Princeton, N.J.—According to a new NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll, although a majority of rural Americans are optimistic about having an impact on improving their local communities (62%), a small share are experiencing problems in areas that carry major consequences, including financial insecurity, trouble accessing affordable, quality health care, lack of high-speed internet access, housing, and isolation/loneliness.
Despite a growing national economy, four in ten rural Americans (40%) say their families have experienced problems affording medical bills, housing, or food in the past few years (see table below). A sizeable share of rural Americans face challenges with financial insecurity, as nearly half (49%) say they cannot afford to pay off an unexpected $1,000 expense right away.
This is the second poll in the Life in Rural America series, conducted among 1,405 adults living in the rural United States. This survey found the vast majority of rural Americans say their communities are safe from crime (88%, see figure below), and a majority (73%) are satisfied with their quality of life.
However, many rural Americans continue to lack adequate health care access. Though most rural Americans have health insurance, about one-quarter (26%) have not been able to get health care when they needed it at some point in the past few years. Nearly one in ten rural adults (8%) say hospitals in their local community have closed down in the past few years.
“Even with major improvements in health insurance coverage over the last decade, it is concerning that one in four rural Americans are struggling to get the health care they need,” said Robert J. Blendon, co-director of the survey and the Richard L. Menschel Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health.
Beyond health care, rural Americans are left unable to participate in the digital economy without reliable, broadband (high-speed) internet access. About one in five rural adults (21%) say accessing high-speed internet is a problem for their family. Among rural adults who use the internet, a majority say they do so to obtain health information (68%), for personal finance (61%), and for work-related activities (54%).
When it comes to homelessness and housing issues, one-third of rural Americans (33%) say homelessness is a problem in their local community, while more than one in ten have experienced several types of housing problems in their current residence, including the safety of their drinking water (17%) and mold or other environmental problems (16%).
In addition, while nearly one in five rural adults say they always or often feel isolated or lonely (18%), most report having at least a few people nearby they can rely on for help or support (92%).
“An important goal in funding this research is to help build a more complete understanding of the challenges to being healthy and the strengths of rural places in fostering good health,” said RWJF President and CEO Richard Besser. “While it’s encouraging to see neighbors looking out for each other and strong networks of social support, it’s sobering to see that rural families struggle to pay for housing or food, go without needed medical care and lack financial security and essentials like high-speed internet access.”
This report also includes key findings among the following rural subgroups: adults living with disabilities, Black adults, Native American adults, adults living in mobile homes, and low-income adults. Key findings are also presented by education, age, and region.