Overview:
A webinar hosted by the Public Health Institute of Western Massachusetts discussed the public health challenges facing rural communities in Franklin and Berkshire counties, including access to health care, mental health services and substance use treatment, transportation barriers, economic hardship, and digital access and literacy. The presentation also highlighted the progress made from shared services and state support.
A Public Health Institute of Western Massachusetts webinar provided a check-in on public health issues facing rural communities on Friday, while also detailing progress made in shared services and state support to Franklin and Berkshire counties.
The presentation provided an overview of public health needs and effective policy measures that are underway, along with questions from the audience on the impact of federal funding cuts on western Massachusetts.
Using data from the 2025 Community Health Needs Assessment conducted by Cooley Dickinson Hospital, Lisa Ranghelli, director of assessment and capacity building at the Public Health Institute of Western Massachusetts, explained there are overlapping themes across rural populations, which include challenges with access to health care, mental health services and substance use treatment, along with transportation barriers, economic hardship, and digital access and literacy.
“We saw a lot of themes that really resonated in rural communities,” Ranghelli said of the data. “We specifically were looking at certain populations, which included young children and their parents and caregivers, older adults, 65-plus, immigrants and refugees, people experiencing poverty, and people who are unhoused or face housing challenges.”
In Franklin County, Greenfield and all towns north, west and east of the city are ranked as Level 2 Rurality, described as “most rural,” which means these towns are not densely populated and are more remote. Data from the 2023 Community Health Equity Survey, involving 1,397 respondents in most rural western Massachusetts communities, also illuminated the issues facing these towns. Forty-one percent of respondents reported struggling to meet basic needs and 19% shared that they have unmet health care needs.
The data laid the foundation of “what’s on the ground” from the perspective of Franklin Regional Council of Governments Director of Community Health Phoebe Walker and Berkshire Regional Planning Commission Public Health Program Manager Laura Kittross.
One of the commonalities between Franklin and Berkshire counties, Kittross said, is that virtually every municipality is covered by a shared service arrangement, “which has really allowed us to provide professional, standardized public health services across the counties.” Kittross noted these services are funded by the Public Health Excellence Grant Program, which provided $26.2 million to 56 recipients in fiscal year 2026.
In Franklin County, funding from the Public Health Excellence Grant Program supports a shared service agreements through FRCOG called the Cooperative Public Health Service, which help 15 boards of health in member towns with permitting, licensing and inspections, along with other health and regulatory services. Earlier this month, state public health leaders visited Orange, Gill and Amherst as part of the Public Health Excellence Grant Tour, where the Cooperative Public Health Service received praise from officials for its scope and efficiency.
“It is transformative to actually have rural communities be able to have a professional team of public health inspectors and public health nurses,” Walker said.
Two other successful public health initiatives, Walker and Kittross noted, were the Franklin-Hampshire and Berkshire-Hampden training hubs for public health practitioners to gain standardized knowledge for health inspections. The Community Health Improvement Plan is also an initiative of both FRCOG and the Berkshire Regional Planning Commission, and both share similar programs for the distribution of opioid settlement funds and initiatives for aging and dementia-friendly communities.
The end of the presentation allowed time for questions, including about how federal changes to eligibility to programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP), and funding for subsidies from the Affordable Care Act not being renewed, might impact rural communities.
State Sen. Jo Comerford, D-Northampton, explained that the federal turbulence has impacted the FY26 state budget. This includes leaving $800 million in funding unappropriated for state programs, with another $130 million then cut by Gov. Maura Healey before the budget was signed in July.
“Many programs were either held static, which means they actually got a cut because of inflation, or they were actually cut, including rural school aid cut by $4 million,” Comerford explained. “Why was that? Because already we could see the turbulence with regard to health insurance and the forthcoming cuts to Medicaid.”
Comerford also noted the difficulty caused by the SNAP funding crisis during the 43-day government shutdown, the loss of SNAP assistance for people due to eligibility changes in the One Big Beautiful Bill Act and future issues facing the health care system as Medicaid changes go into effect.
“The people on this call, who care about this, you can help,” Comerford said. “You can help us by prioritizing what’s most important to you. You can talk to us about increasing possible revenue.”