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Rural Health Information Hub

State of Philanthropy in Rural Areas

While estimating the total share of grantmaking in rural communities is challenging, research suggests that only a small percentage of foundation grants are dedicated to rural communities. Specifically, in 2015, the Economic Research Service (ERS) within the U.S. Department of Agriculture released a study on grantmaking trends in rural communities. This study found that rural organizations received, on average, 5.5% of total domestic grants from large foundations between 2005 and 2010. From smaller foundations, rural organizations received 7.5% in 2005 and 7% in 2009 of the value of small grants. The ERS study notes that these figures do not take into account that some grants for urban communities may have benefited people in rural communities. It is not possible to quantify these benefits based on the available data.

Key findings from the ERS study include:

  • Private independent foundations (those that receive endowments from individuals or families) provide the most grant funding to rural and non-rural organizations.
  • The average real value per person of grants from large foundations to organizations in nonmetro counties was $88 per person, almost half the average provided to organizations in metro counties.
  • Metro and nonmetro counties with either a larger college-educated population or more assets held by nonprofits received more grant dollars per person.
  • Rural organizations received more grants for higher education; the environment; and recreation and leisure activities — in contrast to urban organizations, which received more grants for health; medical, science, and technology research; and the arts, culture, and humanities.

Efforts to Encourage Philanthropic Investments in Rural Communities

Efforts are underway to explore ways to encourage philanthropies to invest in rural communities. For example, Rural Philanthropic Analysis, a project at Campbell University, supported in part by the Robert Wood Johnson Foundation, is working to enhance the field of rural philanthropy by exploring how to shift the paradigm of philanthropy to encourage investment in rural communities.

Representatives of various parts of the federal government have made statements about the importance of increasing philanthropic support in high-need rural areas:

Despite federal efforts to encourage philanthropic investments in rural areas, building partnerships with philanthropies remains a challenge for many rural programs. Challenges Rural Organizations May Face in Seeking Philanthropy Support describes possible reasons for this challenge.

Anecdotal evidence based on discussions with philanthropies investing in rural communities suggests that there is a resurgence of interest in funding rural communities and a new movement of engagement about improving health and well-being in rural communities.

Philanthropic Investments in Rural Community Health

Philanthropies are investing in rural communities in a number of important ways. Some philanthropies offer core support — unrestricted funding that supports any aspect of a program. By securing unrestricted funding, rural programs can respond to unforeseen challenges and pursue more innovative solutions to local issues.

Below, we describe several ways that philanthropies invest in rural communities.

Strengthening Community Capacity

Strengthening rural community capacity involves providing the necessary tools, training, and/or funding to individuals and local organizations in order to improve their ability to serve the needs of their communities. Examples include:

  • Implementing model interventions, policies, and practices
  • Sustaining programs, services, and supports
  • Building and maintaining a workforce
  • Providing community education
  • Achieving policy, systems, and environmental changes
  • Funding operational costs that cannot be financed in other ways, such as employee salaries, rent, technology, utilities, office supplies, and professional development activities

Improving and Supporting Economic Development

Many rural areas across the country are facing economic challenges related to a loss of production jobs and declining populations. Philanthropies can help support economic development in rural areas by funding job training, education programs, start-up costs for new businesses, and other efforts to spur job creation. For example, the Claude Worthington Benedum Foundation has a long history of supporting economic development in rural West Virginia and southwestern Pennsylvania. The Foundation takes a regional approach to economic development that involves promoting agricultural and technological advances as well as providing capital for communities in concentrated poverty.

Investing in Healthcare Infrastructure and Increasing Access to Care

Rural communities may require capital funding in order to maintain and grow healthcare facilities and increase access to quality care. Philanthropies have played an important role in building healthcare capital in rural areas, which can include making renovations to facilities and installing health information technology systems. For example, the Leona M. and Harry B. Helmsley Charitable Trust Rural Healthcare Program provides funding to improve access to and quality of care in the Upper Midwest.

Promoting Healthy Aging

Older adults disproportionately live in rural areas compared to urban areas, and most people want to remain in their own homes and communities as they get older (“aging in place”). To support healthy and successful aging, rural communities need resources like geriatricians and other healthcare specialists, long-term care services, social services providers, and accessible transportation.

Grantmakers in Aging is an organization of philanthropies that make strategic investments in programs that promote healthy aging in rural areas. These initiatives include a three-year project, Creating a Sustainable Network for the Rural Aging Movement, that is designed to increase knowledge-sharing, facilitate partnerships, and invest in resources for rural older adults.

Improving Access to Transportation

Transportation presents a key challenge for rural communities. Safe, reliable transportation networks are needed to support access to healthcare, social and community services, education, employment opportunities, and healthy food. For more information, see the Rural Transportation Toolkit.

Philanthropies can improve access to transportation in rural communities by supporting community-based transportation services. Grantmakers in Aging held a rural mobility summit to focus on addressing the challenge of transportation and aging in rural communities.

Addressing the Opioid Crisis

Opioids, alcohol, and other substances are a concern across the U.S., and rural areas face additional barriers to preventing and treating substance use in their communities. These include having fewer services, such as treatment facilities and challenges related to stigma in seeking services. For more information, see the Rural Substance Use Disorder Toolkit.

Many philanthropies are interested in addressing substance use disorders by promoting prevention activities and increasing access to treatment and rehabilitation. For example, the Montana Healthcare Foundation makes investments targeting substance use disorders during pregnancy.

Resources to Learn More

Foundation Funding to Improve Rural Health Care
Provides examples of how foundations have supported efforts to increase access to care, implement alternatives to hospital services, and create telemedicine networks.
Citation: Health Affairs, 35(1), 174-5
Date: 1/2016

Government and Philanthropies Join Forces for Rural Health
Provides an overview of the first three annual meetings of the Rural Health Philanthropy Partnership, a collaborative group connecting foundation executives, federal government agencies, and other key rural health stakeholders.
Author(s): Cruger, B.
Organization(s): Rural Health Information Hub
Citation: The Rural Monitor
Date: 6/2015

Rural Health Philanthropy Partnership: Leveraging Public-Private Funds to Improve Health
This column describes two of the projects funded by the Rural Health Care Coordination Network Partnership Program (RHCCNPP) grant, which use two different care coordination models to bridge their regions' health equity gaps.
Author(s): Miller Temple, K.
Organization(s): Rural Health Information Hub
Citation: The Rural Monitor
Date: 5/2017