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Very small town life in isolated rural areas

Maister

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Take a quick google drive around Dunning, Nebraska. According to Wikipedia, the population of Dunning was 104 in 2017 (but was a whopping 289 100 years ago). I note they have a post office, church, school, and a bar/restaurant (but it's not clear if Duff's is still open). It also appears there was a bank in Dunning at one point too.

When it comes to small isolated villages, I've long been fascinated by the question of why/how that community came to be there? It's not clear to me what economic activity, apart from farming, would attract people to congregate in this location.

Has anyone ever visited family or spent any time visiting a very small town? What was daily life like for the residents?
 

JNA

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Here are the current or historical actions to create small isolated towns -

Close
single large employer
the Post Office
the school
the doctor's office/clinic

The truly historical actions to create small isolated towns
Railroad doesn't or didn't even run to it
Got bypassed by the interstate & didn't get an interchange
 

DVD

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There were dozens of these tiny towns in Kansas. Most people I met were retired farmers that moved to town so the kids could have the farm. Some people didn't want to live in the BIG city (you know, 20-50k people), but they worked there. Any food and stuff was in the big town. They would make weekly or sometimes even up to monthly trips to the store to stock up. They all had freezers in the garage to really stock up stuff. A lot of them would go in together or the family would have a cow or pig slaughtered for meat instead of going to the store. Biggest thing was probably the church if the town even had one.
 

Dan

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The Google Streetview link shows an extremely wide main street for such a small town. I've noticed a similar phenomenon in Texas -- a state road in a remote rural area will widen to four lanes through tiny little towns, where there's almost no traffic to begin with.

Many of these towns have a street grid that's far larger than what the population justifies. Either they were standard railroad townsites that were never built out, or the communities have shrunk to a point where there's "rural urban prairie", for lack of a better term. I've seen this a lot more in dryland states (Texas, Oklahoma, Colorado, Nebraska, Wyoming, Kansas) than in Iowa, Illinois, or Indiana, where the tiny towns seem more built out.

A lot of these little towns I've passed through have curbs and sidewalks in seemingly random locations, as if early civic leaders anticipated bustling urban context streets filled with pedestrians. Here's what it looks like a block away from that main street in Dunning, Nebraska.

The nearest "big city' is Broken Bow. I've never heard of Broken Bow, but it looks like they have a downtown that's still intact, a couple of tiny suburban strips, hotels, new car/truck dealers, and no big box retail except for a small Shopko. It's definitely a frontier ag service town, with a rugged look that's a bit hard on the eyes, but it's still a viable full service community. Looks like they have very basic zoning.
 

Hawkeye66

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We have many many of these in Iowa and most of them were on a railroad at one time. In fact there are a couple not far from me at all. They are now bedroom towns.
 

Hink

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I enjoy driving through these as we go to Gunnison, CO. From Limon to Colorado Springs there are a bunch, then from Colorado Springs to Gunnison there are a bunch more.

It is hard to pinpoint why they exist, but likely they are river or mining related. They do mostly all have Post Offices too, which is why our mail system is broke.
 

Big Owl

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My favorite local small town origin story is Dellview, NC.

Wikipedia said:
Dellview was incorporated as a town in 1925 as a political gesture. Gaston County law prohibited the shooting of stray dogs that crossed onto a citizen's land. The law was disliked by two families of the Dellinger name, who were both poultry farmers. They complained that stray dogs were raiding their chicken coops on their farms, which neighbored each other. To remedy the situation, the Dellingers petitioned fellow kinsman David R. Dellinger, who was a North Carolina state representative, to propose a bill to the General Assembly for incorporating the Dellinger's farms into a town known as "Dellview" (the clipped form of Dellinger merged with the word "view"). The bill passed, formally incorporating the town in 1925. Immediately thereafter, the town leaders passed an ordinance allowing for the citizens to shoot any stray dog that crosses onto their property.

No one for Dellview responded to a Census Mapping Survey in 1978, and as a result, the town was declared inactive, and thereby the governing rights were transferred fully back to Gaston County. In 1980, the decision was reversed after a citizen petitioned, but the town was declared inactive once again on the Census 2000.[9] For many years, the town of Dellview enjoyed the distinction of being the smallest incorporated community in the state.
 

