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What’s at Stake as Rural America Loses Its Hospitals

Rural regions across the country are facing are losing their hospitals. The wave of closures poses huge burdens for those in need of urgent care, and can be a matter of life-and-death in emergencies. The shutterings come as rural America confronts a series of health crises that go beyond the opioid crisis: higher rates of teen births, disabled workers, cardiovascular disease, as well as deaths from cancer and chronic lung disease. Rural residents also tend to be older and their towns suffer from higher rates of unemployment. When hospitals close, the surrounding economy often takes a hit as well, further undermining the well-being of rural communities. This webinar will provide a fresh overview of the trend and explain the forces driving closures and what they mean for health. Reporters will gain crucial context and insights that will deepen their coverage of imperiled health centers and the communities that rely on them.

WHEN: Jan. 22, from 10-11 a.m. PT / 1-2 p.m. ET 

REGISTER: [Now closed]

Our panelists:

Dr. Katy Kozhimannil is the director of research at the Rural Health Research Center at the University of Minnesota, where she’s also an associate professor of health policy and management. Her research focuses on the ways in which health policy can improve health care delivery, quality, and outcomes during critical times such as pregnancy and childbirth. Her work aims to bolster the evidence base for policies that advance racial, gender, and geographic equity and address social determinants that shape health and well-being. Her research has been published in journals including Science, the New England Journal of Medicine, JAMA, Health Affairs, American Journal of Public Health, Medical Care, and the American Journal of Managed Care. Her work has also been featured in stories by The New York Times, Washington Post, NPR, Wall Street Journal, US News & World Report, and the Huffington Post. Kozhimanil holds a Ph.D. from Harvard University, and a masters degree from Princeton. 

Betsy McKay is a senior writer for The Wall Street Journal. She writes about U.S. and global public health. Previously, she was Atlanta bureau chief, managing a team of reporters covering the Eastern U.S. and several industries. As a reporter before that in Atlanta, she covered the beverage industry, and public health. McKay joined the Journal in Moscow, where she wrote about Russia's post-Soviet political and economic transformation. She is a member of the team of Journal reporters awarded the 1999 Pulitzer Prize in the international reporting category for in-depth analytical coverage of the Russian financial crisis. She has won awards for stories on public health issues, including drug-resistant tuberculosis and maternity care in the rural U.S. McKay holds a B.A. from Amherst College and an M.A. in Russian language and literature from Bryn Mawr College. 

 Webinars are free and made possible by The Commonwealth Fund and the National Institute for Health Care Management Foundation.

Presenters' slides:

Dr. Katy Kozhimannil: "What’s at Stake as Rural America Loses Its Hospitals"


Suggested reading

A Sense of Alarm as Rural Hospitals Keep Closing,” by Austin Frakt, The New York Times

A Hospital Crisis Is Killing Rural Communities. This State Is ‘Ground Zero,’” by Lauren Weber and Andy Miller, Huffington Post/Georgia Health News

"Death by a Thousand Cuts: Rural Healthcare Left Behind," by 2017 Center for Health Journalism California Fellow Elizabeth Zach, Rural Currents/High Country News/Redding Searchlight

Why Rural Health Care Is Failing New Moms,” by Betsy McKay and Paul Overberg, Wall Street Journal (VIDEO)

Rural America’s childbirth crisis: The fight to save Whitney Brown,” by Betsy McKay and Paul Overberg, Wall Street Journal

Rural America's Childbirth Crisis: The Fight to Save Whitney Brown,” by Betsy McKay, Wall Street Journal

"Sick, Broke and Left Behind," by 2018 Center for Health Journalism National Fellow Luann Rife, Roanoke Times

When Obstetrics Units Close, Rural Hospitals Save At The Expense Of Women’s Health,” by Natalie Krebs, Texas Standard

Healthcare Triage: Rural Hospital Closures Impact the Health of a Lot of People,” by Aaron Caroll, Healthcare Triage


Rising Closures Of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations,” by Renee Yuen-Jan Hsia and Yu-Chu Shen, Health Affairs (2011)

Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States,” by Katy B. Kozhimannil et al., JAMA (2018) 

Why Are Obstetric Units in Rural Hospitals Closing Their Doors?” By Katy B. Kozhimannil et al., Health Services Research (2016)

Hospital Closures Had No Measurable Impact On Local Hospitalization Rates Or Mortality Rates, 2003–11,” by Karen E. Joynt et al., Health Affairs (2015)

Rural Hospital Closures: Number and Characteristics of Affected Hospitals and Contributing Factors,” U.S. Government Accountability Office

Rural hospital closures tracked by UNC's Cecil G. Sheps Center for Health Services Research


The Center for Health Journalism’s 2023 National Fellowship will provide $2,000 to $10,000 reporting grants, five months of mentoring from a veteran journalist, and a week of intensive training at USC Annenberg in Los Angeles from July 16-20. Click here for more information and the application form, due May 5.


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