Research with rural populations shows that small towns aren’t always better for health equity.

By Anjulie Rao

As part of an ongoing effort to make content more accessible, LAM will be making select stories available to readers in Spanish.

Backdropped by the COVID-19 pandemic, the shift of city dwellers to rural home buyers has been framed as a panacea to the health risks posed by dense urban environments. But rural towns often present invisible, compounding health risks, especially to their most vulnerable residents, says Ben Shirtcliff, an associate professor of landscape architecture and urban design at Iowa State University.

Shirtcliff has devoted his career to studying underrepresented and vulnerable populations in the built environment—primarily young people—and his recent study, “Crosscutting Environmental Risk with Design,” was published in the journal PLOS ONE. In it, he and his fellow researchers—Rosie Manzo, a graduate student in landscape architecture, and Rachel Scudder, a graduate student in community and regional planning—investigated the risk of exposure to pollutants and its relationship to the infrastructure that might support those communities.

Since arriving in Iowa in 2014, Shirtcliff says he has found a research gap in rural landscape studies, primarily in areas that have seen a growth in migrant workers from places such as Mexico and Central America over the past 20 years. Though literature exists about historic “gateway communities” in California, Arizona, and Texas, newer rural migrant populations in the Midwest have only become of interest to research funders in the past decade, he says, when organizations such as the National Institutes of Health classified rural, underrepresented communities as a federally funded research base. “I had to start from building a basis: What does vulnerability look like in small towns?” he says.

Shirtcliff studied three rural Iowa towns proximate to Iowa State’s base in Ames—Perry, Ottumwa, and Marshalltown—that have a growing migrant workforce and changing economic resources, to better understand intersecting risks of environmental pollutant exposure and social vulnerability.

The researchers used a transect methodology. This approach to sampling, Shirtcliff says, is derived from ecological studies and, in an urban context, is used to “cut through” political and ideological conditions in different locations such as redlining, income levels, school districts, and more, to “see the actual relationship, from a public health perspective, that people have with the land.” His research team found that environmental risk from pollutants was not consistent within the three towns, and in some cases risks of exposure to substances like diesel, lead paint, cancer-causing air toxins, and chemical accidents was substantially higher than state averages. They used publicly available data from the Environmental Protection Agency’s Environmental Justice screening and mapping tool that uses demographic vulnerability indicators such as age, income, racial or ethnic identification, education, and linguistic isolation, along with environmental indicators for toxicity and proximity measures for air, waste, water, and soil. They combined these data sets with data from physical and social condition measurements from the three towns, and analysis found what Shirtcliff calls “a double threat,” attributed to the social and economic conditions of migrant workers.

The study illustrates an urban–rural paradox: “When you think about the exposures that happen in urban areas, there’s hopefully more political power for underrepresented communities to advocate for safer, cleaner urban environments, but you just don’t see that happening in rural towns,” Shirtcliff says. Cities, with higher tax bases and density, generate more reporting around environment-related health outcomes and can address those issues with mitigating landscapes. In contrast, Shirtcliff says, rural areas experiencing dwindling tax bases often lack basic health care infrastructure, much less the means to invest in health-promoting landscapes. They also lack the density that might aid health-impact reporting, making small towns appear safer and less in need of intervention than their urban counterparts.

The paradox is further exacerbated by climate change, which can affect small Midwest towns as well as coastal cities in the form of flooding. In large cities like New York, which is currently embarking on mega-landscape projects to protect its coasts from rising sea levels, capital investments can help prevent climate change and improve health. The smaller, more rural Perry, Ottumwa, and Marshalltown don’t have the funding or tools to mitigate against their climate change effects, outside of using what Shirtcliff calls “aggressive” measures such as increased pesticide and fertilizer use—measures that are more likely to expose these vulnerable populations to toxicity.

What Shirtcliff wants landscape architects to draw from the study isn’t only that rural areas are in need of reparative landscapes, but that small-scale interventions can be just as influential on public health. One example highlighted by the study is the lack of privacy experienced by vulnerable populations, which can increase stress factors and human weathering that affect health outcomes. This issue can be prevented with intentional tree and garden plantings that can provide a sense of privacy and security, as well as visual interest, and can serve vulnerable families in healing from traumas and processing change. Migrant workforces have, in many ways, demonstrated small towns’ capacities for transformation.

“Rural life is shifting more rapidly and more visibly than in cities,” he says. “A town that, in 1980, had less than 1 percent minority population now has 75 percent minority. The population didn’t diminish—it’s the same number of people—but it’s an entirely different culture. This suggests that rural towns actually have a higher ability to shift and transform the local environment.”

In his research, Shirtcliff has also observed the ways migrant workforces have used the landscape to promote their own healing processes: artwork made by residents that discusses challenges of leaving their home countries, little free libraries to share books with neighbors, and altars placed by workers alongside makeshift pathways to factory jobs that help them heal.

“It’s really important to consider how these communities have already demonstrated the ability to invest into this recovery,” Shirtcliff says. “Rebuilding doesn’t necessarily mean to build new. It means to incorporate diverse cultures and become embedded into these communities.”

Anjulie Rao is a Chicago-based journalist and critic focused on the built environment.