Fall 2025 Issue

Rural Social Work: The Impact of Rural Social Work
By Sue Coyle, MSW
Social Work Today
Vol. 25 No. 4 P. 8

Rural social workers can help bridge the gap between communities and resources.

When Peg Munke, PhD, MSW, BSW, program director at Murray State University in Murray, Kentucky, and outgoing president of the National Rural Social Work Caucus, transitioned from working in a city to a rural area, it was a bit of an adjustment. “I was working in San Antonio, but I was hired by two rural probation districts. I was amazed at the differences between the way things operated in rural areas and how things operated in urban San Antonio. I felt kind of at sea,” she remembers, “because I wasn’t prepared to do rural social work.”

While the location of where a social worker is does not change the core principles and ethics of the services provided, geography and setting do have an impact. Rural social work differs from its urban and suburban counterparts. For social workers in rural areas to be truly effective, they must understand not only the need for their presence but also the challenges and benefits that they will encounter. When they do, they will recognize how important rural social work can be.

Addressing Needs
Rural areas in the United States are like any other in that the communities and individuals within them may struggle with physical and mental health needs, substance use, domestic violence, hunger, unemployment, and more. However, where they differ, at least in part, is that finding resources to meet those needs can be uniquely challenging in rural regions. While city facilities may have waitlists and overcrowding, some rural counties may lack providers altogether.

For example, many rural communities are considered health care deserts, despite having a high need for quality and close health care professionals. The National Rural Health Association (NRHA) reports that there are just “68 physicians per 100,000 people compared to 80 in urban areas. This shortage underscores the struggle to access vital medical services, particularly specialty care.”1

NRHA further notes that “Many rural areas are located far from medical facilities, making it difficult for residents to access timely care, especially with limited public transportation. Additionally, rural communities often face higher rates of poverty and unemployment, which can impact residents’ ability to afford services and secure transportation.”1

Access to health care is likely to worsen in the coming years, as well. The One Big Beautiful Bill Act is expected to lead to the closure of a number of rural hospitals due to cuts in Medicaid funding. Additionally, analyses of the bill predict that more than 10 million Americans will lose their health insurance, according to the Congressional Budget Office. While that number is not exclusive to rural communities, it does include them.

Munke adds that these closures do not happen in a vacuum. “When rural hospitals close, that’s bad enough, but often when they close some services, [more follow]. For example, if you lose your OB/GYN services, you’re also very likely to lose your pediatricians. The emergency room is also a loss leader. When those close, you don’t have the social worker in there who understands all of the services that people can apply for and get and walk them through the process.”

Similarly, rural communities have fewer mental health providers. In 2020, researchers found that “as many as 65% of nonmetropolitan counties do not have psychiatrists, and over 60% of rural Americans live in designated mental health provider shortage areas.”2 For social workers specifically—not just those working in mental health care—it is estimated that there are 96.4 social workers per 100,000 people in urban areas vs just 57.7 in rural counties.

These shortages persist across multiple facets of life, including transportation and access to food. Feeding America notes that “Rural areas comprise less than two-thirds of all US counties, but nine out of 10 counties with the highest food insecurity rates are rural.”3 Again, food insecurity is expected to worsen with the passage of the One Big Beautiful Bill Act, as millions become at risk of losing their SNAP benefits.

The lack of accessible resources can exacerbate the impact of any concern or challenge, which in turn exacerbates the need for quality support services such as those from a social worker.

Facing Challenges
However, the challenges residents face in accessing services also affect the providers. Rural social workers are not without obstacles. For instance, “In rural communities, there may be only one social worker covering a vast geographic area, and that professional often wears many hats—providing clinical services, case management, and community-level advocacy all at once,” says Rachel Forbes, MSW, a professor of the practice of social work and Western Colorado MSW Program director at the University of Denver Graduate School of Social Work.

