Thurka Sangaramoorthy and Adia Benton
Political myth-making about America’s rural “heartland” is doubly pernicious, increasing rural vulnerability to COVID-19 and ignoring the disintegration of rural health services.
In March 2020, Fairmont Regional Medical Center, the only hospital in Fairmont County, West Virginia, closed its doors amid increasing financial strains. Later that month, an ambulance was called to take an 88-year-old woman infected with COVID-19 to the hospital. Instead of making the usual two-minute drive to Fairmont Regional, the ambulance had to drive 25 minutes to the next-nearest facility. Days later, the woman became West Virginia’s first reported coronavirus death (Healy et al. 2020). While some may point to the woman’s age as a deciding factor in her declining health and eventual death, her fate more aptly underscores how the public health infrastructure in rural regions is potentially the most fragile aspect of the rural health care continuum. The imagined immunity of rural America omits entire swathes of rural land in the South and Midwest, where many Black and Latino people reside and work; they do not include the rural residents of Native reservations; they do not recognize the vast influence of prison economies throughout rural America.
As the total number of COVID-19 cases in the United States surges past 1.5 million, much of the focus in news media and discussions among national experts has long been on large, urban metropolitan areas. The rationale is that their dense populations engaging in frequent interpersonal contact are at heightened risk of contracting the disease. When rural areas have been the focus of stories of community spread, the vectors of infection were often wealthy urbanites fleeing rising case counts in the city. The county commissioner of Tillamook County, Oregon, for example, took to the pages of the Washington Post opinion section to convey what he described as a “plea from rural America,” urging “COVID-19 urban refugees” to stay home. “Thousands of urban visitors descended on our villages, with cars lined up for miles on highways to the coast,” he wrote.