Support The Daily Yonder on this National Rural Health Day!

This blog post is from Whitney Kimball Coe, Coordinator of the National Rural Assembly.

The Daily Yonder doesn’t shy away from drama. I love that.

As a community theater nerd, it was gratifying to me that the Daily Yonder was on hand at the 2018 National Rural Assembly in Durham, North Carolina, to capture some of the most newsworthy and dramatic moments, like David Toland waving an empty pickle jar from the main stage.

Toland, CEO of Thrive Allen County in Kansas, waved the large glass jar, “otherwise known as a rural healthcare financing system,” to illustrate that rural folks throw nickels in a pickle jar “to pay for healthcare when one of our neighbors gets cancer, has a farm accident, or is in a car wreck.” 

The fragile laughter in the room confirmed the drama of the moment. The donation jar shows that we try hard to take care of each other in small towns and rural communities. But that pickle jar also reminds us that we’ve got a long way to go to create a healthcare system that is fair and accessible for all of us.

On this National Rural Health Day, we shine a spotlight on the 60 million people who live in small towns, rural and frontier communities across the country. And we remember their efforts to work together for a stronger, healthier future. 

For more than 10 years, the Rural Assembly has relied upon the Daily Yonder to tell the story true about rural health and everything else, too. From pickle jars to politics to national polls on rural health and well-being.

Combining drama, data, and diverse voices to shape a portrait of modern life in rural America, the Daily Yonder is making us smarter, more compassionate, and better advocates for our neighbors and our nation.

I hope you'll join me in giving to the Daily Yonder pickle jar this year. 

Whitney Kimball Coe, Coordinator of the National Rural Assembly

It’s National Rural Health Day, Y’all!

Thursday, November 16 is National Rural Health Day, a collaborative effort to highlight the challenges faced in rural communities and to amplify the courageous, innovative work of rural health care providers, National Organization of State Offices of Rural Health, educators, and others working at all levels to improve the health of rural people and places.


The National Rural Assembly believes that when rural places are doing well, our country is stronger and our collective future is more sustainable.

Commitment to the health of rural people is one of the four pillars of our work, and we’re eager to amplify the good work that is happening to support healthy futures for rural communities.

That’s why today we want to acknowledge the leadership of the Robert Wood Johnson Foundation (RWJF) by looking across their current work and out to the field to learn about rural health in new and important ways.

As part of a larger rural learning effort, this summer RWJF surveyed, interviewed and convened over two dozen rural stakeholders, including Rural Assembly participants, for Rural Lessons for Building a Culture of Health, an active shared learning series to ensure that rural considerations deliberately inform the foundation’s and other funders’ work.

Facilitated by the Center for Rural Strategies, Rural Lessons engaged rural researchers, policy-makers and practitioners from a diverse set of sectors, geographies, and cultures to contribute to a more holistic notion of rural health and well-being. The discussion went deep, but four clear, powerful takeaways emerged:  

  1. It’s time to invest in an evidence base to inform policies, practices and systems that fit rural contexts. To do so, public and private funders must better adapt their expectations for scale and success in rural communities and help create a more localized rural research infrastructure that engages diverse populations, new kinds of intermediaries, and varied local organizations in research design, objectives, and implementation. 
  2. The narrative of rural America should acknowledge and elevate diversity and value. Narrative drives the resources and public support for the layers of work that lead to healthy communities. We must create opportunities to promote narratives of rural ingenuity; lift up messengers that reflect the diversity of rural America, including youth and people of color; and use tailored communications strategies that appeal to our varied community cultures.
  3. Building healthier rural communities requires attention to whole systems and not silos. Access to capital, housing, transportation, childcare, college readiness, broadband and other tools for economic opportunity are critical to building positive health outcomes across race, ethnicity and socio-economics. In tandem with health care initiatives, investments in community and economic development strategies like these will lead to enduring results. 
  4. Re-imagine the role of health care providers and institutions and support systems in rural America. Rural health care providers play a dual role as both clinical care and economic drivers, and it is important that they embrace this dual role to create healthier communities. Key opportunities include home-based care and telemedicine approaches, transforming required health care community assessments into community investment plans, and investing in creative healthcare workforce development strategies.

Undergirding these lessons is the undeniable need to strengthen local capacity and action to address racism, marginalization and historical community trauma in rural communities, even in communities where the hyper majority population is white. While the forces of systemic racism are often explored in an urban context, rural communities and organizations could use better tools and training to break through critical barriers to the long-term health and well-being of their communities.

There is an important role for foundations, researchers, policy-makers and practitioners in this arena. National Rural Health Day is a good opportunity to for all of us working in rural America to recommit ourselves to doing the deep, long-term, and necessary work that supports healthier, more equitable rural communities.

