Author: Hope Friedman

Why Compare?

Many of the people who read this blog are likely from the United States, and while it’s easy to focus on the challenges we see here, it’s important to recognize that people in other countries often face very different, sometimes more severe, healthcare struggles. At the same time, the U.S. itself isn’t in the best shape when it comes to medical access and equity.

By looking at both domestic and international health disparities, we can better understand how widespread these issues are. Learning about the healthcare situations in other countries not only broadens our perspective but also helps us recognize warning signs, take action in our own communities, and support those living in underserved areas around the world.

Domestic Issues Vs. International Issue

Domestic health issues in the United States go beyond common illnesses like the flu or a cold. Many communities, especially rural and underfunded areas, face limited access to quality healthcare, high medical costs, and disparities in treatment. In fact, over one-third of rural Americans report skipping needed medical care because of cost, a rate more than twice as high as in many comparable countries. Rural areas also have fewer providers, with only about 39.8 physicians per 100,000 people compared to 53.3 in urban areas. These shortages contribute to worse health outcomes, including higher mortality, cardiovascular disease, and infant mortality rates among rural populations. In the U.S., the core issue is often not the absence of advanced technology or medicines, but rather affordability, insurance complexity, and systemic inequities that prevent people from accessing care.

International health issues, by contrast, frequently stem from the absence of even basic infrastructure and medical resources. Globally, 2.1 billion people still lack safely managed drinking water services, and unsafe water, sanitation, and hygiene caused 1.4 million deaths in 2019 alone. Diseases like malaria, tuberculosis, and cholera remain widespread in many regions, where access to hospitals, clinics, and trained health professionals is extremely limited. While Americans may worry about paying for insulin or navigating complex insurance plans, people in many low-income countries may worry about whether they can find any medicine or a trained doctor at all.

Vaccination highlights another contrast: in the U.S., coverage is generally high but uneven due to pockets of vaccine hesitancy, while globally, immunization efforts have prevented at least 154 million deaths over the past 50 years. COVID-19 revealed both kinds of vulnerabilities. This showed how U.S. hospitals struggled with surge capacity, costs, and equity, while many countries around the world struggled with disrupted supply chains, lack of vaccines, and already fragile healthcare systems.

The key difference lies in the nature of the barriers: in the United States, the challenge is affordability and equity within a highly advanced but uneven system, while internationally the challenge is gaining access to the most basic healthcare resources. Both reveal the urgent need to address health disparities at every level.

Warning signs

Domestic Warning Signs:

• More people skipping medical care because of cost or lack of insurance
• Shortages of doctors, nurses, or hospitals in rural areas
• Rising gaps in health outcomes between rural and urban communities
• Increasing medical debt and bankruptcies from healthcare costs
• Declining vaccination rates in some regions

International Warning Signs:

• Healthcare systems disrupted by poverty, conflict, or weak infrastructure
• Populations lacking access to clean water or sanitation, leading to disease outbreaks
• High maternal and infant mortality rates
• Shortages of essential medicines, vaccines, and trained health workers
• Frequent outbreaks of preventable infectious diseases like malaria or cholera

How to take action

Educate yourself and others: Stay informed and share knowledge to raise awareness about health disparities.

Advocate for change: Support policies that improve healthcare access, equity, and funding.

Volunteer your time: Help at local clinics, food banks, health education programs, or global aid initiatives.

Fundraise or donate: Contribute to organizations working to improve healthcare access and resources.

Use your voice: Write, blog, or present about health issues to inspire others to get involved.

Promote healthy living: Encourage preventive care, wellness, and good hygiene practices in your community and beyond.

How to support those living in underserved areas

Expand access: Support initiatives that bring mobile clinics, Telehealth, or transportation to care.

Provide resources: Donate to programs that supply medicine, food, clean water, or hygiene products.

Promote education: Volunteer in schools or health education programs that teach preventive care and wellness.

Advocate for equity: Push for policies that fund rural hospitals, community health centers, and affordable care.

Build awareness: Use platforms like blogs, social media, or community events to highlight the challenges these areas face.

Partner locally: Work with community organizations that already have strong connections and know the specific needs.

