Weeds have punctured through the vacant parking lot of Martin General Hospital’s emergency room. A makeshift blue tarp covering the hospital’s sign is worn down from flapping in the wind. The hospital doors are locked, many in this county of 22,000 fear permanently.

Some residents worry the hospital’s sudden closure last August could cost them their life.

“I know we all have to die, but it seems like since the hospital closed, there’s a lot more people dying,” Linda Gibson, a lifelong resident of Williamston, North Carolina, said on a recent afternoon while preparing snacks for children in a nearby elementary school kitchen.

More than 100 hospitals have downsized services or closed altogether over the past decade in rural communities like Williamston, where people openly wonder if they’d survive the 25-minute ambulance ride to the nearest hospital if they were in a serious car crash.