For generations, small towns and rural communities have been a foundation of American life. These places have powered the country through agriculture, manufacturing, and resource production, yet in many ways, they have been left behind. While urban areas receive major policy attention and investment, rural America faces shrinking population, economic opportunities, crumbling infrastructure, and ever-worsening access to essential services.

This isn’t just a rural issue; it's a national problem. When communities struggle, the economy weakens, workforce shortages increase, and political divides deepen. If leaders continue to ignore these issues, the long-term consequences will be severe.

A Nation Overlooking Its Heartland

Rural America is home to nearly 60 million people, that's about 18% of the population, yet these communities rarely receive the investment and policy focus they need to thrive. The industries that once powered rural economies, manufacturing, farming, energy production, have evolved or diminished, but little has been done to build a new foundation in their place. 

The result has been a slow-moving decline. Job losses have led to population decline, as younger generations leave - not because rural life lacks value, but because it is harder to sustain. In many towns, small businesses struggle to grow without reliable infrastructure or workforce support. Even basic services like grocery stores, medical offices and pharmacies have disappeared in some areas, forcing residents to travel long distances for every day needs.

But this is not just economic. Rural communities are also contending with something that is harder to quantify - feeling that their way of life is being overlooked or dismissed. The dignity of rural living has been eroded by years of neglect and a narrative that treats city life as “hip progress" and rural life as something to progress from. 

Infrastructure That Can't Keep Up

The decline of rural infrastructure is one of the clearest signs of neglect. Roads, bridges, and broadband access have not kept pace with national investment, making it harder for rural communities to attract businesses or support local economies.

According to the American Society of Civil Engineers (ASCE, 2021), approximately 7.5% of U.S. bridges are considered structurally deficient (ASCE Report). A separate report by TRIP highlights that 12% of U.S. rural roads are in poor condition, and 8% of rural bridges are rated as poor or structurally deficient (TRIP Report).

Transportation isn’t the only failing system. Access to broadband remains a major barrier to economic and educational growth. The Federal Communications Commission (FCC, 2024) reports that 22% of rural Americans still lack access to high-speed internet, compared to just 1.5% in urban areas (FCC National Broadband Map). Without reliable internet, businesses cannot expand, students cannot access modern education, and telehealth services, essential in communities without nearby hospitals, remain out of reach.

Water infrastructure is another neglected necessity. In Blanco, Texas, a recent water main break left the entire town without running water, highlighting the vulnerability of aging systems. Some of Blanco’s pipes have surpassed their 50-year lifespan, with estimates for necessary upgrades reaching $200 million (Express News).

In the Mississippi Delta, inadequate sanitation systems have led to significant health issues. Residents in towns like Shaw, Mississippi, have experienced chronic stomach problems due to contaminated water. Research indicates that 38% of children in the area have parasitic infections, linked to exposure to raw sewage resulting from failing infrastructure (The Guardian).

Midland, Texas recently faced water pressure failures due to a combination of a failed pressure valve and an infestation of zebra mussels at their water treatment plant. These challenges disrupted the water supply, underscoring the need for resilient infrastructure (Midland Reporter-Telegram).

When the infrastructure holding a community together is allowed to degrade, the long-term effects are felt in every sector. Failing roads make transportation more expensive. Limited broadband shuts out businesses and educational opportunities. Aging utilities leave entire towns vulnerable to public health crises. These problems are not just inconveniences; they are direct barriers to economic growth and stability.

A Growing Healthcare Crisis

The decline of rural healthcare access is one of the most urgent issues facing small-town America. Since 2010, more than 140 rural hospitals have closed, with hundreds more at risk of shutting down, according to the Chartis Center for Rural Health (2024) (Chartis Report). Many rural counties have no practicing physicians at all, forcing residents to travel long distances for basic medical care, or, in many cases, to go without it.

Emergency care is often out of reach. In life-threatening situations, minutes matter. When hospitals close, patients suffering from heart attacks, strokes, or other medical emergencies must travel long distances for treatment. For some, that distance can be the difference between life and death.

The lack of local healthcare options also affects businesses and job creation. Companies are less likely to invest in regions where employees and their families cannot access reliable medical care. A declining healthcare system is not just a personal hardship—it is an economic threat that discourages growth and stability.

Why This Should Matter to Everyone

It is easy to see rural struggles as isolated concerns, but the reality is that they impact the entire country. When these communities decline, the consequences ripple outward.

Economic instability in rural areas weakens national markets. Agriculture, energy production, and supply chains rely on rural communities to function. When these areas struggle, disruptions drive up costs for everyone.

Failing infrastructure raises costs over time. Poor roads, outdated bridges, and limited broadband access make it harder for small businesses to grow, limiting job opportunities and reducing overall economic mobility.

Political polarization worsens when rural communities feel ignored. When people believe that Washington D.C. does not care about their struggles, trust in government erodes. This fuels resentment and division, making bipartisan cooperation even more difficult.

If these issues continue to be ignored, the national consequences will only become more severe. Rural America is not separate from the rest of the country—it is an essential part of it.

The Grand Bargain Approach: Investing in Rural America

The challenges facing rural America are not new, and they cannot be solved with temporary solutions. A comprehensive approach is needed—one that ensures rural communities are no longer an afterthought in national policymaking.

A functional Grand Bargain would invest in modern infrastructure, ensuring broadband access, road and bridge repairs, and clean water systems are prioritized. It would create economic incentives for businesses to invest in rural communities, providing job opportunities beyond agriculture and resource extraction.

Healthcare must be a priority, with funding directed toward preventing further hospital closures and expanding telemedicine services. Workforce development programs should align with modern job market needs, ensuring that rural workers have access to the training and education necessary to compete in a changing economy.

Investment in these communities must go beyond temporary grants or political talking points. It requires a long-term strategy that treats rural America as an integral part of the national economy, not as an add-on to “must pass” legislative issues.

The Time to Act is Now

If America is serious about building a strong economy, it cannot afford to leave rural areas behind. If policymakers want to address national polarization, they must begin by ensuring that all communities, not just the largest cities, have the resources they need to succeed.

The future of America does not depend on urban centers alone. It depends on every community, large and small, having the opportunity to prosper. The Grand Bargain Project is committed to ensuring that all Americans, no matter where they live, have the opportunities they deserve.

Learn more about how real reform can work: