'It's gone haywire': When COVID-19 arrived in rural America

An empty road leading towards a rural countryside of Dawson, Ga., is seen on Friday, April 17, 2020, in Dawson, Ga. Of the 20 counties with the highest death rate in America, six of them are in rural southwest Georgia, where there are no packed skyrise apartment buildings or subways. Other out-of-the way places so far unscathed by the pandemic might believe, like many in Dawson once did, that the virus won't find them out there. But ambulances rushed along country roads, fields and farms in either direction, carrying COVID-19 patients to the nearest hospital, for some an hour away. 

Over the last two months the coronavirus pandemic has brought our nation’s largest and most powerful cities to their knees. But as curves show signs of flattening in many urban areas and governors have begun the process of “reopening” their economies, new hot spots are emerging in places such as southwest Georgia, the Navajo nation and in and around meat-packing plants in Iowa and the Texas Panhandle.

Rural communities such as these lack the health-care infrastructure and financial resources of larger cities. At the same time, they’re home to older and sicker populations, more likely to suffer serious complications or death due to the virus. That’s why governors reopening their economies prematurely are not only misguided but could end up driving the devastation of rural America.

Long before people started falling ill and businesses started shutting down due to the novel coronavirus, rural America was already suffering. There are many indications that rural communities had not fully recovered from the Great Recession. As of last year, employment in non-metro counties had not yet returned to pre-2008 levels. Data also show that since the last recession virtually all new business growth has been concentrated in the 20 largest metropolitan counties. Overall rural counties have been steadily losing population for more than a decade now.

At the same time, rural communities have long been experiencing a health crisis. Roughly 170 hospitals in rural communities have closed in the last 15 years, leaving rural Americans with fewer and fewer health options. Due to the longstanding economic crisis in these communities, along with many states’ refusal to expand Medicaid, hospitals in rural areas have struggled.

Hospital closures put undue burden on rural residents. As it becomes more difficult to access health care, resident must travel farther for care. An estimated 8.6 million people live more than a 30-minute drive from their nearest hospital. Rural areas are already experiencing issues with transportation, which only adds to this burden. Even in places that still have hospitals, many provide only basic care and lack the ICU beds necessary in treating serious COVID-19 cases.

These challenges have become even more acute in certain places. Many rural communities, especially in the West, are home to large aging populations who can be more at risk of contracting the virus. Meanwhile, much of the South is home to predominantly African-American rural communities. In these communities, structural and environmental racism create conditions leading to residents suffering more chronic health conditions, which make them more susceptible to the coronavirus. Many Native American communities are struggling with a lack of running water and sewer, which makes it difficult to combat the coronavirus.

In all likelihood, the pandemic will only compound the dual economic and public health crises that many rural communities were already experiencing. But rural America is being dealt an even more devastating blow by governors in states such as Georgia, South Carolina and Oklahoma, beginning to reopen their economies while cases are still on the rise in rural areas. These decisions to reopen businesses before the public health threat has passed show a clear disregard for human life.

As states begin deliberating when to reopen their economies, they must exercise caution because the country has not taken appropriate steps to stem the rapid rise of confirmed cases. It is not too late for the White House to impose a national stay-at-home order to prevent community transmission. Another step is ramping up testing and the production of personal protective equipment so that the essential workers and health-care providers can do their job safely and effectively.

The pandemic is hitting rural America after more than a decade of neglect. Elected officials largely looked the other way while hospitals shuttered, jobs disappeared and people were forced to move away. However, by reopening the economy prematurely, governors are now inflicting direct harm on the millions of rural Americans who have been denied the resources to handle the crisis as well as their big city counterparts.

If governors allow the pandemic to infect rural America at New York City levels, it is quite possible we will no longer have a rural America.

Olugbenga Ajilore is a senior economist at the Center for American Progress. His expertise includes regional economic development, macroeconomic policy and issues in diversity and inclusion.

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