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I've got nothing against protests. They're part of a healthy democracy. But the yelling over health-care reform (including false rumors of 

) is threatening to detract from more substantive issues, such as disparities in access. Especially among women. Especially among rural women.


Women overall pay higher premiums, face higher out-of-pocket health care expenses, are less likely to be insured through their employers, less likely to pay off medical debt and more likely to delay needed care.


At our 27 clinics in Minnesota and the Dakotas, Planned Parenthood is seeing increases in the number of women who have been laid off, who are without insurance, and who cannot afford to follow up on problems that are discovered during their exams.
 
Here's what we're hearing:

"I just graduated from college and can't find a job."

"I can't fill my prescription because I have to buy groceries."

"My husband just lost his job and I've been cut to part time."

Nowhere are these problems more evident than in our 16 rural Minnesota clinics. More than half of our 64,000 patients -- 94 percent of whom are women -- live in poverty. In rural Minnesota, the number who live in poverty jumps to 63 percent. Just one in three has public insurance, and one in five has private insurance. Only 3 percent can afford the full cost of their health care.


These income disparities, combined with a 

shortage of primary care providers in rural Minnesota

, have some dire health outcomes. For example:

 are 30 percent more likely than urban women to be diagnosed with invasive 

. They are less likely to receive recommended preventive gynecological care, including 

 is endemic in rural Minnesota -- 43 Minnesota counties have teen pregnancy rates higher than the state average. All but two of these counties are in rural Minnesota.

 in the rates of sexually transmitted infections continue to occur in rural Minnesota.


Our national health care reform package must contain direct access to affordable health care services for all women, including comprehensive reproductive health care.  The most important conversation about health care in a generation is happening now. Let's not get sidetracked by the shouting.


Sarah A. Stoesz is president and CEO
of Planned Parenthood Minnesota, North Dakota, South Dakota.

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Sarah Stoesz

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The emotional nationwide debate over health care reform pulls attention away from some fundamental problems -- like wide disparities in access to care.

More than reform, rural women need health care

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