A part of those services typically involves finding resources. As noted, “Resources are typically fewer, which means rural social workers must be especially creative in finding solutions and often rely heavily on collaboration with schools, nonprofits and local leaders,” Forbes adds.

Munke notes that when resources are available, they aren’t necessarily convenient. “You’re very much less likely to have access on site or in the communities to [a lot] of resources without driving quite a distance,” she explains. “Many clients can’t afford to [make that drive] or don’t have transportation or time, so you learn about the natural helping networks within the community.”

Focused on Benefits
The benefits, however, of being a rural social worker, outweigh the challenges, say Munke and Forbes, both of whom are clearly passionate about the rural communities they help serve.

For one thing, social workers are more visible and well-known in rural areas. While that means they must be even more vigilant about boundaries, it also means an opportunity to foster deep connections with the individuals and communities served. “In rural practice, you’re not a distant professional; you are a neighbor, a community member, someone who’s deeply invested in the well-being of the place you live,” Forbes says. “That creates opportunities for meaningful relationships that fuel long-term change. Rural social work shows how our profession’s competencies—engagement, advocacy, collaboration—are truly lived out in practice.”

It also gives social workers the opportunity to see how communities can work together to, if not overcome, lessen an obstacle for an individual or the community as a whole. “You would be amazed at how communities come together to help each other and solve their problems. It doesn’t make up for the lack of funding, but [the lack of funding] doesn’t mean that rural areas are resourceless. People have always been problem solvers. They’ve always been creative, and this has continued,” Munke says of rural communities.

In creating those connections and becoming more aware of the community, rural social workers then have the opportunity to truly recognize the difference that can be made. “Rural social workers often see the impact of their work ripple out beyond individuals and families to affect the whole community,” Forbes says. “Because communities are smaller and more interconnected, building trust with one partner—say, a school principal or a clinic director—can lead to collaborations that touch hundreds of lives. Rural social workers help weave together networks of support, strengthening the overall resilience of their towns and regions.”

Preparing Rural Social Workers
Such benefits emphasize the importance of preparing social work students—whether they come from rural areas or are simply interested in working in one—for rural social work. To do so, schools must consciously incorporate programs and curriculum or, at minimum, discussions about rural social work and how it may differ from other settings.

To an extent, this is already happening. For example, “At the University of Denver’s Western Colorado MSW Program, we use a place-based educational model. Students live and learn in the rural and mountain communities they’ll serve, completing field internships in local schools, clinics, and nonprofits. This approach allows students to experience the unique dynamics of rural practice firsthand while also building the relationships that are essential to success. It also reflects one of the greatest lessons of rural social work: the importance of collaboration and partnerships,” Forbes describes.

Even where there are no programs in place for rural-specific educational opportunities, Munke says there are professors who will focus on it. “I think from people who have an understanding and a background in rural, even if they teach in urban programs, there probably is [class discussion]. They teach the comparisons.”

As for schools in rural areas, they might have a majority of students who want to remain rural throughout their career, and that can help open the door to more conversations about rural social work. “What you find is that with people from rural areas,” Munke says, “they really want to serve their rural areas, and it’s not just because it’s home. They want to bring back to where they grew up and where they live everything that they have learned to make their area better. There’s a sense of place, a strong sense of wanting to do well by my community.”

And for them, as students and as professionals, she continues, “There is no money and no job that could tempt them to go elsewhere.”

— Sue Coyle, MSW, is a freelance writer in the Philadelphia suburbs.

References
1. National Rural Health Association (2024, September 9). Bridging the Gap: Addressing Health Inequities in Rural Communities. https://www.ruralhealth.us/blogs/2024/09/bridging-the-gap-addressing-health-inequities-in-rural-communities

2. Morales DA, Barksdale CL, Beckel-Mitchener AC. A call to action to address rural mental health disparities. Journal of Clinical and Transitional Science. 2020;4(5):463-467.

3. Hunger in rural communities. Feeding America website. https://www.feedingamerica.org/hunger-in-america/rural-hunger-facts. Updated 2025.