A path toward improvement in rural America


Roughly 57 million Americans live and work in a rural community. Living in a small rural town is a unique and precious experience, in which neighbors respect one another and work together. Rural America is also a powerful economic engine.

However, living in a rural community also comes with challenges and unique health care needs. For example, geographic circumstances often put rural Americans at a disadvantage when it comes to accessing medical facilities and transportation difficulties for residents trying to reach healthcare providers. Whether it’s a hospital, a doctor’s office or a physical therapist, the numbers show that these facilities are oftentimes scarce, requiring residents to travel great distances to reach them.

What makes this barrier to treatment worse is that small town hospitals have been closing at an alarming rate for years. Since 2005, 176 rural hospitals have closed permanently across the United States. Of course, with a lack of hospitals and medical facilities comes a lack of health care personnel. According to research from the National Rural Health Association, there are less than 40 primary care physicians per 100,000 rural American dwellers.

And while COVID-19 has resulted in an acceleration of virtual physician/patient visits, this has been particularly challenging for rural America, where 53 percent of residents lack access to 25 Mbps/3 Mbps of bandwidth. Lack of high-speed internet hinders the ability of rural Americans to access technologies, such as a virtual doctor’s appointments. These staggering numbers point to a less than ideal situation for rural residents in need of care, particularly those without high-speed internet or those that require in-person treatment options.

One prime example is rural Americans living with chronic pain. The Centers for Disease Control and Prevention (CDC) found that 24 percent of rural adults suffer from chronic pain, compared to 18 percent of urban dwellers. The high prevalence of chronic pain in rural communities coupled with the severe shortage of hospitals and physicians in these areas, creates a severe access issue.

Americans suffering from chronic pain often find it difficult to continue working or performing the most basic of daily activities. Ensuring chronic pain sufferers have access to a trusted physician who can work with them based on their specific needs to find the most effective treatment plan is a critical first step. We also need more treatment options that are both safe and effective to fit the unique needs of rural Americans living in pain.

Therefore, the National Grange, where I serve as president, recently adopted a resolution to prioritize and address the issues surrounding chronic pain in rural America. We pledge to support more research to be done to help identify the causes of chronic pain in rural life. We will dive into various issues to determine why there is such a high prevalence of pain among rural Americans, and what we can do to change it. Because chronic pain has contributed so much to the tragic opioid crisis in rural America, we will support national and state initiatives that encourage the research and development of new pain relief therapies that avoid opioids and other addictive drugs. Lastly, we will host robust policy discussions about pain management among our fellow Grange members and their rural communities to ensure our unique needs are being met.

We must not forget the power of rural America, and we must refuse to leave the millions of Americans suffering from chronic pain in these areas behind. By joining the conversation, educating ourselves and others and pushing for change, we can take the necessary steps forward to address the barriers to health care that rural Americans face and provide a brighter future for those living in pain.

Betsy Huber is president of the National Grange, America’s oldest agricultural, rural life and small town citizen advocacy organization.

Tags Broadband access Chronic pain COVID-19 Health care healthcare disparity Opioids Rural America Rural communities rural hospitals

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