A group of rural policymakers and advocates has released its top priorities to help small towns thrive in Iowa and across the country.

The 2023 Rural Policy Action Report said right now, there is too much corporate influence and not enough access to health care in America's heartland. It calls for better investment in what it labels four "main pillars of success" in rural America.

Rep. J.D. Scholten, D-Sioux City, who attended a Rural Action Policy summit on behalf of Iowa, said chief among them is making sure people can live and work safely in Iowa's small towns without fear of facing discrimination.

"Everything from environmental justice to protection of Native American Tribes and Nations, to equitable funding in projects and labor protections, health access," Scholten outlined.

Scholten pointed out the other pillars include ensuring access to infrastructure in small Iowa towns, with equitable funding for things like broadband internet and child care, limiting the power of corporate influence in rural communities, and investing in renewable energy and other sustainability efforts at the local level.

Scholten argued a lack of local investment has a domino effect, which not only costs small towns opportunities, but causes a population decline, too. People are moving away, he said, because corporations are taking resources out, creating fewer jobs, leaving fewer reasons for people to stay and work in their hometowns.

"It's almost like their economies are extraction," Scholten contended. "We have a lot of corporations that 'take out,' whether it's corn, soybeans, hogs, wind energy, all that stuff. Not a ton is going back in, and so policies are not necessarily working for a lot of rural folks right now in rural communities."

He added this year's report built on previous years' efforts and lays the groundwork for future progress in rural Iowa and across the Midwest.


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Federal funding for infrastructure improvements in colonias, predominately rural, Hispanic communities near the U.S.-Mexico border, including 150 in New Mexico, is getting a second look from the U.S. Government Accountability Office.

Jill Naamane, financial markets and community investment director for the GAO, said there are grant and loan programs targeting colonias to improve water and wastewater systems and housing but the U.S. Department of Agriculture does not have accurate data on the extent of program benefits.

She pointed out colonias have high poverty rates.

"Many of them started as settlements that were associated with military forts or missionary activities, so they kind of grew up outside of cities without being connected to the same infrastructure," Naamane explained.

The GAO analyzed program documentation and funding data from 2020 to 2023, conducted local interviews and made physical observations during 24 site visits in the four U.S.-Mexico border states. They recommended Congress consider revising the population requirement for colonias to continue receiving block-grant funding given population growth in the Southwest.

Naamane acknowledged many colonias face challenges in obtaining and using federal assistance because local governments do not have the staff to apply for federal funds. Without some administrative revisions, she projects nearly 60% of colonias will likely become ineligible in the future for certain targeted financial assistance.

"They're typically areas that have poor water and sewage infrastructure, substandard housing and a number of other economic and environmental challenges," Naamane outlined. "There's a continuing need for assistance in these communities."

In southern New Mexico, the designated colonia of Anthony, home to about 10,000 people, is refurbishing and expanding its wastewater treatment plant with grants and loans from the USDA. The new plant started treating wastewater this month, with the entire project scheduled for completion in November.


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Rural voters in Colorado and across the U.S. tend to be swing voters, and may decide the outcome of this year's presidential election.

Their biggest concerns are the economy, threats to democracy, and abortion - according to a new Rural Democracy Initiative poll.

Sarah Jaynes - executive director of the initiative - said these voters want elected leaders to make lowering costs and increasing wages for working people a priority, not cutting taxes for the rich or deregulating corporations.

"They're very focused on working people as kind of the heroes of the economy, and concerns that impact working-class people," said Jaynes. "Rural people and small town folks are more likely to be working class. About 70% of rural folks are working class."

Seventy-one percent of rural voters agreed with the statement: "True patriotism is protecting the freedom to live our lives as we choose."

Just 23% agreed that "patriotism is about preserving a traditional way of life." The poll was conducted between August 28 and September 8 in ten battleground states.

Nearly eight in ten rural voters are firmly against banning abortion. Jaynes noted that's the same number pollsters saw in a similar survey in March.

"They either said that they were against abortion themselves, but didn't think that the government should control a woman's choice in the matter," said Jaynes. "Or they just thought that abortion should be legal."

The poll shows Donald Trump with an 18% lead over Kamala Harris among likely rural voters. But that is down from a 26% lead in March, before Harris announced her campaign.

Jaynes said the big takeaway for both major parties should be that rural voters want to see worker-centered policies.

"People want to make sure that they have the tools and the opportunities to create a good life for themselves and their families," said Jaynes. "And that shows up in their support for child care and health care."

This month, a North Dakota network of rural hospitals enters its second year of trying to make local operations more efficient, so they can keep the doors open for patients and keep their local communities thriving.

The Rough Rider High-Value Network was announced in October 2023. It is made up of 23 independent, critical access hospitals in smaller towns and cities across the state. Leaders from the facilities share best practices and ways to keep costs lower.

Kylie Nissen, executive director of the North Dakota Rural Health Association, said she is encouraged by the effort, knowing the long-standing struggles hospitals and clinics in these areas have faced.

"It's not only closures that we're concerned about, it's rural community members (who) don't want to see their hospital bought out by a large system, too," Nissen observed. "Because then, the decision-making and the care for their local community just isn't there."

Since it began, the collaborative has secured at least two desirable contracts with commercial health insurers, benefiting all member hospitals. In its August forecast, Becker's Hospital Review reported five North Dakota hospitals were at immediate risk of closing within the next two to three years.

Nissen pointed out the ripple effect of keeping the hospitals independent and running efficiently, while improving patient care, can be felt across an entire community.

"Health care is huge when it comes to economics," Nissen stressed.

She added a healthier population, that does not have to travel as far for appointments or other care needs, results in a stronger workforce. She acknowledged they are still navigating challenges, like reducing maternal care "deserts," noting federal grants are competitive. The state of North Dakota chipped in $3.5 million to help get the Rough Rider Network started.


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