Community responses and adaptations following the closure of a rural pharmacy and primary care facility

Abstract

Purpose

This study investigates the experiences of one rural community in Central Pennsylvania following the closure of its singular pharmacy and primary health care facility. It aims to understand community members’ responses and adaptations to declining health care accessibility and broader implications for rural health policy and practice.

Methods

Employing a qualitative case study design, researchers conducted 26 in‐depth interviews from May to December 2022. Interviews were grounded in a phenomenological approach and focused on participants’ perceptions of their community and experiences accessing health care. Data were analyzed thematically following a coding reliability approach.

Findings

The closure of the health care facilities resulted in significant social and economic impacts, particularly among vulnerable groups, such as older adults, people with disabilities, and working‐class families. Participants reported increased reliance on their social support networks to access care, delays in seeking care due to the strain from longer travel distances, and loss of familiar and trusted care providers. We also found an over‐reliance on local emergency medical services for routine care. Although the community demonstrated resilience through the use of social networks, some adaptations carried health risks, including delayed care and unmonitored use of alternative remedies.

Conclusions

This study highligths the need for health care policies that address the immediate loss of services and support the social networks and economic stability that rural communities rely on in the absence of local health care facilities. This research contributes insights for policymakers, health care providers, and community leaders working to support rural communities facing similar health care losses.

INTRODUCTION

In recent decades, inadequate access to health care services in rural areas has become a pressing global issue. Rural populations—especially older adults, individuals with chronic illnesses, low‐income families, and those without insurance—face higher rates of preventable diseases, greater morbidity and mortality, and delayed access to care compared to their urban counterparts.1^,2 These disparities stem from a combination of factors, including geographic isolation, shortages of health care professionals, limited transportation options, and reduced access to health insurance coverage. ¹ , ²

In the United States, policy interventions have attempted to address these disparities, including the expansion of federally qualified health centers (FQHCs), ³ the development of telehealth programs, ⁴ and the provision of grants to support rural health care infrastructure. ³ , ⁴ However, these efforts often fall short due to the unique challenges faced by rural communities. For example, rural telehealth initiatives are often limited by broadband connectivity issues, and the closure of local health care facilities results in reduced continuity of care, leaving residents without regular access to primary care. ⁵ , ⁶ Addressing these challenges requires targeted and sustainable solutions that consider the specific context in which health care access occurs.

Moreover, research has shown that the closure of rural health care facilities carries enduring consequences for health care access. ⁷ , ⁸ , ⁹ , ¹⁰ Facility closures may necessitate that residents undertake longer journeys to obtain basic care—including for regular preventive screenings and acute illness treatment. ⁵ Longer travel distance requires greater transportation expenses, extends the time invested in accessing care, and can impose additional costs (e.g., hotels). ⁵ , ¹¹ , ¹² , ¹³ These burdens raise the risk of delaying or foregoing care. ¹¹ , ¹⁴ , ¹⁵ Such diminished access and utilization is linked with detrimental health outcomes, including elevated rates of morbidity and mortality for preventable diseases and diseases that could be managed effectively if detected earlier. ¹¹ , ¹²

The literature also shows that the repercussions of health care loss is deeply intertwined with other Social Determinants of Health (SDoH), including economic stability, social and community context, and neighborhood environments. ⁵ , ¹⁶ , ¹⁷ , ¹⁸ For example, the closure of rural primary care clinics and pharmacies can lead to economic instability, as these facilities are often significant local employers. ¹ , ² , ¹⁰ , ¹⁹ Socially, the dismantling of health care services can undermine community cohesion and support networks, which are essential for the social fabric of rural communities. ²⁰

Despite this existing research into the challenges and impacts of health care loss in rural areas of the United States, there remain two important gaps in knowledge. First, much of the existing research focuses on the impact of rural hospital closures, ⁸ , ⁹ , ¹² , ¹⁴ , ¹⁵ , ²¹ due to heightened concerns in both public health and health care policy about hospital access. There remains a need to examine the impacts of the loss of pharmacies and primary care clinics, which typically act as a catch‐all for local patient needs. Second, we lack a comprehensive understanding of the ways that community members adapt to the loss of such facilities. This study bridges this knowledge gap by examining the ways rural residents experience and navigate the sudden loss of pharmacy and primary care services. Specifically, it seeks to answer the following research questions: (1) How do rural residents adapt to the loss of local health care facilities, and (2) what are the social, economic, and health‐related consequences of these adaptations?

