When Janice Probst read a report released in March by the federal Department of Agriculture’s Economic Research Service confirming that the health disparities gap between rural and urban Americans is widening, substantially, she was dismayed but not surprised.
According to the report, between 1999 and 2019 the gap in rural/urban natural-cause deaths for those aged 25–54 surged from 6 percent to 43 percent. Researchers also found that the more rural the region, the greater the increase. Recently retired as a professor of health services policy and management and as director of the University of South Carolina’s Rural & Minority Health Research Center, Probst has long decried the neglect of rural health in particular and rural communities in general.
The folks at the University of Wisconsin Population Health Institute’s County Health Rankings & Roadmaps have been thinking a lot about civic infrastructure and civic participation. By civic infrastructure, said Michael Stevenson, the programs co-director, they’re referring to the places “where people connect, where they gather, where they share information, and how that fuels civic participation.” This infrastructure includes many things: parks; schools; libraries; access to the information, resources, and services that support good health.
Regions with relatively under-resourced civic infrastructure, the institute’s researchers wrote, include the Black Belt region in the southeast, Appalachia, counties along the U.S.-Mexico border, and American Indian and Alaska Native tribal areas — regions that “bear a legacy burden of various forms of disinvestment and structural racism.”
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