NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health, Life in Rural America, 6/6/18 – 8/4/18. N=1,300 rural adults ages 18+.

A quarter of rural Americans say that drug addiction is the biggest problem their communities face, according to a new poll of rural residents.

A lot of that assessment is based on first-hand information. About half of rural residents say they personally know someone, like a friend or family member, who has struggled with opioid addiction. Younger adults were even more likely to know someone struggling with addiction.

While drug addiction topped the list of community problems, a slightly smaller percentage of rural residents think that economic concerns are the biggest issue in their communities, according to the poll. 

When it comes to family matters, however, rural people are more concerned about money and financial problems. Twenty-seven percent said economic issues were their biggest family problem (as opposed to community problem), while only 1 percent said drug addiction was their family’s biggest problem. Health concerns overall (including drug abuse) were the second biggest family problem on the open-ended list, at 16 percent of respondents. The third highest group said their families had no “biggest problem.” 

The findings are part of a public opinion survey of people who live in nonmetropolitan counties. (See “How the poll defines rural” at the bottom of this article for more information.) The poll was commissioned by the Robert Wood Johnson Foundation, the nation’s largest philanthropy focused solely on health, along with NPR and the Harvard T.H. Chan School of Public Health. 

Aside from being more likely to personally know someone struggling with addiction, younger people (ages 18-49) were also more likely than older respondents (aged 50 and up) to know someone who struggled with suicide.  

On economic matters, however, younger people were more optimistic than their older neighbors. They were more likely to think the number of good jobs had increased in the past five years (36 percent vs. 25 percent). Young people were nearly twice as likely to say their personal finances had improved in the past five years (61 percent vs. 33 percent for older rural residents). And they were a bit more likely to be involved in solving problems in their communities (59 percent for young people vs. 45 percent for older respondents). 

Young people were also much more likely than older people to perceive that residents of their communities discriminate against groups like Latinos and Hispanics, recent immigrants, and gays and lesbians.  

Politically, both conservatives and liberals were more likely than the general population to think that they were being discriminated against. More than a third of liberals said they were discriminated against in their rural communities, while only 21 percent of the total population said that was the case. A fifth of conservatives also felt they were discriminated against, while only 15 percent of the general population did. 

Different opinions about the existence of discrimination were also observed among racial groups:  

  • 36 percent of African Americans said they were discriminated against, versus 22 percent for the total population. 
  • 44 percent of Latinos and Hispanics observed discrimination, vs. 21 percent of the general rural population.   
  • 22 percent of disabled people said they were discriminated against while only 12 percent of the overall rural population shared that belief. 

Rural Americans said they have a lot to love about their nonmetropolitan communities. The best thing about living in a rural area had to do with a feeling of closeness to other residents, the perception that people there were good and friendly, and that church and religious communities were important, they said. More than half said they are active in their communities. 

Rural residents were also optimistic that rural areas could solve their community’s major problem in the next five years. But a majority also said they would need help from outside their community to make progress. Of the people who thought rural areas need outside help to solve problems, about two thirds say local, state, or federal government should be the source of that help.

Other findings in the poll: 

  • Most rural Americans (54 percent) say they are better off today than their parents were at the same age.
  • A majority of rural parents (55 percent) think their children will be better off financially than they are. 
  • Nearly half of respondents (48 percent) think the opioid epidemic has become worse in the past five years. Another 40 percent say the problem has remained about the same. 
  • Half of rural Americans say their health-care costs have caused a serious problem for their overall finances.
  • Fifty-five percent of rural Americans rate their local economy as only fair or poor. But 45 percent say their personal financial situation has gotten better in the past five years. 
  • Nearly nine out of 10 rural Americans believe the number of jobs in their community will remain about the same or increase in the next five years. Twelve percent believe the number of jobs will decrease. 
  • About eight in 10 rural residents believe their community’s population has increased or remained stable in the past five years. 
  • Of parents who have children age 18 an up who moved out of the area, about two-thirds said they moved because of employment issues. 
  • Most rural Americans (59 percent) have lived in other places, while 41 percent say they have lived in and around their community all their lives.
  • The biggest reason rural people chose to live where they do is to be close to family (31 percent). Twelve percent said they were there because of job opportunities, and 10 percent said they lived there because that’s where they were born. 
  • Rural residents of Appalachia were much more likely to say that the opioid epidemic is the biggest problem their community faces (41 percent vs. 25 percent nationally). People in the Midwest were slightly more likely to name economic concerns as the top problems (24 percent vs. 21 percent nationally).  

How the poll defines rural.The poll defines rural as nonmetropolitan counties (i.e., respondents to the poll were located in counties that are not within a Metropolitan Statistical Area). There’s more (lots more!) on how to define rural over at the USDA Economic Research Service website. 

The survey used a probability-based sample of 1,300 “rural” respondents age 18 or older. Telephone interviews (both land line and cell) were conducted in English and Spanish. The margin of error is plus or minus 3.6 percentage points for questions involving the entire sample.  

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