METHODS

Study design and setting

This study employed a qualitative case study design to examine the impacts of health care infrastructure loss in one rural township in Pennsylvania. This township is defined as “rural” by the Center for Rural Pennsylvania, with a population of fewer than 1700 residents and a population density of roughly 20 people per square mile. ²² Similar to much of rural Pennsylvania, the township is predominantly white (97%) with a median age of 48, 10 years older than the national average. ²² Although educational attainment is relatively low, with only 13% holding a bachelor's degree (compared to the national rate of 36), the community's economic situation is middle‐of‐the‐road. ²² The township has a median household income of $63,500, a poverty rate of 9%, and an unemployment rate of 2%. ²²

Yet although the township may not seem particularly economically depressed demographically, local health care infrastructure has been in persistent decline in recent years. In 2020, the only pharmacy, a satellite location of a privately owned pharmacy based in a nearby larger township, closed. Then, in 2021, the only health clinic, a privately owned FQHC, shuttered as well. These closures stemmed from a declining population base and the retirement of the clinic's doctor and owner, a local resident himself. The pharmacy could not financially justify keeping the satellite location open, and although the town doctor sold his practice to a local health care company before retiring, this company, too, found the location financially inviable and closed the office shortly thereafter. These closures left the next closest pharmacy and clinic a 25‐min drive away.

Due to the relative physical isolation of the study community from other nearby communities, and because the closed clinic and pharmacy were the only local health care institutions, these closures provide a unique opportunity to examine the impact of health care infrastructure loss on rural residents’ health care access and well‐being.

Data collection

In May 2022, the Pennsylvania State University College of Medicine launched a free mobile health clinic (MHC) to provide preventive health services in the study community. The MHC is run by a supervising physician and medical students, serves any person who approaches for services, and provides services such as flu and COVID immunizations, blood pressure and glucose screenings, and general consultations. The MHC sets up once every 2 weeks in the parking lot of the former brick‐and‐mortar clinic.

When launched, the MHC leadership team invited a group of rural health researchers to accompany the clinic and conduct a community needs assessment. ²³ These researchers were trained as social scientists and had experience conducting qualitative research on health issues in rural US communities. Over 8 months in 2022, the researchers joined the MHC team for every visit to the community. During these visits, the researchers did not personally provide health services to the patients or observe patient appointments, but they could observe general operational processes and recruit patients for interviews.

During this 8‐month window, researchers conducted in‐depth interviews with 26 community members. Some participants were recruited during clinic visits; researchers provided all patients with information about the study, and those interested completed the consent process and provided their phone number to be contacted later. However, this method of recruitment would provide a sample only of residents who were seeking services from the MHC. Thus, the researchers also recruited community members via social media advertisements and snowball sampling to include others who had not sought out MHC services. Interested individuals recruited through these methods were encouraged to reach out to the researchers via phone to participate. Additionally, a few participants were recruited purposively via email due to their key roles in the community (e.g., paramedics, nurses, and community leaders). These participants who were not recruited in person completed the consent process online via a REDCap survey.

All interviews were conducted over the phone and ranged from 20 to 60 min. Interviews were semi‐structured and grounded in a phenomenological approach. ²⁴ Interviews largely followed participants’ narratives, with a focus on their perceptions of their community, their experiences accessing health care services, and, for those who had visited the MHC, their experiences obtaining care at the clinic. Interviews were recorded with consent, and participants were provided a $40 gift card. This study was approved by the IRB of the Pennsylvania State University (STUDY00019793).

