Rural Americans Are Vulnerable to the Coronavirus

Billing envelopes litter the floor of the shuttered Southeast Health Center in Ellington, Missouri, July 2019.

The outbreak of the new coronavirus—which causes the disease COVID-19—has policymakers and health officials working around the clock to find a vaccine to stem its spread. Key in containing the virus is having people take preventative measures to stay healthy and avoid contact with potentially infected people. The Centers for Disease Control and Prevention (CDC) outline instructions to make sure that people do not spread the virus. In addition to washing hands, not touching your face, and disinfecting objects you use, the CDC calls for people to stay home when they are sick. The CDC also urges people to contact their health care professional if they believe they may have been exposed to the virus.

For many vulnerable individuals, following these instructions are not an option. Though government health agencies may instruct the public on how to combat COVID-19, they don’t give them the capacity or tools to do it. For rural America, which has a higher proportion of people vulnerable to the virus—including those who are older and those with disabilities—these resources are sorely lacking.

As experts have recently noted, many low-income individuals are employed in occupations that do not have health benefits or provide paid sick leave. Rural workers are less likely to have access to paid sick leave than urban workers. Many individuals may be working several jobs so, for them, staying home is not financially feasible. Some companies have encouraged their employees to work from home in order to reduce the chance of transmission, but that isn’t feasible for individuals that don’t have reliable, high-speed internet access at home. Many more Americans work jobs that cannot be performed remotely.

For many who live in rural areas, including many communities of color, LGBTQ people, and people with disabilities, these factors make it impossible to work remotely. Almost one-third of rural households lack internet at home. Though many conflate the agriculture sector with the entire rural economy, the service sector employs the largest number of workers in rural counties, and many of those are in lower-paid occupations in the education, health, and food service sectors. More likely than not, these workers cannot work remotely—nor can they afford to miss work. Because of the economy that rural Americans face, they do not have the capacity to keep themselves safe from COVID-19 and continue to make a living.

The spate of rural hospital closures and other health institutions further put these communities at a severe disadvantage as the rest of the country takes steps to combat the spread of the virus. How can someone contact their health professional when hospital closures have led these same professionals to leave the community? A viral outbreak is especially challenging for persons with disabilities because they already struggle with limited access to health care services. As rural hospitals continue to close without suitable replacements, rural folks will lack critical services to help them fend off any outbreak of COVID-19.

In addition to a lack of services, rural Americans are also more likely to lack adequate, affordable health insurance. Data from the Federal Reserve Board’s Survey of Household Economics and Decision-Making for 2018 illuminates the health care struggles rural people face. Individuals living outside Metropolitan Statistical Areas (MSAs) are more likely to go without health care because they could not afford it than their metropolitan counterparts. Moreover, individuals in non-MSAs are more likely to have debt from unexpected major medical expenses. Americans living outside MSAs are also more likely to be covered by Medicaid or other programs for those with low incomes or disability programs. This data highlights the particular struggle for those in live in rural areas, and it shows that if COVID-19 hits a rural community, they are not going to be able to take the necessary steps to stem the outbreak.

To assist vulnerable communities, policymakers should provide resources to the existing institutions in these areas, such as community centers, places of worship, and schools. We must provide access to diagnosis, medical treatment, and eventually vaccines without cost. We cannot allow access to safety to merely be allocated to those who can pay the most. As policymakers make plans to fight the new coronavirus, rural America must not be left behind.

Olugbenga Ajilore is a senior economist for the Economic Policy Team at the Center for American Progress. Zoe Willingham is a research associate for the Economic Policy Team at the Center.

To find the latest CAP resources on the coronavirus, visit our coronavirus resource page.