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By Ella Reeve, Kennedy Williams, Maggie Hynek, and Olivia Cassidy


Our group chose an overarching theme of access to care, using interview clips from individuals living in rural North Carolina. In order to develop a robust understanding of factors that limit individuals’ ability to access care we first analyze the macroscale structures of transportation and insurance. We then narrow our focus on the specialty treatment of substance abuse and reproductive health to serve as case studies that critically examine problems within the healthcare systems.

Without transportation, patients are unable to reach the care they need. George Cosmos, retired OB-GYN living in Warren County, discusses how many of his patients could not access care due to a lack of personal or public transportation. Norma Armwood, a behavioral health specialist in Wayne County, reflects on what it was like having to drive extensive distances for her mother to receive cancer care.

Regardless of location or gender, one of the most indicative factors regarding access to care is insurance, or lack thereof. Insurance impacts people of all demographics and backgrounds, and can severely skew the treatments accessible to patients. Shannon McGowan, a longterm healthworker, acknowledges this fact as she discusses the changes she has witnessed in the medical system as a result of changes in insurance and treatment costs, especially within under-resourced communities. Kesha Neely shares a contrasting perspective on the topic of insurance. Kesha shares her family’s experience on Medicaid and as a mother of two, sheds light on the fear a parent can experience when facing life without insurance.

Another measurable indicator of negative effects stemming from lacking access to care is the prevalence of substance abuse in rural communities. Tiffanie Cotton, a substance abuse counselor at The Harvest House in Dunn, NC, describes the need for outreach and resources for rural patients, especially in terms of substance abuse support.

With the hardships faced to gain adequate health insurance, some narrators discuss its overreaching effect on people’s lives, specifically discussing reproductive health for patients. Stephanie Atkinson, an employee at CommHealth, discusses the issues she witnesses first-hand with patients who have been diagnosed with HIV and how being uninsured creates more barriers to receiving treatments. Mirna Allende, a former employee of CommWell Health, discusses her own experience with lack of insurance, and the alternative methods she partakes in to avoid going to the medical professionals. While also detailing her work with HIV patients, and experiencing the loss of a family member to HIV complications. Through the varied experiences of the narrators’ access to care can be viewed as a complex multifaceted issue that needs to be addressed.

Student Essays