Typically, rural businesses generate lower revenues and employ fewer employees than their urban counterparts, in part because lower populations and lower income populations generate less demand for what businesses offer yet are dependent upon these offerings. Current assessments indicate that improvements in educational attainment and health status are lagging in rural areas, which threatens rural businesses as well as the vitality and resilience of rural communities. Small businesses are an important key to rural revitalization and prosperity because of their potential to provide employment and goods and services (Gladwin et al., 1989). Small businesses are the subject of research on many fronts, but there is insufficient research with respect to their place in rural community resilience and their ability to enhance health equity. Moreover, there is scant research on the health disparities of women and minority owned small businesses in rural communities.

Over the last four decades, globalization and technological change have altered the nature of work in rural communities. In many cases, global outsourcing has replaced traditional trades in mining, manufacturing, and agriculture. While these trends have affected the entire economy similarly, the slowness or inability of rural areas to recover has created an increasing economic divide between the labor and economic opportunities in urban versus rural communities. This confluence of events has led to the out-migration of the younger, more educated population while leaving in place an older population with skills that may not perfectly match the skills demanded by the types of jobs in the new economy (Dabson, 2018). This leaves in place a workforce that may be discouraged, displaced from previous jobs, and with no previous experience relative to the jobs available in these rural communities. As well, in some rural areas, out-migration has led to a labor shortage of working-age adults.

Rural areas rely on a higher proportion of self-employed and employment in small businesses and microenterprises (Phillipson et al., 2019). Small businesses and microenterprises, in turn, rely on a rural labor force limited by persistent labor obstacles – from labor shortages, lower wages, to slow technological advancement – resulting in lower revenues and lower productivity (Lund et al., 2019; Cromartie, 2017; Partridge et al., 2010). The rural labor force has been deeply affected by issues such as physical and mental impairment (von Reichert et al., 2014), lack of training and education infrastructure (Fletcher et al. 2002; Johnstone et al., 2003), and the prescription opioid-use epidemic (Havens et al., 2007; Wunsch et al., 2009). Current research highlights that health services and workplace training are lagging in rural businesses and have important implications on the overall wellbeing and economic opportunities of rural residents (Watkins et al., 2018; Vogler, 2019).

In particular, rural small businesses are constrained by their limited ability to sustain and promote workers’ mental wellness and productivity. Rural areas have higher behavioral health disparities (Gale et al., 2019), substance abuse (Wunsch et al., 2009), and suicide rates (Ivey-Stephenson, 2017) as compared to urban areas. Because workers’ state of mental wellness implicates physical health and productivity, rural small businesses are facing immense challenges in maintaining labor supply, productivity, and quality. To overcome these challenges, community trainings are instrumental. And yet, these resources are not currently accessible to rural small businesses. Moreover, the existing training programs are typically designed for large urban workers so the resource content may not be directly relevant or useful to rural small businesses. These training programs are also expensive, so are probably cost prohibitive to implement. Hence, the current state of the rural workforce still lacks proper educational support and is rife with worsening health and productivity issues at work leading to a decline in rural labor force participation and slower employment growth (Pender et al., 2019).

Organizations invest a significant number of resources in workforce training and development to improve employees’ technical, management, and supervisory skills (Cromwell and Kolb, 2004).  Wellness programs have become increasingly popular among large firms who are looking to improve employee wellbeing. Most workplace wellness programs tend to focus on modifiable risks such as nutrition, physical activity, and smoking cessation (Volpp et al., 2008; Halpern et al., 2015) over a short period. However, workplace wellness programs that have focused on overall employee wellbeing over a longer period (e.g., multi-year) have also examined whether these programs accrued any cost savings (health, absenteeism, etc.) for the employer (Jones et al., 2019; Song and Baciker, 2019).

