This article reports results of a field study of the impact of acute and chronic economic stressors on elderly residents of four economically threatened small towns in Kansas. Guided by a conceptual model of environmental stress, risks and benefits associated with everyday life m these towns for older residents are explored for four issues: health risks, the health/housing dialectic, maintaining psychological control, and risks to community identity. Psychological and behavioral strategies employed by older residents as well as communities to deal with changes in these areas are illustrated. It is suggested that community intervention models (e.g., community development, empowerment, triage, or hospice) attempting to stabilize, rejuvenate, or resurrect economically endangered towns must consider a variety of context-specific needs and resources within and between communities. Recommendations for intervention are offeredfor rural practitioners (health professionals, community planners, housing experts) and policymakers . Rural communities face unprecedented economic and social challenges as agriculture restructures and America enters its third century. The costs of assisting that transition pale when compared to those of ignoring it. (U.S. Senate, 1986, p. 56) Economic restructuring in rural communities has had dramatic consequences that have contributed to a decline in the quality of social and community life (Bergland, 1988). Data on rural poverty indicate that the decline and demise of small rural communities are widespread (Coward, 1987;Fitchen, 1991) and that economic stress will continue and perhaps increase in many rural communities in the foreseeable future (Johansen & Fuguitt, 1990). Fitchen has observed, &dquo;because poverty is increasing in rural America, the community context may be deteriorating for the nation's oldest rural people, whether or not they themselves are poor&dquo; (Fitchen, 1990, p. 32).