Rural America, as has been well documented, faces many challenges. Businesses and people are migrating to more urban and suburban regions. The extraction and agricultural economies that once helped them thrive—mining, tobacco, textiles—are dying. And, as we discuss below, residents of rural communities tend to be older, poorer, less credentialed in terms of their education, less healthy, and declining in population.

On a regular basis, political leaders on both sides of the aisle, and on national and state levels, make commitments to rural areas to help improve the quality of life for residents, to listen, and to help. Even with all the attention, many challenges remain, leading policy makers to ask: How can we help our rural communities?

In this Article we try to answer that question by looking specifically at the Commonwealth of Virginia, a state whose rural residents suffer disproportionately worse life outcomes than their counterparts in other parts of the state. While it is true, as we will show, that state leaders have paid attention to these challenges, it is equally true that many of the challenges facing rural Virginians persist.