Rural populations have often been viewed as especially vulnerable with respect to access to health care. Rural populations have a less developed health care system. Residents of rural communities also report having a higher rate of chronic illness and disability. Rural communities face economic hardships, this makes it hard to access health care when it is needed. All this combined with the fact that rural communities face physical barriers such as distance and availability of transportation, makes accessing health care very difficult. Limited health care systems make it harder for rural residents to obtain access.
             Measures of access need to be expanded to address issues of particular concern in rural areas and gain a better understanding of access problems that may be specific to rural areas. Access in rural areas is complicated, partly because of different employment patterns and insurance coverage among rural residents. "Rural residents are on average poorer, older and for those under the age 65, less insured than persons living in urban areas."(Braden and Beauregaurd 1994). Rural Americans are also more likely to be self-employed; this makes employment related insurance benefits less widespread and less generous. "State-focused studies have found that urban families have more insurance coverage than their rural counter parts and that rural families pay a higher proportion of their income for insurance premiums (Hartley, Quam 1994). Transportation and travel times also play a big role in access of health care in rural areas " Evidence indicates that rural residents have greater transportation difficulties and often travel longer distances to receive health care" (Cunningham and Correluis 1995). Lack of public transportation in rural areas also creates a barrier to receiving care. "Only 12% of communities with populations less than 2,500 have public transportation systems" (Seccombe
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