When three students from small-town Iowa graduate from the University of Iowa College of Public Health in May, they’ll leave with more than their diplomas. They will take with them a sense of accomplishment and empowerment.

That’s because an informal conversation they started over a Zoom call in 2022 with a few other students interested in rural health has grown into an official student organization spanning multiple colleges. The Student Association for Rural Health (SARH), complete with bylaws and elected officers, aims to raise awareness about the health care challenges that exist in rural areas — and the benefits of working in those communities — through programming and outreach, visits with state and federal legislators, and attendance at national conferences, among other activities.

Hallie Vonk, who serves as the organization’s co-programming coordinator and is earning a Master of Health Administration, grew up in Hinton, Iowa, a northwest Iowa community with a population just under 1,000. She says she and her peers who co-founded SARH, also from rural communities, were concerned when they began learning about the health disparities people in their hometowns faced compared with their urban counterparts, and they were eager to make a difference.

“If we believe that health care is an essential right, then health outcomes shouldn’t be predicated on where you live. In Iowa, about a third of the population comes from a rural area, so that is a huge population where health outcomes aren’t as good as they should be,” says Vonk, who earned a BS in human physiology from Iowa in 2022. “I can’t help but think of my own family having to drive long distances to get health care. My grandma is not comfortable driving into a city.”

In addition to transportation issues, other barriers to health care in rural areas include a shortage of providers, limited access to health education, a lack of affordable health insurance, and a cultural mindset that often prevents people from seeking care. Jenah McCarty, of Albia, Iowa, a south central Iowa town of 3,700, says she didn’t realize such inequities existed until she came to campus.

“I took an Intro to Public Health class as an undergraduate, and it was very influential. The idea that you can prevent disease was novel to me,” says McCarty, who earned a BA in public health in 2022 and is graduating with a Master of Public Health and a Master of Health Administration. “I was raised in more of a reactive environment where when you’re sick, you go to the hospital. I never thought about the fact there are things you can do to prevent yourself from getting sick and having to go to the hospital. It was like a light bulb turning on in my head, and I decided I wanted to do pursue a career in public health.”

McCarty, currently serving as SARH president, connected with Vonk and Nick Lembezeder, an MPH student from the eastern Iowa community of Peosta, as well as a couple of others who have since graduated, and realized they had a common goal.

“We wanted to share our experiences and help our classmates — future health care leaders and health care providers — understand that rural areas and rural communities are different and have different needs,” says McCarty, who has accepted an administrative fellowship in Utah but plans to return to Iowa to work in a rural hospital. “We want to make sure that rural health is something they have an understanding of and find important, no matter where they go after graduation.”

That understanding of rural health is key to addressing disparities, Vonk says.

“One of our goals with SARH is to communicate to our peers that regardless of whether you want to work in urban health care or rural health care, you’re going to have some sort of impact on rural, so it’s important to understand the disparities and the dynamics,” says Vonk, who has accepted an administrative fellowship in Minneapolis that includes work with rural hospitals. “There’s a common saying that if you’ve seen one small town, you’ve seen one small town. So, a solution that works in one may not work in another. Right now, a lot of rural hospitals are closing or affiliating with or being acquired by a larger system, so we need to have people at the table who can speak to the communities in rural areas. They need somebody who can advocate for them and make sure that their health needs are properly met.”

The students feel they’ve already made an impact. Not only have they engaged students in the College of Public Health through panel discussions on rural health issues, career networking events with alumni who work in rural settings, and volunteer outings, but they’ve also started to build connections with students in the College of Pharmacy and the Carver College of Medicine. Next year’s leaders plan to recruit students in other health care colleges on campus.

“It’s been exciting to watch students take information about rural health care from our events and have discussions about how it might fit into their future career goals, whether it be in an urban area or in rural communities. Hopefully our work convinces more practitioners to take jobs in rural areas,” McCarty says. “We talk to students about the great things going on in rural communities and show them through panel discussions and site visits that they can do a lot of different things in these communities that they might not have the opportunity to do in urban areas. It’s fun to see that ‘aha’ moment as they consider the possibilities.”

Even if her classmates do not pursue careers in rural areas, McCarty says she feels confident that they could successfully address rural health issues. Some had never set foot in a critical access hospital — a rural hospital that receives benefits from Medicare to reduce its financial vulnerability — or spoken to a provider in a rural area before participating in SARH programming.

Whitney Zahnd, assistant professor of health management and policy, is the faculty advisor for SARH. She says watching the students get the organization off the ground gives her hope.

“It’s one thing to be excited about a topic or an area; it’s another to organize an effort to make other people excited about it as well,” says Zahnd, who has done extensive research in rural health services. “For these students, it’s not just lip service. They are very passionate about rural health, and I find their work very inspiring and encouraging.”

Lembezeder, who serves as co-programming coordinator for SARH, is graduating with a Master of Public Health and will attend the Carver College of Medicine. He says his experience in the College of Public Health will make him a well-rounded physician.

“The public health education I’ve had at Iowa has grounded me in the needs of the community and the health of our nation,” says Lembezeder, who intends to become a community doctor in a rural area. “At a time when we’re so divided — politically, socially, economically, in so many different ways — caring about others in our society is a positive direction. We can bring people together and come up with solutions that hopefully will have a lot of downstream effects and be applicable to a lot of different people.”

Although she is sad to leave SARH behind after graduating, Vonk says she feels the group is in good hands with the next cohort of students.

“I have found so much joy in this leadership position. I’ve learned there is power in finding something that you’re passionate about and advocating for it,” she says. “We may just be students, but I think the impact that this organization can have is greater than what people may have thought.”