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Tag Archives: hospitals

“Saving” Rural America

15 Tuesday Jan 2019

Posted by stevewiegenstein in Rural

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Tags

CityLab, development, economics, factory farming, government, hospitals, prisons, rural life, taxes

Interesting article this morning on the question of how rural America can be “saved,” and what “saving” would look like. Here’s the link.

I agree with most of Hardy’s essential points, that rural America has often been undercut by policymakers who have either failed to understand the strengths and appeal of rural life, or who have ignored them in favor of short-sighted and reflexive grabs at “development” that end up damaging the very areas they’re supposedly helping. I’ve written before about how the Missouri legislature’s refusal to expand Medicaid has hastened the closure of rural hospitals (six since 2014), thus contributing to the decline of the districts that, ironically, those very legislators represent. That refusal also harms clinics, nursing homes, and general practitioners too, of course, but there’s nothing that communicates high-profile community destruction than the closure of a hospital. It’s like a declaration of unlivability.

Similarly, an over-reliance on property taxes, which in Missouri’s case is built into the state’s constitution, has cramped the ability of many areas to fund their school systems properly. Two pillars of economic development are schools and medical facilities, and without  those two (and the third pillar, a robust public infrastructure) efforts to revitalize rural communities are almost inevitably doomed. I remember a few decades ago when prisons were going to be the salvation of rural communities; towns all over the state competed for the privilege of hosting the newest supermax or medium-security. Indeed, prisons bring employment, but it’s the sort characterized by chronic underpayment; corrections workers often need exactly the kind of social safety net that rural communities are losing. What kinds of businesses are drawn to towns with prisons? Budget motels and payday loans. And don’t get me started on the folly of communities offering property tax breaks to companies for locating there; “Come to Happyville, we’ll shortchange our kids for you” has never seemed like a very good slogan to me.

If policymakers really wanted to see healthy rural areas, they would be directing resources there in a sensible way. But often, it unfortunately seems as though even the communities themselves are contributing to their own destruction, a point that I think Hardy minimizes in his article. Think, for example, about the unending debate over CAFOs (“concentrated animal feeding operations,” better known as “factory farms”). Most of the time, those arguments are framed as not-in-my-backyard debates, with the relatively small number of neighbors who will be adversely affected by the smell and waste pitted against the “general good” of economic development. But that general good only lasts until the first big flood, when the widespread costs of environmental destruction become evident. Then we discover that the next county’s “back yard” is ours too.

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