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About 1 in 3 rural Americans say they've struggled to afford health care in recent years – even more so than the share who have had trouble paying for food or housing, a new survey indicates. Rural communities – which tend to be older, poorer and sicker than urban areas – can face a complex set of challenges in accessing health care and other services. In all, about 4 in 10 rural adults have struggled to afford medical bills, housing or food in recent years, according to the new poll. About a quarter of rural adults have skipped health care at some point because they lacked either financial or physical access to care, the survey found. While rural adults without health insurance were more likely to forgo care than those who had health coverage, 24% of insured adults had not received the care they needed, the survey found. The most common reasons people didn’t receive health care were affordability, a health care provider being too far away or difficult to get to, not being able to get an appointment during certain hours and not being able to find a doctor who took their health insurance, the survey found. Recent hospital closures in rural areas make health care access even more difficult, the report noted. Eight percent of rural adults said local hospitals had shuttered in recent years, with two-thirds saying the closures were problematic for their communities. More than 60 rural hospitals closed across the U.S. between 2013 and 2017, driven in part by a falling number of people seeking inpatient care and reductions in Medicare payments, according to a 2018 report from the federal Government Accountability Office. A separate analysis published earlier this year found that about 1 in 5 rural hospitals were at risk of closure if their financial situations did not improve. Source: https://www.usnews.com/news/healthiest-communities/articles/2019-05-21/1-in-3-rural-americans-struggle-to-afford-health-care