RURAL HEALTH: Our work in the field, and resources for reporting on health-care reform

This page provides links to assist in reporting on the massive legislative package, the Patient Protection and Affordable Care Act, passed in March 2010, and describes some of the health-related work of the Institute for Rural Journalism and Community Issues.

Health coverage is major mission for Institute

Most rural areas face challenges in the accessibility and affordability of health care, and many have poor health status. However, rural news outlets often lack the knowledge or motivation to help their readers, listeners and viewers live healthier lives and make better health-care decisions.

Some shy away from looking like crusaders, but the Institute for Rural Journalism and Community Issues argues, “If a news outlet can’t take a stand for good health and better health care, what can it stand for?”

Health topics have been a major focus of the Institute from the start, and are increasingly so.

Its first conference for journalists, “Covering Health and Health Care in Central Appalachia,” led to an Institute presentation, “How Rural Journalism Can Help Rural Health,” at national and state rural-health conventions, and a project that provided a template for rural health coverage.

The Institute obtained funding from the Foundation for a Healthy Kentucky to produce locally oriented stories for special sections on health in weekly newspapers in Appalachian Kentucky. Papers financed the sections by selling advertising, mainly to health-care providers.

At the Institute’s urging, one paper mailed copies to nonsubscribers, who probably need health information more than subscribers. A survey found they would be more likely to subscribe if they knew the paper would have regular features on health. That provided a good argument for papers to do health sections on their own, and several have.

At least one, the Todd County Standard, not only mailed to all homes, but designed its section around a packet of information the Institute sent to every Kentucky paper – the pertinent pages from a county-by-county compilation of health data, including strategies for addressing the main health problems in each county.

The Institute used the report’s data on diabetes to recruit rural journalists to attend the Kentucky Diabetes Solutions Summit in 2008. Journalists came from three of the five counties with the highest diabetes rates, two others in the top 20, and two other counties. All wrote articles about the subject, and one did a four-part series. This suggested that when told their community has a major, specific health problem, rural journalists and their employers will respond.

The Kentucky Institute of Medicine was less successful when it tried to use the county data to get news of certain health problems in print, but it pointed the Institute for Rural Journalism and Community Issues in a direction that may result in more coverage.

With the IRJCI's assistance, an intern for KIOM prepared articles for 16 Kentucky papers about health problems in their regions, but only two published the articles. A rural-journalism institute researcher found that the plurality of articles on health-related behavior in the papers were “advertorials” promoting a health product, service or provider, and that relatively few articles were written by health professionals or newspaper staffers. Results of the study were presented at a national conference.

Under a contract with the Foundation for a Healthy Kentucky, the Institute is conducting research to determine why Kentucky papers run certain health-related articles and not others. Some rural editors have told the Institute that they would like to do more health coverage, but are reluctant to make special efforts for fear of being seen as crusaders.

The findings of the research will guide the Institute as it generates health stories and distributes them to news outlets.

The Institute makes a point to avoid advocating for anything but coverage, commentary and things that facilitate them, in order to maintain its credibility with its clientele, which ranges from very liberal to very conservative. But it partnered with advocates of smoking bans on “Sorting Through the Smoke: Covering Tobacco and Health in Your Community,” a series of seminars and a soon-to-be-developed website, because heavy use of tobacco in Kentucky has such a major impact on the state’s health. The Institute made sure that a leading opponent of smoking bans had time to espouse his libertarian and free-market views and answer journalists’ questions in a give-and-take session with the leading advocate of smoking bans in the state.

The Institute’s health work extends to the national level, with presentations at national conferences and hundreds of items on The Rural Blog. The Institute also helped a talented rural journalist, Tara Kaprowy of The Sentinel-Echo in London, Ky., gain a national Health Coverage Fellowship funded by the Foundation for a Healthy Kentucky. Her reporting since her week in Boston has included a series on obesity, with some follow-up stories. “They were well received and created a lot of positive conversation in the community,” Publisher Willie Sawyers said.