New report shows rural health care falling behind

Though rural Americans have more chronic health issues than those who live in urban centers, they have poorer access to health care, a working paper released last month confirms. Health experts are pointing to technology, such as telemedicine, to help bridge the gap.

The paper was compiled by the UnitedHealth Center for Health Reform & Modernization, an arm of the nation's largest health insurer. It found "there are only 65 primary care physicians per 100,000 rural Americans — 40 or so less than the 105 per 100,000 urban and suburban Americans," Molly O'Toole of Reuters reports. "Already five million rural residents live in 'shortage areas' defined by the government as counties with less than 33 primary care physicians per 100,000 residents." The problem intensifies when it comes to specialists, with rural areas having fewer than half the number of surgeons and other specialists per capita.

The study incorporated results of a survey of about 3,000 patients and primary-care physicians. It found drug abuse and teen pregnancy are bigger concerns in rural areas than in cities. Rural people tend to think their local health care is lower in quality than in urban centers. In many instances, they're right. "UnitedHealth confirmed this 'equality deficit' is supported by data showing that in 70 percent of markets, rural quality of care was measurably worse than in urban areas," O'Toole reports. "With expanded coverage through recent health-care legislation, the study predicts around "8 million more rural residents will join Medicaid." (Read more)

Mountaintop-removal foes press for Blair Mountain hearing as CNN documentary is set to air

Several groups opposed to moutaintop-removal coal mining are asking a West Virginia judge to order a state Department of Environmental Protection hearing to determine the fate of Blair Mountain, just days before CNN is to air a documentary on the issue, using the mountain as an example. (MapQuest image)

"DEP can't just skip the public hearing because it's more convenient for them to do so," Bill Price of the Sierra Club said in court. "Blair Mountain belongs to all West Virginians, and all West Virginians have a right to weigh in." The Associated Press reports the National Trust for Historic Preservation, Friends of Blair Mountain, the Ohio Valley Environmental Coalition, the West Virginia Labor History Association and the West Virginia Highlands Conservancy are also in the lawsuit.

On Sunday, Aug. 14 at 8 p.m. ET and PT, CNN will air the documentary, "The Battle for Blair Mountain: Working in America," focusing on mountaintop removal's impact on communities, jobs and the enviroment, Taylor Kuykendall of The Register-Herald in Beckley, W.Va., reports. The documentary will air again on Saturday, Aug. 20. (We have seen promotions on CNN saying the program airs this Sunday, but CNN's website says Aug. 14.) Correspondent Soledad O'Brien examines the fight over proposed mining of the mountain and a recent march to it protesting the plan and commemorating the 1921 battle between union members and federal troops.

For CNN's summary of the show, click here. Click here for additional reporting on the mountaintop-removal debate and video excerpts from the show. CNN Student News says it will have guides for educators and parents on its website before the documentary airs.

Universities in Va., W.Va., N.C. start project to improve Southern Appalachia's food system

Researchers from three Appalachian universities are teaming up to make healthier food more accessible in the southern half of the region. By surveying where food is grown, assessing farmland and gauging the distance between food and residents, the researchers will identify areas of greatest need and try to help establish sustainable food systems, Zinie Chen Sampson of The Associated Press reports. The goal is to improve individual health and the regional economy while strengthening local communities. (Virginia Tech photo: Farmers' market in Blacksburg, Va.)

"The Southern Appalachian region has historically struggled with high levels of food insecurity and economic instability," Susan Clark, associate professor of human nutrition, foods and exercise at Virginia Tech and lead investigator on the study, said in a release. "We aim to enhance knowledge of barriers and opportunities for improving food security and economic viability through local and regional food system development in this region."

The project is part of a three-year, $2 million initiative by the U.S. Department of Agriculture's National Institute of Food and Agriculture. Partners are West Virginia University and North Carolina State University. (Read more)

Local food may be better, but it's often more expensive, and that has been the main obstacle for a striggling restaurant in Meadowview, Va., Jane Black of The New York Times reported last week. The Harvest Table is owned by Steven Hopp, husband of author AnneBarbara Kingsolver, whose 2007 book Animal, Vegetable, Miracle: A Year of Food Life, a memoir about their attempt to produce all their own food for a year, "helped introduce Americans to the locavore creed," Black writes.

