Recent reports identify rural public health interventions, some with potential to mitigate Medicaid cuts

U.S. Department of Public Health Building.
Image courtesy of Boston Public Library. 

Healthcare in rural America finds itself a topic of much discussion lately, with mainstream media coverage of the crisis unfolding after Medicaid cuts by the Trump administration's 2025 budget reconciliation bill, which was signed into law July 2025. By some estimates, the new law will increase the number of uninsured people by 10 million in 2034. Other coverage concerns the fate of a $50 billion rural health slush fund that is yet to pay out in the communities who need it most and the recent slew of hospital closures in rural communities.

While the new restrictions on Medicaid eligibility and reduced federal spending will be felt across the nation, rural communities will be hit especially hard, due to the higher rates of people on Medicaid in nonmetropolitan areas. Sarah Jane Tribble, reporting for KFF Health News, writes: 

People who live in the nation’s rural expanses have more chronic diseases, die younger, and make less money. Those compounding factors have financially pummeled rural health infrastructure, triggering hospital closures and widespread discontinuation of critical health services.

Hospital closures (online tool showing a map of recent closures) exacerbate the present struggle to meet rural healthcare needs, where people are generally more vulnerable and less likely to utilize primary care services due to structural barriers like cost and provider shortages. In 2016, Dr. Julia T. Caldwell et al. published a paper in the American Journal of Public Health, which states that "[r]ural adults are less likely to be insured, less likely to use healthcare, and more likely to delay seeking care than urban residents." To put it plainly, access to acute care is bleak in much of rural America right now, and reductions in Medicaid spending and eligibility are poised to make things worse. 

Rural hospital closures, 2005-2010 (in blue) and 2010-present (in yellow).
Graphic courtesy of Sheps Center for Health Services Research, UNC. 

There is, however, another dimension of the rural health conversation that is gaining traction in public discourse – rural public health. Where the trends in healthcare are alarming, improvement in public health feels tractable. This post focuses on insights from two recent reports – this one from the Aspen Institute (Feb. 2026) and this one from California's Department of Public Health (Feb. 2026) – to highlight opportunities for high-impact rural public health intervention amid the ongoing healthcare crisis. 

Public Health: Rurality in Focus

In general, the healthcare industry aims to treat people who are sick or injured, whereas public health seeks to keep people from getting sick or injured in the first place. According to the American Public Health Association, healthcare focuses on individualized care; public health focuses on entire populations. Because a key responsibility of public health is to collect, analyze, and interpret health data to inform timely public health interventions, policies, and resource planning, it is more likely to analyze and include the axes of identity and experience that inform vulnerability. In fact, rurality has been an axis of analysis in public health research for decades. "Place," meaning where people live, work, and play, is widely understood by experts in the field as a fundamental social determinant of health.

In February 2026, the Aspen Institute and the California Department of Public Health each published reports that examine, in significant detail, the state of rural public health. The Aspen Institute Report is titled "Meeting the Health Needs of Rural America," and represents the tenth installment in the Aspen Health Strategy Group's mission to tackle a single health issue annually through year-long, in-depth study. The California Department of Public Health Report, the State's second-ever "California State of Public Health Report," ("Cal. DPH Report") carves out tens of pages devoted to risks, trends, and interventions specific to rural children, adolescents, and adults.

All-Cause Mortality Rate by Race and Ethnicity in Urban/Rural
Areas, California 2022-2024 (Cal. DPH Rep., p. 32)

This post focuses on one paper from the Aspen Institute Report titled Population Health in Rural America: Changes, Challenges, and Opportunities, authored by rural demographer Shannon M. Monnat and sociologist Tim Slack. Their paper tees up several useful policy proposals, which provide a path to remedying the so-called "rural mortality penalty" – the name for a widening disparity where rural U.S. residents experience higher age-adjusted mortality rates than urban counterparts. The authors suggest that the relative recency of the rural mortality penalty, which emerged in the data only four decades ago, "provides reason to believe it can be reversed." (Aspen Inst. Rep., p. 5). 

Systemic Risks and Opportunities 

Each report does a thorough inventory of factors driving mortality rates across the lifespan, from infants to working-age adults to the elderly. Unsurprisingly, barriers like lack of access to healthcare, transportation, healthy food, broadband internet, and other social services are central to their findings. But each goes a step further to do some accounting of recent social and economic trends driving the numbers: substance abuse and misuse; growing gaps in educational attainment; and persistent economic disinvestment that has hollowed out local institutions and workforce pipelines. Environmental risks (including climate change) and exposures also explain recent losses in resilience and increases in mortality rates. These overlapping stressors compound, reinforcing cycles of poor health outcomes that are difficult to interrupt through healthcare access alone. 

Adult Mortality Rates in Nonmetropolitan (Rural) Counties,
2000-2022 (Aspen Inst. Rep.)

Writing for the Aspen Institute, Monnat & Slack characterize "rural economic and human health" as "intertwined." The data in both studies bears this out. Lower income, wealth, and levels of educational attainment correlate strongly with shorter lifespans and fewer years lived in good health. Importantly, both reports frame these outcomes not as inevitable features of rural life, but as the product of policy choices and disinvestment patterns that can be changed. The California report, in particular, emphasizes that upstream interventions–those that target education, early childhood development, and economic stability–offer some of the highest returns for improving long-term health outcomes (Cal. DPH Report). 

The reports identify education policy reform as a major inroad for uplifting rural communities struggling with economic disinvestment and population decline. 

