'Terrible, no good year for rural health': Why healthcare leaders are leaving small-town America

Healthcare providers and leaders are choosing to leave rural communities that have grown socially tense over pandemic politics, NPR reports.

In Kansas, more than 25 percent of the state's public health administrators quit, retired or were fired this year, Vicki Collie-Akers, PhD, an associate professor of population health at the University of Kansas, told NPR. Some received death threats and had to hire armed guards.

Kristina Darnauer, MD, resigned as medical director of Rice County in Kansas in July after her medical advice to wear a mask was met with contempt from some of her friends, neighbors and patients. 

"Hard things should bring us together," Dr. Darnauer told NPR. "And instead, this hard thing has driven a wedge between us."

Alan Morgan, CEO of the National Rural Health Association, says the departures in Kansas reflect what's occurring across a lot of rural America, describing 2020 as a "terrible, an absolute terrible, no good year for rural health." He worries that the departure of county health directors in the middle of a pandemic will result in sicker rural populations and added pressure on local hospitals.

Nationwide, at least 181 state and local public health leaders have resigned, retired or been fired since April 1, many because of pandemic-related backlash from citizens and politicians.

Dr. Collie-Akers expressed concern for how these public health positions will be filled, particularly in rural areas. "It's not a secret that the position is open because of extreme tension between the health department director and the city commissioner, county commission, or because the person has required a guard," she said.

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