Sunday, August 30, 2015

Do Rural's Best and Brightest Back Away?


dartmouth students allegro Takahi Summer students at Dartmouth College, ranked 11th among national universities. Dartmouth is located in rural Hanover, New Hampshire. Any ruralites here?

A new study by two scholars at the University of Michigan has found that top students from rural high schools were 2.5 times less likely to enroll in the nation’s most prestigious colleges and universities than were their urban and suburban counterparts.

Though most universities have taken steps to diversify student populations – notably with special scholarships for low-income applicants – Julie Posselt and Matthew A. Holsapple, Ph.D. candidates in Postsecondary Education, wrote that “large disparities exist” at the nation’s most prestigious colleges and universities. In “The Best in the Country?”, Posselt and Holsapple write that the gap in prestigious postsecondary schooling between urban and suburban high school grads and their rural peers represents “an enduring dimension of inequality in education.”

The researchers drew their findings from the Educational Longitudinal Survey (2002) to determine students’ probability of enrollment in U.S. News and World Report's (USN) 50 top universities and 50 top liberal arts colleges.

“Even when holding academic achievement, demographic factors and financial aid constant," they wrote, “rural students are as much as 2.5 times less likely to enroll in a USN-ranked institution.”

graph of college going Holsapple and Posselt/"The Best in the Country?" Michigan researchers found that top urban and rural students of similar socioeconomic status followed similar patterns in enrollment in two-year (blue lines) and most four-year (red lines) colleges. But urban students from higher socioeconomic backgrounds were far more likely to enroll in prestigious colleges and universities. (Note the green lines: rural students represented on the left, urban students at right.)

Princeton is a community of learning that is enriched by the wide variety of experiences and perspectives of its students, faculty and staff.”

Yale prides itself on its diversity,”

These universities currently rank #2 and #3 in the nation, according to the widely-cited (if not universally accepted) assessment from U.S. News and World Report.

Williams College, which U.S. News ranked as the nation’s top liberal arts college, touts its “steps” toward diversity; at Williams, the concept of a diverse student body “has primarily taken the form of men and women from all segments of American society -- ethnic, racial, and socio-economic -- and increasingly also from countries beyond the United States.”

Yet neither Williams nor Yale nor Princeton cites rurality/urbanity as a component of efforts to diversify.

The University of Michigan scholars emphasize that college enrollment combines structural features over which students have little control (like distance, cost, and -- ultimately -- admission) with aspects of personal choice. The present study, they write, can’t determine which of these elements (or what combination of the two) may account for rural students’ lower rates of enrollment at prestigious schools.

Posselt and Holsapple are now studying whether rural, suburban and urban students differ in their rates of application to top colleges and universities. They write that “Rural students may not be as sensitive to the allure of rankings.”

But there may be other factors that dissuade rural high school graduates from applying to the nation’s most prestigious schools, as well as biases that work against them at top colleges.

Several earlier studies assumed that rural youth were more home-bound than suburbanites and urbanites, thus less willing to apply to distant institutions. For the most part, however, researchers have found rural students no less willing to move either for work or for higher education. One recent study, in fact, found that urban students were less inclined to move for college. Also, whereas rural dwellers were initially more enthusiastic about online education than urban or suburban students, that gap is closing.

Peter Schmidt reported on the Michigan study in the Chronicle on Higher Education April 30, and his article fomented some heart-pounding replies.

“As a high school physics teacher in a somewhat less-than-affluent school,” wrote one reader, “I routinely discouraged many of my students from going to the Ivy League, or similar schools. I had no doubt that many of them were capable, but I explained to the parents that there was definitely a 'snob factor' to be considered. These kids would NEVER fit in at such a place and would be the target of unceasing condescension.”

“Colleges need to recruit teachers to recruit students,” wrote a Princeton graduate, who moved to rural South Georgia to teach. “If no one familiarizes the top high-schoolers with the experience of the top schools, they won't apply. Takes a lot of courage for a kid from a small Georgia town without a McDonald's even to want to apply to some out-of-state school.”

