Rural health care: good for the economy?

• Author: Flanders, Gretchen
• Position: Includes related articles on special loans for rural businesses and on federal health incentives

Saving a rural hospital or building a health center in small towns brings more than health care to a community. It's "economic development."

The early '80s were bleak for Southern Illinois. Factories closed, unemployment burgeoned, property values plummeted and there weren't enough doctors for rural residents. Today, however, the area enjoys a strong economy and there's better health care for everyone. What happened?

The turnaround can be credited, in part, to a small group of community members who got together with two goals: bring desperately needed physicians to the area and beef up the economy.

The town of Centerville, population 10,000, had a hospital and a health department, but neither provided basic services like checkups, immunizations or treatments for colds. Residents traveled to another town to see a doctor or went to the local hospital emergency room, an expensive and inefficient place to have minor ailments treated. In 1985, the local health department provided the space for the first community health center and a state public health service grant supplied the operating funds.

Since that first clinic opened its doors with one doctor and a nurse, the Southern Illinois Healthcare Foundation has been developed and has built another 14 clinics that provide a wide variety of primary medical services, including well-baby checks and physicals. Doctors, nurses and other traditional health care providers work at the centers, but so do nutritionists and social workers, who help people become and remain healthy.

"As an elderly woman, it's very important for me to have a doctor close to my home," says Mary Wilkerson. "The foundation has clinics all over the area so that people like me don't have to travel long distances." She has been a patient of the Centerville clinic for more than three years, and is "very pleased" with the health care she receives. The clinics also provide transportation for elderly patients who can't get around by themselves and young mothers who need extra help.

Today, the foundation employs 39 doctors and nurses and 550 people from area communities. The centers directly and indirectly support 679 full-time jobs, and those employees handled 81,000 patient visits in 1997.

THE MONEY STAYS HOME

Every health care dollar spent in a rural area recycles through that community at least one and a half times. One rural physician generates more than five full-time jobs and $233,000 in local economic activity, according to the Federal Office of Rural Health Policy. Statistics show that the health care industry provides up to 20 percent of the payroll and employs up to 15 percent of the people in rural communities.

Through their activities, the Southern Illinois Healthcare Foundation centers generated $53 million in local revenue in 1997. The indirect effect of that economic activity on household incomes was almost $27 million.

"Community health centers make dramatic contributions to the health and well being of their communities and to the economic output of the United States while operating under a very small budget," says Dan Hawkins, vice president of the National Association of Community Health Centers.

Yolanda Smoot, a registered medical technician at...