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A $50 Billion Health Fund and Rural America’s Internet Gaps
Awards from a $50 billion federal rural health fund included in the One Big Beautiful Bill Act from July 2025 are now paying for digital health care records and home monitoring devices. But whether
Rural America May Be Ground Zero for Health System Reform
AFT Health Care has posted an article by senior fellow and director of healthcare reform Jeanne Lambrew on health reform through the lens of rural
Rural MAHA followers say Trump hasn't improved health of their communities, an AP-KFF poll finds
The findings signal an apparent disconnect between the Trump administration’s MAHA-branded policy priorities and rural America’s perception of their reach and effectiveness.
When “DEI” research is cut, what happens to community health?
“I’m just going to run to the grocery store!” How many times have we said this without thinking about it? For most of us, it's usually an easy walk or a short drive to get the cheese we forgot. In reality, though, 13% of the U.S. population (about 39 million people) live in “food deserts,” which means living more than a mile from a grocery store in urban areas and more than 10 miles in rural areas. This was the case for people in Pittsburgh’s Hill District, where a quick run to buy food wasn’t an option. In the 1930s, federal maps marked the Hill as "hazardous" for lending, a practice known as redlining that steered investment away from Black neighborhoods. Decades of disinvestment followed, and residents went about 30 years without a nearby grocery store. This made it hard to keep healthy eating habits and contributed to chronic disease. When a grocery store finally opened in the area in 2013, researchers saw the opportunity and launched the PHRESH study, which initially compared the health of participants from the Hill district to those in the Homewood district. Over time, the study expanded to other factors such as brain health and Alzheimer's risk. Residents like Roderick Blair overcame initial hesitation to share their health data, trusting it would benefit their neighborhood. Then, in August 2026, the NIH abruptly canceled the study’s grant, citing that it was “subjective” and fell outside their scientific scope—an effect of the administration’s interpretation of diversity, equity and inclusion (DEI). Research like PHRESH can help determine what changes in a neighborhood actually improve health, so cutting it has left that question unanswered. Other canceled studies have examined health issues like maternal health, preterm birth rates, or sickle cell disease. Courts have reversed some of these grant cancellations, but not all of them. If we really want America to be healthier, research into why some communities get sicker than others is absolutely critical. The law that created the federal minority health research institute passed with bipartisan support in 2000. But these days, as evidenced by grant cancellations, the political shift in attitudes toward DEI means we often lose access to the health information we need to help all communities thrive. DEI vs. health equity vs. equality and the overlap (or lack thereof) The letters “DEI” evoke very different reactions depending on who you are in the U.S. DEI programs can address gender, disability, age, and other factors, but the fiercest debate centers on race. For some people, hearing DEI brings to mind policies that may have cost them a job or a college seat because they are white. Others see DEI as a matter of justice: a way to expand representation and opportunity for groups that have been historically marginalized. Both perspectives are rooted in lived experience, and both center on the same question: whether hiring and admissions practices are fair. Hiring and admission practices, though related, are not the same as health equity. Health equity is “the attainment of the highest level of health for all people.” It’s the recognition that some groups of people consistently experience worse health outcomes than others. For instance, black mothers die from pregnancy-related complications at three times the rate of white mothers, and rural Americans are more likely to die from issues such as heart disease and cancer. Equity is also often conflated with “equality,” which leads to misunderstanding of how to actually best support communities. Equality ignores the fact that we aren’t all starting life with the same resources or circumstances, whereas equity is about helping people get what they specifically need based on their situation so they have the chance to achieve the same outcome as anyone else. For example, if every household in Pittsburgh got a $30 grocery gift card, that would be equal. But during the decades the Hill District went without a grocery store, that card wouldn’t have helped much. Equity means making sure everyone can actually access a store in the first place. DEI policies can overlap with health equity in many ways. For example, they may help expand access to quality education and stable, well-paying jobs, which in turn can provide health insurance, safer housing, and improved finances—all of which can reduce health disparities. But to make that happen, we first need data to identify disparities in communities and to develop solutions that effectively address them. What we lose when the research stops Community data is important to health equity because: You can’t fix what you don’t see: Data show which communities are most affected by health factors such as infection, heart disease, and cancer. If we don’t know what is happening and where, then we can’t develop interventions to help. Poor health costs everyone: Chronic disease is expensive—both to the individual person and to the overall