Analytic approach

Interviews were audio‐recorded and transcribed, and transcripts were imported into NVivo for systematic examination. To ensure confidentiality, all identifiable information was removed from the transcripts. A team of four researchers conducted a thematic analysis, using an iterative, six‐step process akin to the coding reliability approach ²⁵ to detect themes, patterns, and categories within the dataset. The team first generated codes deductively using the interview protocol. Each team member then read the transcripts and added additional codes inductively. Following this initial independent reading, the team met to discuss emerging themes, compare lists, and merge them into one final list of primary codes. Using this final list, each transcript was coded by two different researchers. Regular communications among all four researchers were held to resolve discrepancies between the two coders and reach consensus regarding data interpretation. There were minimal discrepancies among coders, pointing to a high level of intercoder reliability.

This manuscript draws on data from two primary codes, “Loss of healthcare infrastructure” and “Strategies to overcome barriers to accessing healthcare and health resources.” In developing this manuscript, two researchers reviewed these primary codes to identify the major themes in each. This manuscript reports these themes. All names used in this study are pseudonyms.

RESULTS

Participant characteristics

Reflecting the racial composition of the study community, all 26 participants identified as white. Most participants (85%) were women. The mean age of participants was 57 years, with ages ranging from 27 to 90. The majority (88%) reported long‐term residence in the area, either from birth or after marriage; two participants lived in the community only during summers. Most participants (96%) were insured, with about one third holding Medicare or Medicaid; the remainder were covered through employment‐based plans.

Both health and economic challenges were evident. During the last month, over one third (38%) reported having good health, another third (34%) experienced brief episodes of illness lasting 1–7 days, and the remainder (25%) encountered extended illness ranging from 15 to 30 days (none experienced poor health between 8 and 14 days a month, which was the other option presented). A notable proportion (38%) expressed difficulties affording essential goods, such as utilities, medical bills, and transportation costs.

Impacts of pharmacy and primary care loss

The closure of the community's pharmacy and primary care clinic had far‐reaching impacts, affecting not only the immediate health needs of residents but also their overall sense of security and economic well‐being. These impacts were particularly pronounced among vulnerable populations, including older adults, people with disabilities, and working‐class families.

Logistical challenges and behavioral health impacts

The closure of the community's sole pharmacy and clinic, which had offered a broad spectrum of services, including primary care, laboratory work, family planning, women's health, pediatric care, and immunizations, posed logistical challenges and affected the behavioral health of residents. Residents reported longer commutes to pharmacies and providers in adjacent communities, which posed challenges, especially in winter months when travel over the mountain to the next town became dangerous. Residents also lamented the loss of familiarity they had experienced at their local facilities. The pharmacy and clinic had been housed in the same building, facilitating convenient and smooth communication, and they felt the clinic's doctor had provided compassionate, efficient, person‐centered care that prioritized residents’ needs. These changes elevated stress levels among individuals who previously depended on close, familiar, and convenient access to health care services.

The implications of these closures also transcended immediate health care needs, impacting a broader quality of life. One participant lived in Snow Shoe seasonally in the summers. She shared that, since the closures, her husband no longer felt safe living in town for the summers: “My husband had a stroke last fall, and he doesn't want to go over to [the town] anymore, because there's no medical service available. If anything happened to him, it'd be an hour, probably, until we got to the hospital, or I'd have to call 911 for the ambulance” (Marie, seasonal resident, >65 years old). This situation underscores the broader consequences of health care facility closures, as the perceived reduction in safety can influence decisions about where to live and spend leisure time. Residents grappled with constant apprehension over potential medical emergencies, and as this participant demonstrated, the closures may also be deterring local tourism, which the town has long depended on economically.