One possible cause of rural obesity: lack of sidewalks

People living in neighborhoods with sidewalks get approximately 35 to 49 more minutes of physical activity per week than those with sidewalks, a 2009 study found, and "An emerging public health perspective links the ability of residents to easily walk or bike to a person's risk of becoming obese," The Tampa Tribune's Daniela Velasquez reports. "The streets in rural areas often don't have sidewalks or places where people can walk, jog or ride their bikes." (Photo by Joan Ginsberg)

The study's author, San Diego State University psychology professor James Sallis, told Velazquez, "In the U.S., probably half the population lives in neighborhoods where it is not feasible to walk for transportation, thus putting them at risk for many diseases." The design of neighborhoods "influences people's walking, bicycling and jogging habits, according to a University of North Carolina-Chapel Hill study published in December," and a 2008 study by the Centers for Disease Control found "children who walk or bicycle to school have better cardiovascular fitness than children who do not actively commute to school," Velazquez writes.

Dolly Parton apologizes to lesbian couple for censorship of gay-marriage T-shirt at her park

Jennifer Tipton and Olivier Odom

"Dolly Parton has apologized to a lesbian couple for an incident in July in which one of the women, who was wearing a T-shirt with a slogan promoting gay marriage, was denied entrance to Dollywood's Splash Country theme park until she turned the shirt inside out," Jayne Clark reports for USA Today.

Parton issued a statement saying in part, "Everyone knows of my personal support of the gay and lesbian community. Dollywood is a family park and all families are welcome." She issued the apology after Dollywood canceled a meeting with the couple because they wanted to include a representative of the Campaign for Southern Equality, a gay-rights group, the Knoxville News-Sentinel reports. (News-Sentinel photo by Saul Young)

Dollywood is in Pigeon Forge, Tenn., near the Great Smoky Mountains National Park. Parton grew up nearby.

Maine police chief sees crisis in abuse of bath salts

Police in Bangor, Maine, the big town for most of a very rural state, report as many as seven daily incidents involving bath salts, "a synthetic cathinone" that produces highs lasting 20 minutes to three hours with possible manic behavior, delusions, paranoia, hallucinations, hyperactivity, nightmares, violence or suicidal depression to follow, Andrew Neff of the Bangor Daily News reports. This high volume of incidents have local law enforcement seeking answers. (CBS News photo)

"Over the last two months, it has gotten out of control quickly and as bad as anything I can recall in my nearly 29 years in law enforcement," Police Chief Ron Gastia told city officials, emergency workers and politicians at an assembly. "This issue has reached close to epidemic proportions and certainly, at least to me personally, is a crisis."

The first reports of bath salts in Bangor came in the spring, and the drug's popularity has since grown. Police Lt. Tom Reagan credits that to cheap prices, easy access and small legal penalties. "It was initially thought of as safe, cheap and easily available. Also the penalties are not as severe as it is a Class E crime to sell it. People still look at this drug as one worth taking the chance to use because there is little chance of jail time if you get caught." The penalty for users and sellers may be as small as a $350 fine or a summons, Neff reports.

Click here to listen to The Maine Public Broadcasting Network's report on bath salts.

There's one proven case of fracking ruining a water well; critics suspect drillers settle to hide more

Former Environmental Protection Agency officials are speaking out against the gas industry's claim that hydraulic fracturing poses no risk to drinking water, while the American Petroleum Institute defends fracking, saying the sole available example of contamination "was potentially caused by a malfunction," Ian Urbina writes for The New York Times.

