Third Way: The Plight of Rural Communities during the Pandemic
RJ Sangosti/MediaNews Group/The Denver Post
While much of the media’s attention has been focused on the way the coronavirus and economic crisis have impacted large urban regions and cities like New York City, the rural regions of the country have also weathered the wrath of the pandemic. Many of the problems the pandemic imposed in large urban cities were the result of how densely populated the cities were and of how connected they were to international trade routes. These problems do not impact rural regions as severely — but that does not mean that they were not going to face their own challenges. The role rural communities had in agriculture means that the problems facing them have also impacted urban areas that depend on more rural regions for food. This pandemic highlighted and exacerbated the preexisting problems that rural communities face.
Rural communities have had underlying problems before the pandemic. These communities have been suffering from a brain drain since the mid 1990s. Younger people have been moving out and there have not been enough people moving in. This has had devastating impacts on these communities. This can even be seen in that there are neither enough teachers nor doctors to service these areas. The last one is incredibly problematic as physicians and other health care workers are needed now more than ever due to the pandemic. Not only is there a lack of doctors, but the hospitals themselves are under threat. There was already not enough income to sustain the revenues of these hospitals before the crisis. With 170 rural hospitals having closed since 2005 and the Chartis Center for Rural Health predicting that 453 rural hospitals were at risk of closing before the pandemic. The majority of rural hospitals have also been forced to cancel elective procedures, which are the most significant source of revenue for these entities. The lack of money has prompted hospitals to furlough and lay off nurses and other health care workers even though they are needed now more than ever. This puts heavy financial strains on rural communities and their governments.
Rural communities also have a unique set of problems that many urban areas do not. Many of the states and counties that initiated shutdowns later and opened up earlier had higher rural populations relative to the whole population. A lot of these states and regions argued that they did not have very dense populations. This prompted their governors and political leaders to assume that the pandemic would not have as severe of an impact on their states as it did in New York City. Even local public health experts believed that this gave their states and regions an advantage as social distancing is easier, and long lines and mass transits are less present. But this did not mean they were immune to the crisis. Just as urban communities are reliant on rural ones for food, rural communities are reliant on urban ones for medicine and supplies. This puts rural communities into direct contact with the virus as people leave their towns to go into the cities for work or supplies. If they get infected, they may bring the coronavirus back to their communities. If the virus gets into a rural community, the consequences can be especially devastating. Not only is there a shortage of necessary health care workers and hospitals, but there are other underlying problems as well. Rural communities have higher portions of elderly individuals, individuals who smoke, individuals with chronic health conditions and individuals who are uninsured. All of these vulnerabilities put rural communities at particular risk and mean that rural people may face higher hospitalization or casualty rates.
This means that rural communities need specific solutions to deal with their underlying problems. Farmers were already the primary casualties of President Donald Trump’s trade war with China. To alleviate their concerns, they received a cash bailout and it seems the federal government is willing to do so again.
However, none of this will fix the fundamental problems in rural communities. Especially since there are concerns that cash aid will go to the largest farms, just like the last cash bailout during the trade war. These problems existed before the pandemic and have been exacerbated as a result of it. A lot of these regions have also been forced to rely on tourism to replace the jobs and revenue that have been lost by the decline of the mining and logging industries. These communities have been suffering for a while and have been heavily debated due to the Great Recession. The fact is that many of the more rural states rejected aid from the federal government during the expansion of Medicaid during the Obama Administration. Around 75% of rural hospitals that have closed were in states that had rejected Medicaid expansion. Research done by the Kaiser Family Foundation has shown that Medicaid expansion under the Affordable Care Act would have alleviated many of the economic and health concerns that rural communities face. This has had negative repercussions on rural communities that have been exacerbated by the pandemic.
This may mean that any substantial rural recovery program would require substantial investment. States need to accept federal aid and Medicaid Expansion. Both the federal government and the states need to heavily invest in rural communities, in a way that is not a mere cash bailout. They need to make sure that rural communities have an adequate degree of health care and the necessary infrastructure. There also needs to be steps implemented to recruit students in rural communities to become doctors and other necessary workers. The problems rural communities face are not rooted in the COVID-19 pandemic. Yet it has exposed their issues to the rest of the country. This means that fundamental changes need to be made to the way that the states and the federal government interact with and manage rural parts of the country.
