Inequality, Family Processes, and Health in the “New” Rural America

Abstract

Rural America is commonly viewed as a repository of virtuous and patriotic values, deeply rooted in a proud immigrant history of farmers and industrious working-class White ethnics from northern Europe. These views are not always consistent with the population and socioeconomic realities of rural terrains. Exceptions to these stereotypes are self-evident among large poor racial/ethnic minorities residing in rural ghettos in the “dirty” South and among poor Whites living in remote, mountainous areas of Appalachia. For these disadvantaged populations, sociocultural and economic isolation, a lack of quality education, too few jobs, and poor health have taken a human toll, generation after generation. Moreover, the past several decades have brought dramatic shifts in the spatial distribution and magnitude of poverty in these areas. And, America’s persistent racial inequalities have continued to fester as rural communities become home to urban-origin racial minority migrants and immigrants from Mexico and Latin America. As a result, the face of rural America has changed, quite literally. In this article, we address the primary question these changes pose: How will shifting inequalities anchored in poverty and race shape health disparities in a “new” rural America? Guided by fundamental cause theory, we explore the scope and sources of poverty and race inequalities in rural America, how patterns in these inequalities are transduced within families, and what these inequalities mean for the future of health disparities within and across rural U.S. terrains. Our goal is to review and interrogate the extant literature on this topic with the intent of offering recommendations for future research.

Death of family members as an overlooked source of racial disadvantage in the United States

“…Earlier birth cohorts were characterized by greater racial disadvantage (41), which may have resulted in higher levels of early-life exposure to death, but family deaths may be even more consequential for later birth cohorts because these deaths are less expected. Future research should also consider possible variation in racial patterns of death exposures based on geographic concentrations of poverty (5) and violence (42) that may vary across urban/rural and South/non-South regions as well as across neighborhoods and cities; this approach may reveal variation in spatial concentrations of disadvantage (43,44).…”

An Ecological Perspective on Rural, Low-Income Mothers' Health

“…Moreover, they have significantly fewer occupational, social, and mental health resources to cope with such stressors. The "cultural strain" of traditional gender-role expectations on rural women predominates despite the fact that rural women have entered the workforce at higher rates (Burton, Lichter, Baker, & Eason, 2013). As a result, women's work is often undervalued in economic and social terms (Riebschleger, 2007).…”

The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care

“…The past few decades have brought enormous social changes to the rural United States. With the decline of the agricultural and manufacturing sectors, rural economies have become dominated by lowwage, part-time employment (11). In this context, rural poverty has become increasingly concentrated (12), and opportunities for mobility have declined (11).…”

“…With the decline of the agricultural and manufacturing sectors, rural economies have become dominated by lowwage, part-time employment (11). In this context, rural poverty has become increasingly concentrated (12), and opportunities for mobility have declined (11). In response to limited opportunities, many young adults have out-migrated, leaving fewer people to sustain communities (13).…”