living in rural areas with limited access to health care. One new method involves a single blood draw that has shown an ability to test for more than 50 kinds of cancers using our now highly advanced understanding of human genomics.
However, we cannot assume a “if you build it, they will come” mentality. There is hard work to be done even once this breakthrough screening is available. For example, the Medicare program responsible for the care of American seniors may not cover these new cancer screenings for up to a decade or longer – even after they’re approved by the Food and Drug Administration. We must now think about creative solutions to ensuring Texans can access these screenings. If nothing is done, we may be faced with years or even decades of waiting.
Now the ball is in the hands of policymakers. To our representatives in Washington and health care leaders across the state, the challenge is this: you have the opportunity to iron out the details so that Texans can access and benefit from these exciting new cancer screenings. This is no small charge, but rural Texans are counting on you.
Kelly Cheek has served on the Texas Rural Health Association Board of Directors since 2015 and has been the President of the Board since 2018.