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Rural Pain, Republican Gain
How the Republican Party Is Killing Rural America and Why Democrats Are Blamed
Brief Description
An eye-opening look at how Republican policies have affected health outcomes in rural communities and why poor, rural white voters are turning to the Republican Party—not despite this harm, but because of it. Over the last four decades, the health of rural Americans has been in...
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Rural Pain, Republican Gain
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Description
An eye-opening look at how Republican policies have affected health outcomes in rural communities and why poor, rural white voters are turning to the Republican Party—not despite this harm, but because of it.
Over the last four decades, the health of rural Americans has been in free fall. Just as opioid and gun deaths have ripped apart rural communities, hospitals have closed at alarming rates, leaving millions desperately far from care. At the same time, voters in struggling rural communities have increasingly come to vote for the Republican Party.
In Rural Pain, Republican Gain, Michael E. Shepherd demonstrates that these two trends are closely connected. At both the federal and state levels, the Republican Party has increasingly enacted policies that worsen rural health. Rural voters are not indifferent to this development (quite the contrary), but they misassign blame, in part, because the Democratic Party is more commonly associated with health-related policy initiatives and has ownership of health as an issue area. Republican politicians can reap rewards from their own destructive policies by appealing to the shared grievances of rural people.
Shepherd draws on new, wide-ranging data, including in-depth studies of the opioid epidemic, hospital closures, and COVID-19. In so doing, he quantifies the harm of Republican policymaking and its disproportionate effect on rural communities, recasting how readers understand growing Republican support among less healthy, lower-income rural white Americans.
Series: Chicago Studies in American Politics
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Book Details
INFORMATION
ISBN: 9780226851792
Publisher: The University of Chicago Press
Format: Paperback / softback
Date Published: 17 August 2026
Country: United States
Imprint: University of Chicago Press
Illustration: 23 halftones, 23 line drawings, 12 tables
Audience: Tertiary education, Professional and scholarly
DIMENSIONS
Width: 152.0mm
Height: 229.0mm
Weight: 454g
Pages: 352
About the Author
Michael E. Shepherd is an assistant professor at the University of Michigan, where he holds appointments in the School of Public Health and the Department of Political Science. The New York Times and Bloomberg have featured his research, and he has published op-eds in Jacobin and the Washington Post. He grew up in rural Kentucky, where he experienced firsthand many of the shifts that he describes in his research.
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