rural issues

Jackie Fortier / StateImpact Oklahoma

It’s hard to get basic health care like shots and x-rays in rural Oklahoma. The federal government considers all but one of the state’s 77 counties to have a primary care shortage. The problem is driving a legislative effort to allow highly educated nurses to fill that gap — but doctors and nurse practitioners are butting heads on who is qualified to help.

Lindsi Walker sits behind a glossy wooden desk at Cordell Memorial, a hospital on Oklahoma’s western plains. She’s surrounded by pictures of her family — a stethoscope hangs around her neck.

When Dustin Gordon's high school invited juniors and seniors to meet with recruiters from colleges and universities, a handful of students showed up.

A few were serious about the prospect of continuing their educations, he said, "But I think some of them went just to get out of class."

In his sparsely settled community in the agricultural countryside of southern Iowa, "there's just no motivation for people to go" to college, says Gordon, who's now a senior at the University of Iowa.

Updated at 4:45 pm ET

President Trump thanked America's farmers for their political support on Monday and unveiled a plan designed to help revive fortunes in struggling rural areas. At the same time, the president is pursuing trade and immigration policies that could be harmful to farmers' bottom lines.

The retail economy in rural America has been rough for decades. But where thousands of stores have closed in recent years, Dollar General is thriving, sometimes at the expense of local shops. Dollar Generals are discount stores that sell goods from hand tools to hot dogs. They're reshaping the retail landscape in small towns. And making lots of friends — and enemies — in the process.

Microsoft is announcing a new effort to connect more people to the Internet. Not people far away, in the so-called emerging markets — where other American tech giants have built Internet balloons and drones. Instead, Microsoft is focusing right here at home, on the 23.4 million people in rural America without broadband access.

When you pull into Hugo, a town 100 miles east of Denver on Highway 287, you're greeted by one grocery store, one restaurant, one liquor store, one historic railroad roundhouse, two bars and a single antique store by the name of Main Street Mama's.

"I am the Main Mama, I am indeed," says Linda Orrell, who runs the shop.

Sitting on a bar stool in what used to be an old pool hall, Orrell says Hugo is pretty small — "about 825, or so, maybe 850 [people] on a good year."

The population has held steady for a long time, she says, because it's a good place to live.

For the hundreds of rural U.S. hospitals struggling to stay in business, health policy decisions made in Washington, D.C., this summer could make survival a lot tougher.

It became clear in the last election that a stark division existed between urban and rural areas. In places such as north Idaho, people with similar political stripes have begun seeking each other out.

When Adrien Koch retired last summer from her job with FEMA in the Bay Area, she and her husband resettled in the wooded mountains of north Idaho. They had visited only a few months before on a vacation but had quickly fallen in love. For Koch, Idaho reminded her of the California she knew in the 1970s.

Moriah, N.Y., is a tiny, sleepy place on the shore of Lake Champlain. Not so long ago, this was a major industrial port. Iron ore carved out of the hills here was packed onto train cars and barges. That iron ore helped build America's cities, but "then it all came to an abrupt halt," Tom Scozzafava says.

Scozzafava grew up in Moriah and now serves as town supervisor. He remembers the good times and he remembers the summer the good times stopped.

"1971, the miners — 600 of them — went home for their annual August vacation and they were never called back," he says.

President Obama sees a role for himself in rebuilding the Democratic Party after he leaves office — coach.

Pages