Health Needs On The Eastern Shore of Maryland 

James Bogden • May 30, 2018

The Maryland Rural Health Association, with funding from the Robert Wood Johnson Foundation and in association with the state health department, recently completed a comprehensive study on the health care needs of people who live on the Eastern Shore and other rural counties of Maryland. Project staff examined available data, reviewed existing reports, and conducted focus groups of consumers and health care providers in each of the 18 counties included in the study.

On the Eastern Shore, transportation to medical care services stood out as the most commonly identified barrier to good health by consumers in 7 of the 9 counties, and by health care providers in 8 of the 9 counties. Many low-income and senior people do not own cars. Participants complained that bus routes do not allow people to travel to appointments on time without committing an unreasonable portion of a person’s day. Some communities have no public transit system at all, requiring people to use friends, family, volunteers, or paid commercial transportation to access health care facilities. Some county health departments provide transportation, but these services are typically targeted to certain groups and exclude a large percentage of the population.

The next most commonly identified problem concerned the affordability of health care. Even for those with health insurance, most plans do not cover all costs. Consumers complained about needing to pay out of pocket for tests that their doctors had recommended because health insurance would not cover the exam. Some people said they struggle to afford co-pays, deductibles, or prescription costs. Government assistance for oral health care is inadequate, preventing many from being able to afford the dental work they need.

The shortage of providers , a common problem of rural areas across the USA, was another major theme that was identified by both consumers and providers. Almost the entire Eastern Shore is designated by the federal government as a “medically underserved area” and as a “health professional shortage area.” There are scarcities of primary care providers, medical specialists, dentists, and mental health providers. In particular, pediatric specialists are in short supply. The need to travel further to access care exacerbates the transportation problems. Providers and facilities within a convenient distance are often overbooked, leading to long wait times for appointments. Office hours are often not convenient to working people. The end result is that some people fail to obtain all the care they need.

Consumers also complained about the fragmented nature of the health care system. Medical care is not very well coordinated; navigating through networks of health insurance providers can be a challenge. Information is hard to come by about available services locally. The study found that many counties had a lot of resources that went unused because residents are unaware of the different services available to them.

A lack of adequate services for children and adolescents was another theme, particularly with regard to mental health and recovery from substance use. The focus groups found that consumers would also like to see more health education in the schools and have increased access to prevention services before children reach late adolescence. Some counties do not have school-based health centers. Children need to learn about practical ways they can achieve the best health care possible.

Health care providers also discussed translation services as a gap. Maryland is becoming increasingly diverse and not all health care providers are set up to provide care to those who speak languages other than English. Providers would like an increase in language services in order to serve everyone in the county.

On the positive side, the consumer focus groups in five of the Eastern Shore counties praised their emergency medical services . Otherwise, comments about what was working well varied widely, including parks & recreation services, employee wellness efforts, and public health department services.

The study included a number of detailed recommendations for improvements to the formal health care system, as well as innovative ideas for alternative ways to deliver quality health care in rural settings. The study’s findings and recommendations have been used to update the official Maryland Rural Health Plan. Access it at http://mdruralhealthplan.org.


Common Sense for the Eastern Shore

Farm in Dorchester Co.
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By Jared Schablein, Shore Progress April 22, 2025
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