Montana. and South Dakota are three times the rates in urban States. The rural poorand 43 percent of those in poverty live in rural Americasuffer most of all. Both infant and maternal mortality rates for migrant workers exceed the national average by approximately 25 percent. In Appalachia. infant mortality is twice the national average and deaths from infectious diseases are some 33 percent higher than the national average. Older citizens. who comprise a substantial portion of most rural communities. although now covered by medicare. frequently cannot take advantage of these new benefits because of the lack of clinics and hospitals in rural areas