Another Chronicle reader wrote, "It was the polite but clueless contempt for my way of life that made me uncomfortable at Yale. Classmates and faculty who invested great effort in the study of third world societies knew nothing about America. I put up with it because the resources and contacts made available to students there were superb.”

college urbanicity Holsapple and Posselt/"The Best in the Country?" University of Michigan scholars compared the college enrollments of students from geographically different high schools. Of the top urban students, 7.56% enrolled in prestigious colleges and universities; 3.37% percent of top rural students enrolled in such schools.

The ticklish subject of status ratchets up to something more like pain with the prospects of rural youth on the line. Highly emotional responses to the Michigan researchers’ work indicate that they’re on to a significant topic, one with potential to disclose much more about the bigotries of  Americans, rural and urban, and the real life chances or penalities that those sensibilities may have power to incur.


Rural's Best and Brightest

The failure of rural high school grads to apply for/attend better upper level schools is probably attributable, as least n part, to reluctance of parents to have their children very far out or their sight. This, in turn, results from the "fearfulness" that permeates the rural character.  That is, rural parents fear that if their children are outside their immediate area, they may no be there to "help" them.  Likewise, the fear of urban, society and culture on the part of urban parents results in gross over protectiveness of their children from "outside influences" and tends to result in rural students staying close to home.  Finally, in general rural school districts simply don't prepare students for attendance at better schools.  And this problem is merely one more manifestation of the failure, sometime deliberate failure, of rural-ites to accept change and deal with it.  And this, of course, is a root cause of just about every other problem dogging rural America.

fearful farmers

We farmers are so fearful of losing our car keys that we leave them in the ignition at all times.  And so afraid of losing our house keys that we lock the house only if we go on vacation for a week in the big city.

On the other hand I did actually lock my 250 gallon barrel of gasoline during one period when I thought my son was using it to fill his car.  But he grew out of it.

Frankly I think rural students are less impressed by so-called prestige schools, and doubt that they are worth the big bucks.

evidence of parity among rural/urban students on tests


You write, "Finally, in general rural school districts simply don't prepare students for attendance at better schools."

We don't think that's true though we don't know what manner of "preparation" you mean. Please consider findings from a 1999 national study comparing rural and urban students' scores on standardized tests.

“Students from rural schools perform as well as their peers in metropolitan areas in the four areas of school learning: reading, math, science, and social studies….These results do not support the conjecture that students in rural schools nationwide are at a general disadvantage in terms of the quality of their education, at least as reflected in their performance on standardized achievement tests.”

Xitao Fan and Michael J. Chen -- “Academic Achievement of Rural School Students: A Multi-Year Comparison with their Peers in Suburban and Urban Schools.” Journal of Research in Rural Education, Spring 1999, Vol 15, No. 1, 31-46

There is quite a lot of "conjecture" out there about rural students, their capabilities, their families. Please send us information you have about "fearfulness" or any other aspect of "the rural character." 


While students from rural areas may perform as well as their peers on standardized tests that does not necessarily imply that rural students are prepared for the academic rigor of the elite schools.

As a graduate from a reasonably elite East Coast school, I don't believe that my rural Nebraska education at all prepared me for the expectations of my college professors. I was able to adapt but my first year was quite a struggle, particularly compared to many of my classmates.

The students that surrounded me had spent most of their junior and senior years of high school taking AP and honors courses specifically designed to prepare them for top tier schools. My high school had only added the three AP classes, which are still the only ones offered, my junior year and only opened them to seniors. Even then, students were discouraged from taking the AP exams because they were deemed to be "too hard" by the teachers teaching the AP classes.

Beside academic preparation, there could sometimes be a lack of awareness in what students applying for top tier schools should expect among those who are supposed to give guidance. When I approached my guidance counselor about the prospect of applying for schools outside the Great Plains region, my counselor had no advice and instead referred me to a book on his shelf that listed short descriptions of high ranked schools. He could give me no other information and made no effort to find more information for me.

So perhaps standardized testing isn't the best way to determine whether a student is adequately prepared for the academic rigor of top tier schools. Perhaps the attitude that rural schools have toward top tier education has something to do with the disparity, at least in some cases.

