Kicking off the 2026 Obermann Symposium, Dr. Kozhimannil presented her research on rural obstetric and gynecological care at the University of Iowa Hospitals and Clinics. She is the Director of the Rural Health Research Center and the Rural Health Program at the University of Minnesota, and focuses her research on access to maternity care in rural communities across the nation. Dr. Kozhimannil discussed the challenges and benefits of giving birth in rural places.  

The presentation walked through five key areas of her research: why rural care matters, where and how access to care is declining, what happens when rural care is lost, why rural OB-GYN units close, and what could help keep rural OB-GYN care viable and accessible. Dr. Kozhmannil emphasized that we should talk about these rural care gaps as just that, because referring to them as “rural care deserts” undermines the idea that rural care gaps are systemic and structural failings, and not naturally occurring and desirable. Rural access to OB-GYN care is declining for a myriad of reasons, including financial constraints and hospital administrators’ aversion to liability.  

Because of lack of financing and care concerns, hospitals are attempting to avoid risk and improve patient safety by eliminating OB-GYN units. Importantly, Dr. Kozhimannil emphasized that the safety and liability risks are not eliminated when the units are cut—instead, people return to these same hospitals to give birth but now lack a dedicated unit for birthing care. When maternal care is lost, according to Dr. Kozhimannil’s research, there is an increased risk of preterm birth, out of hospital birth, birth in hospitals that do not offer obstetric care, higher emergency room births, increased adverse outcomes, and increased need for emergency birth training. As solutions, she offered financial, workforce, and rural-centered approaches to address the holistic challenges. These include cost-based reimbursements for low-birthing hospitals, more specialized OB-GYN training for rural practitioners without dedicated OB-GYN units, increased midwifery and doula care as well as telemedicine, and centering rural voices and maternal mortality review committees in these rural hospitals.  

Dr. Kozhimannil emphasized how important it is to reframe our view of rural communities. We should be focused on the benefits and joys of working in rural environments—for health care professionals, that means working with deeply diverse communities and the opportunity to know your patients very well. By centering the positive aspects of rural life and practice, we can reshape the narrative and encourage more practitioners to work in rural communities. And by mobilizing and organizing rural voices, we can fight against the closure of rural OB-GYN care units. More of Dr. Kozhimannil’s research can be found at: https://rhrc.umn.edu/publication/information-for-rural-stakeholders-about-access-to-maternity-and-obstetric-care-a-community-relevant-synthesis-of-research/. 

Notes prepared by Caroline Scott, March 24, 2026 

Andy Mink is the founding Director of the Rural Initiative at the Smithsonian and has been in this role since 2023. Mink serves on multiple local, regional, and national Boards, and is originally from rural eastern Virginia. His closing keynote addressed the intersection of rurality and work being done at the Smithsonian.  

Mink began by describing exhibits at the Smithsonian that may seem nondescript, but gain their value based on the context, meaning, and stories people bring to them. The Smithsonian has worldwide recognition, in part because it is the “nation’s museum” and functions in service for others. Part of that service is doing rural outreach work to bring the Smithsonian to rural communities across America. The Smithsonian’s rural initiative statement is to engage with and amplify the voices of rural Americans to better serve local communities, raise the visibility of their cultural stories, exchange research, and join in conversation about our shared future.  

Part of this outreach is Museum on Main Street—a rural initiative that brings museum exhibits on common themes, such as water or elections, to rural areas. Mink emphasized that rural communities aren’t an afterthought for the Smithsonian, but an important aspect of any rural work is deciding what “rural” means. While having an objective definition may be important, our conception of rurality must be more than “not urban.” Small towns and rural areas are all unique, but there are many commonalities between them: an appreciation of the natural world and its beauty, hyper-local but also broad connections, the ability to bring others together, their functioning as a literal and theoretical crossroads, a historical aspect, and people with a sense of contribution and connection to their community.  

People who live in rural areas invest their lives and their time in these areas. Similar to John Dewey’s “little ‘d’ democracy” idea, people must invest in their communities every day in different ways to ensure a continually thriving community.  