Education, particularly possessing a bachelor’s degree, has become an increasingly important determinant of health and longevity in the United States. Higher education confers economic, social, and lifestyle advantages that manifest as a “personal firewall” that protects health, even in the face of external and unpredictable threats, such as pandemics, recessions, and natural disasters.

(Aspen Inst. Rep., p. 76). Investments in vocational programs, community colleges, and early childhood education programs like Head Start not only improve education and employment outcomes, they also provide measurable health benefits over time. Many health outcomes and disparities in adulthood are rooted in childhood conditions such as family and community health, neighborhood safety, policies, and systems" (Cal. DPH Report, p. 58). By strengthening local economies and expanding opportunities, these interventions address root causes of poor health, rather than treating symptoms as they occur. In this way, rural public health policy begins to function as a cross-sector strategy for community resilience. 

Conclusion 

The current crisis in rural healthcare access underscores the need for action, but it also highlights the limits of a healthcare-only response. As the reports analyzed in this post make clear, improving rural public health outcomes requires sustained investment in the social and economic conditions that shape health, long before a person ever becomes a patient. Public health offers a framework for identifying upstream opportunities and making interventions where they can have the greatest impact. In the face of hospital closures and shrinking coverage, this broader approach might provide a path forward: one that treats rural health not only as a medical issue but as a function of place, policy, and long-term community investment.

Gabbs, Nevada is a real place

During Thanksgiving Break 2024, I traveled with my partner at the time to visit her family in Gabbs, Nevada. Leading up to the trip, I told my friends and family where I was going by saying the name of the town, waiting for a second, then dramatically saying "population: 58." This usually got a bit of a puzzled reaction, but I felt it effectively conveyed my bewilderment. It seemed like an impossible place to me, far more remote and isolated than anywhere I had been.

A faded sign outside of Gabbs with a list of obsolete churches and social clubs, November 2024 

It turns out the population is greater than 58, with the most recent numbers I could find putting the population at 237. I'm not sure if the discrepancy was because of my ignorance or some miscommunication. Regardless, the town was certainly isolated. It was about seventy miles away from the nearest gas station and grocery store, deep in the magnificent beige of the Great Basin Desert. 

I was perhaps too unbothered by the isolation, as I neglected to fill up my car at the gas station at our last stop at the Walmart in Fernley, Nevada. As Interstate 80 changed to US 50 which changed to NV 361, the setting sun cast a lovely red glow on the desert, before turning into a pitch darkness that properly spooked me. I love a good country drive in pitch darkness, but the lack of trees or any shapes for my headlights to bounce off of was causing a low-grade panic to set in. My paranoia about running out of gas certainly did not help. 

NV 361. I swear this was terrifying at night. November, 2024

We did arrive safely, not quite sure if we were going to spend that night with our hosts or at a local motel that one Yelp review referred to as "Norman Bates scary." We thankfully did not have to find out what that meant, and spent the night on the couch after some stargazing and exploring our hosts' underground library. As always, I was stunned by the view of the night sky when there was no light pollution.

Our hosts were my partner's great uncle and aunt, we talked with them quite a bit about life in Gabbs. They were constantly on the road spending about half of the year driving to visit friends. They preferred to hole up in Gabbs in the more temperate seasons, leaving mainly during winter and summer. For them, the remoteness was peaceful, and there was a family tie. My partner's great aunt and grandmother grew up there.

Gabbs was founded around a magnesium mine in 1941, when demand for the mineral was high due to World War II. Though demand dropped off sharply after the end of the war, operations in the mine continued, and the town was built up with a library and a K-12 high school, where my partner's grandmother attended while growing up there through the 1950s. She mentioned seeing nuclear blasts on the horizon, likely seeing explosions from the Nevada Test Site, which operated continuously through the 1960s.  

Wide-Lens Shot of Gabbs, a view from the desert. November, 2024.  

The next day we had a two hour excursion of wandering in the desert and exploring the town. While the previously cited Nye County Civic-Plus source indicates that the town has an operational school, library, and community pool, it was clear from our exploration and conversations with my partner's family that this was no longer the case. The pool was dry and overrun and the library and school were just empty facades with decayed interiors. Apparently the town had been losing population over time and the population was now mostly retirees.  

An abandoned pool in the center of town, November, 2024. 

 Our discussions of rural disadvantage earlier this semester reminded me of wandering around Gabbs. The readings around the crises facing rural schools brought the image of the empty school back to my mind. This simply seemed to be a later stage of the problems described in those articles. I am now struck by how Gabbs is so remote that its decline is not noticed at all by the outside world. There is so little information available about this town even in our internet age. If I had not been there, it would have been impossible to see it as a real place.   

 On the drive back home I appreciated the beauty of the desert a good deal more. I am also happy to report that I did not run out of gas, though it got a bit too close for comfort at the end there.  

The Grange: Community building in rural America

                      

Credit: Anderson Valley Grange

Some of my earliest memories are attending the yearly variety show at the Anderson Valley Grange in Mendocino County, California. During these performances the bustling Grange hall felt like the busiest gathering of the year, besides the county fair. The Grange gives fair warning that “this is a variety show NOT a talent show.” In catching up with my grandma about the Grange, which she was a member of for many years, she remembered most performances as “really bad,” noting affectionately that the emcee was “extremely corny.” She and her hippie friends were often among the acts of the night and may have been at least in the neighborhood of “really bad” also.