Lack of resources

"Finally, in general rural school districts simply don't prepare students for attendance at better schools."

Rural schools often lack the same resources that suburban school districts take for granted. I graduated from a rural school in 1990 and then attended a liberal arts college in the Chicago suburbs. I found that most of my fellow Literature majors (from the 'burbs) had studied from individual novels in high school, while I had studied from an anthology. Our school district simply couldn't afford to buy books for every single student. We didn't have astronomy clubs or a theater program or even a school newspaper. There were fewer leadership opportunities. It's not for lack of interest; sadly, it's about money.


I think the only local I've ever known to attend "back east" was my cousin who took her final year at Duke. Maybe part of it is the conservative rural mindset about what "they" do out there. But here in the midwest we're more than a little insulated from the rest of the world. Most of the teachers (if not all) in our schools are midwestern born and raised, right down to attending local teacher colleges and getting jobs within 100 miles of home. When I was on the school board our superintendent at the time pointed out that the faculty of our school was evenly divided between teachers trained 10 miles to the west and those who went to school 30 miles east of town. He said it was good we had the diversity. :)

And of course there's money to think about. Local scholarships are much easier to attain than from a place like Princeton or Yale.

Chances are they could pick up a few rednecks if the bluebloods came to town a'courting us.

That'll be the day-

Fearful? I think not.

Rural kids have an advantage. Having grown up around animals, they more readily recognize BS when they encounter it. Perhaps they prefer to gain knowledge that they can apply in the real world, instead of having to endure years of irrational liberal indoctrination, subtle racism and overt classism.  

Rural Origin Medical School Admission

About 70 years ago over 25% of the physicians entering the rural workforce were rural in origin. Specifically they were rural, white, and male. Typically they have been lower and middle income in origin. The physicians entering the US workforce that are rural white males are now 2 - 3% of those entering the workforce. Rural females are soon to be (or already are twice as likely to be admitted) Origins associated with the following are lower in probability of medical school admission and appear to be declining: rural, white, male, lower income, middle income, lower property value, birth in a lower population density county, birth in a farming or manufacturing dependent county, birth in a county that does not have a medical school, and birth to non-professional parents. They are being replaced by all others associated with concentrations, particularly those associated with combinations of concentration.

The 1950s, 1970s, and 1990s periods all appeared to stabilize the declines in rural origin admissions to medical school, but did not stop the decline. The 1950s impact appeared to be the GI bill. In a few medical schools the underrepresented rural populations for a brief time period were represented in the proper proportions according to the state population. This is perhaps one of the only times that the US has accomplished such an intervention. The 1970s involved a number of changes, the doubling of US medical students, and perhaps the greatest US focus on education in its history (most education degrees). The 1990s involved retraining medical school admission committees to look at the candidate and not just their scores (3000 by 2000) and there was great emphasis on primary care in addition to broader admissions. Reversals in the past decade have also followed standardized test emphasis and preparation, worship of prestige ranking, Pell Grant problems, and funding schemes favoring higher income children (college marketing). For medicine the standardized test emphasis provides no evidence of a better physician and may well bring more physicians who have lower people skills, communication skills, and awareness of the needs of others - particularly the needs of lower and middle income Americans.

When working with rural high school students, there are a number of barriers to medical school admission. A special program almost failed until ETSU coordinator Linda Nwoso visited rural high schools and figured out that the students did not believe that the program was for them and found out the particular individual at the school to contact. At different schools this was a different person (teacher, counselor, vice principal, etc.). The emphasis is on straight from high school to college to medical school and few are taught the second track of late entry or use of another career to gain admission to medical school (common for all lower and middle income and disadvantaged populations). Even after 10 years of a program to admit rural high school students to UNMC, only 4% knew about the program. The positions were often filled by rural high school students connected to professional or physician parents or those in the know. Rural high school students often do not have the same counseling or the parents that can provide the college and professional career counseling. Delays of a few years prior to admission are common as rural origin students overcome barriers of income, education, and parent origins. Lower and middle income origin students that do not work extra years before college and after college to gain admission do not get admitted. This compares to highest income, most urban, children of professionals that can often decide late in college to attend medical school and make it due to any number of advantages.