Mink discussed some relevant recent research conducted in rural communities, with one significant finding being that understanding your local and family history has an impact on democracy as it functions in rural areas. If you know your local and family history, you are 28% more likely to vote, 20% more likely to volunteer and play a leadership role, 15% more likely to be interested in national affairs, 5 times more likely to run for elected office, make 10% higher donations in dollars, and 25% more likely to engage in civic life, like signing a petition or going to a public meeting.   

Another rural initiative the Smithsonian has launched is the Rural Needs Sensing Report (“RNSR”). The RNSR seeks to gain insight from rural community members about topics that matter the most to those communities. So far, the RNSR has found that 70% of rural Americans have a favorable association with the Smithsonian, and more than 80% were interested in partnering with the Smithsonian in an authentic, meaningful way. Adiditionally, rural Americans “overwhelmingly express interest in connecting real world experiences and skills with hometown priorities.” The RNSR aims to acknowledge that rurality is more than just metrics and numbers; it can be very diverse, and rural communities can change more quickly now than ever before.  

The five key priorities of the RNSR are to provide support for cultural preservation; access to art, culture, and history; access to educational resources and experiences; access to career readiness opportunities; and support for commemorating America 250. Cultural preservation may look like some sort of memory preservation or recordation system for elderly community members. Access to arts and education resources may look like providing rural schools equipment and supplies they need to bring them in the 21st century. Career readiness involves preparing students in schools for real life and college or career readiness. 

The Smithsonian has also launched the Rural Leadership Summit (“RLS”). The RLS composes rural leadership teams from eighteen communities and gathers them periodically to maintain community partnerships. The Smithsonian will send their experts in each of the 5 key priority areas of the RNSR into these rural communities with the leadership teams to use their expertise to connect individuals and built on the work being done. Communities include places in Tennessee, Georgia, Alabama, Kentucky, Texas, Arkansas, California, Ohio, North Carolina, Oregon, and many more. There is specifically a Rural Cohort for libraries, too: twelve rural libraries across the country are selected to be provided with free virtual Smithsonian programming. 

Mink emphasized that throughout all of the work the Smithsonian is doing to research and contribute to rural communities, the throughline is that there must be things that bring us together and inspire us all to be part of something bigger. Rurality cannot be just one thing; it is a collection of people and communities who live with and help each other whose stories must be told.  

The 2026 Obermann Symposium Keynote speaker was Esther Peeren. Dr. Peeren is a professor of Cultural Analysis at the University of Amsterdam. She studies the complexity of globalization and the visible and invisible ghosts that reside in rural places. Dr. Peeren discussed a project that she has worked on about the need to recognize rurality as the global front to globalization, and many of her inspirations behind her work. Dr. Peeren emphasized that globalization should not be equated with urbanization.  

The Hinterland was a concept in her second book and counters the romanticization of rurality. Further, rural places are a space where people make lives and care for each other, and not a space that is entirely devoid.  

Dr. Peeren then presented a paper that will be coming out later this year. She discussed the rural childhood idyll and how children, in particular, are said to benefit from being in harmony with nature and in open spaces. However, she noted that many children live rural lives that are not about running free in the fields, but are in the form of child labor and working in fields. Farming is viewed as a vocation rather than a profession, which enables child engagement despite the risk of accidents and abuse. In the United States, 600,000 children under age 18 were reported to work on farms.  

Dr. Peeren discussed Jean-Thomas Tremblay, Breathing Aesthetics, and children finding breathing space. She talked about how breathing registers in differentiated ways. Her interest is in how these forms of breathing impact children living in these rural hinterlands. Dr. Peeren reviewed the background scholarship contained within her article, including several articles, books, and films. She discussed how children are not able to dream and that many are excluded by the “American dream” and how many children find themself stuck with no way out. She also noted that the hinterland atmosphere does not easily accommodate respite.  

Dr. Peeren noted the differences between the different forms of media, focusing mainly on the film Three Sisters and The Harvest (La Cosecha), and points out that they introduce and compare the ways they differ or compare. 