Compounded challenges for vulnerable populations

The closures had substantial effects on vulnerable residents, including older adults, people with disabilities, and working‐class families. Older adults and people with disabilities, who often face mobility limitations and have higher health care needs, found themselves confronted with new transportation challenges getting to health care services. Some could not drive long distances or afford the gas needed for frequent appointments. The closures also disrupted established relationships with providers, resulting in a loss of continuity of care and leaving many older residents without a designated primary care physician. One participant shared, “When our medical center closed down and I had to get a new primary care physician, it was not easy to find a new doctor… It just [took] a while of many phone calls and trying to get a new one in a timely manner” (Fran, resident, 50–59 years old). This account highlights the broader, systemic issues with the US health care system that further complicated older residents’ abilities to navigate the closures.

Similarly, working‐class residents, already constrained by financial limitations, found the closures particularly burdensome. Increased travel distances imposed additional financial pressures and logistical challenges, especially for those juggling employment and family responsibilities. One participant shared, “One big problem now is time, because I have two little kids, so I drive an hour to work and then get home in time for them to either get off the school bus or pick them up from whoever's taking care of them. Obviously, I'm on a time crunch with those things” (Kelly, resident, 40–49 years old). These personal accounts illuminate the multifaceted nature of the challenges encountered by working‐class families, who now must contend with both the increased gas costs and the logistical complexities associated with seeking health care.

Community adaptations to facility closures

Residents reported making numerous adaptations and shifts in their health care–seeking behaviors because of the closures. Some adaptations—like depending on social support networks—point to the resilience of the community. Others—like delaying treatment, relying on paramedics and emergency rooms, rationing or sharing medication, and relying on homeopathic remedies—could have potentially harmful impacts on individual or community health.

Depending on social support networks

A strong sense of community and the presence of supportive relationships helped some residents overcome the transportation barriers imposed by facility closures. Family members, neighbors, and friends became essential sources of transportation assistance. Older residents and those with limited mobility relied heavily on the goodwill and support of their social networks to accompany them to medical appointments or pick up prescriptions in neighboring communities. This informal network of caregivers provided a crucial lifeline for individuals who would otherwise struggle to navigate the logistical complexities of seeking distant health care services.

One participant described a communal effort in supporting older adults with limited mobility, stating, “There's a senior's group here, and there's a lady who doesn't drive, so they all take her everywhere she needs to go. It's like a buddy system” (Heather, community leader). The reliance on family for support was highlighted by nearly every participant in our sample. One mentioned, “Now, you always rely on family members. We do that for some family members and friends. We pick up medications, we do this, do that, because they just don't drive, and they can't get there” (Jane, emergency medical services [EMS] worker). These accounts illustrate the vital role played by community and family in mitigating newfound challenges to health care access.

Nonetheless, institutional barriers still restricted the benefits conferred by this adaptation. One resident with mobility limitations explained that he often asked for assistance on the community's Facebook group. For example, he might ask someone to pick up a prescription if they were passing by the nearest pharmacy. However, he cannot pre‐pay for prescriptions like he can for grocery pick‐ups. Asking for assistance requires an additional step of transferring money to a neighbor willing to help.

Limiting and delaying treatment

Social support networks allowed many residents to continue accessing care, despite newfound difficulties. However, some felt this reliance imposed a burden on neighbors and loved ones, and therefore, they tried to limit their trips. Other residents, especially those who were homebound or socially isolated, did not have as robust of a network to lean on. In these cases, residents reported delaying seeking medical care. Although they would have visited a closer facility, the challenges of long travel distances, the scarcity of immediate appointments, and transportation hurdles forced them to defer medical consultations, waiting to see if a concern would disappear or worsen.

This deferral could result in the late detection of health conditions. One participant, Kris, put off seeking care due to the distance of her doctor and the fact that she relies on her son for transportation. She reflected:

I have had a little bit of a problem with my eyes. But I just kept thinking it's going to get better. I'd use different eye drops and different things. Until I finally called my doctor and told him, “Hey, there's something wrong here. Am I going blind or what?” Of course, he's way up at the other end of [the county]. And I had to get my son to take me up to my appointment… They did a scan on my neck. Something about my carotid arteries, something that he thinks might have a lot to do with my vision (Kris, resident, >65 years old).

