Insurers exiting Obamacare exchanges will leave many rural counties with limited plan options

Americans throughout the country — especially those in rural counties — have growing concerns that they will have limited choices when selecting an individual health plan when open enrollment on the Obamacare exchanges begins Nov, 1, Deborah Dorman-Rodriguez and David Kaufman report for the Legal Solutions Blog. Concerns heightened after Aetna announced "that it will exit the Affordable Care Act marketplaces, commonly known as the 'exchanges,' in 11 states for the benefit year beginning in 2017."

As many as 19 percent of all exchange or "marketplace" enrollees across the United States could have only one insurer to choose from going into 2017, according to an analysis by the Kaiser Family Foundation. "In rural counties, the numbers increase: 41 percent of all marketplace enrollees will have only one carrier to choose from for marketplace policies in 2017, compared with 7 percent in 2016," writes Dorman-Rodrigues and Kaufman.

Wyoming was the only state in 2016 to have only one marketplace insurer. Next year, five states — Alabama, Alaska, Oklahoma, South Carolina and Wyoming — are likely to have only one marketplace insurer available in all counties, Dorman-Rodrigues and Kaufman report.

"Insurers have been vocal regarding ACA marketplace-related losses, and carriers losing money have either actively sought premium increases for 2017 plans or withdrawn from markets entirely where they have determined losses are unsustainable," the reporters write. "Losses are attributed to several factors. These include the complex interaction between the sicker, higher-risk population covered by marketplace plans; the relative lack of healthy individuals in the marketplace risk pools; and the failure of the market stabilization programs to adequately address the overall goal of providing certainty to insurers, protecting against adverse selection and stabilizing premiums in the individual market. This analysis explores the possible regulatory implications of insurers’ exits from the rural marketplace and the potential regulatory responses to the issue." 

Lack of data on number and location of factory farms makes regulation by states difficult

A lack of data on the number and location of factory farms "makes regulatory oversight weak and in some cases, nonexistent," Georgina Gustin reports for InsideClimate News. There has been concern in North Carolina over the unknown number of animal carcasses and levels of animal waste that have flooded waterways in the wake of Hurricane Matthew. North Carolina state regulators exempt poultry CAFOs from public records disclosure.

"These massive farms, or CAFOs—concentrated animal feeding operations—can house hundreds of thousands of animals in confined spaces, creating potent volumes of nutrient pollution that have fouled rivers, lakes and oceans," Gustin writes. "Decomposing manure releases toxic chemicals, mostly ammonia and hydrogen sulfide, into the air. Manure stored in lagoons releases methane and nitrous oxide, global warming gases more powerful than carbon dioxide." (Map of North Carolina's animal feed operations created by nonprofit advocacy group Waterkeepers Alliance. For an interactive version click here)

The Environmental Protection Agency estimates "that about 11 percent of the greenhouse gas emissions in the U.S. come from agriculture and about 12 percent of total methane emissions comes from manure management, a rise of about 65 percent since 1990," Gustin writes. EPA, which regulates CAFOs under the Clean Water Act, estimates there are about 19,200 CAFOs, up from 3,600 30 years ago. "Environmental groups say that number is probably higher, largely because the agency has been unable to get reliable and comprehensive information, thanks to patchy state regulation and years of legal pushback from the livestock industry to keep the information from the public."

Last month "a federal appeals court ruled EPA violated the privacy of CAFO operators by releasing information about their farms, which had been requested by three environmental groups through the Freedom of Information Act in 2013," Gustin writes. "The ruling was a victory for the $186 billion meat-and-poultry industry, but environmental groups say it prevents the agency from better regulating CAFOs, at a time when a boom in construction may be on the way."

NAFTA, which Trump calls 'a disaster,' was a Bush-Clinton project that boosted U.S. exports

Republican presidential nominee Donald Trump has said he will renegotiate or eliminate the North American Free Trade Agreement, signed in 1992 and ratified in 1993, calling it "one of the worst deals ever made of any kind signed by anybody. It’s a disaster." Trump claims NAFTA has cost jobs throughout the U.S. and hurt local economies. (U.S. Chamber of Commerce graphic)

While Trump blames the deal on Bill Clinton—thereby linking it to his competitor Hillary Clinton—it was actually initiated by President George H. W. Bush, and more Republicans than Democrats voted in favor of it, Adam Chandler reports for The Atlantic.

