The share of rural Americans who live in communities without a hospital grows each year. It’s part of an ongoing collapse in rural health care that has persisted for decades and isn’t improving, despite regulatory efforts to shore up small-hospital finances.

Since 2010, about 150 rural hospitals have shuttered and hundreds more have slashed services, leaving a growing number of America’s 60 million rural residents in health care deserts.

In this 2020 encore episode of the “Tradeoffs” podcast, Dan Gorenstein talks with KFF Health News chief rural health correspondent Sarah Jane Tribble about her yearlong effort to document the collapse of one rural Kansas community hospital. Nearly six years later, the residents of Fort Scott, Kansas, still live without a local hospital, a reality visited upon dozens more small towns in the years since.

“We’re talking about millions of lives affected by the kind of health care delivery that’s in these communities,” Tribble said. “Rural America, on a whole, is poorer, sicker and older than urban America. People whose lives are affected daily by chronic health issues.”