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"Since 2010, 135 rural hospitals have closed and an additional 453 are vulnerable to closure," said Rural Development's Xochitl Torres Small as she testified recently before the Senate Ag Committee as they looked at opportunities and challenges in the rural care economy.

"The rest of the picture is similarly bleak," she continued. "There are fewer nursing homes in rural America, even though the average age in rural America is higher.  More than 60% of rural residents live in a mental health desert.  More than 60% of rural families also live in a child care desert."

Meaning areas that are lacking such facilities. The Under Secretary notes various ripple effects that are both economic, "when a sole community hospital closes, per capita income actually decreases by 4% and unemployment increases by 1.6%."

And social she added, such as lack of rural care for substance abuse and mental health issues.

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