The same situations are found for all lower and middle income in America. As lower and middle income fall behind in the nation compared to highest income, this is most reflected in their children. Only 3% of bottom income quartile students attended a top 146 college compared to 73% for the top quartile in income (Carnevale, New Century Foundation). This is a direct reflection of medical school access as fewer and more prestigious colleges supply more and more US medical students. Only 25 - 70% of lower and middle income students attend college compared to over 90% of the top income quartile (Mortensen, Postsecondary Education). Medical schools are a reflection of higher income origins and those from highest income origins have increased by 70% since 1997 while middle income origin has declined by 25% with a 35% decline for lower income origin (AAMC data).

Rural origin is maintained in those that choose family medicine, but family medicine has declined from over 15% to just 8% of US MD graduates. Family physicians arise from the population at a set rate of 1 per 100,000 per class year or 30 - 40 per 100,000 for a generation of physicians (25% FM choice for rural origin, 5% FM choice for most urban in origin) and FM docs are found distributed according to the population at 30 - 40 per 100,000 - the only specialty to distribute according to the population. This results in family medicine graduates with a three times rate of rural location rate and family physicians with multiple times the care of the elderly, lower and middle income, CHC locations, whole county shortage areas, and all in need of basic health access.  

But family medicine is stuck at 3000 annual graduates, a level first reached in the 1970s or the last time the US emphasized education, opportunity, primary care, teaching, and serving where needed. A 2% annual growth rate of family physicians would have resulted in all the primary care needed as the elderly double and as we attempt to add lower and middle income Americans to health access.But we have no preparation for this time as there are no additional basic nurses and basic generalist physicians coming to serve this massive health need increases.

In fact, the entire US design for health care workforce is stuck at 1970s policies, support levels, and types of physicians. This is totally unsuitable for 2010 and the direct result of 30 years of policy failure and ignoring the needs of most Americans, particularly the elderly, lower income, and middle income. The primary care workforce is also stuck at 260,000 according to the ancient 1970s design. Primary care is stuck at 5% of national health spending and less than 5% of spending goes to either of rural locations or underserved locations.Rural areas dependent upon primary care (particularly FM), dependent upon rural health spending, and dependent upon underserved health spending has suffered the most. Often funds intended for the underserved go to zip codes with top concentrations of physicians and health spending. The consequences for rural areas include insufficient economics, services, jobs, and leadership of physicians and others in health care as well as insufficient health care facilities. These cascade into other local consequences.

Rural-urban politics plays a role. When states flipped from majority rural to majority urban, they also had declines in rural origin medical student admissions as demonstrated by greater rates of decline in states with 40 - 50% rural population. Only medical schools preserving a mission for rural health managed to keep these declines to a minimum but the declines continued and rural mission has been tougher and tougher to keep.

Those most likely to be found serving rural communities as physicians are rural origin, family physicians, those trained in health access schools and programs, and those of lower and middle income origins - those being left behind. Nurse practitioners and physician assistants are also leaving the family practice mode down from 50% to below 25% and still falling. There is no help on the way under the current design that sends all except family medicine toward higher concentrations. Rural specialists are entirely dependent upon rural origin, rural training, and rural policy support and all are in decline.

Changes in areas such as rural opportunity involve a close examination of what is happening in lower and middle income America across the entire nation. This is the part of the nation most common to most people, but very different than what is seen in the press, by politicians, or by leaders in education or health. It is the part of the nation that provides the serving occupation human infrastructure that keeps the nation going, growing, and together - teachers, public servants, nurses, family physicians, and others who serve on the front lines. These are who represent government and government policies to the people. If they can do their jobs well, then the nation does well. But they are compromised throughout their development and in their support. Recovering a nation will require recovering lower and middle income people beginning with children in the earliest years of life and improving support for all who serve where most needed.

Robert C. Bowman, M.D.  A T Still University