Using a national dataset, the influence of the community and individual provider characteristics on the availability of healthcare resources in rural areas was evaluated. Disparities continue to exist in the availability of providers including organizational types of providers such as Community Health Centers and Community Mental Health Centers. A lower percentage of nonmetropolitan counties have such centers, and more rural counties within the general grouping of nonmetropolitan counties have fewer of these organizational resources. A case study on the Southwestern region of Virginia is presented to highlight the impact on health outcomes and an innovative community response to the lack of availability of needed healthcare services. © 2006 Lippincott Williams and Wilkins, Inc.