"So of what use is this talking point?" Chandler asks. "Well, for a candidate staking much of his presidential run on voters’ anger over America 'getting killed on trade' and courting factory-heavy swing states, the populistic invocation of NAFTA is extremely effective. To many working-class Americans, international trade is shorthand for economic distress. Trump’s statements have seized on this sentiment." In the first debate Trump chastised NAFTA by pointing to job losses in Michigan and Ohio, but since his numbers have fallen in Michigan, he switched Michigan in the third debate to battleground states Pennsylvania and Florida, as well as including upstate New York. He and Clinton are running neck-and-neck in Ohio but she has opened up small leads in Florida and Pennsylvania.

NAFTA accounts for about $1.225 trillion yearly—$662 billion between U.S. and Canada and $533 billion U.S. and Mexico—in direct trade across North America, Chris Clayton reports for DTN The Progressive Farmer. Agricultural interests generally favor foreign trade.

The U.S. had a $46.1 billion net trade deficit in 2015 under NAFTA, accounting for about 8 percent of total U.S. export volume of $575.6 billion last year, Clayton writes. The U.S. exported $337.3 billion to Canada in 2015 while importing $325.4 billion for an $11.9 billion trade surplus, while exporting $238 billion in goods to Mexico and importing $295 billion, a $58 billion trade deficit.

Study: Many rural Calif. counties will need to replace 1/3 or more retiring teachers by 2023-24

Percent of teachers expected to retire by 2023-24, by county

California could be facing a teacher crisis, especially in rural areas, says a study that WestEd, a San Francisco-based non-profit research organization, conducted for the Institute of Education Sciences (IES), an evaluation arm of the U.S. Department of Education. The study found that one-quarter of teachers who worked the 2013-14 school year are expected to retire by 2023-24, with numbers much higher in rural areas.

In northeastern Sierra County, the state's second least populated county, 60.5 percent of teachers are expected to retire by 2023-24. On average, "counties in the rural NorthCoast, Northeastern and East Inland regions are expected to need to replace 36 percent (more than 1,900 teachers) of their 2013-14 teacher workforce over 2014-15 to 2023-24, compared with an average of 27 percent across other regions." In many of the state's largest metro areas 19-23 percent of teachers are expected to retire by 2023-24.

"The study didn’t address other teacher workforce issues contributing to teacher shortages in some districts and teaching areas: a decline in college graduates going into teaching and attrition by younger teachers who change professions or move to lower-cost-of-living states," John Fensterwald reports for EdSource, a California non-profit that reports on education.

"'For the past decade, some education authorities had assumed there would be a tsunami of baby boomer teachers retiring, but retirement rates have proved to be more gradual,' said Fong, the chief researcher," Fensterwald writes. "WestEd last did a teacher retirement forecast a decade ago and estimated roughly the same percentage of retirements from 2006 to 2013-14 as it projected for the following decade. And the average retirement age—61—has remained constant. Teachers can retire with their full California State Teachers Retirement System pension at age 62 with 30 years of teaching."

N.H. daily examines one city's rural homeless concerns through ongoing series

Homeless in Lebanon, N.H. (Photo by James Patterson)

The Valley News, of Lebanon, N.H., in the Upper Connecticut River valley, is chronicling local homelessness in a series. The city's population of 13,599 typically doubles during the day because it is the region's hub for work and shopping.

This summer Lebanon created a nine-member task force to address the city's growing homeless problem, Tim Camerato reports for the Valley News. Homeless concerns include an encampment on city-owned land where 12 people were believed to be living in a vacant lot.

While the original squatters were believed to be law-abiding people, there has been concern that more people are flocking to the lot, leading to a rise in drugs and gangs, Camerato writes. Camping is illegal "in the city’s general commercial zone, where the lot is located. There’s also a state law prohibiting unauthorized camping on government property." One solution, to find housing for the homeless, has been met with some resistance from homeless at the lot.

Bing map

Lebanon city officials in June proposed a camping ordinance that would allow police to "impose a $100 fine for parking or camping in city-owned lots for more than two hours between dusk and dawn," Camerato writes in a separate story. The American Civil Liberties Union protested that decision as "bad policy". Attorney Gilles Bissonnette, the ACLU’s legal director, wrote in a letter to city officials: “Fining and evicting individuals who lack even the most basic means is a poor use of police resources and only serves to further burden and marginalize the most vulnerable citizens in our community."

