All of us, individuals and families, go through difficult and stressful times. They can be sudden and traumatic and requiring an immediate response, like a car accident or a house fire. Others are long-term troubles that can plague us for months or years, like a chronic illness or ongoing economic distress.

Communities and states suffer as well. North Carolina has centuries-long experience with the immediate aftermaths of hurricanes and flooding, and, millions of Tar Heels feel the ongoing impact of lost manufacturing jobs as we transition into a service-based economy.

There is more to come as urban North Carolina booms and rural North Carolina struggles.
Cumberland County has a population of almost 336,000 people with nearly two-thirds of them living in Fayetteville, making Cumberland a largely urban county. It is surrounded, however, by mostly rural counties that lack much of the basic infrastructure found in urban areas. The result is that people living in those counties do without or come to Fayetteville for critical services such as health care. This pattern is true across the state.

The North Carolina General Assembly is doing little to help.

It took the legislature 12 years — yes, 12 years — to expand Medicaid coverage even though the federal government covers about 90% of the cost. In the meantime, our state became #3 in the nation in rural hospital closures, losing 11 over the last two decades and with seven more in danger of closing.

This means that people living in rural counties must come to urban areas, like Fayetteville, for health care, and many of them simply go without. This is one reason that Methodist University and Cape Fear Valley Health are partnering to establish a medical school with the goal of providing more doctors to our state’s rural communities. (Full disclosure: I am a Trustee of Methodist University.)

Many rural North Carolinians do not have internet access, which means that parents drive their children to libraries and hot spots so they can do their homework and small businesses have little chance of competing successfully with those who do have access.

The General Assembly has protected large internet providers from competition municipal broadband, giving them little incentive to provide service to rural communities with small populations. Can anyone realistically expect rural areas to prosper when technology is leaving them behind?

And, then there is public education, which is largely funded by the General Assembly with tax dollars, with some federal money and county tax dollars added. The legislature has both slowed the growth of state public education expenditures and siphoned off state education dollars off to private, sometimes religious, schools under the banner of “school choice.”

Wealthier urban counties can afford higher levels of public school funding, but rural counties simply cannot, meaning that teachers make less and often leave, students have fewer educational opportunities and resources, and, often and sadly, more compromised futures.

To be fair, North Carolina is not unique. The imbalance of the “rich get richer and the poor get poorer” is occurring in urban and rural areas throughout the United States with varying degrees of severity and shows every sign of continuing.

That said, while the North Carolina General Assembly cannot unilaterally reverse much of this increasing inequity, it can address some of it and it should have.
It is deeply shameful that our legislators, those representing rural areas most affected and damaged, and those representing thriving urban areas with a wealth of resources, have chosen not to respond.