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A friend of mine recently called my attention to this excellent article in The Chronicle of Higher Education, not usually the sort of publication that one associates with societal analysis. But it’s comprehensive, it’s long, and it’s well worth the time.

The subject is the interconnection between poverty, education, and health in a rural Missouri town – Kennett, a town in the Bootheel, the seat of Dunklin County. I don’t remember much about Kennett from my childhood except that I think we drove through it once; it also had an excellent newspaper, the Daily Dunklin Democrat, locally owned, that we read and admired when I was working for the Journal-Banner. (It’s now just the Dunklin Democrat, published three days a week, and kinda-sorta locally owned.)

But Kennett is not the story here; Kennett is merely the example of a story which can be repeated a thousand times across the country. Rural poverty, rural despair, forgotten people whose sense of futility leads to addictive behaviors and self-harm.

What’s remarkable to me is that this story could have been written a hundred years ago. Read Hamlin Garland, read Sarah Orne Jewett, read Sherwood Anderson, and you’ll read these same stories from a different era, with only the superficial details changed. The intractability of rural poverty is a continuing theme in America.

In Sinclair Lewis‘ novels, the warping power of rural despair is portrayed as malevolent, and the smug inhabitants of Gopher Prairie are portrayed as co-conspirators in their own limitation. In the work of someone like Frank Norris, by contrast, the rural folk are helpless victims of larger forces, cruel fate or wicked industrialists.

I think it’s possible to be both villain and victim in one’s own story, as we see in the Chronicle article: people who know the self-destructive consequences of their actions but who do them anyway. The great dilemma of rural poverty is its self-perpetuating quality. Poor folks can’t pay much in taxes, so they are unable to finance the kinds of improvements that would attract industry or a wealthier strata of people; thus the roads grow ever more pitted, the hospitals scratch along with the barest of talent, the educational system strains for the minimum. Putting a dent in rural poverty requires outside intervention. That’s why the state legislators in Missouri (and elsewhere) who turned down the expansion of Medicaid for partisan reasons were so foolish: they were essentially condemning themselves and their own constituents to a cycle of degradation. As we watch the lights of rural hospitals blink out across the state and nation, making those impoverished areas even less desirable to live in (an inevitable consequence of the refusal to expand Medicaid), we can see the future of towns like Kennett. And it’s not pretty.