The ordinance was revised in September to give first-time violators a warning, with a second offense resulting in the $100 fine, Camerato reports in a separate story. The revision was the result of a June meeting, attended by 100 people, where "many argued the proposal effectively criminalized homelessness since it’s unlikely those fined would be able to pay." A public hearing earlier this month on the ordinance was postponed in "order to rework the proposal to give police more discretion when dealing with the homeless."

Feds estimate that 1.1 million more people will sign up on Obamacare exchanges in 2017

About 1.1 million more people are projected to sign up for health insurance on the Obamacare exchanges for 2017, according to the U.S. Health and Human Services Department. The agency estimates that 13.8 million people will sign up in 2017, compared to 12.7 million in 2016, Toni Clarke reports for Reuters. Officials said "average monthly enrollment in 2017 is estimated at 11.4 million people, up from 10.5 million people in 2016."

"Enrollment has been about half of what was initially expected and some large insurers this year have said they were losing too much money on the exchanges because of that and the fact that enrollees are older and sicker than expected," Clarke writes. "Aetna and UnitedHealth Group have largely pulled out of the exchanges for 2017."

Officials said "there are 10.7 million uninsured people who are eligible for the exchanges but unenrolled," Clarke writes. About 40 percent of those people are 18 to 34 years old. (Read more)

Fact checking the final presidential debate on voter fraud, national debt, border security, refugees

The final presidential debate between Hillary Clinton and Donald Trump contained plenty of factual errors. We only have room here for a few. If you want to re-publish them, we encourage you to look at reports by The Washington Post's Fact Checker unit, PolitiFact.com and FactCheck.org for full context and things you may want to add.

Trump, who has suggested the election could be rigged, cited a Pew Center on the States study, in saying, "If you look at your voter rolls, you will see millions of people that are registered to vote … that shouldn’t be registered to vote.” Post fact-checkers Glenn Kessler and Michelle Ye Hee Le point out that the study did not indicate there was widespread voter fraud, but found "more than 1.8 million records for people who are deceased, but whose registrations were still on voter rolls. About 2.75 million people were registered to vote in more than one state. This could happen if voters move to a new state and register to vote without notifying their former state. Outdated technology, shrinking government budgets and paper-based registration systems contributed to inaccuracies and inefficiencies."

Clinton said her economic plans "do not add a penny to the debt," but "the nonpartisan Committee for a Responsible Federal Budget, which has analyzed the economic impact of every proposal by both nominees," concluded that her plan would "add $200 billion over a decade, which is a relatively small amount compared to the debt," the fact-checkers note. "That $200 billion could be canceled out by Clinton’s business tax reform plan, which is estimated to generate $275 billion in revenue. . . . Trump’s plans would add $5.3 trillion to the debt."

Trump, who supports building a wall along the Mexican border, said, "Hillary Clinton wanted the wall. Hillary Clinton fought for the wall in 2006 or thereabouts. Now, she never gets anything done, so naturally the wall wasn’t built. But Hillary Clinton wanted the wall.” Kessler and Le write, "Clinton supported the Secure Fence Act of 2006, which authorized the construction of fencing along the U.S.-Mexico border. The fence is mostly vehicle barriers and single-layer pedestrian fence. Trump has called for a border wall of precast concrete, as tall as 30 to 60 feet."

Trump said, “She’s taking in tens of thousands of Syrian refugees, who probably in many cases — not probably, who are definitely in many cases, ISIS-aligned, and we now have them in our country.” Kessler and Le write, "Trump has no evidence to make this claim. The U.S. accepted about 13,000 Syrian refugees in the 2016 fiscal year, and Clinton wants to increase that number. But refugees spend as long as two years being vetted by U.S. counter terrorism experts. So not only would it be difficult to infiltrate the system, but it would be time-consuming, compared to simply getting a tourist visa to enter the country." (Read more)

Trump did best in rural areas, but urban votes were more important to his nomination

Reports that suggest rural America is a guiding force behind Donald Trump's success are wrong, Bill Bishop and Tim Marema write for the Daily Yonder. During the Republican primaries and caucuses Trump earned a slightly larger percentage of votes in rural areas than he did in urban areas, but the U.S. has a much larger urban population, meaning Trump won the nomination largely on the strength of urban voters.

