
Communities and regions do better as more and more local people – from newcomers to long-time residents – are in the position to pursue their aspirations; contribute to civic life, culture, and the economy; and realize their full potential. In any community, residents have varying knowledge, skills, and economic status, and striving families and individuals encounter life situations, policies, and behaviors that can either facilitate or impede them from thriving.
Community governance, leadership, and local organizations must work together to improve the well-being of all residents, especially those who lack sufficient housing, health, workforce preparation, transportation, safety, and other factors critical to well-being. This includes examining and removing all discriminatory barriers to personal and family advancement based on personal characteristics such as socio-economic class, gender, identity, race, country of origin, religion, or place of residence.
Building Block Evidence
Evidence suggests this building block is important because our well-being is determined in part by economic, social, and environmental factors that shape our health,1,2 including in rural communities.3 Experts note that our well-being depends on our good health, positive social relationships, and availability and access to basic resources (e.g., shelter, income).4 Higher levels of well-being are associated with many benefits, such as lower risk of disease and speedier recovery when we are sick; longer life; higher productivity; and higher likelihood of contributing to our communities.4,5 Wealthy countries with greater well-being tend to have greater equality between population groups and fewer people living in deprivation.6
Rural communities are unique in terms of geography, as well as experiences of wealth, income, and poverty; education and labor markets; and transportation.7 Historically, rural communities have been under-resourced in addressing many of these areas, which are important determinants of health.7 However, rural areas also have important assets, such as the natural environment.3 Research finds that living near natural outdoor environments (green and blue spaces) might help reduce stress, promote physical activity and social relationships and potentially improve human health and well-being.8,9 Rural areas may also have greater housing space, food security, and social capital compared to urban areas.3 Aspects of social capital, especially relationships with family and friends, are positively associated with mental well-being for older adults.10
Studies of people living in rural areas tell us more about what predicts well-being. For many rural individuals and communities, health and well-being have been greatly influenced by the “loss of land rights, natural resources and the distortion of physical environments coupled with histories of trauma and profound loss (related to “legacies of enslavement and forced assimilation”).7 Research shows that across urban, rural, and remote settings, racial discrimination affects health and wellbeing, with a strong and consistent link between experiencing racial discrimination and poor mental health and birth-related outcomes.11 Well-being is also linked to a sense of belonging (see also, A: Welcome All to the Community) in rural communities, including among immigrants12 and adults with disabilities who are receiving long-term services and supports.13 For adults with disabilities, inclusiveness, and accessibility of community spaces and activities contributes to fostering a sense of autonomy and self-determination.13
Rural policy frameworks call attention to the need for supports for well-being like technology and digital innovations, and considerations for building the skills and capacity of current residents, as well as ways to attract new residents.3 A policy response with a focus on raising living standards and reducing inequalities could advance well-being in rural areas.3
- Healthy People 2030
- RHI Hub: Social Determinants
- OECD 2020
- CDC-Well-Being Concepts 2018
- Lyubomirsky 2005
- OECD-Better Life
- National Advisory Committee (NAC) on Rural Health and Human Services 2017
- Gascon 2017
- Houlden 2018
- Nyqvist 2012
- Priest 2013
- Caxaj 2017
- Thurman 2019
Curated Resources

Reproductive Healthcare: An Intersectional Component of Healthy Rural Communities
Just like other momentous occasions in history, a likely topic of future conversations is “Where were you when the Supreme…

Opportunity Makers: Melding Health and Equity in Rural Places
Nov. 10th, 2020, 3PM
POWERPOINT FOR ROADS 4 Hospitals and clinics are critical institutions in rural places not only because they provide essential healthcare…

Creating A Force Multiplier – Why Advocates for Rural Health and Health Equity Should Work Together
Rural health disparities are well documented, as are racial and ethnic health disparities (Agency for Healthcare Research and Quality 2020). Evidence suggests that we have made little progress in closing these gaps over time, and in some cases disparities have widened, in spite of numerous efforts and improved health and quality of care for everyone…

Rural Public Health and Health Care: A Scan of Field Practice and Trends
This field scan is a contribution to Thrive Rural, specifically intended to provide an understanding of the state of relevant…
Field Items
We see the framework as a living document, which necessarily must evolve over time, and we seek to expand the collective ownership of the Thrive Rural Framework among rural equity, opportunity, health, and prosperity ecosystem actors. Please share your insights with us about things the framework is missing or ways it should change.