在农村地区获得医疗保健已经很困难了。流行病使情况变得更糟
Even when there isn't a pandemic, finding the right doctor can be tough in rural eastern Ohio. Reid Davis, 21, and his mother Crystal live in Jefferson County, which hugs the Ohio River near West Virginia. Their home is surrounded by farms, hayfields and just a few neighbors.
即使在没有流行病的情况下，在俄亥俄州东部的农村地区，找到合适的医生也很困难。21岁的里德·戴维斯和他的母亲克里斯托住在杰斐逊县，该县靠近西弗吉尼亚州的俄亥俄河。他们的家周围是农场、草地和几个邻居。
"To the nearest hospital, you're talking about 50 minutes to an hour," Reid Davis says.
“到最近的医院，大约需要50分钟到一个小时，”里德·戴维斯说。
Davis' mother has rheumatoid arthritis, a severe autoimmune condition, for which she sees a specialist. That doctor prescribes an injectable medication and also works on her joints to ease inflammation and pain, he says.
戴维斯的母亲患有类风湿性关节炎，这是一种严重的自身免疫性疾病，她为此去看了专家。他说，那位医生会给她开了一种注射的药物，还对她的关节进行了治疗，以缓解炎症和疼痛。
But when the pandemic began, that doctor stopped seeing patients. Nearly six months went by, and only recently was Crystal Davis able to resume in-person visits.
但当流行病开始时，那位医生就不再诊治病人了。将近六个月过去了，直到最近，克里斯托·戴维斯才重新亲自去看医生。
In the meantime, her condition got worse.
与此同时，她的情况更糟了。
"There have been days where she's just been unwilling to get out of bed because of pain," Davis says.
戴维斯说:“有些时候，她因为疼痛而不愿意下床。”
There were only a few other rheumatologists within a two-hour drive and none of them were accepting new patients at the time.
在两个小时的车程内，只有少数几个风湿病专家，他们当时都不接受新病人。
Even before the pandemic, the health care systems that serve rural Americans were in decline: rural hospitals were closing their doors, and the medical workforce was shrinking. This year, as the coronavirus outbreak has made its way from major cities to rural America, threats to the rural health care infrastructure have only increased.
甚至在流行病之前，服务于美国农村地区的医疗保健系统就已经在走下坡路:农村医院纷纷关门，医疗队伍也在萎缩。今年，随着冠状病毒的爆发从主要城市蔓延到美国农村，对农村医疗基础设施的威胁只增不减。
A new nationwide poll shows that one in every four rural U.S households have been unable to get medical care for serious problems. Among those households that had trouble getting care, more than half reported that a family member experienced negative health consequences as a result.
一项新的全国性民意调查显示，每四个美国农村家庭中就有一个因为严重的问题而无法得到医疗照顾。在那些难以获得照料的家庭中，一半以上报告说，家庭成员因此遭受了负面的健康后果。
The poll was conducted by NPR, the Harvard T.H. Chan School of Public School and the Robert Wood Johnson Foundation.
这项调查是由美国国家公共广播电台(NPR)、哈佛T.H. Chan公立学校和罗伯特·伍德·约翰逊基金会进行的。
"The crisis is really widening the fractures that have already existed in rural communities," says Brock Slabach, senior vice president of the National Rural Health Association, based in Kansas.
堪萨斯州的全国农村卫生协会高级副会长布洛克·斯拉巴赫说:“这场危机确实扩大了农村社区已经存在的裂痕。”
Rural Americans contacted for the NPR poll — from Montana to Georgia to upstate New York — discussed problems getting treatment for many types of health problems, including the virus.
从蒙大拿州到乔治亚州，再到纽约州北部，参与NPR民意调查的农村美国人讨论了包括病毒在内的多种健康问题的治疗问题。
In the U.S., one of the biggest obstacles to getting health care is the simple fact of not having health coverage, and people living in rural areas are more likely to be uninsured compared to other Americans. Not having insurance can also mean higher out-of-pocket payments for treatments or medications, on top of other pandemic-related financial stresses.
在美国，获得医疗保健的最大障碍之一就是没有医疗保险，而生活在农村地区的人比其他美国人更有可能没有医疗保险。没有保险还意味着，除了其他与流行病相关的财务压力之外，还要为治疗或药物支付更高的自付费用。
But the poll also revealed many non-financial obstacles. In interviews with NPR, rural respondents talked about being forced to cancel surgeries, waiting months for appointments, putting mental health care on hold. Because of these problems, many were experiencing increased pain, anxiety or financial hardship.
但调查也显示了许多非财务方面的障碍。在美国国家公共电台的采访中，农村受访者谈到被迫取消手术，为预约等待数月，暂停心理健康护理。由于这些问题，许多人经历了更多的痛苦、焦虑或经济困难。
