A pregnant woman in rural Iowa must make so many extra decisions about her and her baby’s health. It isn’t just whether she should go to the hospital about unexpected complications, but which one. If she goes to the closest hospital, will it have the expertise to treat her? If not, will it have an ambulance that can transfer her to a more urban hospital? 

One Iowa mom facing these questions inspired Stephanie Radke, clinical associate professor of obstetrics and gynecology at the University of Iowa, to found the Iowa Perinatal Quality Care Collaborative (IPQCC). IPQCC is responsible for improving communication and collaboration among groups addressing obstetrical and neonatal care in Iowa, especially in rural communities. 

“Simply living in a rural area is an independent risk factor for experiencing severe maternal morbidity and mortality based on national data,” says Radke. “One reason is that we don’t have specialty services consistently available in rural areas.”

The challenge of accessing health care when living in a rural community starts at birth and continues through old age. Harleah Buck, Sally Mathis Hartwig professor in gerontological nursing, is a researcher and champion for living well into the golden years. 

“The majority of Iowa’s rural population is over the age of 65,” says Buck. “It isn’t just health care that can be an issue. It is social isolation, transportation, access to healthy food, and so on. We’re at our most vulnerable in old age.” 

Buck also directs the Csomay Center for Gerontological Excellence at the University of Iowa. The Csomay Center serves as a hub for research, training, expertise, and resources for older adult well-being for all of Iowa. One of the projects they fund, led by Betty Mallen, assistant professor of instruction in nursing, takes the “age-friendly” model from medicine and applies it to public health. Now, Iowa is leading the nation in building principles of older adult health and autonomy into county public health programs. 

Hahn, Radke, and Buck will be part of the Rural Access to Services and Resources panel at the Cultivating Rurality: Building Community around Rural Research Symposium at 1:45 p.m. on Friday, March 27 at the Iowa City Public Library, Room A.

The people living in rural communities understand these challenges best. Tyler Hahn, director of the Cherokee Public Library, grew up in a small northwestern Iowa town, earned his degree from the University of Iowa, and returned to a rural community because of the great job opportunities available to him at the local public library. 

“I think I have the coolest job in the world because I get to not only work with books, but directly with the community,” says Hahn. “I get to work with the city on economic development, as an advocate for our community, and as an educator.”

The Cherokee Public Library has become local residents’ first destination when they have a challenge. When they need to fill out FEMA paperwork, they ask Hahn for help. If they receive new technology for Christmas, they go to a Tech Tuesday event. Or, if they are a grade-schooler with no one waiting at home for them, they go to the library after school. 

Hahn has also partnered with a nearby community college and Iowa universities to bring learning and career development opportunities to Cherokee residents, including classes and certifications in the Meta Business Suite, Canva, and Microsoft Office. 

“After you complete a demonstration of the skills needed, we give out a certificate, a credential, that you can use on your resume,” says Hahn. 

Jennifer Jones, outreach, education, and programming coordinator at the Csomay Center, grew up in rural Illinois and had 42 fellow students in her graduating class. She has also experienced just how strong a small community can be. 

“I think there's a sense of community that exists. If you haven't lived in a rural area, you might not expect that. People are there to help one another,” says Jones. “Because we don't have other resources, I think there are opportunities for intergenerational experiences. The people who stay, they're the ones caring for their grandparents or their former teachers.”

Radke has seen how the resourcefulness and know-how of rural residents has benefitted IPQCC’s operational practices. 

“One of the things that make the IPQCC successful is that our staff come from the rural communities we serve,” says Radke. “For example, if a clinical practice has good evidence behind it, our staff has the background and knowledge to adapt it for a 25-bed critical access hospital that only has two nurses in the hospital in the middle of the night on a Saturday night.”

Brian Farrell, associate professor of instruction in the College of Law, was motivated by his small-town upbringing and experience practicing law in rural Iowa to begin researching rural access to justice and legal services. Now, he’s thinking more broadly about the role of universities like the University of Iowa in examining rural issues and serving rural populations. 

“Universities can help identify where services might be lacking and understand how to more effectively deliver them in a manner tailored to the unique needs of rural communities,” says Farrell. “They also play a role in recruiting and training the next generation of professionals to serve rural areas.”

Farrell and his colleagues Daria Fisher Page and Ryan Sakoda are co-directors of the Obermann Center for Advanced Studies’ 2026 symposium Cultivating Rurality: Building Community around Rural Research.This event will bring together scholars and community leaders who work with people who live and work in rural communities. Their goal is for participants to leave the symposium with new scholarly tools and professional connections to more effectively address interdisciplinary issues of rurality. 

“There are opportunities to have more conversations about the place of rurality in academia and the role of universities in rural areas,” says Farrell. “A first step is to identify the people on our campus already teaching about, researching, and serving rural people, places, and issues. That is the primary goal of the Cultivating Rurality symposium.”

Cultivating Rurality: Building Community around Rural Research is free and open to the public. It will take place on March 26 and 27, 2026, with both in-person and virtual events in Iowa City.