More than 60 million Americans live in rural areas, and they tend to be older and generally in poorer health than city dwellers, the U.S. Government Accountability Office says. But in the last 18 years, it has become even more difficult for them to find health care: 195 rural hospitals have either closed completely (100) or converted to emergency or outpatient care only (95), based on data from the University of North Carolina’s Cecil G. Sheps Center for Health Services Research. Ten states account for 60% of total U.S. rural hospital closures since 2005, with nearly a quarter of the closures among the top 10 in Texas alone, according to U.S. News & World Report. Eleven rural hospitals have closed so far this year.