Carla Greathouse, lead author of a 1987 EPA report detailing the only publicly accessible, documented case of fracking contaminating drinking water, in Jackson County, West Virginia, speculates there could be others among many sealed legal documents. "I still don't understand why industry should should be allowed to hide problems when public safety is at stake," she told Urbina. "If it's so safe, let the public review all the cases." Dan Derkics, a 17-year EPA veteran, told Urbina, "I can assure you that the Jackson County case was not unique." It was reported in 1984, did not involve the use of chemicals used today, and at 4,200 feet the gas well was shallower than many modern wells. The contaminated water well was 400 feet deep. Perhaps most importantly, a nearby abandoned well, with faulty casing and cracked cement, may have been the conduit for the contamination. (Times diagram by Frank O'Connell and Haeyoun Park; for the full version click here)

Urbina writes, "Drilling technology and safeguards in well design have improved significantly since then. Nevertheless, the report does contradict what has emerged as a kind of mantra in the industry and in the government," that there are no documented cases. Researchers "were unable to investigate many suspected cases because their details were sealed from the public when energy companies settled lawsuits with landowners," Urbina writes. American Petroleum Institute spokesman Eric Wohlschlegel told him, "Settlements are sealed for a variety of reasons, are common in litigation, and are done at the request of both landowners and operators."

Though there have been many reports of fracked gas migrating into water wells, "Most drilling experts indeed have said that contamination of drinking water with fracking liquids is highly improbable," Urbina writes, but EPA is studying the risks. Fracking fluids contain carcinogends such as benzene, he notes. (Read more)

National Newspaper Association announces winners of its awards for general excellence

Seventeen non-daily and three daily newspapers were recognized today for general excellence as a part of the National Newspaper Association's Better Newspaper Contest. Each daily and non-daily entry was evaluated on quality of writing; headline language; use of photos and art work; evidence of craftsmanship and skill in composition, reproduction and presswork; editorial pages; front page; family life/living pages; sports pages; advertising design and layout, quality and technique of writing copy; handling of classified and/or reader ads and taste; and treatment of public notices.

The Antelope Valley Press of Palmdale, Calif., won the daily division. It finished in the top three (unranked at this point) last year, and we wrote here about Editor Dennis Anderson, right. The Press was followed by the Wyoming Tribune Eagle of Cheyenne and The Union of Grass Valley, Calif. We wrote about Union Editor Jeff Pelline here.

The non-daily division was divided into four divisions based on circulation. The repeat winner in the 10,000+ division was The Taos News of New Mexico, edited by Joan Livingston, left, followed by the Idaho Mountain Express of Ketchum and The Ellsworth American of Maine, which also placed last year. The Valencia County News Bulletin of Belen, N.M., received honorable mention.

All three winners in the 6,000-9,999 division were repeats from last year. The N'West Iowa Review of Sheldon was first, followed by The Southampton Press-Eastern Edition of New York and the Jackson Hole News & Guide of Jackson, Wyo. The Sequim Gazette of Washington state received honorable mention.

There was a repeat winner from earlier years in the 3,000-5,999 division: The Wise County Messenger of Decatur, Tex. It was followed by the Hutchinson Leader of Minnesota and the Mount Desert Islander of Bar Harbor, Me., sister paper of The Ellsworth American. Both won last year. The Litchfield Independent Review of Minnesota won honorable mention.

The winner of the small-newspaper division was the West Point News of Nebraska, followed by The Journal of Crosby, N.D., and the Countywide & Sun of Tecumseh, Okla. The Banks County News of Jefferson, Ga., and the Delano Herald Journal of Minnesota won honorable mention. All awards will be presented at the Toast to the Winners award reception, Saturday, Sept. 24, at NNA's annual convention in Albuquerque.

Nominations sought for Gish Award for courage, integrity and tenacity in rural journalism

The Institute for Rural Journalism and Community Issues seeks nominations by Sept. 1 for the annual Tom and Pat Gish Award that recognizes courage, tenacity and integrity in rural journalism. The award is named for the couple, right, who published The Mountain Eagle in Whitesburg, Ky., for almost 52 years. Last year’s winner was Samantha Swindler of the Tillamook Headlight-Herald in Oregon for her investigative reporting at The Times-Tribune in Corbin, Ky., and the Jacksonville Daily Progress in Texas. Earlier winners have been the Gishes; the Ezzell family, publishers of The Canadian Record in Texas; and former publisher Stanley Dearman and Publisher Jim Prince of The Neshoba Democrat of Philadelphia, Miss. For more details see http://www.ruraljournalism.org/.