During the Republican nominating process Trump received 48 percent of votes in rural areas, 45.5 percent in micropolitan areas (counties outside of metro regions that have towns between 10,000 and 50,000 people) and 44.8 percent in metro areas, Bishop and Marema report. Overall, 47.2 percent of his votes came from the nation's largest cities (ones with more than 1 million residents) and 19.1 percent came from rural areas. (Yonder graphic: How Donald Trump performed in Republican primaries and caucuses)

Rural economic index in IL-to-WY region drops to 7-year low; negative for 14 straight months

For the 14th straight month the Rural Mainstreet Index was below 50, indicating economic decline in the 10-state region that stretches from Illinois to Wyoming and is dependent on agriculture and energy. Creighton University economist Ernie Goss surveys bank CEOs in rural areas of Colorado, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, Wyoming and the Dakotas.

The index dropped to 31.8 in October, its lowest since 2009, from 37.3 in September. It was at 49 in September 2015. The October hiring index declined from 54.8 to 45.4. Rural Mainstreet employment is down 1 percent over the past 12 months, compared to a 1.5 percent increase in urban areas during that same period. For current and historical data by state, click here.

Goss said in a statement, "Over the past 12 months, livestock commodity prices have tumbled by 19.7 percent and grain commodity prices have slumped by 18.5 percent. The economic fallout from this price weakness continues to push growth into negative territory for six of ten states in the region.” (Creighton graphic: Rural Mainstreet Index)

Bank CEOs project 21.6 percent of grain farmers will suffer negative cash flows for 2016, said Goss. The farmland and ranchland price index for October was 25.0, down from 40.3 in September, marking the 35th straight month the index has been below growth neutral of 50.0. October farm equipment-sales index declined from 14.3 to 13.1.

Lack of high-speed internet service is blamed for population losses in rural Kansas

Lack of high-speed internet could be fueling an increase in migration from rural areas to urban ones, Dion Lefler reports for The Wichita Eagle. Kansas, where many rural counties have poor internet service, has seen population decline in 81 of 105 counties since 2000. "The consensus is that trend will get worse—especially among young people—until and unless someone can find a way to get better internet service to the outlands," Lefler writes.

"The overarching issue is how to pay for replacing thousands of miles of obsolete copper wire with modern fiber-optic cable, without making internet service so expensive for customers that only businesses and the wealthy would be able to afford it," Lefler reports. "The costs are staggering, about $20,000 a mile for fiber cable to serve widely dispersed customers in small villages and isolated farms." (Eagle graphic: The state's top 10 counties with the biggest population losses from 2000-15 are all rural)

Kansas Republican Sen. Pat Roberts brought Ajit Pai, a member of the Federal Communications Commission, to rural Kansas recently "to meet with officials from about a dozen small telephone companies who are facing difficulty upgrading their networks," Lefler writes. Roberts, who chairs the Senate Agriculture Committee, told Lefler, “I don’t know of anybody on the Senate Agriculture Committee, on either side, who does not want to further expand our investment in broadband. The support is there. The problem of course is the budget.”

During a roundtable discussion with Roberts and Pai, the biggest issue among telephone executives was who would foot the bill to expand broadband, Lefler writes. "Much of the funding for broadband deployment in rural areas comes from the Universal Service Fund, created by Congress in 1934 to string phone lines to isolated communities and farms. In 2009, FCC expanded universal service to include broadband and created the 'Connect America Fund' to help spread the money around. But some telephone company officials say that kind of end-user funding is obsolete in the context of the internet, where the biggest users of the system aren’t necessarily the end-of-the-line consumers."

Arts events and entertainment venues are helping revitalize some struggling rural towns

The Red Ants Pants Music Festival in Sulphur Springs,
Mont., has helped the local economy (Tony Demin photo)

Some small towns are revitalizing their economies by creating homespun arts and entertainment venues, Teresa Wiltz reports for Stateline. "Community leaders say the arts can foster community pride and create jobs, even on a modest scale," she writes. "To be successful, they say, a rural community must figure out what makes it unique and capitalize on that."

While individual figures are hard to come by, arts and cultural production in the U.S. in 2013 contributed $704 billion to the U.S. economy and supported 4.7 million jobs, Wiltz writes. Rural towns across the nation have cashed in on local arts and entertainment. For example, Sulphur Springs, Mont., a once-thriving logging town of 939 that fell on hard times, is now flourishing through the arts, including an annual music festival that brings the town thousands of visitors and much-needed revenue.

