Rural Americans Are OK With 'Outside' Help To Beat Opioid Crisis And Boost Economy

Enlarge this image toggle caption Angela Hsieh/NPR Angela Hsieh/NPR

Rural Americans can take a dim view of outsiders from Washington, D.C., (or even from the state capital) meddling in their communities.

Ronald Reagan summed up the feeling when he was president: "I've always felt the nine most terrifying words in the English language are, 'I'm from the government, and I'm here to help.' "

But rural Americans have come across scarier phrases since then, like "the opioid epidemic."

"So what you have are some very serious problems — particularly around the economy and opioid and drug abuse — that really worry people," says Robert Blendon, professor of health policy and political analysis at Harvard's T.H. Chan School of Public Health.

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Small towns face big problems. In rural America, rugged individualism is still prized, but so is the pragmatism that has begun to trump traditional disdain for government.

When NPR, the Robert Wood Johnson Foundation and the T.H. Chan School of Public Health polled rural Americans this summer, 58 percent said they want outside help with community problems.

"I think that's a surprise for a lot of people," says Blendon, "that there is a willingness — by most, not all — to reach out for outside help."

Many rural communities are facing two big, persistent issues: drugs and economic stagnation. Take Belle, Mo., with its population of 1,500.

"Money is a big problem," says Kathy Stanfield, who is in her late 60s and raised her children here. "You don't have the tax base anymore that you used to have."

Stanfield says Belle has struggled since the shoe factory closed decades ago. It was once the town's biggest employer.

Increasingly, the town relies on grants to pay for basic maintenance, like replacing crumbling sidewalks or fixing faulty water lines. And that money is getting harder to come by.

Belle has a drug problem, too, and Roxie Murphy, a newspaper reporter who covers Belle for the Maries County Advocate, says drug-related crime is on a lot of people's minds.

"Even though we're rural, the idea that we're safe isn't really there anymore," says Murphy.

But she also calls Belle a proud town — one that isn't giving up.

That's consistent with NPR's rural poll results. Blendon says fully half of those surveyed say their community problems can be solved within five years.

"It is not all a world of hopelessness, as many others have described," Blendon says. "There's a great deal of optimism that 'we can deal with these issues if we can get outside help.' "

Blendon says that of those looking for outside help, three in five expect it to come from the government — state government, mainly.

The problem is, many state governments have been cutting taxes for years and are short on funds.

Johnathan Hladik, policy director for the Center for Rural Affairs, says state budget cuts are taking a heavy toll on small towns that depend on government funding far more than their residents realize. And with state funding drying up, he says, appreciation for those funds may be growing.

"This is symptomatic of a country that is re-evaluating itself, and re-evaluating these decisions, and realizing the importance of civic infrastructure and the importance of being part of a community and part of a state where we're all pulling in the same direction," Hladik says. "I think this could be a positive sign."

If rural hostility toward government is in fact easing, Hladik says, the optimism many rural residents feel about solving persistent drug and economic problems may be justified.