CARBONDALE, Ill. (AP) – Southern Illinois residents continue to lack easy access to hospitals with trauma centers that offer specialized care for severe injuries.

The Southern Illinoisan (http://bit.ly/2ameCrT ) reports that there aren’t any trauma centers south of Springfield, which puts Southern Illinois in a trauma desert. For many Illinois residents, the closest trauma center is located in another state, such as Indiana or Missouri.

Illinois Department of Public Health spokeswoman Melaney Arnold says hospitals voluntarily become trauma centers. To be designated as a Level I or Level II trauma center, the department requires the hospital to have sophisticated equipment and qualified staff, such as subspecialty surgeons.

Arnold says it can cost more than $20 million yearly to operate a trauma center and that many hospitals can’t afford it. The department also doesn’t have authority to require a hospital to become a trauma center.