The Institute seeks nominations that measure up, at least in major respects, to the records of previous winners. Nominators should send detailed letters explaining how their nominees show the kind of exemplary courage, tenacity and integrity that the Gishes and other winners demonstrated in their rigorous pursuit of rural journalism. Documentation does not have to accompany the nomination, but will be needed in choosing finalists, and additional documentation may be requested or required. Letters should be postmarked or emailed by Sept. 1 and mailed to: Institute for Rural Journalism and Community Issues, 122 Grehan Journalism Building, University of Kentucky, Lexington KY 40506-0042. For more information, contact Al Cross at 859-257-3744 or Al.Cross@uky.edu.

6 major phone companies' rural broadband plan would make some rural places rely on satellites

Leading telephone companies' proposal to boost rural broadband would leave some rural Americans "consigned to satellite broadband," which is expensive and sometimes unreliable, Matthew Lasar reports for Ars Technica.

On Friday, AT&T, Verizon Communications, CenturyLink, Fairpoint Communications, Frontier Communications and Windstream gave the Federal Communications Commission a five-year plan to modernize the FCC's Universal Service Fund, part of which subsidizes standard telephone service with a tax on phone bills, to help bring broadband to "nearly all" rural Americans, The Associated Press reports.

However, "The telcos would be allowed to opt out of servicing high-cost areas under the guise of 'efficient network design'," Lasar writes. The companies say he government "should only provide funding in geographic areas where there is no private sector business case to provide broadband and high-quality voice-grade service."

While the FCC is expected to receive dozens of proposals, "the new plan is particularly significant since it has the backing of six key telecommunications companies that are some of the biggest recipients of Universal Service dollars," AP reports.

Amid relief about debt bill's passage, states and localities wonder about impact on budgets

The bill that raises the national debt ceiling and calls for a projected deficit reduction of $917 billion over 10 years leaves many state and local governments relieved but worried about its impact to state budgets, John Gramlich and Melissa Maynard of Stateline report. (White House photo: President Obama signs the bill)

“We’ve always known that big reductions were coming,” Michigan budget director John Nixon said Monday. “Now, it’s just a matter of figuring out where they’re going to come and how quickly. But from a state-level perspective we’re thrilled to see a deal.”

Medicaid, the biggest expense item in many state budgets, is temporarily protected, but failure of a special congressional committee to meet the deficit-reduction goals will create an automatic reduction in Medicaid. Other possible cuts, states fear, may come in transportation and discretionary funds many states use for education, housing, criminal justice and community development. (Read more)

New York Times reporters Adam Nagourney and Michael Cooper got Americans’ reactions on the debt deal, here.

New column tries to close communication gap between scientists and journalists

In June, Nature Geoscience unveiled a new column aimed at reducing confusion and miscommunication between scientists and journalists. Columnist Axel Bojanowski, a geologist and science writer, aims to help scientists better understand journalists' goals and obligations and see science from the public's viewpoint, Julia Pyper of ClimateWire reports.

"Scientists and journalists usually have different objectives," Bojanowski told Pyper. "Scientists . . . want their results presented in detail and to know that the complexity of their findings is being given its due. Journalists, on the other hand, have to direct themselves towards the interests of the general public."

Heike Langenberg, editor of Nature Geoscience, told Pyper,"The climate debate has been polarized in the media, and climate skeptics have a strong counterposition. In a polarized environment, you need to communicate as clearly as you can, because often the subtle tones are lost in such a politicized debate." (Read more, subscription required) To read the editorial introduction of the column, click here.

Bill to make farmers use e-Verify in hiring keeps moving despite opposition from farmers

Farmers continue to mobilize against a bill that would require them, when hiring new employees, to use the Department of Homeland Security's "e-Verify" database aimed at illegal immigrants. The bill, sponsored by Republican Rep. Lamar Smith of Texas, would give farmers three years to comply, but that does little to reassure farmers, Jesse McKinley and Julia Preston of The New York Times report.