Notes prepared by Abigail Bylund, March 26, 2026  

Brandi Janssen introduced the second panel, Conceptualizing Rurality, which consisted of Cherisse Jones-Branch, Rae Garringer, and Stephen Warren. 

The first speaker, Cherisse Jonese-Branch, detailed her past research history. She challenges the notion of the traditional farming rural/narrative in the South. While it is a story, it is only one story amidst others. She noted how several Black farmers actually owned substantial areas of land, gave specific examples with Scott Bond and Pickens Black, Sr. and spoke to how involved those individuals were in the rural community, challenging the notion that there is one singular story that defines the rural Black farmer experience; the narrative is wider. Stories about these individuals were published in White-owned newspapers. They were influential individuals. She then showed instances of meeting pamphlets for several farm bureau units, which Black farmers were actively involved in, countering the notion that they only played a subservient role. Furthermore, Jones-Branch challenged the notion that the Great Migration brought Black farmers; instead, historical records reveal that many moved to other states in the South or simply remained. She then showed records of Home Distribution Clubs, where Black women were playing active roles and having conversations around many areas of civic engagement, such as paying poll taxes. This again underscores that Black rural individuals were actively involved in the wider community and trying to further integrate/discern it. Jones-Branch then spoke to a private interview with a rural Black farmer who took over the farm when her husband died. She was actively involved in the community, was actively involved in the Republican party, and ran for the Arkansas state senate.  

The second panelist, Rae Garringer, spoke about the oral history production they began over a decade ago: Country Queers. They showed many photos of individuals they interviewed with over the course of this project, ranging from Colorado to Virginia. Much of their work is showcased in their podcast (available on Spotify and Apple Podcasts) Country Queers. This challenges the wider narrative that this space of rural individuals was closed off to queer/trans individuals, and instead highlights their accomplishments within this space. 

Stephen Warren was the final panelist. He talked about federally recognized Native American tribal communities who were forcibly removed from their lands, and his work to help them return to their homeland, and educating Midwesterners on how to respect the legacy of these tribal communities and respecting their ancestral lands. He showed documentation of areas of forced removal: many tribal communities in the Midwest were forced to communities in Kansas. For example, in Ohio there are now no nationally recognized tribes despite the fact that before removal there were 12. This speaks to the completeness of the removal process and the ethnic cleansing process and how thorough it was. He cites a record on how 39 federally recognized tribes were consolidated. Some of them held landmasses the size of states. He then shifted to how these lands were utilized after. For example, the Octagon and Great Circle, an intricate earthwork system which acted as a calendar to map the lunar calendar and measured time, was converted into a fairground, a horserace track, and ultimately a golf course. Warren spoke to how, through over a decade of work, much of this challenged land was returned; he also spoke to how Moundbuilders Golf Course was recently taken through eminent domain in a recent in Ohio case, where the presiding judge said years of curated grass does not supersede the rights of those who resided there before. He ended by reflecting on working with rural/tribal communities to reflect local history, to challenge the traditional White Supremacist narrative which drove removal in the first place. 

The panel concluded with questions from the moderator and audience and discussion by the panel.   

Cherisse spoke to how she was not personally from rural communities, but the reception of her first book opened her eyes. She noted the wide ranging narratives, both of success as lost their work when they reflected on their civic engagement. The wider-ranging narrative is what kept her wanting to reflect more on these experiences. 

Rae spoke to how they grew up on a very rural farm and did not know anyone involved in Queer space growing up; it was not until college that they became more aware of internal feelings through their environment. But the narrative at that time was that outwardly Queer people only had one escape, and that was away from the country. But Rae was attached to home, and that was the impetus to learn from others who managed to keep both those experiences existing at the same time. Since then, their interviews have taken them to 20+ states, getting more and more interviews from individuals who contacted them to further address this void of Queer within the rural space. Their goal was to inform and enrich the singular narrative. 

