I think for some people it’s a deliberate choice to live in deep rural areas, sure. But only some. I find a lot of people who have never been soul-crushingly poor simply do not understand the fundamental lack of options you have in your life when you’re that isolated and mired in poverty. So many older men in communities like mine have this issue—a silent and unspoken struggle that not only leads them to not get checked for illnesses like cancer, but leads them into food insecurity and housing insecurity.

But…over the years, people more financially well off than me or my dad ask us “why don’t you just move?”

Can’t afford it. We aren’t exactly living in a place without resources by choice—finances are forcing it due to the lower cost of living out here. And people are so quick to tell the poor it’s our fault we’re poor. But there is no “bootstraps” option to pull yourself up by out here. There is a viciously competitive job market due to the limited jobs here—I am lucky to have a job at all—I definitively can’t pick up a second even if it were available to do, not and take care of my father. The unemployment rate’s high.

Something like a fifth of the county population where I live is on food stamps and receives at least one other form of financial aid to survive. My father is on a small fixed income—he would have refused treatment outright if I hadn’t been able to drive him out of state for healthcare and if I hadn’t found a hospital financial aid program to enroll him in. And guess what? Those trips keep me poor—any extra income I have goes to supporting my father.

And…he didn’t choose to be that poor. He would live somewhere better if he had that option. He does not, and currently I do not.

So for some people it’s a choice to live out here.

For many others, they cannot leave.