When most people hear the word desert, they think of sand, sun, and heat. But there’s a different kind of desert that not many know about, but affects millions of people every single day. It’s called a medical desert. These are areas, often in rural regions or underserved urban neighborhoods, where people have little to no access to basic healthcare.

What does this mean, though? It’s not just about having fewer doctors around. It means that people in these areas may not have a hospital within driving distance. There might not be a single local clinic, no specialists, and sometimes not even a pharmacy. And when medical services do exist, they’re often stretched thin or impossible to get to without a car, money, or time off work.

This is not a small issue. In fact over 80 million people in the United States live in or near a medical desert. According to the National Rural Health Association, more than 100 rural hospitals have closed since 2010, and hundreds more are at risk. Some counties don’t have a single practicing primary care doctor. Others don’t have any OB-GYNs, mental health providers, or pediatricians. And for urban communities, the problem may look different but feel the same: clinics are overcrowded, underfunded, or too expensive for the people who need them most.

Now imagine this happening in your own life. You wake up feeling sick, but there’s no nearby clinic to visit. Your child has a fever, but the wait at the only ER nearby is six hours long. You run out of medication for a chronic illness, but the closest pharmacy is thirty miles away. This is not just a small issue, it can be life-threatening. 

Why Medical Deserts Are So Dangerous?

Living in a medical desert has serious consequences. People in these areas are much more likely to delay treatment, skip regular check-ups, or ignore early warning signs of illness due to limits in resources. This usually leads to worse outcomes for preventable or manageable conditions like diabetes, asthma, heart disease, and cancer.

Here are some important facts regarding the issue:

• People in underserved areas are 60% more likely to die early from preventable causes
• Lack of local OB-GYNs led to the U.S. having the highest maternal mortality rate among developed countries
• Rural residents with chronic illnesses are more likely to be hospitalized for conditions that could have been managed with routine care

Access to healthcare shouldn’t depend on your income, race, or where you live. Healthcare is a basic human need, and treating it like a luxury creates divides in who gets to live a healthy life and who doesn’t.

So, What Can We Do About It?

The good news is that we’re not powerless. The first step is awareness. Many people don’t even know medical deserts exist, let alone how widespread the problem is. Talking about it helps. Sharing stories helps. Advocating for change helps.

Here are some real, actionable ways to make a difference:

• Support mobile clinics and telehealth programs that bring care directly to people in need
• Volunteer with or donate to organizations working to close the healthcare gap
• Push for policy change that increases funding for rural hospitals, expands Medicaid, and offers incentives for medical professionals to work in underserved areas
• Educate yourself and others so this issue gets the attention it deserves

In the US we often assume that help is available when we need specialists or walk in clinics. But even in America, many people struggle with high costs, insurance barriers, or long wait times. Around the world, though, access can be even more limiting. In some countries, people don’t just face delays or high bills they may not have doctors nearby at all. Whether it’s due to poverty, distance, or a shortage of healthcare workers, the results are the same, too many people go without the care they need.

Many countries, typically third world countries, are even more limited because of the amount of doctors in the area. Take countries like Liberia, Malawi, and Niger. They have only about 14 to 19 doctors per million people. That number is hard to grasp until you compare it to places like the United States, Canada, or the UK, which have around 3,000 doctors per million. That’s a huge gap. Liberia, for example, has only about 77 doctors in the whole country, while the United States has over a million. Even though Liberia has a smaller population, the shortage still leaves many people without the care they need.

This isn’t just a problem in one country. Malawi has only around 1,029 doctors total, and that affects more than just medical appointments. It leads to higher illness and death rates, hurts the economy, and makes managing chronic diseases much harder.

I used to think, “I’m not a doctor, so how could I possibly help?” But over time, I realized there are other ways to make a difference. Some American doctors do travel to provide care in underserved communities, and that’s awesome. But not everyone has the training or time to do that, and that’s completely okay.

There are still ways to help. 

1. First, we need to understand the crisis and what causes it. (I’ve learned so much by reading articles and listening to stories from people affected by the healthcare gap.) 
2. Second, we can talk and advocate for it. Sharing what we know with friends, family, or even on social media can make more people aware. 
3. Third, we can support prevention and treatment efforts by donating, fundraising, or volunteering with organizations that bring care to communities in need.

By doing these steps, together, we can make healthcare more accessible to people all over the world.