Rural Health Outcomes and Infrastructure in Arizona Factors affecting rural health outcomes include health insurance coverage, socioeconomics, ready access to primary, preventive and other health care services, providers, infrastructure, and technology. Each rural community has unique strengths, opportunities and challenges in terms of the health of its population. In Arizona, key components of the rural health infrastructure include: n Critical Access Hospitals (CAHs): There are 15 federally designated CAHs in Arizona. These are rural hospitals with 25 hospital beds or less, located 35 miles or more from another facility, and providing 24/7 emergency medicine services. In addition to providing essential health services in Arizona’s vast rural regions CAHs contribute to the local economy. l Rural Health Clinics (RHCs): There are 24 federally certified RHCs in rural Arizona communities, most are affiliated with CAHs. RHCs increase access to primary, preventive and other health care services in rural communities using interprofessional, team approaches that include physicians, nurse practitioners, physician assistants, certified nurse midwives, and staff. u Federally Qualified Health Centers (FQHCs): There are 160 FQHCs in Arizona, with 75 located outside of Arizona’s urban areas. FQHCs provide primary, preventive and other health services to all, regardless of ability to pay in areas with access to few health care providers. They are the part of the health safety net providing health services to the uninsured, underserved, and those enrolled in Medicare, Medicaid (AHCCCS), and the Children’s Health Insurance Program (CHIP is KidsCare in Arizona). Health Insurance Coverage Arizona dramatically decreased its population without health insurance since 2013 in every county. In rural Arizona, Medicare, Medicaid (AHCCCS), and CHIP (KidsCare) are important sources of coverage. Source: U.S. Census American Community Survey 0 20 40 60 80 100% Maricopa Pima Yuma Pinal Mohave Santa Cruz Coconino Yavapai Cochise Gila Graham Greenlee Navajo La Paz Apache Percent Population in Rural, Urban Cluster, and Urban Areas The entire population in 7 of Arizona’s 15 counties live in Rural or Urban Clusters. Decrease in percent uninsured from 2008 to 2017 in all counties. Largest decreases were in Santa Cruz & Graham counties County populations have different rates of public and private health insurance* Percent of Arizonan children (<19) covered by AHCCCS, 2017 2 in 5 Children are covered by AHCCCS *Percentages do not add to 100% due to individuals who are uninsured or have a mix of both private and public health insurance coverage. Percent of Arizonans covered by AHCCCS, 2017 1 in 5 Arizonans are covered by AHCCCS 0 30% Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache 28 23 13 9 21 14 18 12 17 9 16 8 16 12 12 12 11 10 15 15 15 22 13 16 11 21 15 17 17 18 0 80% Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache 28 32 27 17 49 15 51 22 31 22 47 12 59 21 24 15 53 20 32 32 29 17 47 16 25 34 14 23 39 39 46 0 80% Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache 24 AZ 38% 41 34 54 41 28 60 35 50 57 40 38 52 40 46 0 40% Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache 39 AZ 21% 24 21 29 28 18 28 19 27 39 22 22 34 20 29 Suggested citation: Koch B, Peters J, Coates S, Carter H, Akmajian P, Derksen D: Rural Health Outcomes and Infrastructure in Arizona. Arizona Center for Rural Health Policy Brief. February 25, 2019.
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Rural Health Outcomes and Infrastructure in Arizona
Factors affecting rural health outcomes include health insurance coverage, socioeconomics, ready access to primary, preventive and other health care services, providers, infrastructure, and technology. Each rural community has unique strengths, opportunities and challenges in terms of the health of its population. In Arizona, key components of the rural health infrastructure include:
n Critical Access Hospitals (CAHs): There are 15 federally designated CAHs in Arizona. These are rural hospitals with 25 hospital beds or less, located 35 miles or more from another facility, and providing 24/7 emergency medicine services. In addition to providing essential health services in Arizona’s vast rural regions CAHs contribute to the local economy.
l Rural Health Clinics (RHCs): There are 24 federally certified RHCs in rural Arizona communities, most are affiliated with CAHs. RHCs increase access to primary, preventive and other health care services in rural communities using interprofessional, team approaches that include physicians, nurse practitioners, physician assistants, certified nurse midwives, and staff.
u Federally Qualified Health Centers (FQHCs): There are 160 FQHCs in Arizona, with 75 located outside of Arizona’s urban areas. FQHCs provide primary, preventive and other health services to all, regardless of ability to pay in areas with access to few health care providers. They are the part of the health safety net providing health services to the uninsured, underserved, and those enrolled in Medicare, Medicaid (AHCCCS), and the Children’s Health Insurance Program (CHIP is KidsCare in Arizona).
Health Insurance CoverageArizona dramatically decreased its population without health insurance since 2013 in every county. In rural Arizona, Medicare, Medicaid (AHCCCS), and CHIP (KidsCare) are important sources of coverage. Source: U.S. Census American Community Survey
0 20 40 60 80 100%
Maricopa
Pima
Yuma
Pinal
Mohave
Santa Cruz
Coconino
Yavapai
Cochise
Gila
Graham
Greenlee
Navajo
La Paz
Apache
Percent Population in Rural, Urban Cluster, and Urban Areas
The entire population in 7 of Arizona’s 15 counties live in Rural or Urban Clusters.
Decrease in percent uninsured from 2008 to 2017 in all counties. Largest decreases were in Santa Cruz & Graham counties
County populations have different rates of public and private health insurance*
Percent of Arizonan children (<19) covered by AHCCCS, 20172 in 5 Children are covered by AHCCCS
*Percentages do not add to 100% due to individuals who are uninsured or have a mix of both private and public health insurance coverage.
Percent of Arizonans covered by AHCCCS, 2017 1 in 5 Arizonans are covered by AHCCCS
0
30%
Yuma
Yavapai
Santa CruzPinal
Pima
Navajo
Mohave
Maricopa
La Paz
Greenlee
GrahamGila
Coconino
Cochise
Apache
2823
139
21
1418
1217
9
16
8
1612 12 12 11 10
15 15 15
22
1316
11
21
1517 17 18
0
80%
Yuma
Yavapai
Santa CruzPinal
Pima
Navajo
Mohave
Maricopa
La Paz
Greenlee
GrahamGila
Coconino
Cochise
Apache
28
32
27
17
49
15
51 22
31
22
47
1259
21
24
15
53 20
32
32
29
17
47
1625
34
1423
393946
0
80%
Yuma
Yavapai
Santa CruzPinal
Pima
Navajo
Mohave
Maricopa
La Paz
Greenlee
GrahamGila
Coconino
Cochise
Apache
24AZ38%
41 34
5441 28
60
3550
57
40 3852
40 46
0
40%
Yuma
Yavapai
Santa CruzPinal
Pima
Navajo
Mohave
Maricopa
La Paz
Greenlee
GrahamGila
Coconino
Cochise
Apache
39
AZ21%
2421
29 28
18
2819
27
39
22 22
34
20
29
Suggested citation: Koch B, Peters J, Coates S, Carter H, Akmajian P, Derksen D: Rural Health Outcomes and Infrastructure in Arizona. Arizona Center for Rural Health Policy Brief. February 25, 2019.
