A crossroads of crisis and opportunity in rural Minnesota

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We who live in rural Minnesota are well aware of the advantages we enjoy — a lower crime rate and cost of living, natural beauty and a strong sense of community. But those advantages are not well-known beyond rural regions. And, along with the advantages, there are challenges.

For starters, there are too few of us.

Rural businesses can't find enough employees. The clinics and hospitals that take care of us can't hire enough doctors and nurses. Too many young people we need to replenish our workforce instead move away, choosing life in the city. Some eventually return, bringing needed skills and entrepreneurial spirit, but they are not enough.

It's perplexing because rural Minnesota has much to attract new residents. A study released in 2020 by the Center for Rural Policy and Development found that housing costs in rural Minnesota were a third lower than in the metro area. Local taxes were cheaper by a similar amount. Full-time child care was running $450 a month in greater Minnesota, as opposed to $1,300 in the Twin Cities.

Despite all that, in many rural Minnesota counties, population continues to decline. Simply, we need more workers, in practically every field. Most acutely, we need more health care providers.

Speaker after speaker struck similar chords: We love our lives here; we can't imagine leaving our homes and communities, but we can't keep working indefinitely, and we don't know who's going to replace us.

A doctor shared a startling statistic — more than half of the physicians working in rural Minnesota right now are aged 58 or older. An even more troubling statistic: Only 2% of medical students express an interest in rural practice.

"That is a crisis," said one doctor.

She was not the only one to use the word. The crisis goes far beyond health care. A recruiter for a major manufacturer with operations on the Iron Range said that she has tried a number of different approaches to lure workers. She has a particular need for welders. "We need them now," she said, "not two years from now." Her firm works with schools and colleges to train future employees, but they are not enough to meet the need.

Area high schools and colleges are retooling their training programs to produce workers in the greatest demand: health care, industrial technology, advanced automotive, construction trades and pre-engineering.

That, too, was a theme heard time and again.

Doctors described the benefits of taking care of neighbors in a community setting. Patients are more likely to listen to their doctors, said one practitioner, "when we see each other in the grocery store, and their kids went to school with my kids."

"I wouldn't want to be in a setting where I don't know my patients," she said, explaining that a small-town practice allows a physician to provide continuity of care. "That's why I enjoy rural medicine."

The picture of rural Minnesota that emerged in these town hall gatherings is one of interconnected strengths and challenges. Participants heard success stories like that of Krewe Restaurant in St. Joseph, where a couple of young entrepreneurs are pursuing their improbable vision of New Orleans-style cuisine combined with a farm-to-table philosophy and a mission of introducing young people of color to the outdoors.

Along the way, they've discovered the benefits of a supportive business community, including friendly local bankers who can get excited about inspired entrepreneurs. They and others spoke of the sometimes bumpy process of securing financing, and the need to develop a realistic business plan. As one participant phrased it: "An educated dream is less likely to get crushed."

If those families visited in person, they might be pleasantly surprised. A participant who often meets with visitors from other parts of the country said, "We sell ourselves short a little bit. … When we talk to people, they say, 'Oh my gosh. You can actually buy a house here. And you can actually do things here!' And they're excited about it."

But obviously, the answer is not to wait for enough visitors to show up.

As if on cue, a strategy emerged from one of the meetings. A health care executive noted that financial incentives might help refresh the supply of physicians, because many medical students graduate with half a million dollars of debt. That caught the attention of an executive at Compeer Financial, a sponsor of the Rural Voice project.

"That's a big crisis you've just pointed out," he said. "We provide tuition support for students going into agriculture, but maybe we need to broaden that out. You really have me thinking, what can we do to be part of that solution?"

The two executives agreed to trade contact information.