One way towns can promote arts and entertainment is through a National Endowment for the Arts grant that gives $125,000 "in seed money to fund a 'Next Generation' initiative to help build arts hubs in rural America," Wiltz writes. "The idea is to connect artists, arts groups, civic leaders and philanthropists and encourage them to create sustainable cultural scenes in rural communities to help spur economic development and entice new, young residents. Iowa, Kentucky and Minnesota participated this year. Other states seek to join next year."

Charles Fluharty, president and CEO of the Rural Policy Research Institute, a public policy institute located at the University of Iowa, told Wiltz, “You need arts in rural America so that the next generation wants to come there and live. If you do not build vibrant, inclusive, diverse places for young people, they’re not going to raise their families there. They’re simply not. And those communities will wither away." (Read more)

Task force releases report of recommendations for storing underground natural gas

A federal task force has released a report of recommendations for the nation's more than 400 underground natural gas storage wells. The task force, co-chaired by the Department of Energy (DOE) and the Department of Transportation’s Pipeline and Hazardous Materials Safety Administration (PHMSA), was designed to help PHMSA develop minimum federal safety standards for underground gas storage that will be issued within two years.

Recommendations for well integrity include: new wells should be designed so that a single point of failure cannot lead to leakage and uncontrolled flow, and except under limited circumstances, natural gas storage operators should phase out single point-of-failure wells; operators should adopt risk management plans that include a rigorous monitoring program, well integrity evaluation, leakage surveys, mechanical integrity tests and conservative assessment intervals; and DOE and DOT should conduct a specific and thorough joint study of subsurface safety valves. (Gas storage facilities, U.S. Energy Information Administration map)

Recommendations for health and environment are: in the event of a natural gas leak large enough to require multiple jurisdictions in the response effort, a 'unified command' should be formed early so that leaders from each primary response agency can provide clear and consistent communications between agencies and with the public about progress toward controlling the leak and understanding the potential public health impacts of the release; states and local monitoring agencies should consider establishing an emergency air monitoring plan that can be expeditiously deployed in the event of a leak; and states should review their authority to require greenhouse gas mitigation plans in the event of a leak.

Recommendations for energy reliability are: industry, federal and state agencies should strengthen planning and coordination efforts to decrease the potential impacts of future prolonged disruptions of natural gas infrastructure; and industry, federal and state agencies should consider broader application of back-up strategies to reduce reliability risks associated with the abrupt loss of natural gas supplies. (Read more)

Clinton and Trump surrogates debate agriculture and food issues at Farm Foundation Forum

By Tim Mandell
Institute for Rural Journalism and Community Issues

Representatives of the Hillary Clinton and Donald Trump campaigns participated Wednesday morning in a Farm Foundation Forum in Washington, D.C. Clinton was represented by Kathleen Merrigan, executive director of sustainability at George Washington University and former depuity agriculture secretary. Trump was represented by Sam Clovis, co-chair and senior policy adviser for the candidate and a professor of economics at Morningside College in Sioux City, Iowa.

Merrigan said Clinton's main agricultural goals are increasing renewable energy, which can lead to more rural jobs, creating an immigration pathway to citizenship for an industry that relies on foreign-born labor, increasing the number of beginning farmers and ranchers, and creating more opportunities for the growing number of female farm operators.

Merrigan said Clinton is focused on making broadband available to all homes by 2020, addressing rural drug addiction concerns and supporting rural revitalization through infrastructure, water and transportation projects. She also touted Clinton's support of the 2008 Farm Bill and said Trump's running mate, Indiana Gov. Mike Pence, voted against the bill 16 times as a congressman.

Clovis said two of Trump's biggest priorities are the impact the next president will have on the U.S. Supreme Court and tax reform. He said new justices on the court could "fundamentally change the nature and culture of the court system," which could affect agriculture and rural areas. He also said reducing the corporate tax would keep more jobs in the U.S., while encouraging companies that left for overseas to return home.

He said trade and border security are major issues. Increasing trade will lead to more producers having "access to as many markets as possible." At the same time, he said a workable system needs to be put in place to address the high number of illegal immigrants working in agriculture. While he said Trump wants to make sure the Mexican border is more secure, he also wants to streamline the H2A visa work program to make those workers legal.

During the question and answer period agricultural regulations sparked a heated debate, specifically rules that are allegedly incompatible with each other, and whether overlapping agencies create conflicts by.

