Author:Tuccille, J.D.

WHAT COULD EXPLAIN the tumbleweeds rolling through the corridors of my wife's usually bustling pediatric practice for one week each May? It's entrepreneurial spirit.

Few things motivate the local kids to suppress their usual sniffles and complaints like the annual fair, when their longtime 4-H and FFA (formerly Future Farmers of America) projects come to fruition. All that time, sweat, and energy expended by them (and, too often, their suffering parents) in raising rabbits, lambs, goats, poultry, and steers find their reward at the livestock auction, from which the kids depart with hard cash and the buyers end up with freezers full of meat. It's a demonstration not just of animal husbandry but of an entrepreneurial spirit that's at odds with the Hillbilly Elegy-esque dysfunction we're told to expect of locales outside city limits.

Not that rural America's problems are imagined. Opiate use is big across the country and bigger still in non-urban environs. "While all states have reported increases in opioid mortality and injury, the largest increases are reported in heavily rural states," the National Rural Health Association reported last year.

Unemployment and poverty are definitely pressing concerns as well. The pool of rural jobs continues to be smaller than it was in 2008 before the Great Recession. And the incidence of poverty is higher in rural than urban environments, according to the Department of Agriculture's Economic Research Service.

That said, the poverty rate is declining (from 16.5 percent in 2010 to 15.8 percent in 2016), and the contrast is nowhere near as stark as it once was. "The rural-urban poverty gap has narrowed... from 17 percentage points in 1960 to 3.6 percentage points in 2016," the Department of Agriculture continues.

Maybe one of the factors narrowing that gap is the sort of entrepreneurialism demonstrated by the epidemic of healthiness among my wife's patients.

"It is in fact nonmetropolitan counties that have higher rates of self-employed business proprietors than their metropolitan counterparts," an academic publication called The Conversation noted last year after surveying social scientists and crunching Census Bureau data. Urban entrepreneurialism is concentrated in counties of 1 million or more people, with 131 self-employed proprietors (measured by IRS tax status) per 1,000 residents. Rural counties, on the other hand, become more entrepreneurial as their populations get smaller and more removed...

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