I grew up in rural America. My home county in South Dakota spans more than 2,800 square miles, larger than the state of Delaware, but its population density amounts to just one person per square mile. Imagine sharing the borough of Manhattan with only 22 fellow New Yorkers.
Rural life comes with strengths and challenges. Distance shapes everything from access to healthcare to education to economic opportunity. These realities are not theoretical to me; they shape the work I do every day.
I work in philanthropy and have spent much of my career focused in healthcare. More than 15 years ago, the foundation I work for opened an office in my home state and hired a team with lived rural experience. It was a rare and deliberate move in a field still largely shaped by urban-centric perspectives.
But despite some progress, the disparity between rural needs and philanthropic attention remains striking.
Now more than ever, there is an opportunity to change this dynamic.
A decade ago, a study by the USDA’s Economic Research Service found that rural areas received just 6-to-7% of grant dollars from large foundations, even though rural Americans make up nearly 20% of the population. Preliminary findings suggest that number may have dropped to just 3%.
Inside Philanthropy’s 2023 rural philanthropy report described a similar picture, noting that despite some gains, overall investment in rural regions remains disproportionately low. The report highlights approaches, from pooled funds to rural-serving intermediaries, that are helping to bridge the gap. These innovations point to what’s possible when philanthropy intentionally builds infrastructure designed for rural contexts.
The stakes are high amid ongoing uncertainty over federal aid and the growing complexity of rural needs.
Federal partners continue to invest in rural communities through programs that expand access to care, strengthen local systems, and support innovation. But federal investments alone are not enough. Rural leaders and communities need predictable partnerships, aligned timelines, and sustained local capacity so they can successfully pursue and implement these opportunities.
In philanthropy, we often talk about the importance of “lived experience.” Baljeet Sandhu’s work on the subject outlines its value: Lived experience brings legitimacy, relevance, and accountability to grantmaking. It drives better decision-making and more authentic community partnerships because residents best know their needs.
Yet when it comes to rural lived experience, there is still room for philanthropy to go further.
I’ve seen requests for proposals with population minimums that automatically exclude most rural communities. I’ve also heard assumptions that models tested in large cities will translate easily to places with far fewer resources, different infrastructures, and greater distances between services. In some cases, these approaches reflect an incomplete understanding of rural partners and the assets they bring.
To their credit, some foundations are working to change this by incorporating lived experience more directly into their grantmaking. They are supporting proximate leaders, implementing participatory grantmaking, and partnering with rural-serving intermediaries. Some are also hiring staff with rural roots to serve as field coordinators and community officers. These are encouraging steps, but they remain the exception rather than the norm.
Being grounded in rural is a strength.
A recent Inside Philanthropy column noted that positive impact comes when philanthropy works with, not around, rooted leaders. Hiring people with rural roots allows grantmaking decisions to be informed by those who understand rural challenges and opportunities.
However, many foundations still require staff to work from urban offices or live near major airports, criteria that virtually ensure rural professionals are excluded.
According to the U.S. Census Bureau, nearly 60% of young adults live within 10 miles of where they grew up. And rural residents are even less likely to move. If philanthropy wants rural insight at the table, it needs to make space at the table through remote work policies, satellite offices, and a commitment to hiring rural talent.
All of this comes amid ongoing challenges.
From broadband access to education to health outcomes, rural America continues to lag behind urban areas. Philanthropy can help close these gaps and complement public investment.
The data on rural funding should not just be a report; it should prompt honest reflection and action. As foundations take stock of their impact and reach, they should ask themselves: Are we funding rural communities in proportion to their need and potential? Are we hiring people who understand rural life from lived experience? Are we willing to invest in places that are often overlooked, but never unworthy?
Rural leaders and communities are proving that constraint can be a catalyst for creativity. Every day, they build solutions despite fewer resources and greater distances between people and services. From health system redesigns to telehealth networks and locally driven workforce programs, rural innovators are developing models that can benefit the entire nation.
Rural America is not asking for special treatment. It is asking for philanthropy to recognize that investing in rural communities is an investment in the nation’s future.
But that requires commitment: to see rural communities clearly, to hire people who understand them, and to fund the solutions they are creating.
Dr. Elizabeth Ruen was born and raised in rural South Dakota and is a Program Officer for the Helmsley Charitable Trust’s Rural Healthcare Program.
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