Clovis said Trump supports creating a commission to look at the agencies and departments and "get people out of each other's lanes." Merrigan said being anti-regulatory is not helpful, that "regulations are not a bad thing" and they create a "level playing field."

Clovis said having a commission would not be anti-regulatory. "When you write regulations without symmetry, then you create situations that cause people to lose competitive advantages," benefiting bigger companies or large farms while hurting small businesses, which suffer more from increased operational costs.

Asked about the Supplemental Nutrition Assistance Program, formerly known as food stamps, Clovis said more people need to "get off the sidelines" and be less dependent on the government and more dependent on themselves. To accomplish that, he said the U.S. needs to increase economic growth, increasing employment and reducing poverty. Merrigan countered that most of the people receiving SNAP need the benefits and "are really hurting." She said said the U.S. Department of Agriculture's rate of improper payments is low, at under 4 percent.

Asked about the Obama administration's redefintion of "waters of the U.S.." Clovis said, "This may be the poster child for government overreach." He said ranchers he has talked to feel the government is not there to help them or protect them. Merrigan said the Clean Water Act "may not be as much a conflict as people assume." She did say that agencies need to do a better job communicating the rules with the public.

Audio from the forum will be made available on the Farm Foundation website and a video is to be posted on the Ag Day site.

Here are tips for reporting on political polls

Graphic by Keith Bishop

As the Nov. 8 general election nears, many public-opinion polls will be released. The first thing to remember when reporting on polls is to consider how the poll was conducted and determine whether the information is valid, Leighton Walter Kille writes for Journalist's Resource., a service of the Shorenstein Center at Harvard University.

"The best polls are produced by independent, nonpartisan polling organizations, with no vested interest in the outcome of the findings," Kille writes. "These include organizations like Gallup and the Pew Research Center and as well as media groups such as CBS News/New York Times, ABC News/Washington Post and NBC News/Wall Street Journal."

"Many surveys are conducted by partisan actors—political consulting firms, industry groups and candidates," Kille writes. "In some cases, the findings are biased by factors such as respondent selection and question wording. Partisan-based polls need to be carefully scrutinized and, when possible, reported in comparison with nonpartisan poll results."

"It’s important to remember that polls are a snapshot of opinion at a point in time," Kille writes. "Despite 60 years of experience since Truman defied the polls and defeated Dewey in the 1948 presidential election, pollsters can still miss big: In the 2008 Democratic primary in New Hampshire, Barack Obama was pegged to win, but Hillary Clinton came out on top. A study in Public Opinion Quarterly found that 'polling problems in New Hampshire in 2008 were not the exception, but the rule.' In a fluid political environment, it is risky to assume that polls can predict the distribution of opinion even a short time later."

Tips for reporting on polls can be found here.

Alarming cancer disparities across rural Appalachia, study finds

Rural Appalachia has gone from having the lowest cancer death rates in the United States to the highest according to a study by The University of Virginia. Calling the disparities "pervasive" researchers are urging a "systematic effort to reduce the burden of cancer for rural Appalachia," because the rest of the country appears to be making major strides in the battle against cancer, writes CBS19 Charolettesville, Virginia.

The study says "it's part of a growing cancer crisis in the region, with disturbing trends in all sectors of cancer care, from screening to diagnosis to treatment."

Nengliang Yao, of the UVA School of Medicine, told CBS19: "Look at the war on poverty that President Johnson declared decades ago . . . We lost the war on poverty, and we're not doing much to battle the health care disparities in rural Appalachia. Because we can see it from our results: It's getting worse."

Decades of data obtained from the National Center for Health Statistics were used in the study, revealing disturbing trends: "Between 1969 and 2011, cancer incidence declined in every region of the country except rural Appalachia, where it increased. During that time, rural Appalachia went from having the lowest cancer death rate in the country to the highest. Cancer mortality rates during 2007-11 were 14.7 percent higher in the rural Appalachian counties in Virginia than in non-Appalachian urban areas in the rest of the country."

"In the rural Appalachian areas of Kentucky, mortality rates were 36 percent higher. Rural residents in every other state in the Appalachian region, except for Maryland, had higher mortality rates than their urban counterparts. Breast cancer is less likely to be caught early in rural Appalachia than elsewhere. People in Appalachia are more likely to die within three to five years of their cancer diagnoses than people in urban areas outside Appalachia."

CBS19 writes that economic, geographic and political challenges all stand in the way of quality cancer care in the Appalachian region, adding that access to health care providers, lower population numbers, significant distances and travel times and people with limited transportation options face major obstacles.

