Newswise — As President Bush looks to the new year to set his priorities for his second term of office, he should remember the rural voters who handed him his victory, says Timothy McBride, Ph.D., a health economist and professor of health management and policy at Saint Louis University School of Public Health.
McBride recently analyzed the 2004 election and found that voters from rural areas provided President Bush with his entire margin of victory -- roughly 3.5 million votes in the election. Bush received a plurality of roughly 4.27 million more votes in rural areas, while Sen. John Kerry received a plurality of about 775,000 votes in urban areas.
"Bush carried rural areas by a huge margin of 59 to 40 percent, while Kerry narrowly carried urban areas by a margin of 50 to 49 percent," McBride said.
In addition Bush's victory in the Electoral College, which actually decides who is the next president, came from margins in rural areas in the four critical 'red' states he carried: Ohio, Iowa, New Mexico and Nevada, adding up to 37 electoral votes.
"Since rural Americans handed Bush his victory, it seems reasonable that rural voters should expect that their issues would top the President's agenda when he sets priorities for a second term," McBride says.
McBride serves on a national panel that advises federal policymakers, and provides briefings and testimony to Congress. He sees several key health issues that affect rural Americans:
· Rural Americans are more likely to be uninsured and less healthy than the rest of America. "Access problems are especially a problem for the Medicare and Medicaid programs, and will be exacerbated by the recently enacted Medicare prescription drug plan," he says.
· Rural Americans have difficulty getting access to quality health care. Many services simply are not present in rural communities, McBride says.
· Rural Americans tend to be poorer. The median income of rural Americans is 24 percent lower than urban Americans, and the poverty rate in rural areas is 14 percent, compared to 11 percent in urban areas. "Rural persons are more likely to be low-wage workers, hit by high health costs, and the employers of rural persons struggle to provide health insurance to their workers."
· Rural Americans are older, and most effected by enormous government deficits " exacerbated by the impeding retirement of Baby Boomers and the rising costs of Medicare, Medicaid and Social Security. "These entitlement programs will put enormous strains on federal and state governments. Rural areas have a higher proportion of elderly living in them than urban areas do (20 percent, compared to 15 percent.) The burden of caring for the elderly will be a bigger concern in rural areas than in urban areas," he said.
In a nutshell, Bush owes it to rural Americans to address their health care problems, McBride says.
"As President Bush struggles to priorities his agenda, meeting the concerns of rural Americans to achieve equity and access to quality health care, while holding down rising costs, should be a top goal."
Saint Louis University School of Public Health is one of only 36 fully accredited schools of public health in the United States and the nation's only School of Public Health sponsored by a Jesuit university. It offers masters degrees (MPH, MHA) and doctoral programs (Ph.D.) in six public health disciplines and joint degrees with the Schools of Allied Health, Business, Law, Medicine, Nursing and Social Service. It is home to seven nationally recognized research centers and laboratories with funding sources that include the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the American Cancer Society, the Robert Wood Johnson Foundation and the World Health Organization.
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