By Jaymie Baxley
Rockingham County struggles with the same health issues that plague most of the state’s rural communities.
Residents suffer from high rates of diabetes and other chronic conditions. There aren’t enough local providers to ensure equitable access to care. The population is aging.
During a recent discussion at Rockingham Community College in Wentworth, the Virginia-bordering county of about 91,000 people was presented as a microcosm of rural health in North Carolina. Organized by Cone Health and UNC Health, the event was billed as an opportunity for local health care professionals to “further understand the needs of our neighbors.”
State Senate leader Phil Berger made an appearance but let others do the talking. The Republican represents District 26, which includes Rockingham County.
About 50 people participated in the discussion. After listening to a presentation on national trends, they were asked to identify what they considered to be the biggest issues affecting health outcomes in Rockingham.
Many of their answers could have easily applied to any of the state’s 78 rural counties.
Barriers to care
Flavel Collins, director of outreach at Hospice of Rockingham County, said a number of residents lack reliable transportation. She acknowledged that some providers are attempting to bridge the gap with telemedicine, but the service can be confusing for older patients.
“For our senior population, knowing what to access and how to access it is an issue,” Collins said.
People age 65 or older account for 21.5 percent of Rockingham’s population, according to the latest estimates from the U.S. Census Bureau. The same age group makes up about 17 percent of the state’s total population.
Digital literacy isn’t the only barrier. Diane Boyd, program manager for Care Connect of Rockingham County, said residents “don’t have high-speed internet in a lot of the county.”
“When COVID came along, […] all these virtual things looked so great on paper,” Boyd said. “But we are working with individuals that when they pull into their driveway, their phone doesn’t even work anymore. They can’t utilize it at home.”
Only 61 percent of Rockingham County residents subscribe to broadband internet, according to the N.C. Broadband Adoption Index. More than a fifth of the county’s households have no internet — high-speed or otherwise.
Lindsay Bridges, a surgeon from Reidsville, cited the county’s ongoing shortage of health care workers as a concern. She said many younger residents who leave Rockingham to study medicine take jobs in other counties after they graduate.
“That’s going to continue to create more disparities with not having enough primary care, not having enough access and [people] continuing to have comorbidities and issues that need to be addressed,” Bridges said. “We really need to have some innovation and thoughts about getting into the school systems, educating people and getting people to want to do these jobs.”
This year’s County Health Rankings report from the University of Wisconsin Population Health Institute rated Rockingham among the least healthy counties in North Carolina. Rockingham has a larger percentage of residents with harmful health behaviors — adult smoking, adult obesity, excessive drinking — than the state overall, according to the report.
Felissa Ferrell, director of the Rockingham County Department of Health and Human Services, believes more can be done to promote preventive measures among residents.
“I think we’ve got to start younger to help our folks grow more stable with their health care needs, as well as understanding that a pill doesn’t fix everything,” Ferrell said. “There are other things that have to go with that. Education is very key.”
Hospitals at risk
Mark Holmes, director of the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, ended the event with a presentation on trends affecting the state’s rural hospitals.
He noted that rural hospitals are less profitable than urban hospitals. Forty-six percent of the state’s rural hospitals posted negative operating margins in 2022. For urban hospitals, the share was 28 percent.
Holmes added that rural hospitals have grown more reliant on outpatient services than their urban counterparts. Outpatient services, he said, make up about two-thirds of rural hospitals’ business.
Twelve rural hospitals in North Carolina have either shut down or stopped providing inpatient care since 2005, according to data from the Cecil G. Sheps Center. The most recent closure happened in August at Martin General, a financially struggling facility in Martin County.
Morehead Memorial Hospital in Rockingham County seemed destined to a similar fate after declaring bankruptcy in 2017. The Eden facility was saved by UNC Health, which purchased the hospital in 2018 and renamed it UNC Health Rockingham.
Holmes described the gathering in Rockingham as “a strategic day” for the county’s health care professionals and stakeholders.
“We have a wide range of people here,” he said. “People who know Rockingham County and love Rockingham County. You know what you have here that makes you unique and what your needs are, but also what you have that’s an asset that needs to be leveraged.”