Why does rural health remain underfunded - even when everyone agrees it matters?

In this opening monologue of Rethinking Rural Health Financing, Chinasa Imo sets the stage for a bold new podcast series that interrogates one of the most overlooked drivers of health inequity: how money moves, who controls it, and who is left out.

This episode challenges the assumption that rural health struggles are simply about distance, infrastructure, or workforce shortages. Instead, it asks harder questions about power, priorities, and financing decisions that consistently place rural communities at the margins of health systems.

From under-resourced clinics and unpaid health workers to donor dependency, political neglect, and the hidden costs rural families shoulder just to access “free” care, this monologue reframes rural health as a financing design problem, not a service delivery failure.
This series will explore:
Why rural health is chronically underfunded
How financing models exclude rural populations
The role of governments, donors, and private investment
Why rural communities pay the most for the least care
What equitable, dignity-centred rural health financing could look like

Rethinking Rural Health Financing is not about easy answers. It’s about asking the questions we avoid - and centring rural lives in global health conversations where they are too often invisible. Listen, reflect, and join the conversation.

Want to be a guest on What About Rural Health?™? Send Chinasa Imo a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/chinasaimo

In Part Two of Resettled and Forgotten, Dr. Jessica Darrow unpacks what actually exists behind refugee and immigrant resettlement in the United States—and where the system still falls short.

She explains the structures currently in place for refugee support across healthcare, housing, and social services, highlighting how government agencies partner with NGOs and caseworkers to provide entitlements during resettlement. Yet, despite these frameworks, real challenges persist, especially in communities facing limited resources.

Dr. Darrow challenges the “refugee versus citizen” narrative, arguing that equitable healthcare and social protection require a shared community identity, one rooted in collective care rather than division. She emphasises that the gap between rural and urban healthcare resources in the U.S. is profound, noting that inequitable access is not only a refugee issue but a rural health crisis affecting everyone.

Resettlement, she reminds us, is a process, not a destination. The funding structures that support it, often tied to performance-based contracts for work placement and healthcare access, reveal deeper tensions in how care is delivered.

To move toward a rights-based health system, Dr. Darrow calls for a shift in mindset: those born into high-resourced environments have a moral responsibility to advocate for the rights and dignity of all people, everywhere.

Want to be a guest on What About Rural Health?™? Send Chinasa Imo a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/1762029634065133df1c28412

What happens after people flee violence, climate disasters, and instability — and where do they go when the headlines fade?

In this episode of What About Rural Health, we sit down with Dr. Jessica Darrow, Associate Instructional Professor at the University of Chicago Crown Family School of Social Work, Policy, and Practice, to unpack the hidden layers of the global refugee and migration crisis, especially as it intersects with healthcare in rural and underserved communities. Dr. Darrow challenges the way migration is often framed, pointing out that climate change is an overlooked driver of displacement, even though those affected are rarely recognized as refugees under international definitions. She also highlights a troubling global paradox: as migration increases, borders are becoming more militarized and closed.

Drawing on global perspectives from Kenya, Germany, and the United States, this conversation explores a powerful shift in thinking, from viewing healthcare as a limited resource to recognizing it as a fundamental human right. Dr. Darrow explains how this lens changes how refugee and host communities are treated, supported, and integrated.

We also examine the gap between policy and practice, where national frameworks often fail to reflect the realities faced by communities on the ground; particularly around mental health, social welfare, and long-term stability.
This episode invites us to rethink care, belonging, and responsibility in a world on the move, and asks a crucial question: who gets to feel at home, and who gets left behind?

Listen, reflect, and join the conversation.

Want to be a guest on What About Rural Health?™? Send Chinasa Imo a message on PodMatch, here: https://podmatch.com/hostdetailpreview/1762029634065133df1c28412