As a resident physician working in a rural state that recently underwent a legislative session characterized by an overwhelming anti-patient, anti-trans, anti-abortion, and anti-physician-patient relationship stance, I find myself invigorated by the commitment and action of community members who persistently call for change and advocate for their right to health. They remind me of the expansive diversity within rural communities.
Despite state legislators who may present a loud, anti-diversity voice, they do not accurately represent the community I serve. Rural communities in the U.S. boast robust LGBTQ+ presences, encompassing rural queer individuals, Indigenous communities, tribal homelands, and a populace of radical rural citizens. I write this to celebrate the diverse rural communities I am honored to know and serve.
Most of my patients during my medical school training years as well as during residency come from rural areas, and they do not fit neatly into anti-trans or anti-education stereotypes. Instead, rural community members benefit from knowing their neighbors, having proximity to rural history and knowledge, and experiencing a life and lifestyle with a rhythm somewhat distinct from urban environments.
Patients from rural areas often endure long journeys to see their doctors, visit family members, or reach the nearest supermarket or big-box store. They maintain a sense of community across vast geographical distances and possess a dignity and self-regard that reflect the landscapes they traverse and their connection to one another.
Rural community activists, especially Indigenous and Black individuals, have a long history of advocating for the health and well-being of their communities, drawing attention to issues such as environmental racism, treaty rights, and the universal right to clean air, water, and land. The actions and visions of diverse rural community members benefit us all.
I write this in appreciation of rural communities, their strong sense of community, their focus on commonalities, and their collaborative spirit. While rural communities may sometimes be depicted as resistant to change, they often serve as the birthplace of change, shaped by human history, sometimes in harsh ways. These are places where individuals who have inherited a challenging history have called attention to it and continue to work towards transformation.
As MLK Jr. reminds us, “injustice anywhere is a threat to justice everywhere.” Rural communities are not merely indicators of American consciousness and population health in the 21st century but also a litmus test of access and equality, reminding us—patients, advocates, community leaders, physicians—of the healthy futures we deserve and the effort required to make those futures a reality.
Kasey Johnson is a psychiatry resident.