economy. Understanding what groups of people are most at risk allows us to develop interventions that can save everyone money. Disparities exist for many communities: Health equity includes disparities that exist due to a whole host of factors, such as family background, race and ethnicity, rural vs. suburban residence, gender and sexual orientation, veteran status, disability, and lower income. This means many Americans can benefit from research into differences in health outcomes and how to improve them. Trust is easy to lose: Some participants in the PHRESH study were initially vocal about their concerns about participating. But that trust was earned because the researchers kept their promises and centered their work on the community. When projects are canceled mid-cycle, researchers have no choice but to leave behind communities they had promised to help. This hurts trust in the long run. It’s also a very inefficient use of resources, and it will take significant time and effort to redo the work when the government realizes this work is important again. How should we talk about health equity? This is hard because the words “equity” and “DEI” are currently very politically charged. So whether you’re a public health professional, teacher, or friend, how we talk about this topic matters. The right framing can help people who might otherwise be skeptical see why health equity research is important and deserves funding. Here are some suggestions to help your conversations: Choose your words strategically: Who are you trying to reach with your message? Are they likely to be resistant to terms like “diversity” and “equity”? If so, find alternative words to use to still get the message across. It is frustrating to be in that position, but the goal of improving health is too important not to try to make inroads. Sometimes simply reframing can help the message reach those who need to hear it. Focus on the problem: The terms “health equity” and “DEI” are abstract. Make it more specific. For example, discuss differences in maternal death or ways to improve health outcomes in rural communities. These still have equity at their core but will likely be better understood by those you’re talking with. Focus on systems: Disparities exist, but if they are communicated poorly, people can mistakenly think the issue is the individual’s fault. Disparities are largely driven by failures of the system—such as lack of access to health care and a long legacy of racism. When discussing the disparities, frame them around these systemic issues to ensure blame isn’t placed on the individuals impacted. Tell stories: Personalize these policies by using stories from those impacted that connect to the data you’re trying to convey. This helps make the policies and outcomes more concrete and meaningful. Bottom line Some communities end up sicker than others. That’s just the facts. We can argue about the best way to do that research, but canceling it simply because it may be linked to DEI doesn’t make anyone healthier. It just leaves communities like the Hill district behind. And in the end, it causes us all to move backward in our efforts to improve health in this country. Love, EM Big thanks to MacKenzie Isaac & Legairre Radden, who reviewed this piece and generously shared their expertise and lived experience to help improve it. Dr. Liz Marnik, PhD, is Executive Director of The Evidence Collective and a science communicator and immunologist working at the intersection of public trust, science, and public health. To discuss communication training on topics like health equity and storytelling, email Liz at liz@yle.health or learn more on our website. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Your Local Epidemiologist is a reader-supported publication. 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‘The Red Goose’ explores life’s ‘quiet wonders'
Local author Allen Guy Wilcox explores family, loss, rural America and everyday life in his debut poetry collection, “The Red Goose.”
Want to entice new residents? Offer cash, for a start
Lincoln County in Kansas is among the rural counties around the country that are offering cash grants as relocation incentives, even as they have a mixed record of helping cities and towns stand out as people return to rural America.
Why the Democrats' Path Back to Power Runs Through the Kitchen Table
A unique new messaging study underscores the supremacy of economic populism in rural America and beyond.
Patients wary of governments, companies pushing AI as a rural healthcare solution
Two of the nation’s most powerful health officials predict artificial intelligence will play a key role in solving rural America’s health challenges.
Health outcomes in rural America: A prevention-to-crisis view on determinants of health, chronic diseases, and economic consequences
This America's Rural Future symposium explores the interconnections between health outcomes and economic development in rural areas.
Farm Bill Politics - AG INFORMATION NETWORK OF THE WEST
American Farm Bureau Federation President Zippy Duvall says lawmakers must stop with the farm bill delays and deliver some certainty to rural America.
Patients wary of government, companies pushing AI as a rural healthcare solution
Two of the nation’s most powerful health officials predict artificial intelligence will play a key role in solving rural America’s health challenges, but some rural Americans are skeptical.
Patients Wary of Governments, Companies Pushing AI as a Rural Healthcare Solution
The $50 billion federal Rural Health Transformation Program is set to flood rural America with new AI health tools. That’s despite little evidence on whether health-related AI can improve access to care and patient health in those communities.