Farmers say the bill "could cripple a $390 billion industry that relies on hundreds of thousands of willing low-wage immigrant workers to pick, sort and package everything from avocados to zucchini," McKinley and Preston write. George Bonacich, a farmer in Patterson, Calif., 80 miles east of San Francisco, relies on 100 farmhands to pick 50 to 100 tons of apricots each day. "If we don't have enough labor at peak time, the fruit goes on the ground," Bonacich told the Times. (Times photo by Jim Wilson: sorting dried apricots on Bonacich's farm)

Smith, who has the support of some restaurant owners and home builders, said he would introduce another bill proposing changes to the temporary farm worker program known as H-2A or offer a new guest-worker program to meet agriculture's needs, the Times reports.

The bill seems likely to pass the Republican-controlled House but may fail in the Democratic-controlled Senate over fears about lost tax revenue from illegal immigrants' paycheck deductions, McKinley and Preston write. Paul Wenger, president of the California Farm Bureau, says this may result in a shift in the agriculture community's political support. "Most of our folks are Republicans," he told the Times. "But if they do this to them without a workable worker program, it will change their voting patterns, or at the very least their involvement in politics." (Read more)

Heat wave leaves remote, rural elderly indoors, sometimes without proper care and supplies

The heat wave moving across the central U.S. is taking its toll on elderly residents in remote rural areas, in some cases leaving them prisoners of their own homes. Sean Murphy of The Associated Press reports on it from Mulhall, Okla., population 200, one of many towns where temperatures have reached 100 or above for over 30 days in a row. Is there a Mulhall near you?

The local coffee shop, where elderly farmers and retirees usually gather, is almost empty as residents are afraid to go outside for any length of time or distance, especially in the middle of the day. "From 11 to 3, there's nobody here but me, my secretary and my helper," Ray Knight, owner of the makeshift cafe and adjoining steel fabrication shop, told Murphy.

In such communities, "where there are no longer any stores or other services, the elderly must drive other places for almost everything, and that has become daunting this summer," Murphy writes. Many elderly residents in remote areas are staying in their homes, delaying needed medical care and trips to stores for medications and necessary supplies, making them prone to other medical complications.

"I can't hardly do nothing when it's this hot," Bryce Butler, an 86-year-old World War II veteran, told Murphy. Butler said he usually runs errands in Guthrie, about 15 miles away. Marlene Snow, project director of the Logan County Areawide Aging Agency, told Murphy. "We go into plenty of areas where there's not even a service station, no drug store, no grocery stores." (Read more)

Institute for Rural Journalism and Community Issues marks a seventh anniversary today

Seven years ago today, the Institute for Rural Journalism and Community Issues became more than an experiment, as it got its first (and so far only) full-time staff member: the undersigned, who had been part of an ad hoc committee that obtained grants from the Appalachian Regional Commission and the Sigma Delta Chi Foundation of the Society of Professional Journalists to conduct some preliminary research and conferences to explore the notion of a center that would help rural journalists cover issues, especially regional issues that have a local impact but few good local sources.

With the help of grants from the John S. and James L. Knight Foundation, and additional help from the Ford Foundation, the University of Kentucky established the Institute in its School of Journalism and Telecommunications and picked up the slack when the grant money ran out. Now the director has tenure, and the Institute has academic partners at 28 universities in 18 states, from Maine to Texas to Alaska, and an endowment of $1.44 million.

We thank officials of the university and all others who have helped us along the way, including those who have contributed a total of more than $720,000 to the endowment and had their contributions matched by the Research Challenge Trust Fund of the Commonwealth of Kentucky. Because our fund-raising fell short of the $1.5 million available match, our annual budget will be reduced, but we now have more than 500 individual contributors, which we think gives us a strong base of support for an annual fund drive for our operating budget. If you need more information, go to http://www.ruraljournalism.org/ or email me at Al.Cross@uky.edu.

