A recent internal federal investigation reminded us of why elections are important — and how damaging it is that discussion of issues affecting rural America is nearly missing from this presidential campaign.

The Office of Inspector General of the federal Health and Human Services Department released two reports criticizing the care provided in 28 hospitals directly operated by the federal Indian Health Service. The Associated Press reports that “the often substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources, and difficulty attracting and keeping skilled staff.”

The health care offered at Indian Health Service hospitals would have been an interesting topic for Sunday night’s presidential debate. But, again, there was little offered to rural voters, except, perhaps for Democrat Hillary Clinton’s comments on what the country owed coal mining regions.

Clinton allowed that a clean energy future (and low natural gas prices) were changing the energy economy. “But I also want to be sure that we don’t leave people behind,” Clinton said. “Those coal miners and their fathers and grandfathers, they dug that coal out, a lot of them lost their lives. They were injured. But they turned the lights on and they powered their factories. I don’t want to walk away from them.”

Republican Donald Trump continued during the debate to equate “inner city” with black Americans. “I would be a president for all of the people — African Americans, the inner cities,” he said. “You go into the inner cities and you see it’s 45 percent poverty, African Americans now 45 percent poverty in the inner cities.”

As the Washington Post reports, this was wrong on several counts. First, the poverty rate among African Americans in metro areas is 26 percent. He also misses the five million African Americans who live in rural areas or small towns. Most of those people live in the South. The Post has a good map showing that there is a huge swath of rural America with large percentages of African American residents.

In fact, black citizens are moving out of inner cities to the suburbs or beyond. Black suburbanites now outnumber those living in Trump’s “inner city,” the Post reports.

Aside from those comments, we didn’t notice much that would affect Yonder readers. But, then, perhaps we missed something while we were cringing.

The polls, meanwhile, continue to show Donald Trump leading Clinton in rural areas, particularly in the South. A Vanderbilt University poll in early October found that Trump was up 27 percentage points among rural voters in Tennessee.

In urban areas of the state (think Memphis and Nashville), the poll had Clinton ahead by 22 points.

In Pennsylvania, Trump “is counting on high turnout in small cities and rural areas” to win the battleground state, reports Laura McCrystal of the Philadelphia Inquirer.

Bill Bishop is founding co-editor of the Daily Yonder.

Creative Commons License

Republish our articles for free, online or in print, under a Creative Commons license.