In celebration of National Rural Health Day, we are lifting up the evidence and policy solutions generated by Urban Institute research on how state and federal policymakers can promote health equity in rural communities through smarter investments in housing, water, and food access.

Stable, affordable housing

Housing is one of the best-researched social and economic determinants of health. Yet many rural communities face shortages of affordable rental housing and homes available for purchase at low price points. This is a problem for both low-income growing and aging families who need more affordable choices. Policymakers seeking to help these households can consider the following policy solutions:

  1. Increase the supply of affordable rental housing.
  2. Shape policies to work well in rural places.
  3. Increase the supply of quality housing available for purchase.

Clean and safe drinking water

Some rural communities face long-standing challenges in accessing clean and safe drinking water, particularly tribal communities such as the Navajo Nation, where one in three residents lacks access to running water or indoor plumbing. This inequity has contributed to ongoing health disparities and requires immediate action, as well as longer-term solutions, including the following:

  1. Support universal access to clean water.
  2. Invest in right-sized infrastructure for rural households.
  3. Build capacity of existing systems.


Hunger remains a challenge for many rural communities—rural counties concentrated in the southern US have the highest rates of food insecurity in the country. The lack of public transportation is a significant barrier for accessing food, particularly for people with low incomes. Evidence shows the following can help:

  1. Help people get to food.
  2. Bring food to people’s homes through reliable delivery models.
  3. Target investments to the places with greatest need.

Read the full article about policy solutions for rural health equity by Amanda Gold, Jorge Morales-Burnett, and Corianne Payton Scally at Urban Institute.