Federal policies and programs are typically written with place-neutral intent or without considering how they might affect places differently depending on population compositions or geographic contexts. On average, rural areas are older, sicker, and poorer and have weaker health care infrastructures than urban areas (Jensen et al., 2020). Therefore, we should anticipate that place-neutral policies would impact health and aging differently in rural versus urban areas. Moreover, rural America is not homogenous, but demographically and economically diverse, with a variety of labor markets and social and health service contexts (Leider et al., 2020). Therefore, place-neutral policies will also have differential impacts across the enormous diversity of rural communities.

This study discusses three large, national policies/programs as exemplars of how policies differentially affect population health and aging in rural versus urban populations: the Older Americans Act, the Affordable Care Act, and the Supplemental Nutrition Assistance Program. We also discuss implications for policymakers and identify promising areas for research on the spatially disparate impacts of policies on population health and aging.