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Policy attention to growing rural “health care deserts” tends to identify rural distance as a primary spatial barrier to accessing care. This paper brings together geography, health policy, and ethnographic methods to instead theorize distance as an expansive and illuminating concept that highlights place-based expertise. It specifically engages rural women's interpretations of rural distance as a multifaceted dimension of accessing health care, which includes but is not limited to women's health services and maternity care. Presenting qualitative research with 51 women in a rural region of the U.S., thematic findings reveal an interpretation of barriers to rural health care as moral failings rather than as purely spatial or operational challenges, along with wide communication of negative health care experiences owing to spatially-disparate but trusted social networks. Amid or owing to the rural crisis context, medical mistrust here emerges as a meaningful but largely unrecognized barrier to rural women's ability—and willingness—to obtain health care. This underscores how a novel interpretation of distance may inform policy efforts to address rural medical deserts. 

Rural America faces an increasingly dire access-to-justice crisis, which serves to exacerbate the already disproportionate share of social problems afflicting rural areas. One critical aspect of the crisis is the dearth of information and research regarding the extent of the problem and its impacts. This Article begins to fill that gap by providing surveys of rural access to justice in six geographically, demographically, and economically varied states: California, Georgia, Maine, Minnesota, South Dakota, and Wisconsin. In addition to providing insights about the distinct rural challenges confronting each of these states, the legal resources available, and existing policy responses, the Article explores common themes that emerge through this multi-state lens, with particular attention to the rural attorney shortage, thus framing a richer, broader discussion of rural access to justice. Written for a special issue on “Revitalizing Rural,” this Article ultimately proposes a two-step approach to alleviate rural justice deficits. First, although the information presented here provides a solid foundation, a critical need remains for ongoing, careful, and thoughtful study of the legal needs and lack of legal resources in rural areas. Second, the unique institutional, structural, and demographic characteristics of rural areas will require tailored, innovative, and data-driven solutions to match appropriate legal services with needs. We advocate a re-thinking of the roles of many justice system stakeholders, including the critical steps that legal educators can and should take to help close the rural-urban justice gap. Our hope is that this Article will inform and expand access-to-justice conversations so that they more intentionally address the legal needs of the vast rural reaches of our nation, thus furthering the ultimate goal of realizing access to justice for all Americans.