[This post was written by University of Vermont senior Ella Kenney as part of a National Public Health Week collaboration with VtPHA for her Public Health Sciences Capstone Project. Thank you, Ella!]
Vermont is a state with beautiful mountains, an abundance of hiking trails, waterfronts, and farms. Drive one hour in one direction, and you’re met with a lively college town, top-tier health services, and intercity transportation. Drive an hour in a different direction, and you’ll find yourself in a small and beautiful town with no doctor offices for miles.
This dichotomy of landscapes is unique to the state; however, in all corners of the state, the rurality of Vermont is recognized and embraced as part of Vermont’s identity. In fact, Vermont is the most rural state in the United States, with 64.9% of our population living in rural areas. This rural charm has its benefits, but it also has some unseen consequences. The growing rural-versus-urban divide is having an increasingly negative impact on the lives of rural Vermonters.
Image: source
Economic Inequality
One of the most notable aspects of this divide is the economic disparities that arise. To put it most simply, those who live in urban areas are more likely to have greater economic stability. This encompasses higher incomes, lower unemployment rates, lower poverty rates, and more. Now, let’s explore the average household incomes and poverty rates of two counties: the most urban county, Chittenden County, and the most rural, Essex County.
As demonstrated in the graph above, residents of Chittenden County, the most urban county in Vermont, have an average household income of $94,310 per year. However, residents of Essex County, the most rural county in the state, have an average household income of $58,985 per year. Furthermore, the poverty rate is much lower at 7.8% in Chittenden County, versus 14.4% in Essex County. This stark difference sheds light on the growing inequalities our state is facing.
Access to Care
Across the nation, the shortage of medical providers has become increasingly apparent. Unfortunately, Vermont is no exception– and rural areas are being hit the hardest. Rural Vermont regions are facing more extreme shortages of healthcare providers, including fields such as primary care, dental, and mental health. With fewer healthcare providers, rural Vermonters are often forced to travel further distances for care. One assessment finds that rural Vermonters must travel 3.6 times farther to access hospital-based care than their urban counterparts. Coupled with the lack of a robust transportation network and lower incomes, accessing care becomes much more difficult.
The Potential Consequences
The economic inequality and the differing access to care leads to healthcare disparities between rural and urban Vermont. Often, this means that rural Vermonters face more diminished quality of life. One extreme example of the effect healthcare disparities can have on rural Vermonters is that rural Vermonters aged 15-24 face a suicide risk that is 3.5 times higher than their urban counterparts, underscoring the urgent need for improved healthcare access and emergency response systems in these communities.
Unfortunately, these disparities contribute to lower life expectancies in rural Vermont regions. As seen in the graphic below, life expectancy varies county to county. Continuing our comparison, Vermont’s most urban county has the highest life expectancy, at 81.3 years. The most rural county has an average life expectancy of 78.3 years, which is lower than the state average of 79.2 years. However, Rutland County, another rural county, has the lowest life expectancy at 76.9 years. When economic instability and healthcare inaccessibility converge, the cumulative effect can lead to poor health outcomes that may persist across generations.
The Road Ahead: Closing the Gap
Addressing these health disparities means that a concerted effort must be made. Advocating for reform and action from town leaders, legislators, healthcare organizations, and many others is critical. But, one of our most powerful tools in reducing the rural urban divide comes from that same rural charm that highlights the differences across the state. Being such a small state, we rely heavily on our neighbors, town, and community. So, let’s start by using these powerful connections to advocate for our fellow Vermont neighbors in getting the support and resources they deserve.
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