This opinion piece ran in VTDigger on November 20, 2025 by Mary Cushman, M.D., M.Sc., University Distinguished Professor and vice chair of medicine and co-director of the Vermont Center for Cardiovascular and Brain Health at the University of Vermont’s Larner College of Medicine, and director of the thrombosis and hemostasis program at the UVM Medical Center. Opinion pieces give voice to the University of Vermont’s Larner College of Medicine community members and do not represent the college’s views.
“Our Vermont rural strengths can help us directly and positively impact today’s complex health challenges.”
With nearly two-thirds of our population living in rural settings, National Rural Health Day, on Nov. 20, highlights the strengths of our rural communities. Federal changes to expert scientific panels, cuts to health agencies and health programs, and widespread scientific misinformation create confusion in critical areas of health and science. Our Vermont rural strengths can help us directly and positively impact today’s complex health challenges.
Rural and urban areas have different health outcomes, needs and disparities. Health is heavily influenced by ZIP code due to differences in economic opportunities, affordable housing, food security, transportation and access to health care services.
National initiatives, such as America’s Health Rankings, confirm that many rural states, such as Arkansas, Mississippi, West Virginia, and Alabama are far less healthy, and rural states together have a 23% higher overall mortality rate compared to urban environments. In contrast, despite their rurality, Vermont, New Hampshire and Maine have better health outcomes than other rural states. These rural strengths can help guide us in meeting our health and social challenges.
Publicly accessible health data by geographic regions may also help inform us. One model from the County Health Rankings & Roadmaps project includes measures of population health and well-being, healthcare, quality of life, physical environment, social and economic factors.
Someone living in Addison County, for example, can see how they compare to Vermont and the U.S. in health and social measures. Similarly, Vermont Department of Health cancer data shows differences in risk factors by county, such as tobacco use and rates of HPV vaccination.
The Rural Health Information Hub is another user-friendly source of high-quality data. Taken together as a reflection of our community’s health, these practical sources of data can help us build on our strengths and identify priority health challenges.
Community engagement and partnerships contribute positively to health outcomes and provide proven strategies for our rural communities. Research from the Northern New England Clinical and Translational Research Network shows a high level of trust with our community partners in advancing research that connects community needs and our academic medical centers. Lessons learned from community-academic partnerships in medical education suggest that community benefit is essential for long-term community engagement and further strengthening our collaborative goals.
Communication preferences for health information in Vermont rural communities may differ from urban areas. Understanding these preferences is essential to improving health literacy and empowering individuals and entire communities to act on health information that is based on science.
A pilot study with older adults living in rural housing during the Covid-19 pandemic explored how their feedback influenced the specific ways we communicated vaccine information, and used their communication preferences to maximize confidence in public health science.
A statewide electronic survey, in partnership with the United Way of Northwest Vermont, highlighted key differences in how rural residents preferred to receive health information. Whereas the internet, Front Porch Forum, and television were generally preferred by urban respondents, rural populations preferred word of mouth, posters, Facebook, and local papers. This suggests that community “conversations” through local channels, in addition to information from trusted sources, may be key to further improving our individual and collective health.
Recent examples from the Leahy Institute for Rural Partnerships are testing the possibility of using local libraries to offer telehealth services in rural locations, and our local libraries can also improve health literacy in individuals and families.
What other innovative health connections could we make in our many rural locations? Such strategies can better connect us, reaching individuals, neighbors and families with health information based on science. Whether vaccines, health care services, or advocacy for health and social issues, together, these approaches can contribute to better health, stronger communities and enduring health connections.
We know our most trusted sources for health information. Recent national polls from the Kaiser Family Foundation confirm that for seeking reliable information about vaccines, physicians, nurses and other health professionals, along with local public health agencies are overwhelmingly trusted for critical health information.
The Vermont Department of Health has 12 local health offices throughout our state, part of a trusted network that connects health care and public health. Expanding our range of trusted voices can prevent disease and illness, and promote access to needed health care, social services and life-saving preventive measures.
For health, place matters. Our rural strengths, community-academic research, innovations and health communication are all needed, expanding our network of trusted voices. These represent unique opportunities to further strengthen our collective health and become partners in our own health and health care, at every age and in every Vermont community.
