RURAL HEALTH PROBLEMS DON'T HAVE URBAN SOLUTIONS

 

$50 billion is flowing into rural health.

I'm not celebrating. I'm worried.

Even though I've spent a decade fighting for exactly this.

I'm worried because suddenly everyone's an expert.

But rural health problems don't have urban solutions.

The same factors that affect mental health in cities look completely different in rural America:

1/ Access isn't about "expanding capacity"
↳ Over 60% of rural counties have zero psychiatrists
↳ You can't expand what doesn't exist
↳ This requires building, not scaling

2/ Stigma works differently here
↳ In cities, anonymity protects help-seeking
↳ In small towns, everyone knows your truck is parked outside the clinic
↳ The "fishbowl effect" delays care until crisis

3/ Transportation isn't "inconvenient." It's impossible.
↳ A 200-mile round trip for a 30-minute appointment
↳ No public transit. No rideshare. No options.
↳ This isn't logistics. It's a barrier to survival.

4/ Telehealth isn't the automatic fix
↳ 15-20% of rural areas still lack reliable broadband
↳ You can't Zoom your way to care without internet
↳ The digital divide is a health equity crisis

5/ Community is both the strength AND the barrier
↳ Strong social ties can protect mental health
↳ Those same ties amplify judgment and shame
↳ Solutions must work WITH this reality, not against it

If you're chasing $50 billion into rural health, ask yourself:
Are you bringing solutions designed FOR these communities?
Or are you importing urban models that will fail?
The money is welcome.