Conversations about affordable housing are often dominated with the question of how to get lower-income residents in expensive cities—like New York, Los Angeles, or San Francisco (and their surrounding areas)—safe, affordable places to live. That makes sense: Often urban hubs are a good bet for jobs and economic vitality, but they’re also prohibitively expensive for many—creating well-known housing problems. But cities aren’t the only places that are lacking when it comes to adequate housing at affordable prices. In rural America, it's both prices and the terrible condition of existing homes that are problematic.

Few people think about rural communities—not only when it comes to housing issues, but at all. It’s mostly a numbers game. According to data from the Housing Assistance Council (HAC), in 2012 only about 21 percent of Americans lived in rural areas, which means that not many people outside those areas—or about 80 percent of Americans—probably feel much association with rural issues. And that can make it difficult to shed light on the problems that happen there. Making the case to divert funds and attention to parts of the country that house a mere 20 percent of the total population can be an uphill battle, especially in difficult economic times.

It can be hard to understand how finding affordable housing could be an issue in areas where housing is substantially cheaper than it would be in the nearest city or suburb. But the fact of the matter is, despite lower costs of living, income for many in rural areas is also significantly lower thanks to limited economic opportunities and struggling industries, like coal.

“When we are looking at areas that are most challenged economically we're also finding some of the most challenging housing conditions,” says David Dangler, the director of Rural Initiatives at NeighborWorks America, an organization that advocates for affordable housing and acts as a network for nonprofit housing groups. Poverty is high in rural areas, with about 17.2 percent of rural residents living below the poverty line in 2012 versus 14.9 percent nationwide, according to 2012 data from the HAC. “Much of the affordable-housing stock in rural housing areas is old and in need of repair. Many of the people who live there don't have the resources that they need in order to keep the houses in good repair,” says Sheila Crowley, president of the National Low-Income Housing Coalition.

For example, take Lynne Bouknight, who moved back to her childhood home in Elk Creek, Virginia, after her mother moved away for a job. When she was younger, Bouknight says that her father was able to take care of the upkeep of the place—a two-story, grey brick house—tinkering with things and fixing them as they broke. But by the time she was living in it, the house—built in 1949 by her grandfather—began to show its age. “The water went first,” Bouknight remembers. At first it wasn’t so bad she says, she was in good health then, and she could haul water inside after the pump broke, and pick up kindling and timber from her property to make fires on her wood-burning stove. “I could build a fire in about a minute. The colder it is the faster I could build one,” she said chuckling. She had a friend who’d swing by to help her with small maintenance issues and she could visit neighbors and friends for showers and laundry. But then things took a turn for the worse.

The wind began to tear away at the roof, and rip tin off the house. And some of the windows started to give way, too. Her friend, who would help her out with household maintenance, was killed in a hate crime she said. And Bouknight had a stroke. “As the house came apart, my health deteriorated with the house,” she said tearfully. With the extensive damage, it was easy for the elements to take even more of a toll on the property. Bouknight found herself relegated to a small section of her home—living upstairs in her childhood bedroom—the one place where it was dry and where the roof remained in tact.

She tried to get help from the USDA, the group that is largely responsible for administering housing aid to rural communities, but they said they couldn’t do anything to help her rehab her property, she said. Then help came from somewhere else. A woman who worked for a human-service organization called HOPE Inc., agreed to take a look at her situation to see if they might be able to assist. “One day she came out to the house, I wasn’t at home. She looked around and I suppose her heart was touched. She couldn’t believe someone could live in those conditions,” Bouknight said.

With the help of HOPE Inc., which provides housing aid and support for those living in rural areas, Bouknight’s home was salvaged and she received access to what many might consider basic necessities, like running water. The help came just in time, too. Bouknight says with her depleted health, there’s no way she could have carried on with the house in the state it was prior to the intervention.

Bouknight’s hardships might sound extreme, but dangerous or unhealthy housing conditions aren’t an anomaly in many rural areas. Residents who aren’t able to save their homes, or find new homes that they can afford are often forced to double up with family members, or they become homeless, says Crowley. “It's not visible because people aren't on the streets: They're living in cars and they're living in campgrounds." According to the National Alliance to End Homelessness, on average there are 14 homeless individuals per every 10,000 people in rural areas versus 29 homeless people per every 10,000 in urban areas.