Behavioral health issues such as depression, anxiety, suicidal thoughts, and mental distress are highly prevalent in rural areas (Gale et al., 2019), as is the dependency on prescription opioid-use (Havens et al., 2007; Wunsch et al., 2009). Research shows that the prescription opioid-use epidemic and the prevalence of behavioral health issues reduce the labor force participation rate and increase unemployment rates (Harris et al., 2020). Hence, it is vital understand the tools available and used by small rural businesses that will help them overcome the challenge of maintaining and developing a skilled and healthy labor force. Current research shows that one way to attract and retain talent is for rural firms to provide non-pecuniary benefits such as skills development, career advancement, tuition assistance, and flexible scheduling (Bozarth and Strifler, 2019). To narrow the skill gap, employers need to actively engage in improving the capability and skills of their workers by engaging in training programs (Marri and Schramm, 2018).

Building and maintaining a skilled workforce is a challenge for rural employers. Thin labor markets mean that demand for labor is low, and relatively little competition for workers suggests that employers have little incentive to invest in workforce development training, be it through training or employee wellness programs. There is also a strong call for communities to recognize and to focus on the pervasive mental health crisis in rural America. A crisis which is credited for affecting employee mental health and leading to decreased worker productivity, quality of work, and worker retention in rural America. Previous research has neglected to study the tools that might help rural small businesses cope with these workforce issues, especially those tools related to workforce wellbeing and retention. Designing innovative solutions to tackle these problems is important not only for enhancing employee wellbeing but also to increase the productivity and functionality of rural small businesses.

Once such approach is the recovery-oriented system of care (ROSC). The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a recovery-oriented system of care as being “a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families, and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems.” Over the past decade, ROSCs have been created to address both mental health and substance use. The North Central Cooperative Extension Association (NCCEA) is currently funding an Extension effort focused on ROSC development using a complex adaptive system approach to describe the community relative to the pathways that an individual may take to substance use, their interactions as an active user, and the multiple pathways that may exist for entry into long-term recovery. This current work involves a partnership between Extension at Purdue, Illinois and Ohio State universities.

This novel ROSC model advocates for a broad range of organizations, agencies and employers (businesses), as well as community members, to be included in the system of care. Like the SAMHSA model their conceptual framework is depicted as concentric circles, like a bullseye. In this model, the individual is at the center with support services representing personal contacts in the next layer, coordinated systems representing community assets and organizations in the third circle, and finally, outcomes in the last circle. The innovation is related to how the ROSC is formed and functions. A common hub and spoke approach is replaced with a complex adaptive system that can be catalyzed by Extension, but is not led by any single organization. Instead, the ROSC is an ever-evolving network of connections. Outcomes include both individual and community level measures of success and resilience, recovery, as well as health and wellness goals for the individual.

The personal and community organizations and assets listed in the ROSC framework make up recovery capital. Recovery Capital includes four domains: personal, cultural, family/social, and community. Personal capital are physical and human capitals that a person possesses. Cultural capitals are part of community capitals and represent the availability of culturally based treatment and recovery modalities. Family and social capital is found in supportive relationships which may be in or out of the home, at work, in places of worship, or other social spaces. Lastly, community capitals encompass attitudes among government agencies, policies affecting treatment and recovery services, beliefs of the community at large, and availability of treatment and recovery supports. What remains to be done, from a research perspective, is to determine the optimal role of small business in rural ROSCs and the potential benefits realized by the businesses (increased access to and effective recruitment from a healthy workforce, a decrease in employee retention issues, increased connectivity with community members and organizations and other local businesses, etc.) and individuals in recovery (increased access to employment opportunities, decreased incidence of ‘organizational consequences related to employee performance, etc.).

A systematic theoretical and empirical approach warrants considering simultaneous stressors on the business, family, and employees to understand what leads to small business survival and functioning, enhances human capital, and produces sustainable economic opportunities. This project examines innovative and evidence-based approaches for enhancing workforce development and organizational wellbeing for small rural business owners, with an aim of promoting community prosperity and wellbeing.