Rural areas, which account for 88% of French municipalities and are home to 22 million people, have poorer health indicators than urban areas. Life expectancy at birth, for example, is two years lower there than in urban areas. Rural areas are indeed characterized by specific socioeconomic and demographic vulnerabilities. And “the countryside” is not spared from pollution: pesticides, industrial facilities, and road infrastructure expose residents to harm. Local agriculture, often geared toward exports, benefits residents only minimally. The shortage of healthcare professionals limits access to care and preventive services, while mobility challenges hinder education, employment, and social life, especially for young people. However, stakeholders—whether institutional or community-based, professionals or local elected officials—are committed to promoting health. In Puy-de-Dôme, a network of ambassadors combats isolation among the elderly. In Vercors, a mobile bus addresses mental health issues among 11- to 25-year-olds. In Lorraine, a regional food initiative promotes access to high-quality, locally sourced food for everyone. These initiatives, while promising, would benefit from being more firmly grounded in scientific frameworks, even as the concept of health-promoting urban planning begins to inspire rural towns in their development projects. The rural world, through its diversity and capacity for innovation, offers valuable lessons and points the way toward public action that transforms living conditions, the environment, and the very fabric of social cohesion.