Regardless of the varying quality of the performances, the Grange provided a sense of community in a place where many people lived too deep in the woods to see their neighbors regularly. There was always some friend of my parents or grandparents who had apparently known me since I was a baby, and I likely would not see them again until the next variety show. Unbeknownst to me as a child at the variety show, the Grange had been playing a similar role in rural communities across America for almost 150 years.

The origins of the Grange

The Grange, formally known as National Grange of the Order of Patrons of Husbandry, began as an organization dedicated to agriculture when it was founded in 1867 by Oliver Kelley, a Minnesotan with an interest in reorganizing and educating agricultural workers. Kelley had been sent to the South after the Civil War by President Andrew Johnson to assess the agricultural conditions of the region and formed the Grange partially in reaction to this tour.

I Feed You All! Image Credit: Library of Congress 

The Civil War had marked the culmination of a rapid series of changes to farming communities. The draw of urban economies and the increasing efficiency of agricultural technology had steadily reduced the share of the US population engaged in farming, declining from 90% in 1790 to 42% in 1880. This demographic shift brought changes to the social fabric of rural communities.

Once, farmers had engaged in subsistence agriculture and frequently labored together if one member of the community needed help planting or with harvest. Now, innovations like the cast iron plow greatly reduced the need for farmers to work together in the fields. Additionally, most farmers had shifted from subsistence farming to commercial farming, rendering them competing market actors rather than a community with shared goals.

Kelley began the Grange with the increasing obsolescence of traditional farm life in mind, and his vision for a new farming community was a rather radical one. The National Grange claims that “[s]ince our founding in 1867, we have lived by our motto, “In essentials, unity; in non-essentials, liberty; in all things, charity.,” and that “[w]e have always welcomed and invited people of all races, creeds, religions and nationalities into our membership.”

The Grange did in fact embody principles of equality in many ways. The institution not only welcomed women, it required that at least four members elected to the board be women in order for a Grange to be chartered. Recognition of the labor that women provided in agricultural life was central to the Grange from its inception.

In addition to the social principles espoused by the Grange, the group was strongly motivated by Kelley’s longstanding interest in developing and proliferating farm technologies in an equitable manner. Kelley saw people engaged in agriculture being left behind. In his words, "Everything is progressing. Why not the farmers? The inventive genius of the country is continually at work improving tools, and farmers remain passive."

A particularly interesting feature of the Grange is their Masonic-inspired secrecy and ritual. Kelley had found that his membership in the Masons was a helpful foot in the door during his time in the South. He believed, quite correctly it would seem, that “[t]he secrecy would lend an interest and peculiar fascination.” Grangers ascended through a variety of ranks, known as “degrees”; wore sashes, badges, and regalia corresponding to their rank; and had secret handshakes and passwords. These features faded in modern Granges, but my grandmother still recalls a secret handshake and being given a “goddess name” when she joined in the 80s.

Expansion, goals, and advocacy

The Grange was a near-immediate and explosive success, with over 24,000 chartered local Granges and almost one million members within eight years of its founding. While Kelley had founded the Grange with central planning in mind, hoping to eventually incorporate the Grange into the U.S. Department of Agriculture, Grange chapters quickly became extremely independent, with the National Grange exerting little control over their operations. The Grange was focused on farmers, but were very lenient regarding who could become a member. Even from shortly after its founding, Granges members often included lawyers, judges, and educators.

The early National Grange strongly advocated for cooperative farming. While we commonly think of cooperative farming as groupings of producers, the Grange additionally endeavored to unify production and sale of agricultural products to extract greater profits, a practice known in economics and antitrust law as vertical integration. At the peak of the Grange collectivization attempts in 1877, about 30,000 co-ops existed. The Grange also operated the infrastructure necessary for these co-ops, facilities like mills, grain elevators, and warehouses.

Though the Grange is ostensibly non-political and discourages discussion of politics at their meetings, their concern for the agricultural class manifested in advocacy for a variety of political causes, especially in their early history. Perhaps most prominent was the effort of the Grange to combat the high rates charged by railroads, an effort that resulted in the Granger Laws and inspired modern antitrust law. A contribution that perhaps has the most lasting impact on rural communities is their campaign for rural free delivery of mail.

A critical view of the early Grange

While many accounts of the Grange dote over its inclusivity, Prof. Charles Postel provides a rather scathing perspective on the Grange in his book Equality: An American Dilemma. He notes that gender equality was a relatively palatable position in Washington D.C following the Civil War, where seven of the eight founding members of the Grange were working as members of the federal government at the time of the founding. While women did occupy prominent leadership positions in some Granges, many female members were relegated to secretarial roles.

Additionally, the Grange was somewhat wavering in its support for suffrage. The National Grange came out in support of suffrage in 1885, but the next year reverted to support for state rights to set suffrage policy. Granges did provide an audience for suffragettes, and the National Grange finally backed the suffrage amendment in 1915.

The Grange did not explicitly discriminate against African-Americans; it was nevertheless clear to many that they were not welcome. Kelley was a lifelong Democrat, and many Granges made quite obvious overtures to white Southern farmers. Prof. Jenny Bourne of Carleton College notes in her book In Essentials, Unity: An Economic History of the Grange Movement that the National Master of the Grange in 1873 said that admitting “colored” members was a question best left to local interests. Unsurprisingly, many communities in the South answered this question with exclusion. Black farmers responded by creating the Colored Farmers’ National Alliance near the end of the 1880s.

