We’re reporting on how changes in federal policy show up in rural healthcare. And what that means for the economy wherever you are. We visited Thomasville, a town of about 3,500 people in southwestern Alabama, to learn more about the economic challenges of keeping a hospital running in rural America. What happens to a local community — and a local economy — when the only hospital in town closes? On the main street of downtown Thomasville, there’s a bakery, a movie theater under renovation, and the Thomasville Sports Hall of Fame. It was there we met Jimmy Duncan. “They put me in the hall of fame about six, eight months ago,” Duncan said. He was a college football national champion in 1971. But after his playing days, Duncan worked at the nearby paper mill his dad helped open.

“You see these knees right here?” Duncan asked. “That wasn't from playing football. That was from running up and down that floor, on that cement floor. But the paper mill is pretty tough work, but it was the highest-paying job in the area.” We also met Charlie Anderson, who’s Thomasville-born and -raised. He brought this hall of fame to life a dozen years ago. But we weren’t just visiting to relive the glory days; we also wanted to talk about healthcare, and the lack thereof in this area. “Thirty minutes in any direction you want to go, there are paper mill or wood products industries,” Anderson said. “Jimmy can tell you, accidents that happened at mills, you haven’t got two hours sometimes to drive somebody.”