Our analysis suggests that the socioeconomic disadvantages and health disparities dividing rural and urban communities may be widening. Particularly alarming are gaps in disparity measures between rural communities and those in which a rural hospital is vulnerable to closure.

The COVID-19 crisis is set to linger within rural America, given lower-than-desired vaccination rates and the prevalence of chronic conditions such as obesity and diabetes. We cannot ignore that many of the other factors that pushed rural hospitals to closure, or the brink of closure, have not been resolved. As we move beyond the immediacy of the pandemic, rural health advocates and policymakers in Washington may need to reimagine strategies for addressing the rural hospital crisis and the widespread vulnerability of the communities they serve. 

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