What to do with rural Illinois—poorer, older, less educated and more ill than Illinois in general—has vexed policy-makers and politicians for decades. My solution was to write about it, often. Here the topic I health care, but it could be schools or roads or factories or small towns.
There are whole counties in rural Illinois that boast not a single resident physician. The doctor shortage reduces not only the life expectancies of our country cousins but their economic prospects as well; a BMW mechanic living in Carmi, for example, is as redundant as a camel driver in Nome.
A task force—a body that might be more accurately described as a tsk-tsk force—under the aegis of Lieutenant Governor George Ryan's Rural Affairs Council has pondered the dilemma of rural health care since 1988. It concluded in part that the answer is to bribe would-be medicos by making their location in country towns a condition of state scholarship aid.
If our young doctors are no better at distinguishing symptoms from diseases than is the Rural Affairs Council, Illinois' rural citizens might be better off if they were left doctorless. Rural Illinoisans are sick because rural Illinois is sick. Those who know about rural life only what they can see of it from the interstates imagine it as an enduring bucolic idyll. There, remote from the corruptions of the city, life goes on as God and Ronald Reagan meant for it to. Farmers say howdy to each other on their way to barn raisings, grandmothers deliver apple pies to shut-ins down the road, apple-cheeked youngsters bring home tadpoles from the fishin' hole, and old folks try to remember why Coolidge was a better man than Harding as they sun themselves on the courthouse square.
Never true, alas, at least never true everywhere in rural Illinois, nor for very long even where it was true. You must venture into the grimmest ghettoes of Chicago to find populations of Illinoisans who are poorer, sicker, less educated, or less gainfully employed than those who live in parts of rural Illinois. The only real difference between the alcoholism, child abuse, and mental aberration found in the country and that in the city is that the latter shows up on TV.
The fact is that most Illinois small towns are ugly and ill-shaped, served by aging and ill-financed infrastructure, and economically superfluous. (All but the last can be said about our cities too, but in the U.S.A. of the 1990s one out of three isn't bad.) Politically the small town remains potent, however, which explains the existence of the Rural Affairs Council and its offshoots such as the Institute for Rural Affairs that has been set up at Western Illinois University.
Official initiatives to save the small town, like recurring efforts to save the family farm, beg a much more interesting policy question, which is whether the nineteenth century rural social systems ought to be saved, at least in their traditional forms.
The appeal of the idealized small town for most Americans is that it harbors no insistent minorities, no dangerous social eccentrics, no political or religious nonconformists who might trouble the sweet repose into which the residents' brains have slipped. (The simplicity of small town life is mischaracterized; simple-mindedness is the motif.) The small town that shimmers in the memory of so many of us not-long-off-the-farm Mid westerners is the model for the exclusionist suburb that has replaced it as Illinois' preferred urban living place.
As for the rural economic role, what income growth has occurred there has come largely in the form of the paychecks earned in the city by exurbanite commuters and part-time farmers with town jobs. Few farmers make a living exclusively from farming anymore, and most of what they do earn does not enrich the local economy much, but passes through local middlemen into the vaults of the big oil and chemical companies and out-of-town banks. The successful family farmer is more essential to the economic health of Florida vacation and retirement resorts than he is to Illinois towns such as Swan Creek or Kempton.
What most rural Illinoisans reap these days is a harvest of government checks. Social Security retirement and disability funds, Medicare and Medicaid grants, welfare and food stamps, farm price supports and other farm subsidies. (The last will cost "only" $11 billion nationwide this year, brags the USDA.) In terms of "real" wealth, (as measured by the economist, that is, not by the husbandman) many of our rural counties are destitute. A hundred years ago it was the countryside that sustained the city, but today that relationship is reversed. Rural America—at least that part of it outside the commuting range of the big cities—would have been dead long ago were it not for the extraordinary life support measures applied by Congress and state legislatures.
A few critics have suggested that it's time to start pulling a few plugs. For example, Rutgers urbanologist Frank Popper argues that vast tracts of the rural U.S. have more people in them than their local economies can sustain. These people are the residuum of a vanished, people-intensive agriculture, and are often too old, too ailing, or too dim to make new lives elsewhere. (After a century and a half of out-migration, the gene pool in some places is pretty much dried up.)
According to Popper's "buffalo commons" thesis, many if not most rural small towns are as doomed as the bison herds that once roamed the prairies, and mostly for the same reasons. This conclusion draws gasps from audiences at save-the-small-town conferences—a reaction that suggests that Popper has cut painfully close to a truth that everyone understands but does not want to accept.
One approach is to do what we are doing now. The rural areas will atrophy in time anyway; although billions in subsidy will slow the process that (as the proposed incentives for rural doctors suggests) will only become more expensive for urban taxpayers. Another approach requires that the countryside be made more like the city, encouraging the shift of its economic base from farming to industry. Unfortunately, converting a dispossessed farmer into an industrial worker preserves the form of the small town but kills its essence. Besides, industry moves to southern Illinois for the same reason it moves to Singapore or Mexico, for the chance to exploit cheap, compliant labor; such companies are less dependable a benefactor than the weather on which the farmer relies.
Before we reinvest any more money in rural Illinois, we need to reinvent it. Some further urbanization is agreeable as well as inevitable, assuming it is controlled. The concentration of new light industry (including food processing facilities catering to nearby urban markets) in existing transportation corridors is one example of this, as is clustered residential developments that meet demands by exurbanites for rural space without decimating rural amenities.
Ultimately, the salvation of rural Illinois may require not that they be turned into imitation cities but that they become truer countryside. Wetlands restored for flood control will also revive sport fisheries. Scaled-back rural transportation networks means abandoned road and rail corridors that can be converted into hike and bike trails could link existing state parks to metropolitan centers via cross-country greenways. The "cross-compliance" principle endorsed by recent federal farm bills could be expanded to support income subsidies for fanners who agree to farm marginal lands using sustainable methods, etc. The results will be a rural Illinois that is greener and more scenically varied, where recreation (including vacationing) and tourism are industries, where farming is smaller-scaled and more diverse, where large tracts are allowed to revert to the kind of landscape that once entranced newcomers with its variety and wildness, a countryside in short that sustains the urban hunger for views and sport as well as food.
The key to developing rural Illinois, in other words, is undeveloping it. There is no lack of techniques to do it; other states have been experimenting for years. What is needed is a vision of a rural Illinois in which neither doctors nor their patients will have to bribed to live. □
Backward countryside, forward-looking state
April 19, 1990