COVID-19 Hit Rural America Hard

With a poorer population and declining numbers of hospital beds, more people die in the country than elsewhere. Learn more.

The COVID-19 pandemic came to rural America and made several surges throughout the country. After arriving in New York City and Seattle in the winter of 2020, the outbreak in New York City had grown large enough to seed cases in Louisiana, Texas, and Arizona, researchers say.

By the fall of that year, less populated areas were the hardest-hit part of the nation. The coronavirus vaccine began rolling out to Americans in December 2020, almost a year after the outbreak began.

YOU MIGHT ALSO LIKE: How Safe Are Vaccines, Really?

Rural residents are more vulnerable to COVID-19

Rural states, especially in the South, have tended to have looser COVID-19 (coronavirus) rules, resisting mandates requiring masks or shutting down businesses.

The rural population is also more vulnerable. It’s older, poorer, and less healthy, with higher rates of key health problems that make COVID-19 dangerous, including smoking, obesity, diabetes, lung and heart disease, and high blood pressure. They are more likely to be uninsured, with a history of putting off medical care. They also have less access to healthcare.

More than half of rural counties were coronavirus hot spots during the height of the pandemic, with infection rates of 100 or more per 100,000 residents. Although only 14 percent of Americans live in a rural county, those counties suffered 23 percent of the COVID-19-related deaths in the week in just one week, the Daily Yonder reported.

If you live in Mississippi or Louisiana

As of the fall of 2020, Louisiana had the highest rate of cases among all U.S. states, followed by Mississippi, Florida, Alabama, North Dakota, Georgia, Arizona, Tennessee, South Carolina, and Iowa.

Within a state, you might assume city-dwellers would encounter more infected people, but things didn’t always work out that way. As two sociologists at the University of Mississippi note, many rural residents commute to service jobs in a city or transportation hub. They don’t have sick days, and they can’t afford to stay home.

In mid-April in that state, rural infection rates were higher than in urban areas: 181 cases per 100,000 people compared to 128 in urban counties.

Poverty and race are part of this equation. All over the country, people of color are more likely to get sick and die from the virus. Mississippi and Louisiana are the two states with the highest portion of African-Americans.

In Louisiana, where 32 percent of the residents are black, 46 percent of the COVID-19 deaths in 2020 were black people, according to state reported. In Mississippi, those same figures were 37 percent and 41 percent. Death rates were high in the poorest counties.

Hospitals are closing fast

Across the nation, the vulnerability of rural populations is made worse by tight resources and lack of care. In a nationwide poll, one in every four rural U.S. households reported they had trouble getting medical care for serious problems, including COVID-19. Every county in Mississippi, for example, is considered short of doctors and needed services.

If you need a hospital, you may have to drive long distances, as the number of rural hospitals continues to shrink. Fifteen rural hospitals closed in 2020, speeding up a trend since the beginning of the 2000s (143 have closed since 2010). Among those that remain, many don’t have an intensive care unit.

One reason is that rural hospitals on average charge less for healthcare than urban ones.

At the end of September 2020, Mississippi Gov. Tate Reeves (R) was the first U.S. governor to lift a mask mandate, which he imposed over the summer. The timing was risky: As the weather cools, the country always enters flu season, and the coronavirus still tends to surge. But the governor pointed out that the number of daily cases had fallen by half from a peak in August, and he argued that the state had plenty of hospital beds to handle a fall uptick.

YOU MIGHT ALSO LIKE: How COVID-19 (Coronavirus) Is Changing Healtchare