WSU MUP Student

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My brother lives in one of those tiny towns: the village of Melvin, Michigan - population 170 in 2017 (it was 242 in 1910).

They have sidewalks on the "main roads", a couple of churches, a post office, a nice restaurant, a tiny convenience store, and not much else. I imagine at one point the railroad stopped there for the farms but that probably stopped happening a few decades ago.

Michigan's Thumb is pretty fertile farm land so there are a lot of those tiny little towns and villages that were probably sort of vibrant decades ago but I honestly cannot understand why many of them still exist as a village.

Melvin isn't isolated enough to really survive on its own long term. If they were a bit further from civilization they could probably support an IGA or a gas station but as it is right now, it's only a 10-15 minutes down to the bustling city of Yale (closer to 2,000 residents) or a half an hour to a real city like Port Huron or Lapeer.

There is a considerable Amish population in the area and maybe that's one of the things that has kept these tiny villages and towns from fading away completely?
 

Dan

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One thing I forgot to mention -- what's life like in those small towns? I can't say for the specks on the map with a population in the low three digits. From what I see in small rural villages and hamlets in upstate New York, it's a lot like living in 1978. Supermarkets are small, and will have very few local, artisanal, organic, or gluten-free products. Restaurants are limited to diners, breakfast joints, and Chinese carryout. There may also be a Subway and a pizzeria in the mix. The local liquor store will have the basics. Most cars on the road will be American. If a store sells beer, it'll be mainly domestic macrobrews; maybe Labatt Blue and Heineken too, if you're lucky.

Dollar stores are starting to make inroads in many rural villages and hamlets. There will often be a large gas station with a co-branded McDonald's or small dining area. Most other businesses are mechanical commercial (auto repair, ATV sales, trades, etc), or grandma'a attic-style antique/junk stores. The main street may have a bank branch, a real estate agent, and an insurance agent. If the hamlet is in a touristy area, there will be fewer mechanical commercial and low end uses, and a much wider variety of dining options, a lot of high end art and gift shops, and often a small brewpub or two. The local supermarket will have more organic specialty products.

In UNY, most small towns are no more than a 60 to 90 minute drive away from a decent-sized city -- Buffalo, Rochester, Syracuse, Albany, Binghamton, Elmira/Corning, Utica/Rome. However, most aren't really "connected" to them, culturally speaking. I think it's a bit different in Western states, where longer distances seem shorter, relatively speaking.

My favorite local small town origin story is Dellview, NC.
In Nearby Cherryville, WTF is happening in this mural? It looks like one of the "historic" Pawnee murals.

 

WSU MUP Student

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^ Holy hell that mural in Cherryville is awesome.

I always liked the Pawnee ones and usually have one of those murals as my backdrop on Facebook.
 

Big Owl

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One thing I forgot to mention -- what's life like in those small towns? I can't say for the specks on the map with a population in the low three digits. From what I see in small rural villages and hamlets in upstate New York, it's a lot like living in 1978. Supermarkets are small, and will have very few local, artisanal, organic, or gluten-free products. Restaurants are limited to diners, breakfast joints, and Chinese carryout. There may also be a Subway and a pizzeria in the mix. The local liquor store will have the basics. Most cars on the road will be American. If a store sells beer, it'll be mainly domestic macrobrews; maybe Labatt Blue and Heineken too, if you're lucky.

Dollar stores are starting to make inroads in many rural villages and hamlets. There will often be a large gas station with a co-branded McDonald's or small dining area. Most other businesses are mechanical commercial (auto repair, ATV sales, trades, etc), or grandma'a attic-style antique/junk stores. The main street may have a bank branch, a real estate agent, and an insurance agent. If the hamlet is in a touristy area, there will be fewer mechanical commercial and low end uses, and a much wider variety of dining options, a lot of high end art and gift shops, and often a small brewpub or two. The local supermarket will have more organic specialty products.

In UNY, most small towns are no more than a 60 to 90 minute drive away from a decent-sized city -- Buffalo, Rochester, Syracuse, Albany, Binghamton, Elmira/Corning, Utica/Rome. However, most aren't really "connected" to them, culturally speaking. I think it's a bit different in Western states, where longer distances seem shorter, relatively speaking.



In Nearby Cherryville, WTF is happening in this mural? It looks like one of the "historic" Pawnee murals.