Many positive accounts of the Grange’s early history acknowledge and discuss the exclusion of African Americans, but the relationship of the Grange to Native Americans is often left unexplored. Prof. Postel notes that Kelley was largely disinterested in the Civil War because his “deep antipathy towards the Indians of Minnesota” motivated him to cooperate with Republicans, despite being a lifelong Democrat. While the Grange performed a variety of charitable work for Native Americans from the 1940s onwards, it must be acknowledged that the interests of white farmers were often in direct opposition to those of Native Americans during the early history of the Grange.

As aptly put by Prof. Bourne, “the history of the Patrons of Husbandry exposes the classic tension between the desires for achieving overall economic success and for dictating how the spoils are split.”

The fall, rise, and second fall of the Grange

While declining profits from farming rendered cooperative efforts very attractive, Grange efforts to collectively sell and purchase agricultural products suffered from defection by individual farmers. A lack of effective cooperation between the National Grange and local and state Granges was an additional challenge. Additionally, the cooperative methods employed by the Grange often required an upfront investment that many farmers were unable to afford as the economy became increasingly strained in the late 1800s.

Grange membership had fallen precipitously in the 1880s and 1890s, as many members found that the costs of their membership outweighed the perceived benefits. It did not help that some members apparently found the agricultural programming “dull as well as not worth the money.”

In terms of rural political advocacy, the space once occupied by the Grange had been effectively co-opted by new organizations like the Farmers Alliance, the Farm Bureau, and the Greenback Party by the late 1800s. While the Grange thus receded from national politics, it was a significant influence on these successor organizations and on modern farm interest advocacy groups, like the National Cattlemen’s Beef Association and state dairy marketing boards.

   Combined Grange and Farm Bureau Facility in Del Norte County, California

 (c) Lisa R. Pruitt 2019

While the Grange had largely withdrawn from the political stage by the early 1900s, membership had begun to rebound as Grange organizations started to offer important services to rural communities. In particular, the Grange began offering insurance and created power cooperatives in the 1930s.

While nonprofit utilities and insurance providers initiated by the Grange still serve rural communities, these enterprises are now mostly under non-Grange management and no longer exclusively serve Grange members. The fact that these services gradually stopped being linked to Grange membership and decreasing rural populations has caused a steady decline in Grange membership. Since the 1955 Grange membership has fallen from 850,000 members to 140,000.

The National Grange currently advocates on the level for relatively modest and non-partisan goals, like increased spending on agricultural research. They maintain their longstanding anti-tariff views and have generally favored immigration, but the organization seem to be tempering their language to assuage Trump voters in recent years.

The Anderson Valley Grange and the new role of Granges

The Anderson Valley Grange has a particularly Northern California themed history. This wonderful article by Lisa Morehouse, published recently by KWED, the San Francisso details the initial frictions at the Anderson Valley Grange in the 70s and 80s as the longtime residents of the area, largely loggers, apple farmers, and sheep herders, were suddenly overwhelmed by hippies hoping to use the Grange, home of the best dance floor in town.

The Anderson Valley Grange, Mendocino County, California

 (c) Lisa R. Pruitt 2022

The current head of the Anderson Valley Grange is a man known around town as Captain Rainbow who “wore a loincloth [and] lived up in the woods” when he first moved to Anderson Valley. He tells the story of how a crisis led to a reconciliation of this "old-timer" vs hippie conflict. 

In his early days in Anderson Valley, “if you were a hippie, you weren’t particularly welcome here.” He didn’t go to the local bar, nicknamed “the Bucket of Blood” for about 10 years “because it was chainsaw haircut time if you did." 

Things changed in 1985 when the old Grange hall, built in 1939, burned down. When the Grangers came together to build a new building, the hippies begged the Grangers to include a dance floor and offered to help rebuild the hall if the insurance money ran out.

Captain Rainbow recounts that even if you had a bad encounter with an old timer, “The next day, hungover, both of you would be hanging sheetrock together, and you’d find out that, hey, you’re all right.” After the hall was built, Captain Rainbow was delighted to receive an invite to join the Grange, along with the many other hippies who had been involved in the effort to rebuild the hall.

A post buried about half way down this archive of the Anderson Valley Advertiser shares a similar sentiment, noting that running out of insurance money, “was a blessing in disguise, forcing us to rely on each other, it forged new friendships and respect.”

My grandmother recalls joining after this cultural divide had somewhat mended. She joined because she wanted to find a venue for her Congolese dance teacher to offer lessons, and both were welcomed with open arms.

Today, the Anderson Valley Grange still acts as a center of community for the region. They host their annual variety show, monthly pancake breakfasts, dances, and quinceaneras. The Grange maintains ties to its agricultural roots, collaborating with Anderson Valley Brewery, using the hall for agricultural education, and hosting seed exchanges. Mendocino County Grangers also started a retirement facility that houses 170 people.

Food Bank Sign at the Anderson Valley Grange (c) Lisa Pruitt (2022)

While still lively, the Anderson Valley Grange faces the same issues as Granges nationwide. In Captain Rainbow’s words, “We need some fresh blood.” The Grange is active, but the membership is aging. “When my generation came in and became part of the Grange, the old-timers, they needed us. And [], I’m a geezer now!”

While Grange membership has been on a long downward trend, there has been some incremental growth in the last few years. The Anderson Valley Grange, like many in California, has an increasingly Latino membership. It is also making overtures to Native Americans in the area.