Rural America’s Maternal-Health Crisis Is About to Get Much Worse
Care will be in shorter supply, travel distances will stretch farther, and high-risk situations will more likely result in tragedy.
Rural Health Disadvantages in the United States
Over the last 20 years, rural Americans have been dying at a higher rate than urban residents – and the gap is growing. According to the U.S. Department of Agriculture…
Health care gives Democrats a potent issue for midterm elections in Iowa and beyond
In places like Iowa and rural America, health care cuts and lack of coverage are giving Democrats a potent issue to take votes from Republicans in their bid to retake control of Congress.
'We'll never know if he could have been saved.' The gaps in Trump's rural health fund
Republicans promise that $50 billion in new health funding will help rural America. But it's not expected to aid the years-long effort in North Carolina's Martin County to reopen its only hospital.
A North Carolina farmer is testing whether Democrats can still win rural America
In North Carolina, Jamie Ager is distancing himself from his national party to win a congressional seat.
AgriSafe Network Offers 'Total Farmer Health Tools' To Support Mental Well-Being
New resources and peer-to-peer support networks are available to help combat rising rates of anxiety and depression in rural America.
Native American businesses have diversified beyond casinos to become a rural economic force. Trump is cutting off a lifeline that goes beyond tribes
Tribal enterprises are a lifeline for rural America, but a crackdown on federal contracting initiatives might upend their business model.
Opinion - Bill Bishop: ‘Grievance politics’ thrives on chaos and confusion. That’s our system now
Columnist Chris Clayton noticed something odd in the Trump Administration’s budget for the Department of Agriculture. Since the USDA is the federal government’s primary contact with rural America, Clayton expected to see the word “rural” in the document. And it was there – 12 times in 92 pages. But there were other words that seemed...
What a modest town hall explains about rural America’s political gap
Ten strangers — a mix of conservative and liberal — gathered for a discussion about the rural-urban divide. They came together on a surprising solution.
CEO of ECU Health urges House Ways and Means Committee to abandon "one size fits all" healthcare solutions
The leader of eastern North Carolina’s largest health system was in Washington this week, telling federal lawmakers that rural America is being left behind by current healthcare policies.
Kelly to Health System CEOs: "It's about the math."
WASHINGTON, D.C. -- Today, during a hearing with leaders of some of the nation's top hospital CEOs, U.S. Rep. Mike Kelly (R-PA) questioned the executives about ways rural health care can improve while also highlighting the need for more affordable and accessible health care in Rural America.
Can Democrats win back rural America? Sticker shock has North Carolina voters wanting change
Like ‘driving to San Francisco and back, every week’: In rural America, cancer patients face tall hurdles to get care
As cancer care becomes both more advanced and more specialized, options in rural areas have shrunk.
Amazon Showcases Addison Care(R) at National Rural Health Leadership Conference, Showcasing the First Fully Orchestrated AI-Driven Care Infrastructure Built for Rural America
LAS CRUCES, NEW MEXICO / ACCESS Newswire / February 9, 2026 / At the 2026 AHA Rural Health Care Leadership Conference,
The promise and reality of the rural health fund
In the 2025 budget bill, Congress created the $50 billion Rural Health Fund to help struggling hospitals, doctors, and patients in rural America. But rural hospitals are expected to lose three times that through Medicaid cuts in that same budget bill. So, what will it take to keep rural healthcare afloat?
Inside Maryland’s High-Stakes Bid for Trump’s $50 Billion Rural Health Fund
The White House asked states to compete for a rare pot of new money dedicated to transforming health care across rural America.
LAND O'LAKES, INC. AND IMAGINE ENTERTAINMENT ANNOUNCE COLLABORATION TO REDEFINE STORYTELLING AND NARRATIVES OF RURAL AMERICA
Ahead of the 2026 Sundance Film Festival, Land O'Lakes, Inc., has collaborated with Brian Grazer and Ron Howard's Imagine Entertainment to develop a toolkit for storytellers aimed at changing the way rural America is depicted across film and television.
Rural America relies on foreign doctors. Trump’s visa fee shuts them out.
The Trump administration’s demand for companies to pay a $100,000 fee to hire an immigrant worker using an H1B visa has created turmoil among rural health providers.
People, Politics, and Places fellowship grants students a closer look at rural America
The Hoover Institution’s People, Politics, and Places Fellowship affords students first-hand summer experiences in rural American communities.