Contents lists available at ScienceDirect Journal of Rural Studies journal homepage: www.elsevier.com/locate/jrurstud Help wanted: Health care workers and mental health services. An analysis of six years of community concerns from North Dakota's oil boom residents Karin L. Becker College of Business and Public Administration, University of North Dakota, Stop 8366, Grand Forks, ND, 58202-8366, USA ARTICLE INFO Keywords: Boomtowns Energy development Community health needs assessments Social change Social disruption Rural development ABSTRACT The research exploring the social impacts stemming from rapid growth in oil extraction communities has yielded two viewpoints: one that suggests increased economic development and opportunities and one that indicates social disruption and challenges. It has yet to be determined which hypothesis will be supported by the boomtown residents of western North Dakota. To better understand the extent of change communities in North Dakota have experienced, this article examines concerns derived from community health needs assessment data compiled over a span of six years. Seven community assessment reports are analyzed and aggregated to de- termine the overall prioritized community needs in the Bakken Formation of western North Dakota. Then, the community member feedback is analyzed using a grounded theory approach to better understand the prioritized needs. The community concerns are one way to understand the impacts of rapid growth and provide a snapshot of the extent of change residents have experienced due to an increase in population, wealth, and development. The community member feedback is used as a starting point to enter the corpus of boomtown literature and adds to our understanding of the social disruption theory. As the priority of concerns fluctuate over the years, the common thread of health care workforce shortage and mental health services remain prominent in rural North Dakota as well as energy extraction communities in America. 1. Introduction While it's not a bust, the boom is over in North Dakota. The oil price collapse of 2014–2015, from $115 a barrel in the summer of 2014 to $30 a barrel in 2016, has slowed North Dakota's oil production, causing significant consequences on the state's economy (Berman, 2015). The post-boom economy was marked by a 33% decrease in taxable sales stemming from low crude oil prices and low agricultural commodity prices (Rauschenberger, 2016). Yet the social effects of how the boom, and its downturn, has impacted communities is not as clear cut. Over the last decade, residents living in the oil-impacted areas of western North Dakota have witnessed first-hand the changes in their community due to population growth, stresses on infrastructure, and uses of com- munity services. While objective indicators such as lack of housing and increased demand for law enforcement have been reported, community residents' perceptions of the boom's impacts on their community is not as well-known. This article fills that gap by providing oil patch residents' perspec- tives on community change. Community level data that has been cap- tured in two cycles (2011–2016) of community health needs assessment reports from seven oil-impacted counties are analyzed to determine if North Dakota's oil experience aligns with the social disruption theory. As population increases in boomtowns, which are characterized by declining and relatively homogenous populations prior to the boom, the social disruption theory states that communities enter a crisis period where traditional routines and attitudes are disturbed (Cortese and Jones, 1977; Little, 1977; England and Albrecht, 1984). The rapid changes to the fabric of the community can lead to a variety of social problems including disrupting individuals' mental health, world views, social networks, and disorganizing overall community health (England and Albrecht, 1984; Greider and Krannich, 2009). By comparing how community concerns have changed over a span of six years against the rise and fall of oil, this analysis shows how rapid growth has influenced prioritized community health needs and dis- cusses how community perceptions align with other boomtown ex- traction communities. On an individual community level, the data re- veal locals' concerns; combined, the aggregated assessment data paint a picture of emerging social impacts stemming from the boom. This ar- ticle first provides context of North Dakota's oil boom and examines it against the boomtown and social disruption research. Next, community member feedback is presented which is then examined alongside sta- tewide statistics and national reporting on North Dakota's oil boom to provide a lens in which to view the community responses. https://doi.org/10.1016/j.jrurstud.2018.08.012 Received 12 February 2018; Received in revised form 17 August 2018; Accepted 20 August 2018 E-mail address: Karin.becker@und.edu. Journal of Rural Studies 63 (2018) 15–23 0743-0167/ Published by Elsevier Ltd. T