Rural equals resilience – A new reputation or just a better understanding?

It’s hard to keep track of the number of major issues that rural communities experience that can impact wellness and community health.

Whether increased health disparities, reduction of industry/employment, reduced federal funding, rural hospital and clinic closures or today, a pandemic, each of these concerns alone can and has caused some rural communities to fade away.

However, many communities have not faltered, with some showing population increases. What is the secret recipe that allows rural communities to continue and, in many instances, thrive?

The answer is resilience. Resilience wrapped in a beautiful blanket of values, beliefs and attitudes that promote hardworking, giving, family and community-oriented people. In rural communities everyone knows everyone (and if you think they don’t, you might just be in denial) and when someone needs a hand with a chore, a meal in their bellies, or a mask to protect, many souls will be at your door to help, with no expectation of return.

Today rural communities are at a crossroads. Many will experience increased health inequities due to the pandemic, finding it even harder to pick up the pieces. Others will be examples of resilience. This exact type of resilience was most recently highlighted in the small Italian town of Vo ̀ (~3,000 residents) in which residents were able to halt the spread of COVID-19 (Tondo, 2020).

The strategy was calculated. Test all residents, isolate those who tested positive, and check everyone coming into the town. While in the U.S., there are daily news headlines illustrating the lack of available tests.

Rural communities have the capacity to successfully implement public health orders – physical distancing and local policies to shelter their communities. These types of public health orders may be more successful in rural communities compared to urban areas due to the reduced population density.

Obviously, some residents may not automatically ascribe to physical distancing, as a lack of interaction with family and neighbors who take care of each other on a daily basis, requires buy-in. Thus, it is essential that key stakeholders in these communities understand and agree with the potential impact if not implemented.

Although current (and pre-pandemic) discussions regarding health in rural areas largely focused on access to health care, there is an urgent need to shift the discussion to prevention on how to over such adversity.

More than ever, public health workers need training to provide essential, evidence-based public health prevention and care, tailored to rural areas. Currently, few rural communities have the public health infrastructure to address the multitude of concerns that may arise in areas that are unable to neutralize the virus – further exacerbating inequities.

Now is the time for the federal government and organizations to prioritize structural solutions to the lack of public health care in rural communities. This commitment of funding will allow for the training of a future public health workforce that can address the unique concerns – current or the new ones that will emerge in rural communities.

Will the pandemic allow for people around the world to see the essence of rural resilience? I say yes – but successful efforts require intention and persistence by everyone and not just those living in these communities.
Successful public health promotion requires collaboration, openness/transparency, flexibility, accountability, communication, cultural competency, self and collective efficacy and of course resilience. Only time will tell about how the pandemic will impact rural communities, but you better believe that these communities will not go down without a fight and many of them will be examples of resilience.
Then maybe people will have the opportunity to understand how rural communities are essential to the survival of us all – thinking agricultural and natural resources). Until then, as my Dad tells me each week on the phone, “this too shall pass” – his words are the essence of moving forward in a rural community.

Danielle R. Brittain, PhD and Melissa A. Valerio-Shewmaker, PhD, MPH


Reference
Tondo, L. (March 18, 2020). Scientists say mass tests in Italian town have halted COVID-19 there. The Guardian. Accessed April 10, 2020: https://www.theguardian.com/world/2020/mar/18/scientists-say-mass-tests-in-italian-town-have-halted-covid-19