On a trip to Colorado last year, Gretchen and I wound up in the ditch in the middle of the day a few miles from Lusk, a small town in eastern Wyoming.
We had planned on stopping there for lunch, but an accident stopped us sooner.
Help arrived quickly, and we were transported to the Niobrara Community Hospital where, because an EMT saw me flinch when I stood up from a seat in the ambulance, the ER doc ordered a CT scan. We were astonished that the least-populated county in Wyoming (about 2,500) had a 24/7 hospital and a CT scanner. The scan was sent by the Internet to be read by someone in Montana, and I was cleared to go to a motel a few hours later.
I have wondered since then if the presence of that hospital with its modern technology in such a remote area might have had its beginnings in a 50-year-old report titled “People Left Behind” prepared by President Lyndon Johnson’s Presidential Advisory Commission on Rural Poverty.
Among the many recommendations by the commission to make life better for people in rural America were improving rural health care and being quicker to adopt technology for rural services. I was familiar with the report because I used it as a source for a series of articles on rural poverty in Wisconsin that I wrote as a young reporter for the then-Milwaukee Journal.
What had me looking for a copy of the old report recently was news that some 87 rural hospitals have closed since January 2010 and that an additional 9 percent of the remaining rural hospitals are at high risk for financial problems, according to the Health Research and Policy Analysis Center at the University of North Carolina. Rural health care is still a problem half a century later.
I found a photocopy of the report online, and was reminded of its call 50 years ago to improve the lives of rural children — many of whom were growing up malnourished and with less education than their urban peers.
Earlier this year, the nonprofit organization Save the Children reported that 90 percent of the counties in the United States with high child food insecurity are rural. In a report titled “Growing Up Rural in America,” the organization said that children in rural areas are “more affected than their urban peers to infant mortality, food insecurity, low education levels and teen pregnancy.”
Save the Children argues that these are among the factors that are robbing many rural children of their childhood.
The president’s commission in 1967 noted that “Most rural programs still do not take the speed and consequences of technological change into account.”
Fast forward all these years and our grandchildren who live in rural communities have problems getting the high-speed Internet connections that are needed to fully participate in modern education.
For another comparison of then and now, according to the president’s commission in 1967, “Instead of combating low incomes of rural people, these (farm) programs have helped to create wealthy landowners while largely bypassing the rural poor.” The commission recommended programs to provide stability for small-scale farming.
Recently, President Donald Trump’s trade war has resulted in a plunge in farm commodity prices that threatens, according to farm analysts, to drive more farmers out of business, thus contributing to the consolidation of farming into industrial-sized operations and further “hollowing out” of rural communities.
The president’s commission in 1967 observed after studying the decline of rural America, “As the communities ran downhill, they offered fewer and fewer opportunities for anyone to earn a living. The inadequately equipped young people left in search of better opportunities elsewhere. Those remaining behind have few resources with which to earn incomes adequate for a decent living and for revitalizing their communities.”
Whatever it was that the commissioners expected would happen as a result of their efforts obviously didn’t since the same scenario is playing out in rural America to this day.
The commission said it was “convinced that the abolition of rural poverty in the United States, perhaps for the first time in any nation, is completely feasible.”
Since that optimistic assessment, the United States has fought two wars on credit and endured a major recession. Agriculture has become highly automated as has forestry and mining, cutting back previous sources of employment for rural people. U.S. politics has become more conservative, including the Ronald Reagan era when government was viewed as the problem and not the solution to societal problems. And rural America has lost political influence and, to some extent, its voice in the national dialog resulting in a disaffection that is widely cited as why Donald Trump won 62 percent of the rural vote compared with 34 percent for Hillary Clinton, who won by substantial margins in the cities.
Eliminating poverty and providing the good life for all, whether urban or rural, has proved an elusive quest, not for lack of studies of the causes of poverty and ideas on what to do about it. Rather, as the People Left Behind put it, in what turned out to be a prediction: “The nation has the economic resources and the technical means for doing this. What it has lacked, thus far, has been the will.”
But there is this: The rural hospital that so efficiently helped Gretchen and me after our Wyoming accident is part of a national network of Critical Access Hospitals that receive some federal benefits to help keep them open in remote rural areas, an encouraging sign that there are ways to address problems, both urban and rural, if we have the will and provide the means to do it.