Thanks for sharing. I did not know that mural existed. It's the Cherryville New Years Shooters. Now I wonder if there is a mural in Brasstown, NC for the possum drop on New Years.
 

Bubba

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One thing I forgot to mention -- what's life like in those small towns? I can't say for the specks on the map with a population in the low three digits. From what I see in small rural villages and hamlets in upstate New York, it's a lot like living in 1978. Supermarkets are small, and will have very few local, artisanal, organic, or gluten-free products. Restaurants are limited to diners, breakfast joints, and Chinese carryout. There may also be a Subway and a pizzeria in the mix. The local liquor store will have the basics. Most cars on the road will be American. If a store sells beer, it'll be mainly domestic macrobrews; maybe Labatt Blue and Heineken too, if you're lucky.
That's similar to small towns in south Georgia (at least in the late 90s/early 2000s). Aside from the local BBQ joints and the other local fare, the restaurant franchise progression generally went Subway first, then Hardee's, and then Pizza Hut.
 

mendelman

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Where I grewup in northeastern lower MI there are many places like this.

My hometown was the "big city" in the region at 10,000 population and 10,000 in the adj developed township, which was 2/3 of the entire 30,000 pop County.

Three such very small town places I experienced alot growing up are Hillman, MI, Harrisville, MI and Posen, MI. Wide spots on the US/State highways that had just enough reason to continue to exist, but just barely.
 

Whose Yur Planner

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In the Midwest, there were farm and depot towns. They owned their the life to the farmers in the surrounding area. They had the depot for the grain and cattle farmers. The rest of the town had groceries, a school and farm related stores. When the road system got established to connect the towns to the larger cities, they started to die. A lot of the kids moved off as well.

Where I live now, the towns got their start from the timber industry. The city I live in got started that way. However, between the railroads and being the midway point between ports and larger cities, it grew into something else. The interstate being near it helped a lot as well.
 

Dan

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Does every speck-in-the-map town have one or two auto- or trade-related businesses named J & [some other letter]? It's always "J" as the first letter, too -- I often see "J&M Auto Sales" or "J&R Collision", but seldom "M&J Auto Body" or "A&J Small Engine Repair".

Occasionally, in random "I'm bored so I'll just explore Google Maps" journeys, I'll come across some towns that I've never heard of, that seem unusually ... well, nice, compared to their peers. Here's one that comes to mind -- drop your Google Streetview marker anywhere in little Decorah, Iowa, population 8,172. It's like the baby brother of Valparaiso, Indiana, only it's in the middle of nowhere. You might think "well, it's a college town", but Grinnell, Iowa populartion 9,218, doesn't seem nearly as prosperous. A lot better off than most of its peers in Texas and Oklahoma, but still rough around the edges compared to Decorah.

EDIT: This has to be the most Midwestern small town-ish business ever.
 

Maister

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Does every speck-in-the-map town have one or two auto- or trade-related businesses named J & [some other letter]? It's always "J" as the first letter, too -- I often see "J&M Auto Sales" or "J&R Collision", but seldom "M&J Auto Body" or "A&J Small Engine Repair".
I hadn't noticed it before, but you're right! Another observation is that the use of ampersands is disproportionately represented in automotive business names. I mean you wouldn't hire 'J&B's Business Consultants' to analyze one's business model for operational inefficiencies, would you?
 
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michaelskis

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This is something that I wonder every time I drive through the mountains of WV. There are a ton of them that are unincorporated that seem to have a gas station or something similar.


On a related note, my mom moved from inner-city Detroit to a small tourist village in Northern Michigan when we was a freshman in high school. When she moved there, they had a flashing light, 200 people, a few shops, and the closest high school was more than 30 miles away. She spent more time in the town where the school was than in the town that she lived in because there was absolutely nothing to do unless you enjoyed fishing... which my grandfather did.
 

mendelman

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Here's one that comes to mind -- drop your Google Streetview marker anywhere in little Decorah, Iowa, population 8,172.
Its likely the economic and cultural primary urban center in its actual or effective mircopolitan area. Its downtown probably survived the 50s-80s by being the job and daily business destination for the regional as well.

There is likely a good mix of happenstance and multi-decade concerted community effort to get it to where its now and hopefully continue to be.

