Christiane von Reichert

Reasons for Returning and Not Returning to Rural U.S. Communities

Population loss persists in nonmetropolitan America, especially in isolated counties with limited natural amenities. Communities in these counties experience high levels of outmigration among high school graduates, but low in-migration is more important in distinguishing declining from growing nonmetropolitan counties, and return migration is a much more prominent component of in-migration to these locationally disadvantaged areas. This research uses a multisited, interview-based methodology to understand the factors that influence decisions of people in their late twenties to late forties to move back to rural communities and the barriers that keep others from making such moves. The life course segment considered here captures a critical “settling down” period when career and family obligations overlap and return migration peaks. Interviews at high school reunions, the only venues where stayers, return migrants, and nonreturn migrants are found together, show that limited rural employment opportunities are barriers for nonreturnees. Others intent on returning find ways to secure or create employment but are primarily influenced to move home by family concerns. Connections to the larger social and physical environment of the community are important as well. Interviews affirm that factors affecting migration decisions work in combination, and ties to both people and place are critical for understanding rural return migration.

Intergenerational Relationships and Rural Return Migration

Many rural communities lose population through outmigration of rural youth, resulting in a high concentration of elderly. Concern about these issues sparked our interest in researching rural return migration as a way of countering net migration loss. In the process, we found that intergenerational family dynamics and aging parents residing in the rural hometown are critical for promoting the return move of adult children and grandchildren. Intergenerational relationships and migration to be closer to family provide a context for understanding these moves. Prior research on intergenerational relationships and geographic proximity has focused on the moves of aging parents toward adult children, often using quantitative methodologies. This research focuses on the moves of adult children, using a qualitative methodology. It reveals that the return move of adult children can substitute for aging parents’ move away from a long-term rural residence to live closer to adult children and grandchildren. Migration decisions on the part of adult children thus affect elderly parents’ opportunities for aging in place. Community leaders, especially in relatively isolated, rural towns that find it difficult to attract newcomers, should become cognizant that aging parents can attract younger generations back to their rural home towns.

Access to health care and travel for birthing: Native American-white differentials in Montana

Abstract The location of medical services critically affects access to health care. We examine the extent to which the spatial distribution of health care resources allows expectant mothers to give birth in the county where they live or forces them to travel elsewhere for obstetrical care. We focus on native American-white differentials in access and travel because little is known about inter-racial differences involving native American Indians. Montana birth records for the period 1980–1989 are used to identify the degree to which women leave the county of residence to give birth. Thirty-seven percent of births to native American mothers involved travel, compared to 19% of births to whites. Sixty-one percent of births to whites were to mothers residing in counties with relatively high levels of obstetrical care (Level II hospitals), while that proportion for native Americans was only 18%. Of women who traveled, 65% of whites gave birth in counties with a Level II hospital, compared to 40% of native Americans. Results of logistic regression suggest that the distribution of health care facilities in the county of residence largely explains travel for birthing. Inter-racial differences in travel turn out to be minimal when the spatial distribution of health care resources is taken into consideration, and both groups act similarly when faced with the same level of health care resources. Suggestions to improve the delivery of health care in rural areas are offered.