Conclusions

The Grange is an institution with an extremely rich and complicated history that this post has barely scratched the surface of. While its political relevance has faded, local granges still remain as a hub of community in many rural areas. Living in the city, it is easy to forget how crucial simple infrastructure like a large hall with a stage is to cultivating community. As rural communities struggle and decline, we should be mindful of the role that organizations like the Grange play in supporting them.

Senators call for investigation into the state of rural child care—and how Trump administration policies are undermining it

Head Start offices in Toledo, WA.
Photo by Joe Mabel, distributed under a CC BY-SA 4.0 license.

On January 26, six senators led by Elizabeth Warren and Raphael Warnock announced an investigation into how the Trump administration's childcare policies affect rural families. The letter, addressed to Todd Lindsey, Acting Under Secretary for Rural Development at the U.S. Department of Agriculture, and Alex Adams, Assistant Secretary for the Administration for Children and Families, requests "information regarding ACF and USDA's current capacity to support child care, particularly in rural communities." The senators highlight the national childcare crisis, emphasizing the high costs and lack of access many families face. 

Child Care Funding in Rural Areas

This letter follows a January 6, 2026, Trump administration attempt to freeze federal funding for child care and family assistance in five states. The administration said it was taking this action due to allegations of fraud in the use of federal funding. Courts restored the funding within three days, allowing child care centers to continue receiving federal funds. The freeze temporarily affected the Child Care Development Fund Block Grant (CCDFBG), a federal funding stream that helps make child care more affordable. It also affected Temporary Assistance for Needy Families (TANF), which provides block grants to states. It has been historically known as cash assistance to families, but it also provides direct childcare assistance, as well as state-wide funding. States can choose to transfer up to 30% of their TANF funds to their CCDFBG funds and funnel them towards childcare subsidies and Head Start programs.

The Senators' statement also follows H.R. 1 (the "One Big Beautiful Bill"), which you can read more about here. The bill expanded the Child Tax Credit and increased the amount that employees can set aside pre-tax for childcare. These changes mostly benefit middle- and upper-income families. On February 3, 2026, the House passed a new spending package, and President Trump signed it. That bill increased the Child Care Development Block Grant and Head Start by $85 million each. 

Head Start provides critical resources to children up to age 5. Its programs include providing breakfast and lunch, mental health care, and school readiness. Almost half of all Head Start slots are in rural districts. In a survey of 10 states, Head Start programs comprised about one-third of childcare centers in rural communities. This program supports children and families. Expanding Head Start has drawn bipartisan support, and  78% of rural Americans support it. 

The Rural Childcare Gap 

The senators cited a September 2025 poll by the First Five Years Fund, which found that rural families experience child care challenges across the board. 

Overall, 4 out of 5 [r]ural Americans say the ability of working parents to find and afford quality child care is either in a “state of crisis” or “a major problem,” including 81% of Rural Parents and 80% of Rural Nonparents.

Further, one in five rural parents report having trouble finding or keeping a job because of the cost or access to child care.  

Data collected by the Buffett Early Childhood Institute at the University of Nebraska further illustrates the gap. 31.5 percent of rural children who may need childcare do not have access to a childcare facility within 10 miles of their home. This data assumes that parents drive, but aproximately six percent of rural households do not have a car. Lack of access to transportation can make finding childcare even more difficult in rural areas, especially when transporting multiple children. 

Kickapoo Community Childcare Center in Lincoln County, OK. Photo by Rebecca South, distributed under a CC-BY 4.0 license. 

Effect on Families

The lack of access and high costs of childcare drive parents out of the workforce. A 2021 Bipartisan Policy Center survey found that 86 percent of parents in rural areas who do not work cited child care responsibilities as a reason they stay home. Child care centers face significant economic difficulties, driven by high turnover rates and low wages. Closures have led to parents, often mothers, leaving the workforce at higher rates than ever over the last two years. 

These funds also provide child care to parents pursuing higher education. Congress did not reauthorize the Child Care Access Means Parents in Schools, pausing the program. Programs at rural colleges make child care affordable for student parents and provide other support to help them pursue higher education. 

One administrator at the University of Wisconsin-Whitewater said she expects that this will make it more difficult for student-parents to graduate. Cutting this program means student-parents will either need to work while pursuing their degree or leave their program to stay home with their child. 

The Future of Rural Child Care

Recent federal legislation surrounding rural children and families has proven to be a mixed bag. While bolstering Head Start programs might expand child care resources in rural areas, other funding cuts could undermine those gains. This administration has shown its willingness to use child care funding as a political football. ACF and the USDA, which work together on child care in rural communities, have had their funding withheld, field offices closed, and major workforce reductions. 

The senators concluded their letter with six questions about the future of rural child care, with a response requested by February 16, 2026. As of today, neither ACF nor USDA has responded. Their response—if and when it comes—will inform the debate around the future of childcare funding in rural communities through the remainder of the Trump Administration. 

Truancy laws: Bad for rural students and their schools

Coleville, CA (Mono County)

(c) Lisa R. Pruitt 2024

All states have passed compulsory attendance laws requiring that students in a certain age range attend school. Exceptions vary by state. Sadly, in spite of these laws, nearly one in four students are chronically absent.

Students and their parents can face penalties for truancy. Some states take a punitive approach to truancy, allowing referrals to juvenile court for truant students and imposition of criminal charges on parents. The latter can result in hefty fines and even jail time. 

