Roughly half of rural Americans said they could not afford an unexpected $1,000 expense, according to research conducted by NPR.

The poll, NPR’s second study in collaboration with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, found 40 percent of rural Americans struggle to pay routine expenses such as housing, food and medical bills, and 49 percent said they could not handle an unplanned $1,000 bill. Along racial lines, more than 68 percent of black rural Americans and 62 percent of Latinos could not handle such an expense, compared to 45 percent of rural whites, according to the researchers.

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About 1 in 4 respondents said they were unable to get needed health care at some point in recent years despite the fact that 87 percent now have some form of health coverage, due in large part to the Affordable Care Act and its expansion of Medicaid. Of these, 45 percent could not afford the care they needed, while 23 percent said the location was too far away or otherwise geographically difficult to access, and 22 percent could not spare the time when appointments were available, according to NPR. Nineteen percent could not find a provider who accepted their health insurance.

"At a time when we thought we had made major progress in reducing barriers to needed health care, the fact that 1 in 4 still face these barriers is an issue of national concern," says Robert J. Blendon, co-director of the survey and professor of health policy and political analysis at the Harvard T.H. Chan School of Public Health, told NPR. "Either it is still not affordable for them or the insurance they have doesn't work — or they can't get care from the health providers that are in their community."

Researchers interviewed 1,405 adults between Jan. 31 and March 2. The survey's margin of error is 3.5 percentage points.