Camille Landry is a writer, activist, and social justice advocate who lives in Oklahoma City.  This post is part of our “Neglected Oklahoma” series, which tells the stories of Oklahomans in situations where the basic necessities of life are hard to come by.  These are real people and their stories are true (names have been changed to protect privacy).

Mrs. Emma Oliver warns me, “Don’t have a heart attack in Sayre, Oklahoma.” The hospital in Sayre, about 20 miles southwest of Elk City, just closed its doors. “Don’t wreck your car or have a stroke, either. If you live out here, any medical condition where minutes count is much more likely to kill you now than it was a week or so ago.”

Sayre Memorial Hospital, in this town of 4,600 on I-40 near the Texas panhandle border, went broke. The hospital board had taken out millions of dollars in bonds and citizens raised the local sales tax to fund the hospital, but it wasn’t enough to counter the losses. The facility closed in early February.

Too many people who live in rural Oklahoma lack medical insurance, Mrs. Oliver, a retired nurse, explains. “People with no insurance often can’t go to the doctor so they wait until they’re really sick and go to the emergency room. They can’t pay those bills so the hospital has to eat the costs.”

Things had started looking up for Sayre when the oil boom provided good-paying jobs. “Good salaries but many workers had no benefits,” Mrs. Oliver explained. Nearly one out of five workers in the county were employed in the oil and gas industry. The decline in oil prices made those good jobs a thing of the past. Like much of the state, there’s no other industry offering comparable pay in the region. Some of these workers were able to purchase insurance through the Affordable Care Act or Insure Oklahoma, the state’s program for small businesses and independent contractors, but the end of the oil field jobs made it impossible for many of these workers to keep their insurance.

So far the local ambulance service is still operating. “When we had our hospital here in town we were just minutes away from medical services. It’s at least a twenty-minute drive to the nearest hospital in Elk City, longer than that if you live outside of town or you go across the border to Shamrock, Texas – and that’s after the ambulance arrives at your door, which can take a long time if you live outside of town.”

“Don’t have a heart attack in Sayre, Oklahoma. Don’t wreck your car or have a stroke, either. If you live out here, any medical condition where minutes count is much more likely to kill you now than it was a week or so ago.”

Emma Oliver worked at Sayre Memorial before her retirement. “The staff was good. We were not a big city trauma center, but we could stabilize people and transport them to a regional hospital for additional care if needed. We were all neighbors, and we looked out for each other.” She worries that the increased response time and travel distance to the hospital will result in deaths that could have been prevented. “Minutes count when somebody is really ill or badly injured,” she says. She is concerned about the effects this closure will have on the region’s remaining hospitals. “More people will come to the next closest hospitals. This will mean longer waits in the ER, more patients for the doctors and nurses to take care of.”

“It’s not just emergencies, either,” her sister Evelyn adds. “The doctors around here send you to the hospital for lab work, x-rays, tests. Now we’ll have to travel to Elk City or Texas just for routine tests.” The ladies are luckier than some. They still drive and they have good insurance. “I worry about our elderly and about people who just lost their jobs. The farther patients have to travel, the more it becomes an issue.”  They also worry that the doctors in town will move closer to the hospital in Elk City.

Last year Sayre Memorial Hospital had 3,763 emergency department visits and 526 admissions. Its loss has economic consequences as well. The hospital employed about 130 people and reported $8.7 million in total revenue in 2014. The county, the city, and the state will lose tax revenue and the businesses that serviced the hospital and its staff will lose income as a result of the closing.

Nearly every Oklahoma hospital with fewer than 100 beds lost money between 2009 and 2012. Many of these hospitals are located in rural areas. Some communities have approved sales tax increases to support their hospitals. Many hospitals have borrowed extensively to make needed improvements and cover their losses, but most small hospitals continue to struggle economically. The Oklahoman listed other contributors to the budget crunch, including electronic medical records requirements, new auditing processes for Medicare billing, diminishing reimbursements from Medicaid, the general economic downturn in Oklahoma, and the state’s decision not to accept federal dollars to cover the uninsured.

Mrs. Oliver summed up the situation: “This cannot possibly be good for our community. I’m awfully afraid that this will hurt people who can’t get medical attention fast when they need it the most.”

Note: The initial version of this post incorrectly had a reference to Sayre County (Sayre is in Beckham County) and gave the wrong distance between Sayre and Elk City.