To live a healthy life — this is perhaps the most crucial and elusive human urge, an extension of our primal instinct for self preservation — “wellness” occupies much of the headspace of 21st-century Americans. To reach our personal brand of wellness, we have an individualized list of traits and routines that we check off and apply. Yearly doctor’s visits, a stable diet and a regimen of self care are what we, as Americans, consider to be the most important factors, but in reality, there is so much more to being what we socially determine as “healthy.”
In the United States, it is difficult for all of us to be healthy — it was estimated in 2020 that 28 million Americans were without health insurance. That same year, the average per capita spending on healthcare was almost 12 thousand dollars, over double the amount spent by countries of similar wealth. With outrageous costs and a system that is difficult to navigate, the aspirations of feeling fully “healthy” are unattainable for so many. Location and socioeconomic status are major determinants of our health as well — such divisions determine how healthy we are, and even what we know about health in general.
Rural Americans are distanced from quality healthcare in more ways than one. With long distances to travel and lack of reliable access to medical information, this approximately 20% portion of the U.S. population is inclined to have worse health outcomes. Residents of rural areas are more likely to have illnesses, and are less likely to be insured or be seen by a health provider. Such disparities have created an environment where rural Americans have higher mortality rates, barring millions of people their right to lead happy and healthy lives. One’s zip code should not play a role in one’s access to quality care — whether you live in a bustling city or quiet town in the country, you should be able to consult with a healthcare provider and get the guidance you need.
Similarly, and often relatedly, a lower household income lessens one’s ability to access quality healthcare, which in turn leads to poorer health outcomes and standards. It has been found that facing poverty and social class discrimination in one’s life results in negative health changes. Those American children, adults and families that earn less than the median income are predetermined to lead lives of lower health outcomes and limited access to proper care.
There still remains the greatest limitation to health equity in the United States — the unequal distribution of health literacy, one’s aptitude for collecting health information, and the ability to properly communicate health concerns perpetuated by the digital divide. In a time when usage of telemedicine has dramatically increased, having access to technology is becoming almost essential to leading a healthy lifestyle. The “digital divide,” or the lack of infrastructure to support a remote healthcare experience, is only exacerbated by one’s geographic location. Rural Americans are more likely to have lower digital literacy and lack secure access to a broadband network, an essential piece of infrastructure that determines one’s capability to connect to the Internet. In the 21st century, the absence of a broadband connection results in a decreased rate of health literacy. If we fail to understand our own health and the systems that govern it, we fail to obtain the care we need to achieve our desired outcomes of well-being.
Health literacy is essential to leading a healthy lifestyle. Just like general literacy, health literacy is the ability to both find and understand health-related information, and how to use it as actionable guidance. A high degree of health literacy is defined by an increased aptitude for collecting health information, and the ability to properly communicate health concerns. There are educational, financial and societal barriers that limit specific populations from reaching a just level of wellness knowledge, an inequity that requires immediate solution if health justice is to be attained.
The most impactful way to eliminate the health literacy divide is to eliminate the digital divide. The promotion of digital health literacy can be advocated for on both a personal and institutional level — doctors can supply their patients with online resources to ease their experiences, and politicians can work to advance digital infrastructure throughout the country. For individuals who can’t afford Internet access or who are geographically distanced from strong signals, grants allocated directly to communities to make advancements are essential. By funding public libraries and community centers, we can supply more individuals with information about their health, which in turn will allow them to live fuller and more informed lives.
Rural Americans are at a disadvantage when it comes to being healthy. From food deserts to difficulties in receiving EMS services, residents of the nation’s rural regions are systemically predisposed to a lower quality of health. The largest disadvantage, though, that rural communities face is the inadequacy of health literacy education — without understanding the intricacies of the healthcare system, we can’t properly care for ourselves. In breaking down the barriers of the digital divide we can ensure that all Americans are able to access quality healthcare from an informed and secure perspective. In order to fit one’s personal standard of health, all of us must be able to obtain the required knowledge to do so. Your income and location shouldn’t determine your ability to be well.
Lindsey Spencer is an Opinion Columnist and can be reached at lindssp@umich.edu