Andrew Carnegie Fellow on Rural America’s Vulnerability to COVID-19

Rural America faces unique demographic, social, and institutional challenges in coping with the coronavirus, according to University of New Hampshire demographer Kenneth Johnson

By Carnegie Corporation of New York May 29, 2020

Andrew Carnegie Fellows

Kenneth Johnson, 2016 Andrew Carnegie Fellow and professor of sociology at the Carsey School of Public Policy at the University of New Hampshire, has long been interested in population trends in rural America and their effects on policy. His demographic work has gained wider attention amid the COVID-19 pandemic’s spread to rural counties, whose older populations are far more vulnerable to the virus.

The Wall Street Journal recently featured an analysis written by Johnson looking at the implications for the pandemic’s spread into rural America. Johnson concluded that the virus could cause heavy damage in rural counties where underfunded health care systems may lead to higher death tolls than seen in metropolitan areas.

How did you come to study pandemics?

My research focuses on demographic change in rural America, which includes 46 million people spread over 72 percent of the U.S. land mass. As the SARS-CoV-2 pandemic has spread, attention has focused on urban America, where the bulk of the cases and deaths have occurred. Rural America is at considerable risk as well. While the incidence of the virus in rural America is currently modest, it is spreading rapidly. Rural America faces unique demographic, social, and institutional challenges in coping with the onslaught of the coronavirus. My research documents how the age structure of rural America increases the likely death rates from the coronavirus. The rural population is considerably older than the urban population. Mortality and the severity of the virus are both significantly higher among older adults. Nearly 55 percent of rural counties, compared to 22 percent of metropolitan counties, have estimated mortality rates among those infected significantly higher than the overall United States.

How did your Andrew Carnegie fellowship make possible the work that you are doing today?

My Andrew Carnegie Fellowship has supported my research on changes in the demographic structure of rural America and the implications of such demographic change. I have published numerous articles and research briefs based on my Andrew Carnegie Fellowship and have assembled substantial databases of demographic data that are immediately relevant to understanding the risks of the virus spreading to rural America. I have been able to use the data and expertise from my Carnegie Fellowship to examine the risks that the coronavirus poses to rural America and provide detailed empirical estimates of the relative mortality risks associated with the local age structure in each of the 3,141 U.S. counties.

With COVID-19, how do some of your findings apply? What should we be paying more attention to in the current crisis?

Key findings from my research include:
• The older age structure of rural America increases its vulnerability to the coronavirus.
• Rural exposure to the virus was limited early in the pandemic, but it is now spreading rapidly.
• Factors other than age also influence the vulnerability of rural areas to the virus.
• The fates of rural and urban American are intertwined, responding to the virus must take into account the needs of rural as well as urban America.

I have published a research brief focused specifically on the risks associated with the spread to rural America and two others addressing the demographic implications of the spread of the virus. I’ve also done a webinar on the subject and spoken to policymakers at the New Hampshire Department of Health, as well as many reporters about the impact and implications of the virus.

What has been the impact of your work to date?

My research provides timely information to health and policy planners about the impact of COVID-19 on an important part of America that generally receives little attention from the urban-centric media and policy elites. It aids in the development of treatment and prevention strategies to address the unique challenges rural America faces in mediating the virus there. Any virus-related changes that disrupt the infrastructure and supply chains of rural America has significant implications for the nation at large because it provides most of the country’s food and raw materials. To date, my research has been featured in articles in national and regional media including the New York Times.