Rural Response to Coronavirus Could Be Hampered by Years of Population Loss

The worst impact of the coronavirus as of early April has been in urban areas, but the problem is quickly spreading to less dense regions. Hospitals and public health agencies in the nation’s rural counties, many of which were already struggling before the pandemic took hold, may lack the resources to respond, in part because of shrinking populations.

As data released March 26 by the Census Bureau shows, most of the nation’s rural counties have lost residents since 2010. Population losses weaken a region’s fiscal and economic health, eroding its workforce and productivity as well as the tax revenue available to fund health care programs. With counties serving as critical providers of hospital and public health services, the decline in the rural tax base has probably weakened the nation’s ability to respond to the crisis in many large, less populated areas.

The figures in this interactive show total population change in each county in every state since 2010. Although 46 states saw growth overall (shown by the black line), there is a noticeable difference between urban counties (the orange lines) and rural counties (the blue lines). There are exceptions, however. For example, McKenzie County in North Dakota more than doubled in population from 2010 to 2019 because of a boom in fracking. But nationwide, nearly 2 in 3 rural counties experienced population losses, compared with 1 in 3 urban counties.

As state and federal policymakers craft responses to the pandemic, they should keep in mind the hurdles faced by local governments in rural areas.

Note: Areas are designated as urban or rural by the Census Bureau every 10 years. We used the 2010 definition, so some growing rural areas may be counted as urban in the 2020 designation. For the purposes of this analysis, a county is classified as rural if its rural population share is 50% or more. Four states—Connecticut, Delaware, New Jersey, and Rhode Island—have no rural counties.

Jeff Chapman is a director and Alexandria Zhang is an officer with The Pew Charitable Trusts’ state fiscal health project.