Another participant, Jennifer, a working mom of two children, explained, “It's hard for me [to visit the doctor] because I drive to work, drive home, the last thing I want to do is have to divert to [the nearest town with a clinic] for a doctor's appointment.” However, after pushing off preventive care for too long, a small issue escalated into a larger concern:

There's a lot of medical things people have wrong that they kind of just push under the rug because they think, oh, this is just this symptom or that symptom… Somebody, just a normal person, would just push them all under the rug, which is what I did… In light of recent events, I'm learning that's going to have to be a priority in my life and have to figure out how to schedule it in (Jennifer, resident, 30–39 years old).

These narratives underscore the logistical and psychological hurdles residents were facing accessing care, from minimizing health concerns to the complexity of arranging necessary travel for medical appointments.

Relying on emergency medical services

We found that the closures impacted EMS (paramedics and emergency rooms) in two ways. First, the delaying of care and subsequent escalation of health issues led to emergency medical needs that could have been avoided. Second, residents were increasingly relying on paramedic services and emergency room visits for a broad range of non‐emergency health concerns. The over‐reliance on paramedic services for non‐urgent care, specifically, created strain on this already‐fragile system, potentially delaying response times for true emergencies. Increased use of both parademic services and emergency rooms for non‐emergency care also represented an inefficient use of critical health care resources. A local EMS worker (a paramedic), Jane, shared:

Many people aren't just going to the doctor for little things…So, they wait, or think, “It's not worth going. It's not that bad.” And then it progressively gets worse, and then they call 911 because it's like, “Okay, I just don't feel any better. It's getting worse.” So, they call us even if it is not an emergency.

Jane noted this pattern could risk compromising the efficacy and responsiveness of parademic services, underscoring the need for more sustainable solutions for accessing primary health care solutions in the community.

Rationing or sharing medication

The travel strains associated with accessing medications—either picking up medications from the pharmacy or getting new prescription refills from providers—prompted some residents to alter their medication dosages, aiming to extend their supply and reduce pharmacy or provider visits. The same EMS worker, Jane, described, “I see many people going, ‘You know what, I can take that pill every other day and make it last longer so I don't have to go the pharmacy as often.’” This observation was confirmed by other participants who explained self‐imposed dosage modifications were often driven by financial constraints and exacerbated by delays getting to the closest pharmacy. Residents recounted delays up to a week in processing prescription requests due to the shortage of pharmacies nearby. These delays could create serious issues for individuals who depended on timely access to key medications, causing disruptions in treatment plans and potential adverse health consequences.

Sometimes, community members exhibited resourcefulness and solidarity by sharing medicine. One resident, for example, reported getting free samples of medications at doctor's appointments and sharing those with individuals who could not access appointments or afford necessary medications. This informal exchange of medicines served as a means of supporting those facing financial barriers to medication access. Medicine sharing exemplified the high level of care that existed within the community, with individuals actively looking out for one another's well‐being.

Using homeopathic remedies

Some residents also reported turning to homeopathic remedies, like herbal remedies and dietary changes, as an alternative approach to addressing health issues when they could no longer access conventional health care. Individuals took an active role in self‐care, seeking information and advice from books, online resources, or local community members who had knowledge of traditional healing practices. One community leader, Laura, reflected on the cultural and historical roots of this approach to health care, recounting how their parents, unable to afford frequent doctor visits, would employ home treatments for common ailments, such as using pipe smoke to alleviate earaches or applying traditional ointments. This practice of self‐reliance, passed down through generations, illustrated a deeply rooted cultural perspective that values self‐care and resourcefulness in the face of limited access to formal medical services.