Stephen then responded how he interacted with a singular local tribal museum, and noted how they were massively undershelved, despite Stephen knowing there were graduate level-works that were pertinent to these topics. He wrote letters to these authors to get involved with these local communities, connecting the two, to enrich both. His role as a mediator between tribal communities and museums, to facilitate wider discussion.  

Brandi then asked a question about futures for rural individuals. 

Cherisse responded on how the process of connecting rural individuals with stories of which they were previously unaware allows people to be more comfortable with their history. She spoke about the movement of rural individuals returning to rural homeland.

Rae looks forward to a world where locals are looked to as experts, as opposed to looking at bystanders, particularly in red states. In those areas, mutual aid is ingrained in the way of being, so these communities can deal with them without relying on external federal aid, speaking to their resilience in these troubling times. 

Stephen noted how the assumption is that tribal communities have adversarial relations with settler communities, but he notes that in his mediated conversations, this animus is quickly dispelled and turns into a productive conversation. 

An audience member asked about regional differences historians encounter in their work, to counter overarching singular regional narrative. 

Cherisse noted that the picture of the South is very diverse; there is no singular narrative for the South. Rae noted how central Appalachia is a very unique region, and the stories vary within that same region, which actually caused them to scale back their studies to just this area. Stephen noted how the Trail of Tears is a singular story, when the story is wider, and removal is more of a story in the Southeast/Midwest. Many people are not willing to acknowledge that the land they themselves reside on stems from forced removal.  

Notes prepared by Aaron Pap, March 27, 2026 

Moderator Harleah Buck provided opening remarks discussing her work as Director of the Barbara and Richard Csomay Center of Gerontological Excellence. Dr. Buck is also a professor of Gerontological Nursing at the UI College of Nursing. Dr. Buck was joined on the panel by Tyler Hahn, the Director of the Cherokee Public Library in Cherokee, Iowa, as well as the Midwest representative for the Association for Rural & Small Libraries board. Dr. Stephanie Radke joined the panel as a professor at the UI Carver College of Medicine as well as a Fellow with the American Congress of Obstetricians and Gynecologists. Additionally, Dr. Kari Vogelgesang joined the panel as the Director of the Baker Teacher Leader Center; Director of Professional Development for the Scanlan Center for School Mental Health; and Clinical Professor in Teaching and Learning at the UI College of Education. 

The panel consisted of three questions analyzing rural access issues. The opening question asked the panelists from their perspective, what they see as the strengths of being rural? Answers revolved around the relationship building and deep connections to community in rural areas. The relationships formed in rural communities were discussed as being particularly relevant in combatting the modern loneliness epidemic. Rural communities have a unique advantage in preventing social isolation by creating close-knit social circles between neighbors. Additionally, panelists shared how ingenuity and innovation is seen in rural areas, particularly in the healthcare space. Rural communities create strong team dynamics that can make hospital practices more adaptable and quicker in implementing new developments. 

The second question to the panelists asked, what are some of the challenges you see in rural areas? Panelists discussed rural hospitals closing labor and delivery units, lack of funding for community programs, and consolidation for the sake of efficiency. Rural areas have seen community programs disappear in recent years, creating a need for rural communities to self-advocate. It has become increasingly important for rural communities to take special care in preserving extracurricular programs for local schools and innovate to keep healthcare systems viable. 

The final question to the panel asked what things the panelists have seen on a day-to-day basis that gives them hope for the future of rural areas. Panelists shared their hope in the young people of rural communities. The next generation has shown an interest in advocating for their communities and a desire to modernize while maintaining the character of rural areas. Additionally, the increased dialogue on rurality and willingness by young professionals to engage with careers in rural communities has been an encouraging sign. The discussed focus for the future of these rural communities is for researchers to engage with rural areas rather than simply observe and be prepared to listen to the needs of these communities.  

The panel concluded with some brief questions from the audience discussing the challenges of getting involved in rural communities for newcomers, increasing reliance on midwives in rural healthcare, and the need to take inventory on areas of expertise and areas of need. The panelists urged audience members to reach out if they had any further questions on the topics discussed.

Notes prepared by Eli Walter, March 27, 2026