It's similar to my current City's trajectory and history, but we have the great benefit of being on an edge of a 4.5 million population CSA.
 
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Maister

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There's a 41 mile drive between Dunning and Broken Bow. One's fuel tank might go down a quarter just with the trip to the gas station and back.

I wonder how most teens in Dunning might spend their time after school? The school likely draws students from around a very large district. What are the odds your best buddy is going to happen to live in Dunning? How do you even hook up with them to hang out afterwards? And apart from MOH on Xbox, what are you and your buddy likely to do?
 

DVD

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Most of them actually work the farm. Maybe go shooting, fishing, something like that. Of course there are always parties somewhere. You gotta remember that going into town isn't an attractive idea to most of these people and that includes the kids.
 

Dan

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There's a 41 mile drive between Dunning and Broken Bow. One's fuel tank might go down a quarter just with the trip to the gas station and back.
Dunning has a little Sinclair station. It might be the only gas station in Blaine County, population 478.

Here's the town pay phone.

More stray disconnected sidewalks.

Some houses in town have very tall antennas.

Churches in the area are mostly "[something] Bible Church". I thought Lutherans would be dominant.

There's a link to Blaine County's two other incorporated communities in the Wikipedia article: Halsey and Brewster. Brewster is the county seat. It's population? 17. Seventeen. Blaine County's population is 478.

Dunning somehow supports a high school. It has a rodeo team.

The landscape around Dunning looks like it might have been farmland at one time. I can make out quarter section lines.

From Wikipedia:

As of the census of 2010, there were 103 people, 44 households, and 29 families residing in the village .... The racial makeup of the village was 99.0% White and 1.0% African American.

I wonder what life is like for Dunning's lone African-American resident.

When I have time, I'll post something about Dell City, Texas. I used to go out with a woman who was born and raised in Dell City. Driving between Las Cruces and Carlsbad, I made a detour to Dell City on the way back, and had a blast at the Sheep Herder Bar!
 

Maister

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Dunning has a little Sinclair station. It might be the only gas station in Blaine County, population 478.
Somehow I missed that. And that's not only a gas station, but says 'grocerie' on the front as well - which I'm sure is a huge deal for residents of Dunning, who I'm guessing do a fair amount of 'standard item' grocery shopping there between tedious biweekly treks to the real grocery store in Broken Bow. We all know that this particular 'grocerie' is really a convenience store and when shopping there one should probably expect to pay the usual additional 30-50% markup you'd expect to see in connection with a convenience store. I wonder if they stock Sudafed at the grocerie? You know, to address someone suffering from persistent nasal drip symptoms.

Downtown Dunning also has the "Two Rivers Wellness Center" to meet their medical needs. I truly don't know what to make of that place. I suspect it's operated maybe by a travelling nurse who stops by for a few hours once or twice a week. If one is too lazy or drunk to stagger all the way to the Sinclair station for a Pepsi, one could also take advantage of Dunning's finest vending services located on the east side of that same building.
 
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mendelman

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Here's another good northern Michigan example: Atlanta, MI which is the county seat of Montmorency County, MI

The county has a total population of 9,765. There's probably more white tail deer that humans in the county.
 

mendelman

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Atlanta? I've been through there numerous times. Isn't that the home of the infamous Elk display?
Yep. They love them some large horned fauna up there.

If I needed to 'disappear', the inland forested boonies of northeastern lower Michigan would be a good choice.

There's alot of nothing, except thousands of square miles of trees to hide behind.
 

Dan

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Meh. Try Greeley County, Kansas. Home to 1,296 people and a population density of 1.6 people per square mile.
Where you'll find the City of Horace, one of those "too small for its grid" dryland towns I described earlier. The housing stock looks like it's 90% mobile homes. The population is now 70. However, in 1920, before mobile homes ever existed, the population was 212. I wonder if the site built structures were demolished or torn down through the years, with mobile homes taking their place. It reminds me of some rural towns in the technically-Appalachia part of upstate New York -- the population today is the same or less than in the 1920s, the bulk of housing is comprised of mobile and modular houses built after 1970, and abandoned Greek Revival and gabled-ell farmhouses are everywhere.

There's so many of those oversized, isolated template townsites throughout the drylands of the Midwest.

