Abstract

Disparities exist in the livelihood and opportunities for people living in America’s rural communities. These differences result in a much sicker rural America compared to its urban counterpart. Rural counties have higher rates of smoking, obesity, child poverty, and teen pregnancies than urban counties.1 More uninsured adults live in rural areas, causing rural hospitals to close and/or cut vital services such as obstetrics care.2 Rural hospitals also provide fewer mental health services.3 The result is Americans living in rural areas are more likely to die from the five leading causes of death than those living in urban areas: heart disease, cancer, unintentional injuries, chronic lower respiratory disease, and stroke.4 Depending on the definition of rural, between 46-60 million people, or approximately 15-20 percent of the U.S. population, live in rural communities.5 Rural communities exist in nearly every state with great variability in their culture, economics, and social conditions. In fact, 97 percent of the country’s land mass is rural.6 Despite the ubiquity of rural America, much of the discourse surrounding these communities focuses on dissolution rather than reinvigoration. Headlines over the past year have included, “The real (surprisingly comforting) reason rural America is doomed to decline,”7 “The Hard Truths of Trying to ‘Save’ the Rural Economy,”8 and “Rural America is the New ‘Inner City.”9 These headlines are part of a growing, mostly urban, discourse on whether rural communities are worth saving at all.

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