For example, a 2024 Kentucky law required that a school refer a student to the County Attorney for "formal court action" if a student accumulates 15 or more unexcused absences. Until Governor Newsom repealed the policy in October of 2025, California's truancy laws allowed parents to be fined up to $2,000 or sentenced to up to a year in jail if their child was chronically truant (missed 10% of the school year). In 2017, ten Merced County parents were charged with a misdemeanor for their children's absences. 

Despite a recent shift away from punitive truancy policies, 20 states still require schools to alert courts if a student is truant.

Greenville, CA (Plumas County)

(c) Lisa R. Pruitt 2012

Rural communities are especially susceptible to truancy. The National Rural Education Association found that "[n]early one in seven rural students experiences poverty, one in 15 lacks health insurance, and one in 10 has changed residence in the previous 12 months." Students in schools with greater populations of students in poverty are three times as likely to be chronically absent. Additionally, the spatial isolation of rural areas means that rural students typically travel farther to get to school and may have a more difficult time accessing transportation. The transportation issue, along with limited funding, also means that rural schools have less access to extracurriculars.  leading to students being less engaged in their school community. The lack of opportunities is not a new problem; this blog post from 2014 discusses the struggles related to student involvement in rural schools.

Truancy laws are ineffective

Truancy laws are ineffective at decreasing school absence because they do not address the underlying reasons why students are absent in the first place. 

For example, in a New York Times Magazine story on homelessness in rural areas, author Samantha Shapiro explained a crucial paradox: 

Students who do not have a stable place to live are unable to attend school regularly, and failing to graduate from high school is the single greatest risk factor for future homelessness.

This is just one example of how truancy laws fail to address the problem and instead act punitively. As expressed by California Assembly Member Patrick Ahrens, the sponsor of California's bill repealing criminal fines and jail times, "[f]ining or imprisoning parents did nothing to get kids the education and support they need."

The truancy problem is compounded by rural school funding issues in states where school funding is directly tied to attendance. Six states use average daily attendance (ADA) to determine a student count for funding allocations; they are California, Texas, Idaho, Kentucky, Mississippi, and Missouri. Linking ADA to funding means districts with higher rates of chronic absences are hurt financially. This makes it even more difficult for those schools to address truancy issues. 

Better solutions to chronic absences

While punitive policies are ineffective, other interventions have proved helpful. One study found that truancy decreased by 5% when schools sent simple, periodic, personalized messages to parents about their child's attendance. These messages used templates that automatically pulled information about a student, including their name, details of absences, and goals for decreasing absences. These notices are  easily sent to parents to keep them better informed. 

Data systems, such as Iowa's (uses a system that provides near real-time absence data to schools), that catch absentee patterns early and allow schools to intervene earlier are more effective. Prevention –not punishment– should be the focus of school policies to decrease truancy.

Congress (finally) renews Secure Rural Schools Act, through 2027

Congress voted overwhelmingly yesterday to renew the Secure Rural Schools Act.  Here's an excerpt from the Los Angeles Times coverage, by Hailey Branson-Potts, which leads with a bit historical perspective on rural schools lobbying efforts for the funding over the past few years:  

In February 2023, Jaime Green, the superintendent of a tiny school district in the mountains of Northern California, flew to Washington, D.C., with an urgent appeal.

The Secure Rural Schools Act, a long-standing financial aid program for schools like his in forested counties, was about to lapse, putting thousands of districts at risk of losing significant chunks of their budgets. The law had originated 25 years ago as a temporary fix for rural counties that were losing tax revenue from reduced timber harvesting on public lands.

Green, whose Trinity Alps Unified School District serves about 650 students in the struggling logging town of Weaverville, bounded through Capitol Hill with a small group of Northern California educators, pleading with anyone who would listen: Please renew the program.

They were assured, over and over, that it had bipartisan support, wasn’t much money in the grand scheme of things and almost certainly would be renewed.

But because Congress could not agree on how to fund the program, it took nearly three years — and a lapse in funding — for the Secure Rural Schools Act to be revived, at least temporarily.

On Tuesday, the U.S. House overwhelmingly voted to extend the program through 2027 and to provide retroactive payments to districts that lost funding while it was lapsed.

The vote was 399 to 5, with all nay votes cast by Republicans. The bill, approved unanimously by the Senate in June, now awaits President Trump’s signature.

“We’ve got Republicans and Democrats holding hands, passing this freaking bill, finally,” Green said. “We stayed positive. The option to quit was, what, layoffs and kids not getting educated? We kept telling them the same story, and they kept listening.”

Green, who until that 2023 trip had never traveled east of Texas, wound up flying to Washington 14 times. He was in the House audience Tuesday as the bill was passed.

In an interview Tuesday, Republican Rep. Doug LaMalfa, who represents a vast swath of Northern California and helped lead the push for reauthorization, said Congress never should have let the program lapse in the first place.

I don't agree with LaMalfa on many issues, but on this one he is absolutely correct.  

The five congresspersons who voted against the Act were: 

• Rep. Andy Biggs (R-AZ)
• Rep. Paul Gosar (R-AZ)
• Rep. Anna Paulina Luna (R-FL)
• Rep. Thomas Massie (R-KY)
• Rep. Ralph Norman (R-SC)

Here is an Ed Source story about the passage of the law, and here's an Oregon Public Broadcasting story focused on the significance of this funding to many counties in the Pacific Northwest.  CalMatters covered it here.  An announcement by New Mexico Congressman Gabe Vasquez, who says it means $9 million for his state's rural schools, is here. 