Why Rural Health Must Matter

This is a guest post from Michelle Rathman, President & CEO of Impact! Communications, Inc. This was submitted in response to our request for responses the newly proposed budget.

I have worked in the healthcare sector for the past 21 years, first in public health, and now in rural for over 15 years.  As I travel from state to state, town to town, small hospital to small hospital, I shake hands and have conversations with dedicated, talented, and selfless men and women working tirelessly to support the health and wellbeing of their communities while also under tremendous pressure to do more with far less.

Each place I go, I eat at local restaurants, shop at local grocery stores, and every chance I get, walk along main streets to observe and look into the faces of people who are relying on their hospital to ‘always’ be there for them.  I spend a lot of time in hospital and clinic waiting rooms with the intention if gaining insight that will help hospital teams to improve patient engagement and experiences. I always leave with much more insight than anticipated.

That rural healthcare is, for lack of a more suitable description, under attack, makes absolutely no logical sense. Not in my mind anyhow.  I recognize there is a lot of unmet needs and compelling demands facing our country.  I also believe it's critical to understand that over 60 million people living in 60% of our nation’s most at-risk counties will face unimaginable circumstances if the AHCA or the 2018 Fiscal Budget, (oddly titled, “A New Foundation for American Greatness,”) passes in their current forms.

I’ve been thinking.  If every congressional and senate leader would spend a day in a rural hospital observing and listening (not defending or campaigning), I wonder if they would gain a better understanding as to why it is so essential to protect rural health and strengthen the safety net. While they receive letters from constituents or stand in front of emotionally-charged town halls, and even though we have a bevy of passionate and smart rural health advocates and stakeholders knocking on their Capitol Hill doors, nothing, not any other thing, compares to being there – present with the people affected by these life-altering decisions.

Representatives who come from rural have an understanding of the stakes, better than their non-rural counterparts it seems. The invitation today is for those who don’t know rural, even if they think they do, to spend time in someone else’s hometown.  We must do all we can to open their minds and hearts to learn firsthand what it’s like to have one option for care and wake each morning with the prospect of the only healthcare resource closing. To make matters worse, live day to day with mounting anxiety over losing insurance because there is no company willing to provide coverage in the region, or becomes completely unaffordable.

I don’t live in the rural communities I visit, (although it feels like I do because I’m on the road roughly 26-30 weeks each year) so why do I care so much?  I care because it is the right and responsible thing to do. Whether you live in rural, it is very likely you know someone who has or does. Maybe it’s a grandparent, a cousin, a guy you used to work with, or a classmate from college. 

The issues facing rural communities, including limited access  to jobs, housing, food, education, and healthcare are not just ‘rural’ problems. These are concerns that distress our country as a whole. I am of the same belief when urban centers face these issues; that is, rural folks should care about them too.  It is never okay for any group of people to be without life's necessities.  When rural communities lose their hospitals, they lose health care, and that means emergency rooms, doctors, nurses, diagnostic services, physical therapy, in other words, the works. The rate at which rural hospitals are closing, and projected to close if we keep this up, is alarming. I don't believe it's up to only those in the rural sector to fix it alone - they can't.

Consider that when a rural hospital closes, the health care needs of the community do not vanish, they just disperse. If you live in an area where a hospital 35, 50, 100 miles of you has closed, you're feeling it; you may not even know it. Rural hospital closures cause lives to be lost, displaced and changed forever.  Communities slowly (or quickly) become unrecognizable.

Rural hospitals are up against the clock, and just because you may not see a farm from your front door, it’s essential to understand that there is simply not going to be enough health care to go around for all of us. It's unfair and unreasonable that others, by way of their geography, have no health care and while others get theirs. All are deserving of quality, safe healthcare.  Now, more than ever, we need healthcare resources and leaders to focus greater efforts on health education that leads to improved population health. Instead, they are jumping through hoops of fire.  Shaming people for their medical predicament and punishing them for having a preexisting condition is not the way to greatness.  Doctors and health providers need to be compensated fairly and adequately for their amazing work, for treating chronic illnesses, saving lives, caring for sick kids and elderly patients. We must keep protections in place that support medical education and reward those willing and wanting to serve the healthcare needs of rural populations, not put up more roadblocks. Rural hospitals should not be set up to fail while the larger systems with more affluent communities and covered lives thrive. The passing of the President's proposed budget, along with health care legislation sitting before the Senate, does all this,and sadly, more. 

There is no perfect answer or one solution of course.  Certainly, we can do much better than this.  We must.

Working with The National Organization of State Offices of Rural Health in their efforts to bring greater awareness to National Rural Health Day, November 16,2017, I have developed #PoweofRural.  The goal for this #PoweofRural movement is to bring together industry and non-industry stakeholders to innovate, collaborate, education and communicate to benefit rural lives and those who dedicate their life’s work to improving rural health.