Impacts of Extreme Heat on Rural Communities
46 million rural Americans face mounting risks from temperature extremes that threaten workforce productivity, raise business operational costs, and strain critical public services. Though extreme heat is often portrayed in research and the media as an urban issue, almost every state in the contiguous U.S. has rural communities with above-average rates of vulnerability to extreme heat. To protect rural America, Congress must address extreme heat’s impacts by repairing rural health systems, strengthening the preparedness of rural businesses, and hardening rural energy infrastructure.
Extreme heat exacerbates rural communities’ unique health vulnerabilities
On average, Americans living in rural areas are twice as likely as those in urban areas to have pre-existing health conditions, like heart disease, diabetes, and asthma, that make them more sensitive to heat-related illness and death. Further compounding the risk, rural places also have larger populations of underinsured and uninsured people than urban areas, with 1 in 6 people lacking insurance.
Limited healthcare infrastructure in rural places worsens these vulnerabilities. Rural areas have higher shortages of healthcare professionals who provide primary care, mental health, and dental services than urban areas. Over the last decade, 100 rural hospitals have closed, and hundreds more are vulnerable to closure. Finally, many rural communities do not have public health departments, and those that do are underfunded and understaffed. Because public health systems and healthcare professionals are the first responders to extreme heat, rural residents are severely underprepared.
Congress should provide flexible resources and technical assistance to rural hospitals to prepare for emerging threats like extreme heat. Additionally, Congress should continue to enable the U.S. Department of Agriculture and the Department of Health and Human Services to provide loans or grant assistance to help rural residents retain access to health services and improve the financial position of rural hospitals and clinics. And because Medicaid expansion correlates with better rural hospital financial performance and fewer closures, Congress should invest in Medicaid to protect rural healthcare access.
Extreme heat puts rural businesses and workers at risk
Rural economic health relies on the outdoors (e.g., recreation tourism) and outdoor labor (e.g., agriculture and oil and gas extraction). Extreme heat in many of these places makes it dangerous to be outside, which impacts worker productivity and local business revenues. Indoor workers in facilities like manufacturing plants, food processing, and warehouses also face heat-related safety threats due to the presence of heat-producing machines and poorly ventilated buildings with limited cooling. These facilities are rapidly growing components of rural economies, as these sectors employ almost 1 in 5 rural workers.
Simple protections like water, rest, shade, and cooling can improve productivity and generate returns on investments. But small-to-medium rural enterprises need support to adopt affordable cooling systems, shade and passive cooling infrastructure, and worker safety measures that reduce heat-related disruptions. Congress should help rural businesses reduce heat’s risks by appropriating funding to support workplace heat risk reduction and practical training on worker protections. Additionally, Congress should require OSHA to finalize a federal workplace heat standard.
Extreme heat threatens rural energy security
When a power outage happens during a severe extreme heat event, the chance of heat-related illness and death increases exponentially. Extreme heat strains power infrastructure, increasing the risk of power outages. This risk is particularly acute for rural communities, which have limited resources, older infrastructure, and significantly longer waits to restore power after an outage.
Weatherized housing and indoor infrastructure are one of the key protective factors against extreme heat, especially during outages. Yet rural areas often have a higher proportion of older, substandard homes. Manufactured and mobile homes, for example, compose 15% of the rural housing stock and are the one of the most at-risk housing types for extreme heat exposure. When the power is on, rural residents spend 40% more of their income on their energy bills than their urban counterparts. Rural residents in manufactured housing spend an alarming 75% more. Energy debt can force people to choose between paying for life-saving energy or food and key medications, compounding poverty and health outcomes.
To drive the energy independence and economic resilience of rural America, Congress should support investments in energy-efficient and resilient cooling technologies, weatherized homes, localized energy solutions like microgrids, and grid-enhancing technologies.
To protect rural America, Congress must address extreme heat’s impacts by repairing rural health systems, strengthening the preparedness of rural businesses, and hardening rural energy infrastructure
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