The Columbia Gorge Region where I live is a vast rural area larger than Connecticut but with a population of only 75,000. While many people here are doing well, others live in poverty, or have to drive long distances to get to a doctor’s office. In this land of fruit orchards, one in five people regularly run out of food.

Mandi Rae Pope was once one of those people. A few years ago, during a difficult pregnancy at the end of her husband’s graduate studies, Pope says she was “counting pennies out of a Mason jar to pay for gas.” She struggled with migraines, and they were getting worse. In the midst of all that, our local Women, Infants, and Children nutrition program gave her a prescription for Veggie Rx, a program we started to provide free fresh fruits and vegetables to people struggling with food insecurity. This was a top concern that community members had identified. By using Veggie Rx, Mandi Rae was able to provide fruit to her toddler son, and the more nutritious diet also helped tame her migraines. Grateful for the help, she wanted to pay if forward and expressed an interest in promoting the program.

My passion for public health was ignited early on in my career in nursing, serving children and families in St. Louis’ Head Start program. I quickly realized that the health of the individuals for whom I cared depended on a complex mix of factors—including personal choices, the opportunities they had available to them (or not), and the resources within their communities. And my time in St. Louis set me on a career path in nursing that has shown me just how integral a role nurses can play in the health of not just their individual patients, but the broader population.

• View related RWJF analysis and perspectives on Nurses, Nursing and Population Health
  

Nurses have always played a key role in improving our nation’s health and well-being. We see people—not just at different stages of their lives, but also in all of the different places our patients live—using nursing skills and expertise to care for them in many different ways.

Fourteen-year-old Destiny remembers the spring day when she and a bunch of other kids planted rows of string bean seeds in the dark, loamy earth.

“There was nothing there,” she says, pointing at the dense green plants whose abundant leaves now shelter countless sweet, crunchy pods.

Today, Destiny has returned—this time with a couple dozen other children—to harvest the beans and bring them home for dinner. Later, the children will add freshly picked nectarines, cucumbers, and green peppers to their goodie bags. They’ll also take home recipes for preparing those foods.

It’s one in a series of Kids Farm Days at America’s Grow-a-Row, a nonprofit farm in Pittstown, Hunterdon County, N.J., that provides fresh produce to people in underserved communities, as well as hands-on education to kids about healthy eating.

I grew up in southwestern Ohio, surrounded by woods, corn and soybean fields down the road from a small town. Although my childhood home fits what some might see as a stereotypical description of small town America, I never thought of it that way. Now, as a program officer at the Robert Wood Johnson Foundation (RWJF) working to promote healthy, equitable communities, I’ve had the opportunity to travel to a number of rural places and small town across the United States and see the vast diversity of these places and the people who live in them.

• View related commentary and resources in RWJF's collection on Rural Health in America

Encompassing about three quarters of our nation’s land and home to about 15 percent of the population, rural and small town America is not just one kind of place. It includes the Midwest like the area where I grew up, and nearby Appalachia. It’s also places like the Mississippi Delta and the “Black Belt” of fertile land in the South, unincorporated colonias and many places along the U.S.-Mexico border, remote and geographically isolated “frontier” areas across the West, and Native lands across the country.