Pharmacy closures continue on in rural America
Imagine waking up to find your local pharmacy - your lifeline to vital medications and healthcare services - has suddenly closed its doors. It's a labyrinth of paperwork and emotions, adding to the fatigue of patients who are often already battling debilitating medical conditions.
For many Americans in rural areas, this nightmare is becoming a reality. It's another blow to communities all too familiar with inaccessibility to critical healthcare services.
A Disturbing Trend
Recent years have seen a disturbing trend — major pharmacy chains are shuttering locations across the country, creating "pharmacy deserts" that threaten the health and well-being of our communities. The people residing in these areas often face higher poverty rates due to lower than average income, struggling to afford basic necessities like housing, food, and medical care.
In 2023, Rite Aid announced the closure of 154 stores nationwide, with a significant impact on rural communities. CVS Health plans to close approximately 300 stores annually for three years, totaling 900 closures by the end of 2024. These closures are creating what health experts call "pharmacy deserts" – areas where access to essential medications and healthcare services is severely limited or non-existent.
Dr. Lisa Bielamowicz, president of Gist Healthcare, explains the gravity of the situation: "In some rural areas, the local pharmacy is not just a convenience — it's a lifeline. When these pharmacies close, it's not just about longer drives for prescriptions. It's about losing a crucial point of care in communities that are already medically underserved."
The Human Cost
For rural residents, the consequences of pharmacy closures are far-reaching and potentially life-threatening. As local drugstores disappear, a simple task like refilling a prescription becomes a daunting challenge, often requiring long drives and careful planning. This logistical nightmare isn't just an inconvenience—it's a serious health risk. Missed doses can lead to severe complications, particularly for those managing chronic conditions. The gravity of this situation is underscored by a recent study in the Journal of the American Medical Association, which found that pharmacy closures were associated with a 6% reduction in adherence to cardiovascular medications among older adults.
The true impact goes beyond just access to medication. In small town America, the local pharmacy was a cornerstone of community life—a hub where neighbors caught up and sought trusted health advice. Its loss cuts deeper than mere inconvenience, exacerbating the sense of isolation many rural residents already experience. This isolation is compounded by the economic strain of traveling long distances for medications, forcing impossible choices for many. The stark reality is that 13.3% of rural Americans live below the poverty line, compared to 10.0% of urban residents, according to the Rural Health Information Hub. For these individuals, the added cost of accessing healthcare can be devastating.
The closure of these lifeline rural pharmacies creates a dangerous gap in preventive care. These establishments often provided vital services like vaccinations and health screenings—services that are now out of reach for many. This loss is particularly alarming given that the Centers for Disease Control and Prevention reports higher rates of preventable conditions like heart disease and diabetes among rural residents.
As these essential services vanish, the health disparities between rural and urban America threaten to widen even further, creating a silent health crisis in the heartland of the nation.
A Community in Crisis
Sarah Thompson, a 68-year-old resident of Millbrook, a small town in rural Iowa, shares her story: "When our local pharmacy closed last year, it felt like losing a family member. Tom, the pharmacist, knew everyone by name. He'd call to check if I was feeling better after starting a new medication. Now, I have to drive 45 minutes each way to get my prescriptions. Some days, I just don't have the energy for it."
Sarah's experience is not unique, a 2019 study by the RUPRI Center for Rural Health Policy Analysis found that 1,231 independently owned rural pharmacies closed between 2003 and 2018, leaving 630 rural communities with no retail pharmacy.
Seeking Solutions
As the sun sets on another day in rural America, the lights in many local pharmacies have gone dark for good. But amidst this healthcare crisis, a quiet revolution is brewing. Across the country, communities and healthcare providers are rolling up their sleeves, determined to find innovative solutions to keep vital medications and services within reach.
Some areas are turning to the promise of telepharmacy. Picture Sarah, an elderly resident of a small Midwestern town, speaking face-to-face with a pharmacist – not across a counter, but through a computer screen. This isn't science fiction; it's happening now. A groundbreaking study in the North Dakota Law Review found that these virtual consultations are more than just convenient – they're lifesaving, increasing both access to medications and adherence in rural areas.
But for those who crave a more tangible solution, help is quite literally on the way. Organizations like Mobile Health Map are bringing healthcare to the people, pioneering pharmacies on wheels that rumble down dusty country roads. These mobile clinics are a lifeline for underserved communities, bringing not just prescriptions but hope to areas long neglected by traditional healthcare models.
In Washington, the fight for rural health has reached the halls of Congress. The Pharmacy and Medically Underserved Areas Enhancement Act, currently under consideration, aims to recognize pharmacists as essential healthcare providers in medically underserved communities. It's a potential game-changer that could incentivize pharmacies to keep their doors open in the areas that need them most.
Yet perhaps the most inspiring solutions are coming from the communities themselves. In towns across America, residents are banding together to create community-owned pharmacies. It's a return to the ethos of barn-raising, but with life-saving medications instead of timber. The National Community Pharmacists Association (NCPA) reports that these independent pharmacies, often the last bastion of healthcare in rural areas, are more likely to offer services tailored to their communities' unique needs.
But even with these innovative approaches, a critical challenge remains: staffing. Enter companies like ShiftRx, a startup that's tackling the pharmacy provider shortage head-on. Connecting pharmacists and pharmacy technicians with openings at pharmacies, with an AI-powered approach, and giving these facilities a larger geographic reach.
As night falls and the last prescriptions of the day are filled, it's clear that the story of rural pharmacies is far from over. It's a tale of American ingenuity, of communities refusing to be left behind in the healthcare landscape. And while the challenges are daunting, the spirit of innovation burning bright in these small towns may just be the cure they've been waiting for.
As this crisis unfolds, it's clear that the health of rural America hangs in the balance. Sarah Thompson and millions like her are not just statistics – they are our grandparents, our neighbors, the backbone of communities that have long been the heart of this country.
"I never thought I'd have to worry about getting my medicine," Sarah says, her voice strong despite her concerns. "But we're not giving up. This town has weathered tough times before, and we'll find a way through this too."
The question now is...
Will the rest of the country hear the call of rural America? As pharmacies continue to close, the clock is ticking. It's time for innovative solutions, policy changes, and a renewed commitment to ensuring that no American, no matter where they live, loses access to essential healthcare.
The future of rural communities – and the health of millions – depends on it.
Citations
- Qato, D. M., et al. (2019). Association Between Pharmacy Closures and Adherence to Cardiovascular Medications Among Older US Adults. JAMA Network Open.
- Rural Health Information Hub. (2023). Rural Poverty and Well-being.
- Centers for Disease Control and Prevention. (2023). Rural Health.
- RUPRI Center for Rural Health Policy Analysis. (2019). Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018.
- Friesner, D. L., et al. (2011). Do Remote Community Telepharmacies Have Higher Medication Error Rates Than Traditional Community Pharmacies? North Dakota Law Review.
- National Community Pharmacists Association. (2023). 2023 NCPA Digest.