Accessing health care and the social conditions required for well-being remains a challenge in many rural communities. Persistent workforce shortages, lower rates of insurance coverage, higher rates of unemployment, and limited infrastructure (e.g., broadband and transportation) contribute to higher levels of physical and mental health issues in rural areas. Yet rural communities consistently demonstrate resilience and the ability to build innovative partnerships that strengthen resource-constrained health systems.

To inform positive change, Grantmakers in Health (GIH) and the National Rural Health Association (NRHA) are partnering to reimagine a unified vision for health and well-being in rural America. The Georgia Health Policy Center (GHPC) was engaged to conduct a landscape analysis and facilitate listening sessions with rural health stakeholders at the local, state, and national levels. This work took place during a time of significant federal policy and funding shifts, including passage of H.R. 1, the 2025 budget reconciliation bill. While concerns about the implications of these changes were front-and-center, findings reaffirmed that aligning systems, listening deeply to local needs, and investing in long-term, community-driven solutions remain essential for advancing rural health.

As reflected in the landscape analysis and listening sessions, several persistent challenges emerged that continue to hinder progress toward accessible and sustainable rural health systems:

  • Shortages of advanced practitioners, high burnout, and limited support for training, recruitment, and retention continue to challenge the rural health workforce.
  • Access to essential health and social services, including behavioral and maternal health care, affordable housing, and nutritious food, remains fragile. Many anticipate service line reductions and an increase in hospital closures, further straining safety-net providers.
  • Cuts to Medicaid and social supports are weakening trust and creating uncertainty, unraveling progress in building systems that address health and social needs of communities.
  • Impending disinvestment at the federal level will negatively affect systems of care, coverage, and the health and well-being of rural populations.

Insights gleaned from the landscape analysis and listening sessions offer guidance on ways to reimagine current priorities and strategies. These include direct health care investments (e.g., increasing the capacity of the rural health workforce, leveraging telehealth and other technologies to close gaps in care, and expanding investment in mental/behavioral health and maternal health programs) along with broader consideration of the interconnected factors that shape health and well-being in rural America. Across all strategies, flexible funding and local autonomy remain essential for developing community-driven solutions that reflect the unique needs of rural areas.

Read the full article about reimagining rural health care by Tanisa Adimu, John Butts, Amy Elizondo, Carla Freeman, Cara V. James, Ana LaBoy, Amanda Phillips Martinez, and Colin Pekruhn at Grantmakers In Health.