Rural HealthCare in Crisis

For the first time in the history of this country, rural counties have negative population growth, meaning more rural counties lost population than gained between 2010 and 2014. But you are not hearing about the critical issues in the election process, what this loss of population to rural areas is doing. 

In many of these counties, this has been a trend for more than 100 years. If you live in a rural community, you just might be in crisis due to your economic development efforts.

Rural economic development efforts often bring to mind Einstein’s definition of insanity, “Doing the same things, in the same way, expecting different results!” Rural areas must change up their approach – and acceptance - to attract newcomers.

Is your community still doing economic development the same way as you have been for the last 100 years? Are you getting the results you want?

How Jobs are Created.jpg


This pyramid shows where new jobs are created, but the efforts of most economic development programs are geared to recruit “that” business to town so we can create “good” jobs. If we attract “that” business, it may be good for the community, but a loss for the community “that” business left. We’ve just shifted location, and perpetuated a win-lose game plan. Rural must work differently – and together – to grow.

Healthcare impacted

The National Rural Health Association wanted to know where this trend is heading. They teamed up with the Sheps Center for Health Services Research at the University of North Carolina and iVantage, a health analytics firm. The goal was to identify rural hospital closures when they happen, collect a snapshot of how many rural hospitals are struggling, and where they are located.

The research identifies 2,078 rural hospitals, of which, 1,284 are critical-access facilities. They found 210 were “most vulnerable,” meaning they could potentially close tomorrow. Another 463 were simply labeled as “at risk,” meaning they could close at any point in the next couple of years. Together, 52.4% of all rural critical-access hospitals in the U.S. are compromised.

As more young people leave rural towns to go to work in the larger metro areas, we see the most vulnerable people, the elderly, being left without critical services where they live.

Hospitals, schools, foundations, and businesses need to be involved and turn this around with relationship economic development.

Relationship economic development is all about getting people and communities to learn how to build relationships with each other. Communities need to let go of past hurts of school mergers, county-seat struggles, where the railroad went, and unhealthy athletic rivalries.

Relationship economic development consists of three learning steps:

  • Relationship development - Common knowledge
  • Community development - Common interests
  • Wealth creation - Common work

Forward-thinking metro areas support rural development because, as people move to the metro, the hollowing-out of surrounding communities will minimize potential employees in their current and future workforce pool. Young people have been moving to the metro areas for many years, but with the decline in school populations, that source will soon dry up.

Want to grow your rural area and keep hospitals, schools, services strong? Check these:

  • You may have to work around the “good ‘ol boys” clubs and ideas. Decades-old methods of attraction worked then, but, if still used, you’re likely losing population, schools, hospitals, and youth.
  • Do you truly welcome new people? Most communities want to grow, but often citizens are hesitant to welcome newcomers and their ideas, unless new people think, look like, act, and believe like the community.  
  • Declining population can bring decline in housing options. Buyers are more choosy these days, and homes are not always equipped or updated. Communities are smart to address this trend to remain in the running for new owners.
  • Area leadership must work together to grow. Hospitals, schools, city councils, county commissions, chambers of commerce, economic development organizations, civic groups, community and private foundations – you know your community - are best together.
  • There is the opportunity to build through the telecommunications infrastructure in some rural areas. New home-based businesses can move in. Companies can adopt telecommuting policies and communities and companies can adopt more family-friendly policies.
  • Early care and education must be considered “critical infrastructure” that requires community and business investment to attract families and support workforce needs. 

Relationship economic development will help your community/organization:

  • prepare for newcomers, 
  • learn skills to talk through, not just about, community issues that positively guide the future,
  • learn more about their own area - how each community is unique and complements one another,
  • learn how to encourage & support entrepreneurs,
  • identify, invite, and welcome those from around the globe who want to live in rural areas,
  • grow populations and business sectors.

Global Horizons, LLC is an experienced company with a plan and processes to grow communities by building healthy relationships:

Ready for a better way to build wealth and healthy relationships to change your community's future? We know how and would like to visit with you!