Finally, here is a February 2023 post based on Branson-Potts' previous story about California rural school administrators lobbying in Washington, D.C., for the Secure Rural Schools Act.   The term used there for the pittance represented by this spending--at least from the perspective of all federal spending: "budget dust."  

Rural K-12 education deficits draw (at least) momentary attention from New York Times

Jessica Grose of the New York Times wrote earlier this week about the plight of rural schools.  The headline is "Rural Kids Need More than Vocational School."  Her newsletter was inspired by Beth Macy's new book, Paper Girl, which claims to be about rural America--broadly defined.  In the book, Macy takes up some rural K-12 education deficits, and she cites the work of Prof. Catharine Biddle of the University of Maine.  

[Biddle] explained that while [a range of wraparound] services are also in demand in high-need urban and suburban districts, it’s a particular challenge to offer them in rural America. Most school systems run on economies of scale and a per-student funding model; it poses a great challenge to provide wraparound services to districts with fewer students who have a lot of needs and who are also spread out. Rural districts already face a teacher shortage, and earlier this year, the federal Department of Education cut funding to teacher training programs that might have helped alleviate some of those shortages.

In one paper Biddle wrote, where she spoke to over 100 educators in rural Maine about how they dealt with children with adverse childhood experiences, a teacher mentioned that the school nurse is on site just once a month, and that teachers feel as if they are acting as ad hoc social workers on a daily basis.

Thus, Grose's column, among other things, points out is the spatial inequality between rural and urban.  Other not-so-distant NYT attention to rural educational deficits is here (NYT Magazine 2021).  

New immigration fee will hurt rural schools relying on international teachers

Sequoia Carrillo reported from Hardin, Montana for NPR on a school system's heavy reliance on teachers from the Philippines and what that reliance means given the new Trump administration rule requiring a $100,000 fee for each H-1B visa application.  Here's an excerpt from Carrillo's story:  

Hardin, like many rural districts, relies on international teachers to fill out its staff. Out of 150 teachers in the district, about 30 are in the U.S. on teaching visas. Many are on short-term J1 visas, with hopes to one day graduate to the longer-term H-1B visa.

Now, things are about to get even tougher — for the district and for teachers like Tomimbang [who has taught middle school math in Montana for four years after doing so for 18 years in the Philippines]..

Last month, President Trump unveiled a plan that requires employers pay a $100,000 fee for new H-1B visas. In his announcement, Trump specifically called out high-paying tech jobs that he said were filled by too many foreign workers.

However, the impact on schools and educators will be significant. According to data from the Department of Homeland Security, more than 20,000 educators are in the country on H-1B visas — the third most common occupation group for the program.

"I don't have a teacher in my district that makes $100,000 a year," [Hardin school superintendent Tobin] Novasio says. For school districts, "to pay that fee on top of a salary is just gonna kill the H-1B for education."

The change is a blow to some districts' long-term strategy to keep teachers in classrooms.

More relevant context fron superintendent Novasio:  

"We don't have candidates." ... Earlier in his career, [Novasio] says that if he posted an elementary teacher position, at least 20 people would apply. Now, "if we get two, we're ecstatic."

Here is a prior post touching on a different angle about rural schools' reliance on Filipina/o teachers.  

Recognizing the barrier of distance, transportation in high school vocational training programs

Kavitha Cardoza reported for the Washington Post a few days ago on an innovative apprenticeship program in Elkhart, Indiana.  An excerpt follows:  

Elkhart County is at the forefront of a movement slowly spreading across Indiana and the nation to make apprenticeships a common offering in high school.

In April, President Donald Trump signed an executive order calling for the creation of 1 million new apprentices, the latest step in a bipartisan push for apprenticeships that began during the Obama administration. The “earn and learn” model is taking hold in more than 30 states alongside growing disillusionment with the concept of the four-year college and the fact that well-paying jobs that don’t require bachelor’s degrees are going unfilled nationally.

But in the United States, the number of apprenticeships for high-schoolers is still tiny, just over one-tenth of a percent of students, according to an estimate by the think tank New America. 

In contrast, 70% of high school students in Switzerland--often held out as a model for such training schemes--participate in these programs. 

What I want to highlight here is the recognition that rural locations pose natural limits to these programs. 

Transportation has been a limiting factor, too. There’s no public transit system, and students who can’t rely on their parents for rides are often out of luck. “We’d love to offer a bus to every kid, to every location, but we don’t have people to run those extra bus routes,” [said a high school principal in Elkhart County].

I also appreciate this comment--not rural specific--from the woman who oversees college and career programs at one Elkhart high school: 

apprenticeships help convince students of the importance of habits such as punctuality, clear communication and regular attendance. “It’s not from a book,” she said. “They’re dealing with real life.”

iPhone factory rises in rural India. Does it provide rural development lessons for the United States?

Alex Travelli and Hari Kumar report from Devanahalli, India in yesterday's New York Times on the pending opening of an iPhone factory.  The story features many descriptors suggesting the remoteness and rurality of the place and concludes with a brief comparison to rural development efforts in the United States.  The plant, which will be fully functioning and employing 40,000 people by the end of this calendar year, responds to Prime Minister Narendra Modi's “Make in India” policy, announced in 2015.  The Modi government has committed $26 billion to subsidizing strategic manufacturing goals since 2020. 