When it comes to creating new homes, interest is often thin and those that do opt in, face many unique hurdles. “Developers can't count on any kind of municipal infrastructure to help them,” says Dangler. When it comes to building, things that are often taken for granted in more urban areas, like water, sewers, and even access to quality roads, aren’t guaranteed, which can make building a quality house much more challenging."

Aid is somewhat sparse too, for both building and rehabilitating properties. “There's a handful of programs that serve people in rural communities. They tend to be much smaller in scale in terms of the amount of money than the HUD programs. They also tend to be lost in the bureaucracy,” says Crowley. That’s particularly problematic because “rural areas have been traditionally more dependent upon public subsidies and publicly-funded programs than their urban counterparts,” according to Dangler. “There can be a disproportionate pain in rural areas as we attempt to right our financial books by cutting back on federal-housing programs.”

And in fact, funds for rural housing provided by the USDA via the 502 Direct Loan program—one of the government-aid programs for purchasing or rehabilitating homes in rural areas, cited by several people as a resource for very-low-income residents—have decreased over the past few years, dropping from about $2.1 billion in 2010 to around $828 million in 2013.* Some still say that there isn't enough money, and some even point to the current administration specifically. Jim King, the president of Fahe, a nonprofit housing organization that serves Appalachia, says that the problem is more indicative of the lower prioritization of rural issues overall than it is about one administration in particular. “In light of all the other issues, this is just one that lays further down for almost everybody,” says King. And finding funds from other agencies for rural projects can be difficult and highly competitive, he says, leaving rural residents in a tough spot.

That may be why many rural communities are taking the task of rural revitalization into their own hands with the help of rural-focused nonprofits that help provide everything from advocacy to actual loans. More work done by these groups is cropping up all over the country: In Appalachia Knox Housing Partners built an affordable senior-housing complex. And NeighborWorks of West Vermont successfully helped rehab hundreds of homes for increased energy efficiency, a cause that's particularly important for low-income, rural residents. Some nonprofits are also leveraging what they call sweat-equity, which calls for community members to actively participate in the manual labor of creating and repairing not only their own homes, but the homes of those who live around them as well—decreasing the financial burden of building while, hopefully, forging strong community ties.

Rural housing advocates are also urging residents to consider a type of middle ground between homeownership and renting—manufactured housing. These, prefabricated homes, commonly referred to as trailer homes, are smaller than traditional homes, but offer most of the amenities of a house at a lower price. Rural areas typically have a higher rate of homeownership than the national average, about 72 percent versus 66 percent in 2012, according to HAC. And the desire to own, rather than rent is a hard one to shake, especially when few rental properties exist in these communities. “Because there's such a lack of rental housing, manufactured housing in some aspects fills that void. That is a foot in both worlds,” says Lance George, director of research at HAC. That is, if people can manage to get over the stigma once associated with these properties.

Many housing experts agreed that often the case for investing in rural housing on a large scale feels like a difficult one to make. In a way, it seems counterintuitive: funneling money into communities where population numbers are stagnant, if not declining, as more young residents head to cities and suburbs in search of jobs. And some wonder: Why don’t others just leave, too? But some residents don’t have the means, and others feel tied to their homes, communities, and lifestyles. Many are also older. The population of rural America is aging more rapidly than the nation as a whole, thanks in part to the exodus of young people. That means rural residents are less likely to pick up and move, but they will also require updated homes, facilities, and new infrastructure that can allow them to live safely and access services, like hospitals, which they will probably use more frequently as they age.

Rural housing advocates admit that the task of revitalizing rural communities isn’t a small or simple one. But that doesn’t mean that organizations should shy away, give up, or turn a blind eye says King. “The stakes are very high in rural places if we don't figure some stuff out. People and places shouldn't be disposable.”

* This post was updated to clarify that very-low-income residents were cited as the primary candidates for this specific loan program.