FAIRMONT - Disparities between women's health care in rural and metro areas are highlighted in a report issued Wednesday by Planned Parenthood of Minnesota, North Dakota and South Dakota.

The data comes as lawmakers head back to Washington, and the timing is no coincidence.

"We are asking lawmakers to address these disparities as they consider a broader level of health care reform," said Sarah Stoesz, the CEO and president of the tri-state Planned Parenthood.

Rural, in this case, refers to anyone living outside the seven-county metro area. About 27 percent of Minnesota's population falls into this category - tying with Alabama for the highest percentage of non-metropolitan residents by state, according to the report.

"We are a leading provider of health care to rural women in Minnesota," Stoesz said. "Sixty percent of our patients are rural; of those, 63 percent are living in poverty."

At Planned Parenthood's Greater Minnesota clinics, Fairmont ranks high for the number of patients living in poverty. At about 65 percent, the Fairmont clinic is led only by Duluth, Moorhead, St. Cloud and Thief River Falls.

Besides financial difficulties, women in rural communities often struggle with a lack of public transportation and a shortage of health care providers.

"Geographic and economic status should not determine women's fate," Stoesz said.

As to whether cultural differences in rural and metro areas add to the disparities in health care, Stoesz said poverty is the key factor: "Poverty is the driver, along with geographic challenges and shortage of providers."

In a teleconference call Wednesday, Stoesz was questioned about the feasibility of the state or federal government solving the problems of health care, and whether Minnesota will be able to foot the bill if federal legislation fails to pass.

"Fortunately, Minnesota is ahead of the curve historically in thinking through some of these issues," she said. "We convened a task force in 2007 that looked closely at health care disparities. There is the potential to take this issue seriously, but it's not easy. I don't want to pretend there is an abundance of cash to take care of these disparities."

That said, Planned Parenthood is promoting the savings of preventative health care, which could minimize the cost of health care reform in the long run.

"There is a financial commitment required to address some of these problems but in point of fact, Minnesota taxpayers pay the bill for poor health outcomes," Stoesz said.

"If lawmakers can be convinced to invest upfront - for example, in the case of contraceptives, for every $1, long-term, taxpayers save over $5 in costs related to pregnancies - that seems like a very smart prudent investment," she said.