Rolla, Kansas: https://www.google.com/maps/@37.1181937,-101.635974,1128m/data=!3m1!1e3
Manter, Kansas: https://www.google.com/maps/@37.5242391,-101.8813213,1014m/data=!3m1!1e3
Johnson City, Kansas: https://www.google.com/maps/@37.569103,-101.7513364,2077m/data=!3m1!1e3
Copeland, Kansas (and a clash of the grids): https://www.google.com/maps/@37.540754,-100.6297952,1032m/data=!3m1!1e3
Raymer, Colorado: https://www.google.com/maps/@40.6079692,-103.8435622,940m/data=!3m1!1e3
Grover, Colorado: https://www.google.com/maps/@40.8684855,-104.2252482,1326m/data=!3m1!1e3





I'm also fascinated by odd ethnic enclaves in places where you'd least expect them, like the Somalis and Orthodox Jews of Postville, Iowa. There's also the black pioneer town of Nicodemus, Kansas, which is also one of the more extreme examples of an oversized grid. The original plan:



And today.
 

Dan

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Bumping this again, after reading an article about the closure of the last synagogue in Ottumwa, Iowa.

If you belong to a certain faith or denomination that's not common in an area, the ability to worship or gather with other practitioners becomes more difficult as the population of a region declines. It's especially hard for those who practice a faith with a distinct subculture, like Judaism or LDS.

In these little towns, there's often a Catholic parish within a 30 minute to one hour drive. However, it may be a predominantly Spanish-speaking parish, where cultural practices are much different than in mainstream American Roman Catholicism. If you're in the upper Midwest, there's probably easy access to a Lutheran church, but it is ELCA, Missouri Synod, or Wisconsin Synod? It might be a bit easier to jump synods, but much harder to make the change to a different denomination, especially if there's no full communion agreement.

If you're active in a mainline Protestant denomination, and the only churches remaining in your area are evangelical or non-denominational, you're probably going to stay at home on Sunday.

Small town Judaism is a thing of the past, except in the Northeast and tourism-heavy regions.

if you're agnostic or an atheist, and small town life revolves around a church, you're probably going to be even more lonely and bored. That may be a reason why rural areas are more religious -- atheists and agnostics filter away.
 

Maister

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Timely issue. I'm not sure how many folks watch CBS Sunday Morning, but they had a segment on this past weekend about closures of rural hospitals. Apparently hospitals in small/rural markets are closing/collapsing at alarming rates. Once a small, isolated community's sole hospital shuts down there is usually a cascade effect immediately following where all the associated health care services (e.g. EMS, testing labs, etc.) follow suit, and you end up with medical deserts where residents have to travel sometimes more than 100 miles to obtain any kind of health care services.
https://www.cbsnews.com/news/critical-condition-the-crisis-of-rural-medical-care/

This is some really scary stuff.
 
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kjel

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Timely issue. I'm not sure how many folks watch CBS Sunday Morning, but they had a segment on this past weekend about closures of rural hospitals. Apparently hospitals in small/rural markets are closing/collapsing at alarming rates. Once a small, isolated community's sole hospital shuts down there is usually a cascade effect immediately following where all the associated health care services (e.g. EMS, testing labs, etc.) follow suit, and you end up with medical deserts where residents have to travel sometimes more than 100 miles to obtain any kind of health care services.
https://www.cbsnews.com/news/critical-condition-the-crisis-of-rural-medical-care/

This is some really scary stuff.
Also nursing homes in rural areas are closing which is scattering residents. https://www.nytimes.com/2019/03/04/us/rural-nursing-homes-closure.html
 

Whose Yur Planner

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If you're active in a mainline Protestant denomination, and the only churches remaining in your area are evangelical or non-denominational, you're probably going to stay at home on Sunday.

Small town Judaism is a thing of the past, except in the Northeast and tourism-heavy regions.

if you're agnostic or an atheist, and small town life revolves around a church, you're probably going to be even more lonely and bored. That may be a reason why rural areas are more religious -- atheists and agnostics filter away.
There has been a decline in Protestant church as well. In Evangelical circles, there is talk about a post Christian America.
 

Maister

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Declining numbers for attendance and membership at organized churches is part of a bigger trend in this country (and many other countries) for decades.
 

