Most Foundations Neglect Rural America. Here's a Big One That Doesn't

The dearth of grant dollars going toward rural America has long been lamented by advocates of more equity in philanthropy. These are some of the poorest regions of the country and low-income people in remote places can be uniquely isolated and vulnerable.

That's especially true when it comes to healthcare, and the huge disparities in access to care between rural and metropolitan areas are well documented. When you get off the beaten path, the usual problems of coverage and affordability – a top preoccupation of healthcare funders – are compounded by such challenges as the availability of doctors and up-to-date medical technology, which are issues less often found on the radar of healthcare funders. 

One funder thinking about rural healthcare, with a special emphasis on the tech side of things, is the Helmsley Charitable Trust, established with the multibillion-dollar estate of the late New York City hotel and real estate barons Harry and Leona Helmsley. 

We've long followed the foundation's efforts to expand access to healthcare in rural areas, focusing on the upper Midwest, where the distances between patients and providers can be especially great. In particular, the foundation has given many millions to improve urgent care for heart attack victims, who can die in ambulances that aren't properly equipped. 

It's an interesting niche, and we can't think of many other funders paying attention to these rural healthcare challenges. 

Closing the technology gap can be key when it comes to ensuring quality care. In a tech-laden field like medicine, reducing disparities also means reducing disparities in access to technology – tests, ECG equipment, diagnostics, big machines, tiny machines, lasers, whatever. Of course, a lot of this stuff is very expensive.

Computerized tomography (aka CT or CAT scanning), which take cross-sectional X-ray images of the body, is one of these technologies. In fact, CT is among the most important big-ticket technologies of the last few decades: Its inventors won the Nobel Prize.

But CT machines are not cheap, and the most advanced ones are really, really not cheap. They run $250,000 to $1.5 million, depending on how many cross-sectional slices they're designed to image.

As a result, less-busy hospitals may be unable to use the machines enough to justify such an investment, especially when there are a thousand other pressing needs.

Helmsley is trying to make it easier for rural hospitals to offer their patients this now essential technology. The trust recently announced that its Rural Healthcare Program has launched a CT Scanner Initiative. It's designed to help hospitals in the seven upper Midwest states of Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming afford advanced CT scanners.  The program will award two-year grants of up to $400,000 for the purchase of new thirty-two slice or higher CT scanners. 

Helmsley has given about $300 million since 2009 to improve rural healthcare. The ironic thing is that it's almost impossible to hear the Helmsley name without thinking of the posh Manhattan hotels that were the centerpieces of the family's business – in other words, the farthest thing from the rural areas where they're showing a lot of philanthropic leadership.