内容摘要：has raised doubts about how far he can go in asserting his power to tax imports.

has raised doubts about how far he can go in asserting his power to tax imports.

Haywood Park Community Hospital was the closest hospital for many in Brownsville, Tennessee, a rural city in the western part of the state.Some residents believe it kept their loved ones alive. But

or skipped care completely. The facilityin 2014 after a decline in patients.“Despite my ill feelings or experiences I had in that environment,” said Alma Jean Thomas Carney, who described the hospital’s white staff as unwelcoming, “you have indigent people living in Haywood County who need to get to the closest facility available.”

It’s more common for people in rural areas to die earlier than urban residents from things like heart disease, cancer and stroke, according to the Centers for Disease Control and Prevention. But hospitals have closed throughout rural America in the last decade, leaving some of the 46 million people who live in these areas fewer options to getAdvocates, hospital and health clinic administrators and rural residents say changing disparities in

needs to start at the local level — especially in communities of color that may lack trust in the medical field.

It’s already happening in Brownsville, where the hospital fully reopened in 2022;“If the hospital didn’t exist, there wouldn’t be any physicians there,” Miller said. “There is no place to go and get a lab test except for that hospital. There may be no nursing home or place to get rehab or long-term care other than these hospitals.”

When a hospital does stay open in a large rural area where few people live, the facility may not see the number of patients it would need to see to be profitable, said Arrianna Planey, who researches health policy and management at the University of North Carolina.Leaders in Brownsville tried to find a buyer for the hospital. The county eventually purchased it. Braden Health, a privately held company, then took over the hospital with two conditions from the county supervisors: It must be a full-service hospital with a 24-hour emergency room and staff had to be hired as quickly as possible. Local officials say the hospital is breaking even.

Tennessee is one of 10 states — many of them in the South — that haven’t expanded Medicaid. Michael Meit, the director of East Tennessee State University’s Center for Rural Health Research, believes doing so would be an obvious solution to the problem of growing rural health disparities. More people would be covered by insurance, Meit said, and hospitals could make more money.“They’re providing a lot of uncompensated care,” he said of rural health systems in those states.