It’s in rural areas, especially Central Appalachia, that some of the most important efforts to meet formidable national challenges are being conducted. Appalachians have worked for years to help a generation of workers adjust to the global economy, building community in an era of social isolation, mapping a just transition to a clean-energy economy, and finding solutions to the opioid crisis and ways out of multigenerational poverty.
Yet despite the best intentions of many national foundations, disappointingly little of their money flows to these communities. Less than 6 percent of giving from major foundations has gone to rural areas, according to a recent federal report. Many civic institutions — hospitals, libraries, schools, and economic-development groups — are doing innovative and effective work but do not have the resources equal to the challenges faced by a region hard hit by economic and demographic transformation.
The need is great for philanthropy to do more — and the opportunities are vast. Many foundations struggle to figure out how to make a difference in these regions. What’s more, we have found, there are a number of ways in which foundations’ strategies tend to be biased, if unconsciously, toward urban and suburban contexts.
For example, one national grant maker, in seeking to increase access to medical-based treatments for opioid addiction, encouraged service providers to apply for grants for bicycles that their workers could use to reach people in need of help. That was a good urban solution, but in Central Appalachia, clients can live many mountainous miles from pharmacies and treatment centers. Bicycles would simply not work in rural areas where traveling long distances in mountainous terrain is the reality.
In proposing other solutions to this problem of medical access, many grant makers have focused on remote consulting or telemedicine services, through which patients can contact specialist doctors from their homes or from the offices of their internists. But that isn’t a feasible plan in areas with poor access to broadband, which is a major problem in Appalachia because of its low population density, mountainous terrain, and a lack of investment by broadband providers. Not only do many patients lack access to broadband but so do many doctors’ offices.
In other cases, the metrics for either eligibility or success prove unattainable in rural America. For instance, many major foundations award grants only to large organizations with budgets of at least $500,000. The reasoning is understandable: They want to ensure that grantees have the necessary structure and staffing to manage large grants and multifaceted programs. But most rural organizations are smaller than that.
To help overcome these barriers between major grant makers and rural nonprofits, the Appalachia Funders Network, a nonprofit group founded in 2010, has been working with national foundations to better understand how we can all work together to make a difference in rural parts of America. Here are three suggestions based on extensive research and our years of experience working in one of America’s largest rural areas.
Foundations that want to achieve change in this area should:
Adapt their eligibility requirements to better match the capacity of organizations in rural America.
The first step is to make sure that the groups that foundations want to support are even eligible to apply. Often the first barrier is size.
Some grant makers have been creative in their approach to this problem. The Marguerite Casey Foundation, for instance, provides grants only to organizations with annual budgets of $500,000 or more. To serve Central Appalachia, it collaborated with a local community foundation to create a grant program that ultimately put dollars in the hands of small local nonprofits. The recipients increased their power to make a difference and their ability to grow in ways that will allow them to obtain national grants in the future.
Grant makers should also consider local circumstances and demographics when setting expectations on issues such as staff and board diversity. In rural areas, people are spread across considerable distances, which leads to a different approach to developing nonprofit leadership and achieving social impact than is typical in denser regions.
Tweak their metrics and strategies for success to suit a variety of regions, not just urban areas.
Probably the most notable challenge is measuring impact, which is often viewed in terms of the number of people served per dollar.
While it is understandable that staff members of urban-based foundations look to that measure, it does not translate well to rural communities.
Charleston, West Virginia’s largest city, has about 50,000 people, and the entire state has fewer people than the City of Houston. West Virginia has 77 people per square mile, one of the lowest of any state outside the vast stretches of the American West.
By contrast, New York City has more than 27,000 people per square mile, A clinic in New York may serve thousands of patients a week, while a similar clinic in West Virginia may serve 300.
However, the rural clinic is still making significant progress in improving the health of people who live in its region.
Expanding the universe of possible metrics can help. The Central Appalachian Network of nonprofit groups is working with small nonprofits in rural counties and small metropolitan areas to forge a joint strategy to create a system of food production and distribution that stretches from southeastern Ohio to western Virginia.
By providing expertise, management help, and market access to more than 1,600 small farmers, the network has been able to increase revenue for local food growers by 464 percent over their 2009 revenue, while increasing access to healthful, locally grown food. By 2018, the effort was facilitating $20 million in revenue for local growers.
This is clearly a successful program, but only when the numbers are measured at the regional level. The individual nonprofit organizations that served small communities in the region had numbers indicating they were successful at their level, but they were generally not large enough to attract the attention of national grant makers unfamiliar with the region. By working together through the Central Appalachian Network, these organizations were able to create a story that attracted national funding support. More grant makers should be open to looking at these kinds of regional networks.
Make grants to support the region’s basic infrastructure as an investment in what’s needed to achieve long-term results.
Foundations often resist paying to improve the basic physical, social, and professional infrastructures of a region because it can be difficult to track quantifiable outcomes. Central Appalachia, however, has not received long-term investments in such capacities from philanthropic sources. The lack of this infrastructure is a significant barrier for getting to the outcomes that grant makers are hoping to achieve.
For example, when tackling Appalachia’s health issues, it is clearly helpful to fund the hiring of doctors and the building of hospitals. But doing so can obscure other factors driving those issues, such as unsafe drinking water, lack of access to healthful food options, and even a lack of access to reliable health information because of poor internet connectivity.
Increasing the capacity of grantees can also be a key role for national grant makers. Generally, nonprofits in the region are small with few staff members as a result of the low level of government and philanthropic investment in building strong organizations and leaders. Providing funding for these organizations to hire needed expertise through consulting contracts or other arrangements, and offering money to pay for professional development and software solutions, can help these grantees better achieve their missions.
Overall, it’s clear that there are tremendous wasted opportunities that leaders of national philanthropies must tackle. Some of the issues of biggest concern to national foundations — poverty, the environment, and the basic fabric of our society — cannot be truly solved without strong, well-financed work in rural areas. But today this work lacks the necessary funding. Until that changes, the divides and inequalities that underlie so many of our problems will only worsen. We know that many national foundations want things to change. By recognizing the differing needs and conditions of the region, and adapting their approaches accordingly, they can help make a new reality possible.
Mary Hunt is program director at the Claude Worthington Benedum Foundation and Lora Smith is director and co-founder of the Appalachian Impact Fund. They are co-chairs of the Appalachia Funders Network Steering Committee.