A new iPhone factory in an out-of-the-way corner of India looks like a spaceship from another planet. Foxconn, the Taiwanese company that assembles most of the world’s iPhones for Apple, has landed amid the boulders and millet fields of Devanahalli. 

* * *

By the end of 2025, with the Devanahalli plant fully online, Foxconn is expected to be assembling between 25 and 30 percent of iPhones in India.

* * *

The effects on the region are transformative. It’s a field day for job-seekers and landowners. And the kind of crazy-quilt supply chain of smaller industries that feeds Apple’s factory towns in China is coalescing in India’s heartland. 

* * *

India’s most urgent reason for developing industry is to create jobs. Unlike the United States, it does not have enough: not in services, manufacturing or anything else. Nearly half its workers are involved in farming.

* * *

India is thick with people. A five-minute walk away, a village called Doddagollahalli looks the same as it did before Foxconn landed. Nearly all the houses clustered around a sacred grove belong to farming families growing millet, grapes and vegetables.

Some villagers are renting rooms to Foxconn workers. Many more are trying to sell their land. But Sneha, who goes by a single name, has found a job on the Foxconn factory’s day shift. She holds a master’s degree in mathematics. She can walk home for lunch every day, a corporate lanyard swinging from her neck.

It is people like Sneha, and the thousands of her new colleagues piling into her ancestral place, who make Foxconn’s ambitions for India possible. Mr. Trump wants to revive the fortunes of left-behind American factory towns, but the pipeline of qualified young graduates is not there.

Thus, while Trump wants this to happen in the United States, it probably won't, "without sustained government financial support to revive U.S. manufacturing and training to expand the pool of qualified factory workers."   

Another rural institution certain to be hurt by Trump administration cuts: public libraries

Children's Section of Rio Vista Library, Solano County California
(c)Lisa R. Pruitt 2024

The likely disproportionate harm Trump administration policies and budget cuts will have on rural America has been a theme of several recent posts on the blog.  In this one, I'm going go to leverage a story by Emily Hays of Illinois Public Radio, who reported on the topic a few days ago from Greenup, population 1,365 in central Illinois.  The excerpt that follows provides insights into why rural libraries are so vulnerable and it echoes a theme from other stories about rural vulnerability: because of weak local tax bases, small towns and nonmetro counties are less able to absorb the loss of federal funds that have helped to provide all sorts of services.  

Take and Make Kits at the Newton County (AR) Library
(c) Lisa R. Pruitt 2025 

I'm also using this post to share some photos of rural libraries that I've taken in the past few years, some from my home county, Newton County, Arkansas, and some from California towns.  What I've seen in my hometown library, where I've spent more time recently, is that these institutions provide a wide range of services, from a seed bank to lending telescopes to craft bags for kids.  They host legal aid attorneys coming to chat about elder law and other issues residents may need to know about.  Sadly, to my mind, they may also mindlessly distribute The Epoch Times and other right-wing propaganda.  

(c) Lisa R. Pruitt 2025

The following excerpt from journalist Hayes story features her in conversation with Vickie Pierce, the retired English teacher working part time as the circulation clerk in what is described as one large room: 

Telescopes on loan at
Newton County Library, AR
(c) Lisa R. Pruitt 2025

PIERCE: We're a small-town library, so really small budget. And honestly, I'm not sure how we manage to stay open.

Reading room, Coleville Library,
Mono County, CA
(c)Lisa R. Pruitt 2024

HAYES: Part of how they stay open is through grants from the independent federal agency the Institute of Museum and Library Services. Before the pandemic, the federal government covered around 5% of Greenup library's operating costs. Kate McDowell is a professor at the University of Illinois School of Information Sciences. She says the IMLS is a very small agency...

KATE MCDOWELL: That has impacts on almost every community in the whole of the United States and territories.

HAYES: Public libraries get most of their funding from county and city taxes. IMLS distributes the majority of federal library funds. McDowell says the grants vary year to year and are often small, but they help libraries try new things.

MCDOWELL: What the IMLS funds is not just the subsistence of libraries, although that's there too - it's their future.

Mammoth Lakes Library,

 HAYES: IMLS gave out $267 million last year to libraries and museums. That's 3,000th of a percent of federal spending. But the future of that funding is in doubt. In March, almost all of the IMLS staff were put on administrative leave. In an executive order, President Trump claimed the move would reduce unnecessary bureaucracy. Greenup isn't expecting any federal money this year, and Pierce says the library is financially cautious.

PIERCE: We squeeze every penny three or four or five times to get the most out of it.

HAYES: And Pierce says the idea of taking more money away from libraries sickens her. The American Library Association says that's been happening nationwide to libraries and museums receiving IMLS grants.

Seed saving chart and seed library
Newton County (AR) Library 
(c) Lisa R. Pruitt 2025

* * *

[A] judge has temporarily blocked the Trump administration from dismantling the Institute of Museum and Library Services. Congress has funded the department through September. For now, Greenup Library says it's still providing the same services, but that could change for it and other rural libraries.

Prior posts about rural libraries are here.  I want to specifically highlight this 2013 NPR feature on a rural Missouri library.  Here's one from 2008 about a library in a barn in New England.  This 2017 post is about Douglas County, Oregon's decision not to keep open a single library.   And a dispute about how much to pay the librarian in this Arkansas county was the basis for political ponderings in this lengthy op-ed in the New York Times in 2019.

Libraries are important sources of WiFi,
as illustrated by this sign 
at the Newton County (AR) Library
(c) Lisa R. Pruitt 2025