Whose Yur Planner

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Declining numbers for attendance and membership at organized churches is part of a bigger trend in this country (and many other countries) for decades.
I'd agree with that. My church just started mentioning it about 5-6 years ago. I also live in the middle of the Bible belt. It may have taken longer for the effects to be noticed. I see a lot more people staying home on my trip to church Sunday morning.
 

Dan

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Timely issue. I'm not sure how many folks watch CBS Sunday Morning, but they had a segment on this past weekend about closures of rural hospitals. Apparently hospitals in small/rural markets are closing/collapsing at alarming rates.
Recruiting doctors and nurses in rural areas is also an issue in most parts of the US. I know many states offer free tuition or some kind of student loan forgiveness to graduates that work in targeted rural areas.

It's not just rural areas, either. If you're a recent medical school graduate, and can pretty much work anywhere in the US/Canada, why would you go to ... oh, Utica or Billings, when there's no shortage of jobs in Denver, Seattle, or Chicago? The pay at hospitals and medical practices in rural and fourth/fifth/sixth tier cities is often quite low, even considering a lower cost of living. The Mayo Clinic, and teaching hospitals in smaller college towns, are uncommon exceptions. (For what it's worth, the medical school and teaching hospital for one of the local universities here is five hours away, in New York City.)
 

Hink

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Timely issue. I'm not sure how many folks watch CBS Sunday Morning, but they had a segment on this past weekend about closures of rural hospitals. Apparently hospitals in small/rural markets are closing/collapsing at alarming rates. Once a small, isolated community's sole hospital shuts down there is usually a cascade effect immediately following where all the associated health care services (e.g. EMS, testing labs, etc.) follow suit, and you end up with medical deserts where residents have to travel sometimes more than 100 miles to obtain any kind of health care services.
https://www.cbsnews.com/news/critical-condition-the-crisis-of-rural-medical-care/

This is some really scary stuff.
Most the physicians that work at these places are locums (travelling doctors) and have no connection to the place, which makes the care that these people do get even worse. The large consolidation of healthcare under single umbrellas also hurts rural medicine. Locally owned physicians practices are becoming a thing of the past.

Recruiting doctors and nurses in rural areas is also an issue in most parts of the US. I know many states offer free tuition or some kind of student loan forgiveness to graduates that work in targeted rural areas.

It's not just rural areas, either. If you're a recent medical school graduate, and can pretty much work anywhere in the US/Canada, why would you go to ... oh, Utica or Billings, when there's no shortage of jobs in Denver, Seattle, or Chicago? The pay at hospitals and medical practices in rural and fourth/fifth/sixth tier cities is often quite low, even considering a lower cost of living. The Mayo Clinic, and teaching hospitals in smaller college towns, are uncommon exceptions. (For what it's worth, the medical school and teaching hospital for one of the local universities here is five hours away, in New York City.)
The pay in rural areas is generally more actually. Because it has to be. An emergency room doctor will make much less in Denver than in Indianapolis, mainly because there are so few doctors who want to be in Indianapolis compared to Denver. The market is so small, that hospitals have to pay more to incentivize people to be there. Large sign on bonuses and large salaries still don't guarantee workers, as once you make a certain amount you don't care about the exact figure you just want a better living environment. That is something that most rural areas just can't provide.

I know of a lot of locums doctors who make a lot of money and work in these rural hospitals. They are scared for the future of medicine. I totally understand why.
 
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Maister

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Recruiting doctors and nurses in rural areas is also an issue in most parts of the US. I know many states offer free tuition or some kind of student loan forgiveness to graduates that work in targeted rural areas.

It's not just rural areas, either. If you're a recent medical school graduate, and can pretty much work anywhere in the US/Canada, why would you go to ... oh, Utica or Billings, when there's no shortage of jobs in Denver, Seattle, or Chicago? The pay at hospitals and medical practices in rural and fourth/fifth/sixth tier cities is often quite low, even considering a lower cost of living. The Mayo Clinic, and teaching hospitals in smaller college towns, are uncommon exceptions. (For what it's worth, the medical school and teaching hospital for one of the local universities here is five hours away, in New York City.)
Not only is the pay generally much lower in rural areas, there's also the whole challenge of attracting young professionals to living in isolated rural communities. This is of course not limited to the medical field, but certainly holds true for them. There will probably always be a small contingent of 'crusaders' - people who are willing to accept the sacrifices of low pay and very limited access to cultural amenities (e.g. concerts, dance clubs, hip bookstores, off Broadway shows, etc.) for the benefit of the community they choose to serve, but these are the exceptions and not the rule. We're talking about a 'calling' here.
Dan said:
When I have time, I'll post something about Dell City, Texas. I used to go out with a woman who was born and raised in Dell City. Driving between Las Cruces and Carlsbad, I made a detour to Dell City on the way back, and had a blast at the Sheep Herder Bar!
So what was the thing about Dell City?

