I grew up in Robeson County in rural Southeastern North Carolina. One thing I remember about my upbringing is the close-knit community I had in my formative years, through my family and friends, my church, my hometown of Pembroke, and my Tribe, the Lumbee Tribe of North Carolina. As I entered my professional career in public health research, I began to realize that, despite this wonderful interconnectedness I was a part of, Robeson County had and continues to have an unfortunate distinction of being one of the unhealthiest counties in the state.1 I also learned about the relationship between poor health outcomes and adverse social determinants of health, such as persistent poverty, income inequality and income instability, inadequate quality education, social and environmental challenges, and a lack of access to health care resources.
Sadly, Robeson County is representative of many of the rural counties across the state. North Carolina has the second largest number of residents living in rural communities, and about three-quarters of the state’s 100 counties are designated as rural, with the number varying depending on which designation for rurality is used.2 For many of these rural counties, the situation is similar to what is experienced in Robeson County: poor health outcomes; challenges with substance misuse, violence, and injury; and a lack of local, state, and federal resources to address these issues. However, I have learned that, just like I experienced growing up in Robeson County, rural communities across our state are very resilient, utilizing available resources to their maximum capacity and relying on the good heartedness of the people to overcome obstacles.
In this issue, we celebrate the tremendous work going on across the state that identifies and addresses these obstacles. We also look forward to the future and how leaders across the state will utilize the unique characteristics of our rural communities—from the farmlands of Eastern North Carolina, to the beautiful mountains in the western part of the state, and all the rural communities in between—to implement the Rural Health Transformation Program to achieve the goal of eliminating rural health disparities. North Carolina has the potential to be a model for rural health care, so it’s time to seize the moment and recognize that the future is now!
Correspondence
Address correspondence to Dr. Ronny A. Bell, 301 Pharmacy Lane, 2211 Kerr Hall, Campus Box 7573, Chapel Hill, NC 27599 (bellr@unc.edu).