Using emerging resources

Finally, two emerging resources have also been integral in mitigating impacts on the community. One significant development has been the introduction of the university‐led MHC, which is offering preventive check‐ups locally. Although the MHC was only recently established, early feedback was positive. For instance, several participants highlighted the convenience of receiving a flu shot or getting their blood pressure checked through the MHC, contrasting this experience with the challenges of scheduling an appointment online at a distant CVS—a task complicated by limited web access on mobile devices. One participant explained:

Well, I had an issue with high blood pressure. So going over to the other side of <a town 30 minutes away>, they changed my medicine. They upped it. And she wanted to check my blood pressure every so often. And I knew about the clinic, and I said, “Do I have to come over here or can I go up there?” And she said, “No, you can go up there.” So, what I do is I go up there and then I call her or him, whoever I get, and give him my numbers. I mean, that saves me a trip for a five‐second blood pressure check (Faith, resident, >65 years old).

This adaptation is indicative of targeted efforts to bridge health care gaps locally, though its full potential impact remains to be observed.

Telehealth also emerged as a partial solution, although its application has been uneven. Some younger community members, more familiar with digital technologies, have embraced mail‐order prescriptions and telehealth care, the latter of which was primarily used for mental health counseling. But telehealth has not been widely adopted for addressing new medical concerns, indicating a gap in service that still relies on in‐person care. Moreover, older adults reported facing barriers to using telehealth effectively, including lacking home devices and general discomfort with technology. This highlights a critical limitation in the adoption of telehealth solutions, underscoring the need for broader educational and infrastructural support to maximize its potential benefits.

DISCUSSION

The findings presented here suggest potential short‐ and long‐term consequences (e.g., deferral of care and medication rationing) and adaptations (e.g., over‐reliance on EMS, homeopathic adaptations, social networks, and emerging resources) for the health of those within this rural community that lost both its primary care clinic and pharmacy and for broader rural areas that also experience deteriorating supplies of physicians. ²⁶

Although substantial research focuses on experiences following hospital closures, ⁸ , ⁹ , ¹⁵ we focus on experiences and adaptations following the loss of a primary care clinic and pharmacy in the rural United States. Our findings corroborate the broader literature ¹ , ² , ¹³ , ¹⁵ , ²⁷ by illustrating the over‐reliance on emergency services like paramedics and emergency rooms for routine needs, deferral of medical care, and medication rationing that can result in the face of health care loss. We also found residents relying on homeopathic adaptations, tapping into social networks, and trying emerging resources. These findings complement national‐level studies that show higher mortality rates in areas with fewer primary care physicians ²⁸ by suggesting potential pathways through which such a relationship may occur (e.g., impacts) or be attenuated (e.g., adaptations). ³⁰

The limited availability of reliable transportation served as an exacerbating barrier to health care. We argue that expanding federal and state funding to improve access to free public transportation for medical appointments, especially for those with Medicaid and Medicare, could mitigate some transportation challenges faced by rural residents. Such initiatives would help ensure that patients do not miss critical appointments or delay seeking care due to transportation issues.

For older residents, the dissolution of local health care services also intensifies pre‐existing barriers, including mobility limitations and social isolation. ⁸ , ¹² Our study highlights the critical role of proximal health care facilities in ensuring the well‐being of local residents, as the added burden of travel and the challenge of forging new patient–provider relationships can exacerbate isolation and vulnerability. This may also be problematic given previous research showing that the loss of general practitioners is associated with decreased levels of testing and subsequent diagnoses for chronic conditions once a new physician is found, ²⁹ as the remaining physicians in the area must balance heavier caseloads. Although not in the scope of this manuscript, understanding the long‐term impacts on rural older adult health—a population with higher rates of chronic conditions—is especially important. We found that some older adults (especially those who are homebound) have limited social networks, making that adaptation strategy less available to them. These dynamics underscore the intersectional challenges faced by older rural residents as they navigate fewer health care options.

