Impact of Seasonal Population Variation on Frontier Communities: Maintenance of the Healthcare Infrastructure

摘要

This report presents the findings from three case studies of frontier communities with seasonal population variations. The study builds on the results of a 2003 survey of State Offices of Rural Health and seeks to document the experience of a small number of communities with seasonal populations in meeting the health care needs of both the permanent local population as well as the seasonal residents and visitors. Three communities located in frontier counties were selected for case studies: Skagway, Alaska; Quartzsite, Arizona; and Lake City/Hinsdale County, Colorado. Case studies were developed using a variety of data sources, with key informant interviews providing the primary data. The case studies sought to answer two broad questions: How is the health care infrastructure managed to accommodate variations in need resulting from seasonal population fluctuations. And, how does managing the infrastructure for seasonal populations affect the care of the permanent local population. As found in the earlier study, reliable data on seasonal populations were not available; data sources provided fragmented, incomplete, and often contested estimates of populations throughout the year. Definitional problems contributed to difficulties in estimating seasonal populations. Seasonal populations could include legal residents as well as visitors, temporary workers, employers, and second homeowners; housing in non-permanent structures (e.g. RV trailers) complicates counting methodologies. In all three communities, health services are very limited. Only one community had a resident year-round physician, and only for the past 6 months. None have a pharmacy. Year-round and seasonal residents alike are accustomed to seeking health (and other) services elsewhere, paying high costs for transportation and lodging in addition to medical care, often without insurance. Two of the three communities have developed financial mechanisms to support the public provision of health services; the third is in the discovery process, examining options for doing the same.