Here's a sampling of views from health-care providers about health care and health in rural Kentucky

Louisville-based Medical News recently interviewed five health-care providers in Kentucky about the challenges that face rural health care: "Economic factors, cultural and social differences, educational shortcomings, sheer isolation with limited access to transportation and lack of recognition by legislators." Here are some excerpts:

Poverty and drugs compound each other, said Dr. Philip Hurley of Owensboro: "Whereas these addictions can affect all socioeconomic brackets, the effects on the poor tend to be more devastating as family and public support are often not as readily available. Obesity is another challenge. Sadly, our country has the dubious distinction of being the first country in history where the poor are obese."

Some noted the difficulty of attracting health-care providers to rural areas, but Dr. LaTonia Sweet of Molina Health in Louisville said, "Nowhere else can a physician use the same depth and breadth of skills needed as in rural healthcare. A physician can make a huge impact on the health of a community in rural areas."

"Rural areas work continuously to recruit talent for health-care delivery," said Dr. Brent Wright of the University of Louisville. "In addition to recruitment issues, there are continuous regulatory and technology demands that strain existing resources (electronic medical records, quality initiatives and value-based care). These initiatives drain resources from shrinking margins."

Hurley said electronic health records and telemedicine have helped rural Kentucky, "but most EHR records are close to garbage. It is often very difficult to glean useful, pertinent information. The electronic imaging and the ability to view it remotely is helpful."

Wright was more optimistic: "Telemedicine will see a resurgence as we all become more mobile through our smart devices. Brick and mortar healthcare will not be as necessary as bandwidth and connectivity increases. This is great for rural health because it means less travel and more access."

Asked what changes they would like to see to improve health care in rural Kentucky, Susan Starling of Marcum and Wallace Hospital in Irvine said "improved access to mental health, which has become very centralized in the urban areas; local access to alcohol and drug treatment centers; and support of critical access hospital programs and other federal programs that support rural health care."

Dr. Patrick Withrow of Paducah said he has been shocked by high suicide rates among farmers and other rural residents, which "need to be addressed. The wide geographic population and resultant limited mental and medical health resources in rural areas is a problem. Telemedicine may be a way to improve access to care. Also, the expansion of medical training to the more rural areas (Morehead, Bowling Green, Glasgow and northeast Kentucky) will improve access to care."