For Americans who live in cities or suburbs, going to the doctor is usually a simple errand. Even if they have trouble finding an appointment time that works for their schedule or getting their health insurance to cover it, their doctor’s office or hospital is usually a manageable distance from their home or work. However, for 46 million Americans living in rural areas, accessing healthcare isn’t as easy. According to a 2018 survey by the Pew Research Center, nearly a quarter of rural Americans say access to good-quality hospitals and doctors is a challenge for their community. Making things worse, these rural residents tend to be older, less wealthy, and less likely to have health insurance than their urban and suburban counterparts.

More than 100 million people, or nearly one-third of the nation, have trouble accessing primary care, according to a recent study published by the National Association of Community Health Centers. This number has nearly doubled since 2014. The pandemic worsened provider shortages nationwide, but the problem is more acute in rural areas, which have long struggled to recruit and retain doctors and other medical professionals. Researchers say the relative lack of providers is one reason people living in rural areas experience worse health outcomes than people who live in urban areas.