Survey highlights pandemic’s effects on mental and physical health in rural Iowa

A street in Corning, Iowa, along which stand several local businesses

Corning was one of 73 Iowa towns included in a survey gauging the effects of the pandemic in rural communities. Photo by Kimberly Zarecor. Larger image.

AMES, Iowa – The pandemic has taken a steep toll on mental health in many of Iowa’s rural communities, according to survey data gathered by an Iowa State University rural sociologist.

The pandemic strained the mental health and personal relationships of many rural Iowans, while residents in larger towns tended to report physical health and economic challenges with greater frequency, according to the survey data collected between December 2020 and February 2021. The results illustrate how the pandemic impacted communities in different ways and can inform how public policies are constructed to address these challenges, said David Peters, a professor of sociology at Iowa State University who led the survey effort.

“We know all towns aren’t the same and didn’t experience the pandemic the same way,” Peters said. “Different communities have different needs, so you need a range of programs to help small towns recover from the pandemic.”

The survey asked respondents in 73 Iowa communities to evaluate how the pandemic has affected various aspects of their lives, including their physical and mental health as well as their financial situation. The survey also asked questions regarding respondents’ perceptions of the pandemic and the government response to the public health crisis. The results, including an overall report and statistics for individual communities, are available for download on the Iowa Small Towns Project website.

Survey results

The researchers broke down the survey results by community population, revealing trends that mark how the pandemic affected smaller communities differently than larger ones.

The survey found respondents in the smallest towns were more likely to report worsening mental health and relationships as a result of the pandemic than they were to report worsening physical health. For instance, about 20 percent of respondents in towns with populations under 3,000 reported that their physical health is worse off as a result of the pandemic, but about twice as many respondents in such communities reported worsening mental health. Nearly 40% of respondents in towns smaller than 3,000 also reported that the pandemic had worsened their relationships with close friends.

Economic impacts were relatively less widespread in the smallest communities, according to the survey. For instance, fewer than 5% of respondents in the smallest communities reported their housing situation worsened, and just over 15% said their employment situation was worse off.

In larger communities and in towns with meatpacking facilities, however, more respondents said their physical health and economic situation took a toll as a result of the pandemic. For instance, about a quarter of respondents from communities identified as meatpacking towns said their physical health was worse off and about a third of respondents in meatpacking towns said their personal financial situation had worsened.

The four meatpacking towns included in the surveys were Columbus Junction, Storm Lake, West Liberty and Denison, all of which have minority populations that exceed 60% of the total community population. Peters said minority populations and meatpacking workers tended to suffer heavier burdens due to the pandemic, which is reflected in the survey data. The researchers worked with partner organizations such as the League of United Latin American Citizens and Solidarity with Food Processing Workers to reach residents in the four meatpacking towns to ensure vulnerable populations were properly represented in the results.

The relatively low percentage of respondents who reported the pandemic worsening their physical health may appear to suggest the pandemic was not as severe in rural Iowa, but Peters said per capita mortality rates derived with CDC data don’t bear that out. Rural counties in Iowa with a town of 2,500 or more suffered 270 COVID-19 deaths per 100,000 residents, higher than the national rate of 225. Mortality rates reached 290 deaths per 100,000 residents in rural counties that have no town with a population of 2,500 or more. Peters said many rural residents may believe their communities to be less vulnerable to the coronavirus because of their relatively low population density.

“There’s this perception that people in smaller and rural communities, somehow because of their low density, COVID-19 doesn’t impact them,” he said. “We found there were different impacts. In smaller towns, physical health and economic health were less of a concern, but there are definitely mental health impacts.”


Peters and his colleagues received a grant from the National Science Foundation to conduct the survey, which reached nearly 14,000 households in 73 Iowa communities. More than 5,000 Iowans responded to the survey for a response rate of 38.2%. The survey has a margin of error of plus or minus 1.77% in towns under 3,000, plus or minus 3.8% in towns with populations of 3,000 to 4,999, plus or minus 3.47% in towns of 5,000 or more and plus or minus 3.01% in meatpacking towns.

Nicole Novak, a research assistant professor of community and behavioral health at the University of Iowa, and Mark Berg, an associate professor of sociology at the University of Iowa, also contributed to the project.