It happens every four years. The national media—which is increasingly urban and coastal—descends on the middle of the country in a pitched, last-minute bid to understand the mind of the rural voter. I’ve lived in so-called Red States (states with histories of voting for Republican candidates) for most of my adult life. My family has been in Nebraska for seven generations, and my career, much of it built on explaining rural America in coastal media outlets, has taken me to Texas, Iowa, Virginia, and now Oklahoma. So I’ve seen it as a local, and I’ve seen it as a media professional: well-meaning, well-trained journalists posting up at coffee shops or diners or church pancake breakfasts to ask old-timers why they’re voting the way they do. This fascination became a cultural obsession in 2004 when Thomas Frank published his book What’s the Matter with Kansas?—a look at the death of populist politics in his home state in favor of a brand of dyed-in-the-wool conservatism founded on hatred of “liberal elites.” Frank’s history of that transformation was complex, but his central thesis was simple and lasting: “People getting their fundamental interests wrong is what American political life is all about.”
Unfortunately, Frank’s point has often been misinterpreted—as if Americans are making a conscious decision to vote against their core values and economic interests, rather than falling prey to demagoguery and propaganda. Instead of asking, “How are people being misled, by whom, and to what end?,” the political conversation often spirals into some species of exasperation—“Why are people so stupid?” Viewing rural voters as self-defeating can make it easy to dismiss and abandon them. They get what they deserve, we tell ourselves. But that denies the fact that a belief in self-reliance and rugged individualism, as Bill McKibben details in this issue, are woven into the national character. That skepticism toward interventionist policies at the national level can be born of the well-earned belief that people know what they need and an admirable preference to do for themselves whenever possible.
The dismissal of rural people as self-sabotaging also ignores the degree to which their isolationist worldview is a product of dwindling access to education and the disappearance of facts, in the form of shuttering local newspapers and replacing them with the disinformation of Fox News, right-wing AM radio, and the unregulated Wild West of the internet. A recent study published in the American Journal of Preventive Medicine found that the death rate measurably declines in rural counties where people have access to higher education. A Brookings Institution study documented a connection between the closure of the local newspaper and the rise in conspiracy theories, which in turn has been linked by the American Medical Association to deaths of despair—overdoses, alcoholism, and suicide. In short, growing up without access to education and information often leads to feeling lonely, angry, depressed, and confused by the state of the world.
Unable to comprehend a rapidly-changing society, many people fall back on timeworn narratives. Of these, none is more potent or damaging than the myth that cities are dangerous places, overrun by crime and plagued by disease. Fox News viewers get a steady boost to their fears of urban life from regular segments on the drug crisis in San Francisco and gun murders in Chicago—both cities liberal strongholds. Small towns and farms, by contrast, are portrayed as spread out across the bucolic countryside, protected from these urban ills by the very nature of their isolation. Rural areas, particularly in Red States, are presented as safer, friendlier, healthier—but the numbers don’t bear that out.
According to the U.S. Centers for Disease Control and Prevention, people living in rural areas not only die at higher rates than those living in urban areas; they die of the very causes that supposedly make them fear cities. Gun deaths are more common per capita in rural areas. Deaths from overdose, especially of opioids, occur at higher rates in rural areas and are increasing faster than in cities. Deaths related to long-term illness (heart disease, cancer) are higher in rural areas. The reasons for these disparities seem, on the surface, easy enough to understand. Compared to people living in cities, rural residents are more likely to live in poverty and are less likely to have access to health care. In the absence of contextualized reporting, it’s easy to interpret this lack of economic opportunity and medical access as a plot by coastal elites. In fact, many Red State governments have refused to expand Medicaid under Obamacare, thereby denying health insurance to low-income adults and, in turn, diminishing funding for hospitals, physicians, and EMTs for everyone.
Monica Potts writes with striking intimacy about the hard times faced by rural Americans, even those who thought they had economic advantages, as they try to access a health care system that is ill-equipped to cover an ever-older and less mobile rural population. Even when people have positive support systems—providing healthy food, as documented by Alyssa Schukar, and family members who are willing to become health care providers, as described by Rianna Pauline Starheim—the aging population of rural America faces significant challenges. And the specificity of that problem cannot be ignored. Data indicate that people in Republican-leaning counties die at higher rates than people in Democratic ones. Recent analysis suggests that Republicans have died of Covid-19 at a rate of almost 2-to-1 over Democrats, largely a product of resisting public health measures, such as masking and social distancing, and reluctance to be vaccinated against the virus. Blind conservatism has become a public health risk.
And the roots are unmissable. According to recent studies, one of the main predictive factors in rural death rates is whiteness. That may seem far-fetched or counter-intuitive, but the fact is: in places where rural conservatism is most squarely founded on racism and nationalism, residents suffer in the form of lack of access to health care, particularly addiction prevention and mental health care. In other words, people who would rather be poor, isolated, and vulnerable than to be exposed to people of different races and ethnicities, or people who are LGBTQ+, are literally dying of their own bigotry. And, of course, they are making life miserable for people who are different in any way—people who are gay, as C. J. Janovy movingly describes in her essay about growing up as a lesbian in Nebraska; people who are trans, as documented by Jeff Sharlet in his downhearted and searching exploration of being a journalist who covers political extremism from rural Vermont while raising a trans child; and, of course, people who come from different racial and ethnic backgrounds, as portrayed by Michael Croley in his poignant essay about growing up the son of a Korean immigrant in rural Kentucky.
The problem is big and has metastasized to all parts of the body politic, but the cure may be simpler than we tend to think—if difficult. Maybe it’s time, as Dean Bakopoulos suggests in his heartbreaking and hopeful essay, to begin to imagine a version of rural America that is no longer based on the Hollywood myths of small-town life. Maybe we need to do a better job of highlighting the happiness and community and hope to be found in racial diversity, in a heterogeneity of language and culture, in places where people of different backgrounds mix—urban centers, college towns, and, yes, in multi-ethnic small towns, like the ones that Sterlin Harjo describes here in rural Oklahoma. If we can find a new narrative, a national story that celebrates our contrasts and sees our bonds as strengthened by our disparate backgrounds and our willingness to envision a shared future, then maybe we can find a way to change American political life. Maybe, at long last, we can start to get our fundamental interests right.—Ted Genoways
