Rural Minnesota is aging more rapidly than the rest of the state, and northern St. Louis County is part of that trend. Older adults already make up a growing share of the population, outnumbering children in many rural communities. The 2025 Minnesota Rural Health Care Chartbook, released Monday by the Minnesota Department of Health, outlines how that demographic shift is colliding with signs of strain across the rural health care system.
One of the clearest indicators is in emergency medical services. Minnesota saw a net loss of 542 EMS certifications last year, MDH reported, a decline that is being felt most sharply in rural areas. Small departments often have a limited number of responders, so even one or two departures can reduce coverage and extend response times. The trend arrives as the region’s population grows older, increasing the number of medical calls that depend on a prompt EMS response.
That context matters when looking at the report’s findings on stroke care. MDH notes that access to stroke-capable hospitals has improved substantially, with roughly 84 percent of rural residents now living within a 30-minute drive of a designated facility. The expanded hospital readiness is a clear gain, but its effectiveness hinges on the first link in the chain. Without adequate EMS staffing to reach patients quickly, the benefit of having more stroke-ready hospitals within driving distance becomes harder to realize.
Telehealth is mentioned as a possible solution that isn’t living up to potential…
Telehealth, which expanded rapidly during the early years of the pandemic, has not filled the gap as broadly in rural Minnesota as hoped. MDH notes that rural residents used telehealth at lower rates than urban residents over the past year. While the report estimates that around one in ten rural Minnesotans lacks adequate broadband for video visits, the experience within northern St. Louis County suggests the number may be higher in some areas. Broadband access remains inconsistent, and in locations where fiber has not reached, video-based care can be unreliable. The variation limits the effectiveness of telehealth as a substitute for in-person services.