An important contribution of this paper is that it identifies the adaptations rural residents make to access health care after the loss of a local clinic and pharmacy. The disruption of established care relationships and the resulting over‐reliance on EMS for routine health care needs underscore a critical gap in the health care provision model and the need for continuity of care. While relying on EMS is an adaptation, this can strain emergency services and is likely unsustainable. Therefore, efforts to better support EMS services that are filling the gap should be made a priority. Similarly, policymakers could also prioritize other more financially sustainable alternative models that can ensure continuity of care (e.g., satellite and MHCs). ⁴ , ²³ The introduction of an MHC and the adoption of telehealth represented crucial emergent adaptations for the study community, much like many other rural areas. The MHC has provided periodic access to preventive care and basic health services, albeit with limited scope and frequency. Similarly, telehealth has offered some solutions for maintaining ongoing care, particularly for those comfortable with digital tools. However, as in other studies, ³⁰ , ³¹ , ³² we found the use of telehealth has been uneven, primarily due to technological barriers. Therefore, such approaches could be improved through more frequent MHC visits or the establishment of small satellite health stations that offer a broader range of services. Investing in telehealth infrastructure to ensure it is accessible and effective for all community members is also critical.

The use of homeopathic remedies and medication rationing has also become more prevalent as residents adapt to the absence of immediate health care. Although this reflects a degree of resourcefulness and may offer some individuals a sense of control over their health and symptom management, in many cases, their use cannot replace evidence‐based medical care, and thus reliance on these remedies alone could still negatively impact health. It indicates a need for better education about effective and safe practices. There is also potential for community‐based public health initiatives that promote validated holistic approaches (e.g., balanced diets, regular exercise, risks associated with incorrect medication use) within similar rural communities that lack health care availability. ³³

Lastly, the presence of local health care infrastructure is vital. As previous research has shown, primary care closures can result in deteriorated access to primary care and more fragmented care. ³⁴ Restoring or introducing primary care facilities and pharmacies within these communities is crucial for addressing the health care needs of rural populations. This should be a key component of broader efforts to enhance rural health care access.

LIMITATIONS

The findings of this study should be understood in light of several limitations. First, although the sample's racial composition closely aligns with the demographic trends of the community, it does not capture the experiences of racial minorities. Their experiences regarding health care loss and resilience may vary from those captured in our study. Addressing this gap is imperative for future research to inform more inclusive and equitable health care solutions. In addition, the study, which used a case study methodology, was not intended to capture the diverse experiences or potential solutions applicable to other rural contexts. Acknowledging this, future research should endeavor to execute comparative analyses across varied rural landscapes, aiming to uncover common challenges and devise community‐specific strategies. Finally, the incorporation of longitudinal studies would significantly contribute to our understanding of how community responses to the discontinuation of health care services evolve and assess the long‐term effectiveness of interventions such as MHCs.

CONCLUSION

This research offers insights into the health care consequences and adaptations confronting one rural community in Pennsylvania following the closure of their pharmacy and primary care clinic. Findings underscore increased reliance on local social networks, heightened dependency on emergency services, delays in seeking medical attention, medication rationing, and a gravitation toward alternative health practices due to the absence of local health care facilities. Local health care services are a cornerstone of rural community well‐being. For policymakers and practitioners, additional work is needed to explore sustainable models for innovative health care delivery in rural areas. Approaches that integrate traditional health care with strategies tailored to the unique needs of rural communities, by harnessing local involvement, have the potential to offer a comprehensive model that can effectively overcome geographic and economic challenges. In sum, this research offers insights into the adaptive capacity of rural communities in navigating the closure of local health care services but also highlights the need for policies that ensure ongoing and equitable access to necessary health care services for rural communities.

CONFLICT OF INTEREST STATEMENT

The authors report no conflicts of interest.

Palacios HV, Brant K, Rhubart D, Jackson J. Community responses and adaptations following the closure of a rural pharmacy and primary care facility. J Rural Health. 2025;41:e12896. 10.1111/jrh.12896