Human Services in Rural Contexts: Comprehensive Report

The purpose of this report is to contribute to a deeper understanding of human services programs in rural contexts by providing information on how human services function in rural contexts, the remaining need for human services in rural contexts, and the opportunities and challenges facing human services delivery in these rural contexts.

Overall, the study was able to draw the following conclusions:

• Social and well-being needs in rural contexts are intertwined. We identified needs across transportation, employment, mental health services, and reliable broadband internet. While urban communities may face similar needs, human services staff informed us that these needs are prevalent across rural communities.
• Federal and state requirements such as data collection, reporting, and restrictive eligibility requirements can be burdensome for human services program staff and can hinder time dedicated to the delivery of services that address remaining needs in rural communities. Local factors such as limited staffing and high turnover can also hinder effective service delivery.
• In rural contexts, organizations implementing federally funded human services can partner (either formally or informally) with other nonprofits to address many of the resource and capacity gaps in rural communities. In many cases, nonprofits with multiple funding streams (including non-federal sources) are less constrained by regulation regarding what services they can provide as well as the avenues through which they can seek and spend funding.
• While the level of remaining need for human services is consistently high across rural counties in the United States, there are 26 clusters or geographic concentrations of rural counites that have significantly higher needs than the average. These counties are in different rural regions and in different rural contexts, but we found that persistent poverty and state-administered systems (as opposed to state-supervised and county-administered systems) are more common in these clusters than we see in rural counties overall. The clusters are more likely to be in specific rural regions including Appalachia, the Colonias, the Delta, and Native Lands than rural counties overall. The clusters also seem to lack high levels of human services funding, but our statistical analysis was limited due to a general lack of funding across most rural counties in the United States. Although we found some associations with high remaining need for human services in rural counties, we did not identify any factors that fully explain why some counties have much higher remaining need than others.
• There are several lessons learned related to human services program delivery that can address remaining need for human services in rural contexts, including the following:
  • A tailored approach to service delivery can provide human services practitioners with an opportunity to address highly contextual implementation challenges.
  • During the COVID-19 pandemic, expanded resources and increased flexibility (both funding and programmatic) improved the ability of human services programs to meet the needs of rural communities.
  • Greater state technical assistance and support for collaboration across programs can improve program adoption and fidelity.
• Human services program practitioners can share several recommendations to mitigate barriers to access and improve capacity, including the following:
  • Unify human services in rural areas to mitigate barriers to access.
  • Understand and value local culture and knowledge in developing and delivering human services in rural communities.
  • Prioritize flexibility and allow for ad hoc adjustments in making local decisions.

To meet the study goals, we employed a mixed methods research design combining county-level data analysis with qualitative data collected from more than 100 interviews with human services program providers in 12 diverse rural counties.

Brimsek, Emily, James Murdoch, Emma Ward, Ashton Cain, and Neel Chakraborti (2023). Human Services in Rural Contexts: Comprehensive Report, OPRE Report 2023-030, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.