Abstract

How do rural communities promote residents' health and wellbeing in the context of large and seemingly intractable problems such as persistent poverty, racial inequality, and geographic isolation? Through case studies of two development initiatives, this article examines collective actions by non-profit organizations to improve health and wellbeing in the Mississippi Delta region of the United States over the past 5 years. Our study applies the livelihoods framework to assess what these initiatives can teach us about the multi-level processes that contribute to inequalities in health and wellbeing in a rural setting and about the factors that enable and constrain interventions to address these problems. We find that Mississippi Delta residents pursue livelihood strategies in a context of vulnerability, where they face significant limitations to their ability to access and build human, social, and economic capital. Drawing on original analysis of primary and secondary data, we also find that organizations that provide support for individuals' aspirations, while also exposing and addressing the procedural and structural barriers that prevent the realization of these goals, can contribute to individual, household, and community wellbeing.

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