There are lots of problems with healthcare in rural America.  As one who works in, and advocates for, rural populations, I can say that we constantly face painful challenges.  Whether that challenge is a lack of primary care or a lack of specialists, inadequate hospital beds or insufficient ambulances, bare-bones mental health or drug addiction, the problems are ‘legion, for we are many.’  (A reference rural folks may be more likely to understand than ‘dazzling urbanites…’  HT Mel Brooks.)

But lately, whenever I discuss rural issues, I’m met with at least one comment that suggests the real problem at the bottom of all of this is the lack of COVID vaccination.  I’m pro-vaccine, and actually had my Moderna booster this week. But the belief seems to be that by vaccinating every man, woman and child in rural America, our rural (and some urban) healthcare issues would evaporate like so much news coverage of the Wuhan labs.  While there certainly is vaccine hesitation in rural America, there is also vaccine hesitation in urban and suburban America.  Furthermore, the roots of that hesitation are complex and do not easily boil down to ‘stupid religious people don’t understand science,’ as much as the popular media and online narrative longs for that narrative to be true.

I could go into it.  Maybe I will sometime.  But not today. Today I want to suggest that rural America has sustained the rest of the country during the pandemic.  This is not an opinion one will hear very often, but the country owes a great debt of thanks to those who actually had to do things when so many were able to work from home, planted safely in front of their computers while the kids engaged in online school.  (Well, the kids who could afford Internet and whose parents were able to stay home and help them, both logistically and intellectually.)

‘Why whatever do you mean, Dr. Leap?  The hicks and cretins made it so much worse!’ Well, no.  Because some very important things are done outside populated areas.  And those things made it possible for a lot of folks to stay home, eat well and stay warm.

It is in rural America that coal, gas and oil are extracted from the earth.  While it is popular to believe that all we need for energy will come from sun and wind, and while I’m no expert on energy technology, we’re a long way from that reality.  For the foreseeable future, those lovely electric cars and electric homes are going to be powered by gasoline and electricity from fossil fuels.  And during the pandemic, that meant that it was possible to stream Tiger King or Downton Abbey, or watch 24/7 news fear-streaming from home because somewhere, human beings were actually leaving their homes, going out into the world of COVID, running equipment, drilling on the plains, desert or beneath the sea, or going into the earth, engaging in risky, difficult jobs and making less than they deserved, to create energy.  Furthermore, powerplants tend not to be down the street in cities. Dams and nuclear power plants are generally rural or semi-rural.  These facilities continued to run.  Without them, without those folks who largely live in rural areas, it would have been a cold, far less entertaining pandemic devoid of any of the charm afforded by sitting at home and criticizing anyone who didn’t.

But one of the other great things about the pandemic was that enlightened, educated folks with money could do the ‘right thing’ and simply order food and groceries delivered to the viral bomb-shelters their homes and apartments had become.  Food comes from farms.  Farms, although increasingly mechanized, are run by people. Certainly the products of farms, the milk, grain, vegetables and meat that make for lovely, intimate meals at home come from farms. And other than the occasional roof-top garden or suburban field, these are located in what we consider rural areas.  Those who worked on those farms went out every day and worked, turned soil, fertilized, soil, irrigated and sprayed pesticides on soil, checked it, harvested it. They worked with animals and butchered those animals to make steaks and chicken nuggets and all the rest. They gathered eggs by the gazillion. They were together on boats in the rolling sea, in close quarters at night, bringing up health sources of nutrition for those who try to avoid red meat.  All of this was then shipped by men and women on trucks, trains, ships and aircraft.

This is not to mention cutting trees for paper, or the manufacturing facilities located out of cities that make the products that make our lives happy and pleasant.  Or the facilities churning out medical supplies like ventilators, masks, gowns, gloves, medications, or shipping oxygen and all of the other things necessary for us to survive and manage through the COVID mess.

The individuals above did not have the luxury of avoiding work.  And, prior to the vaccine being developed, did their jobs knowing that there was risk. As they did every day that they went to work anyway.

They were, and remain, courageous.  They aren’t cowards. They aren’t stupid. They take calculated risks every single day.  The things listed above are inherently dangerous.  And when one is badly injured or ill in a rural area, access to life-saving care can be a logistical nightmare when hospitals are far away, ambulances aren’t available or helicopters can’t fly.  And yet, women and men continue to mine, timber, farm and produce power.

As we navigate the next phase of COVID, the latest in the Greek Alphabet litany of terror that makes for great headlines and creates endless division, it would be wise for us to at least try to be one nation, together through this crisis. One nation, Under God, as the pledge says.

It will be unwise, even tragic, if we continue to split into some Hunger-Games-esque Balkanization that leaves the urban areas in the role of the Capital, which governs by fiat and looks down on the unwashed masses of those they consider uneducated and irrelevant. Especially when those ‘uneducated and irrelevant’ workers made life during lock-down not only possible but relatively pleasant for those who were taught to be petrified of leaving their homes.  And continues to do so, vaccinated or not, because of their devotion to family, job and country.

So thank you rural America!  You are absolutely essential to all that we are as a nation.

You are brave, strong and innovative.

And anyone who doesn’t get it is a moron.




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