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Research shows that infants born in rural areas, rather than cities or suburbs, are less likely to celebrate their first birthday.


This inequity isn’t rooted in individual risk behaviors or local health care systems alone, but also in broad community socioeconomic disadvantage. Improving maternal and child health outcomes in rural places requires widespread structural investments in the rural communities that support families. Yet, decision-making about how to invest in rural communities is often missing the perspective of those most affected by investments: mothers and children. 

This project creates a space for sharing those missing stories. 


This project offers a small glimpse into how mothers who are most affected by social, political, and ecological forces perceive these structures to influence their children’s health. Mothers and grandmothers living in rural Pennsylvania lift, through photos and storytelling, the places that support or hinder their family’s health, and how they want to see local investments used. Their experiences are central to re-imagining how governments and institutions could better support the health of rural families.

What is photovoice?

"Photovoice" is a research method by which researchers partner with participants who take photos and share stories about the photos in a way that reveals their own perspective or experience about a certain topic.


Rather than a researcher taking photos themselves, community members select the subject of photos and share their own story about the photo’s content. For example - why is this place important to you? What happened here? What does this place mean to you? How does this place affect your health?

Photovoice re-centers who tells the story and how it is told. It  connects diverse experiences and sparks new dialogue about how rural communities support healthy  families.

Why did we use photovoice to populate the atlas?

This project uses photovoice because we believe that mothers are the experts in their own lives. They know better than anybody what is affecting their health and their children’s health. Mothers possess in-depth knowledge about how social environments, ecology, and place impacts their family’s health.


But too often, the experiences of rural or low-resource mothers are not heard—or worse stereotyped — by those outside their community who have more power and influence. Even inside small and tight-knit communities, the way that individuals experience a place is unique to them.


Mothers, caregivers, and children have an especially unique perspective that isn’t always visible, even to others in the same community.  

Our Rural Pennsylvania is so grateful to the mothers and grandmothers who contributed to this atlas by collecting photos and sharing stories of their most personal experiences and meaningful places. During a pandemic that made everything harder for caregivers, their dedication, openness, and deep care are visible in every photo. 

This project is in memory of Mitchel Jacob and Brice Samuel Wallin. 

It is dedicated to my mother and to all mothers and caregivers who hold untold stories.

May the stories of mothers and caregivers in rural Pennsylvania resonate with mothers from many places,

large and small, raising their children in spaces that value the idea of motherhood

but not the act of supporting mothers.


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