The UNC Sheps Center, which tracks rural hospital infrastructure in the United States, has documented 195 rural hospitals that have closed or converted to outpatient facilities since January 2005. Six are in Pennsylvania. Closures have far outpaced the opening of new rural hospitals during this period. As a physician who has trained in rural communities and a researcher who studies community well-being and public health, we see that every rural hospital closure exerts a domino effect on surrounding communities and residents. This can be difficult to quantify but manifests as lost jobs and economic decline, poorer health and a pervasive...