Nonprofit with free-market views and secret givers opens more statehouse news bureaus

As many news organizations have cut back on statehouse reporters and coverage of state issues, the Franklin Center for Government and Integrity has started news bureaus in several states, most recently in Virginia, that deliver much needed information that is picked up by local news outlets and even by Stateline, the 12-year-old service of the Pew Center on the States.

The nonprofit, tax-exempt center says it is "dedicated to educating the public about corruption, incompetence, fraud, waste and abuse of public trust by elected officials," but it appears to seek reporters who have a free-market perspective that is not always transparent, much as the center does not reveal its contributors.

Jim Romenesko, who gathers news about the news media for the Poynter Institute, reports that he received an anonymous email from a journalist who applied for a job at the Franklin Institute's Wisconsin Reporter, left, and was asked questions that he said "seemed counterintuitive for a journalism job," such as "Do higher taxes lead to balanced budgets?" (Read more)

Also from Romenesko: The Wisconsin Reporter sometimes takes a slanted view, writes Dave Zweifel, editor emeritus of the Capital Times, a liberal alternative paper in Madison, the state capital. He cites a story with a favorable spin for Republican Gov. Scott Walker, and another saying “unions continued to funnel money to recall efforts” without mentioning money “from corporate PACs, right-wing anti-gay and pro-life fronts and other cultural war organizations that have made a habit of spending lavishly on Wisconsin races.” (Read more)

UPDATE, Aug. 8: A spokesman for the Wisconsin Democratic Party told the Reporter that it could expect him to tell the dozen or so newspapers that publish Reporter stories about "our deep concern about the obviuous bias that permeates your entire oiperation. Then, we let our activists know which papers publish you, and they write the publisher and editor. Then, we contact that Capitol press room and let them know our concerns about your credentialing." (Read more)

While the Wisconsin site does seem to have a conservative or Republican slant, as indicated by the large GOP graphic illustrating a story on the screen grab above, my advice to editors and news directors would be to judge each of the stories individually, with a careful eye and a sharp edit, and use a tagline giving the source of the story and the center's background. Sometimes the best place for a story might be the opinion page. Local news outlets need more news on state issues, but it needs to be trustworthy.

Other state sites of the Franklin Center include Idaho, Illinois, Iowa, Kansas, Minnesota, Missouri, Nevada, Pennsylvania and Tennessee. Let us know what you think of them, via comments to this post. The center also operates Watchdog.org, which has sites in many of the same states as well as others, and has a list of them on its site. It emails headline digests of items from those sites and other libertarian- and conservative-oriented sites that focusing on states. UPDATE, Aug. 3: Readers of The Fix blog of The Washington Post voted Red Maryland and the center's Maryland Reporter the best political blogs in the state.

Deal to end national-debt fight is still unlikely to be good for state and local governments

The pending solution to the political crisis over the national debt "could also squeeze state and local governments that are already strapped for cash," Suzy Khimm writes on Ezra Klein's blog for The Washington Post, noting that Congress has its eyes on education and Medicaid, two functions "that make up the largest parts of most states’ budgets. In many cases, such cuts "will pass onto local governments," Frank Shaforth, director of the Center for State and Local Government Leadership at George Mason University, told Khimm.

"There’s already been an uptick of bankruptcy filings by cities, towns and rural districts across the country over the past two months, and there could be more if Washington follows through on its promise to slash spending as soon as possible," Klein reports. "Local governments will try to raise property taxes to raise revenue, which could be yet another drag on a housing market that’s yet to recover. Those who fail to meet their fiscal obligations could see their credit downgraded, making it even harder for them to borrow money to build basic local infrastructure, while both the president and the GOP have threatened to pull funds for state infrastructure. What was once an ideological abstraction — 'austerity' — will have very real effects on everyday life for average Americans." (Read more)

If the crisis is not resolved and there is a technical default or a partial government shutown, things would be even worse, as Stateline reported Friday and The Associated Press did today.

UPDATE, Aug. 1: The Washington Post has a handy chart showing what each political party wanted and what it got at the end of negotiations. And as usual, the Post's Ezra Klein has a sharp analysis.