What the Tehama County, California shooting reveals (or confirms) about rural access to social services and health care

A few days ago, I highlighted in this post a Los Angeles Times report about some apparent mistakes made by the Tehama County criminal justice system, mistakes that enabled Kevin Janson Neal to murder six people and injure eight others before Tehama County law enforcement officers killed him last Tuesday.  Today I want to focus on a Sacramento Bee story that highlights the challenges victims and their families will face in attempting to get services they need to help them cope with what has happened to their small community.  The headline is, "Poor and isolated, victims of Tehama shooter turn to internet for help," and the excellent story is by Anita Chabria and Ryan Sabalow.  Here's the lede:

Poor and so rural the bus only runs into town a few times a week, a rambling community southwest of Red Bluff faces a long road to recovery after a disgruntled gunman killed six and wounded at least nine people, many of them children, this week. 

Chabria and Sabalow quote Amanda Sharp, director of Tehama County Social Services and Community Action: 

The poverty rate is very high and that area has needed help before this tragedy.  This is only exacerbating the suffering people are going to experience.

U.S. Census Bureau data indicate a poverty rate for Tehama County close to 20%, the threshold at which it would be a "high poverty" county.  For Rancho Tehama Reserve, however, the poverty rate is more than double that threshold, a shocking 43%.  Whereas the median household income in Tehama County is $41,000--just two-thirds of the state figure, $64,500--in Rancho Tehama, that figure dips to $27,000, about 40% of the statewide median. 

The other striking thing about the story is how those affected by the shooting rampage have turned to gofundme.com to raise money to help defray the cost of their expenses.  They are experiencing varying degrees of success, which appear related to how worthy (hard working) or vulnerable (children) they are.  This seems tome more evidence of the (rural) bias against those who are perceived as lazy.  For more on that topic, see Jennifer Sherman's book, Those Who Work, Those Who Don't:  Poverty, Morality and Family in Rural America (2009), the research for which was done in northern California.  My The Geography of the Class Culture Wars is also relevant, as is Terrence McCoy's story in the Washington Post here.

As for where the Tehama County victims are hospitalized, the seriously wounded are in Sacramento, home of UC Davis Medical Center, which is more than two hours away.  That distance puts an added burden on families of the injured.  Those with less serious injuries are in Red Bluff or Redding.  That Sacramento (or even San Francisco) is the location of appropriate medical care for the most severely injured was also highlighted by the Redwood Valley (Mendocino County) fire in early October.  Read more here.