...My God, there's no screening around these dumpsters! Ruins the appearance of the entire community!
 
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JNA

Cyburbian Plus
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Talk about rural/small town health care -

Did you know about
"Critical Access Hospital" is a designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS)

The CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.

Eligible hospitals must meet the following conditions to obtain CAH designation:

Have 25 or fewer acute care inpatient beds
Be located more than 35 miles from another hospital (exceptions may apply – see What are the location requirements for CAH status?)
Maintain an annual average length of stay of 96 hours (4 days) or less for acute care patients
Provide 24/7 emergency care services

As of January 31, 2019, there are 1,349 CAHs located throughout the United States.
https://www.ruralhealthinfo.org/topics/critical-access-hospitals
 

Planit

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In some cases you need to know how to pronounce the name of the small town. Please refer to the following informational video to assist with that for towns in NC:

 

Dan

Dear Leader
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The pay in rural areas is generally more actually. Because it has to be. An emergency room doctor will make much less in Denver than in Indianapolis, mainly because there are so few doctors who want to be in Indianapolis compared to Denver.
I know it costs a lot more to pay a traveling nurse than to hire a full-time staff nurse, but the local hospital in town (a "Federally qualified health center outside an urbanized area") seems to favor the higher expense, compared to offering comparable pay and benefits to staff nurses. Nursing pay at hospitals in the Thruway cities is quite a bit higher than here, in a semi-rural area.
 

JNA

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here is another definition -

The Internal Revenue Service (IRS) defines a Rural Airport as any airport that:
  • Has fewer than 100,000 commercial passengers departing from the airport by air during the second preceding calendar year* and one of the following is true:
    • The airport is not located within 75 miles of another airport from which 100,000 or more commercial passengers departed during the second preceding calendar year,
    • The airport was receiving essential air service subsidies as of August 5, 1997, -or-
    • The airport is not connected by paved roads to another airport.
To apply the 100,000 passenger rule to any airport, only commercial passengers departing from the airport by air on flight segments of at least 100 miles are to be counted.
https://www.bts.gov/modes/aviation/rural-airports
 

Dan

Dear Leader
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EG, if you (or anyone else) didn’t giggle at the thought of Pennsylvania towns named “Intercourse” or “Blue Ball”, you’re not human.

4134D039-E2BC-43D4-BBFD-AAC2236B116C.jpeg

For what it’s worth, I can take a 10 to 15 minute drive from my house to Podunk. Yes, it’s a real place. There’s even a NYSDOT sign. Local legend has it that it’s the Podunk of generic middle-of-nowhere small town fame.

I’m still looking for East Jahungaland and East Jesus.
 

Hawkeye66

Cyburbian
Messages
382
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12
Timely issue. I'm not sure how many folks watch CBS Sunday Morning, but they had a segment on this past weekend about closures of rural hospitals. Apparently hospitals in small/rural markets are closing/collapsing at alarming rates. Once a small, isolated community's sole hospital shuts down there is usually a cascade effect immediately following where all the associated health care services (e.g. EMS, testing labs, etc.) follow suit, and you end up with medical deserts where residents have to travel sometimes more than 100 miles to obtain any kind of health care services.
https://www.cbsnews.com/news/critical-condition-the-crisis-of-rural-medical-care/

This is some really scary stuff.
In Iowa we have 3 health networks, and many of the rural people are funneled to University of Iowa Hospitals and Clinics, which is an large teaching hospital. Small towns over 2,000 will often have a clinic that has a PA or NP to deal with the simple stuff and if its something more they are sent to Iowa City or to one of the hospitals in Des Moines, Cedar Rapids, Sioux City or Omaha/Council Bluffs.
 
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