Verbal attacks on journalists by Trump and backers should be met with reporting, commentary

Trump supporters react to the news media Thursday
in Cincinnati (Getty Images photo by Ty Wright)

By Tim Mandell and Al Cross
Institute for Rural Journalism and Community Issues

Donald Trump is waging a war on journalists, accusing them of "rigging the election." His supporters have grown more aggressive, fueled by his allegation that the news media are trying to sabotage his campaign. It's an issue that affects every journalist and should prompt reporting and commentary on every level, to inform readers of the importance of freedom of the press and defend the integrity of our craft.

"As the Republican nominee has resorted to more extreme denunciations of the press in recent days, his supporters have followed suit," Ben Shreckinger reports for Politico. "Chants of 'CNN sucks' have become commonplace at Trump's rallies and members of the traveling press were called 'whores' and 'press-titutes' as they filed out of a Thursday afternoon rally in West Palm Beach. Minutes before, Trump had accused reporters of participating in a vast globalist conspiracy against his campaign and American workers. Crowds that once booed and shouted at the press mainly at Trump’s prompting—when he would decry them as 'dishonest' and 'scum' or demand that television cameras pan his crowds—have now begun spontaneously targeting the press on their own, at a scale not yet seen in this campaign, or any in memory on American soil."

In Cincinnati on Thursday, "Reporters long accustomed to the toxic fervor of Trump rallies were startled, and even frightened, at the vitriol," Nick Corasanit reports for The New York Times. "Trump's efforts to discredit news-media organizations, painting them as part of a broad conspiracy with the Clinton campaign, have reached an intensity never before seen from a presidential candidate." Times media critic Jim Rutenberg has a video report:

Reporters have been the objects of obscenities, leading one who is part of the group traveling with Trump to say it has reached "a mob mentality," Paul Farhi reports for The Washington Post. The journalist, who remained nameless because his employer prohibits him from making public comments, told Farhi, “We’ve been on the receiving end of that throughout the election, so we’ve largely become numb to it. But in the last few days it’s just been so much louder, so much angrier. The people who are shouting look at us like we’re their immediate enemies, not as like . . . primarily late-20-to-early-30-somethings there to do a job.”

"Reporters are now concealing or removing their press credentials when leaving the pen to avoid confrontations with Trump’s supporters," Farhi writes. "The atmosphere is particularly threatening to female reporters and to female TV reporters whose faces are well known, reporters say. Some reporters have wondered aloud about the need for more security, or at least more barriers to separate them from the crowd as they enter and exit Trump’s events."

The Committee to Protect Journalists, which Corasaniti calls "a nonprofit group often focused on defending press freedoms in war-torn and totalitarian countries," made an unprecedented statement regarding American elections: "Donald Trump, through his words and actions as a candidate for president of the United States, has consistently betrayed First Amendment values." A resolution by the CPJ board called Trump "an unprecedented threat to the rights of journalists and to CPJ's ability to advocate for press freedom around the world."

Meanwhile, Pope Francis has asked people to join him in praying that "journalists, in carrying out their work, may always be motivated by respect for truth and a strong sense of ethics." We think the great majority of them are, and journalists at all levels need to stand up for them. The item below also shows the need for that.

Rural residents more alienated, cynical when it comes to politics, elitism and news media

Response to assertion "You can't believe much
of what you hear from the mainstream media"

Rural residents feel more alienated than urban residents and are more cynical towards people who have more money and education than they do, says a study by the Institute for Advanced Studies in Culture at the University of Virginia. The study, "The Vanishing Center of American Democracy," was based on 1,904 telephone interviews as part of the 2016 Survey of American Political Culture.

"Alienation rates are twice as likely to be very high in the most rural areas as in the denser cities; three-and-a-half times more likely if you have only a high school diploma than a graduate degree; and four times more likely if you are in the lowest income bracket than if you belong in the highest income bracket," the study reports. "As with distrust of political institutions and cynicism about America’s 'experts' and leaders, personal alienation is more closely tied to education and income than to other measures of social location."

"Similarly, the population density where one lives is only loosely connected to cynicism—those who live in rural areas tend to be slightly more cynical toward elites," the study found. "The key elements tied to cynicism are income and education, especially the latter."

Responses to "How much confidence
do you have in the people who run our
government to tell the truth to the public?"

Overall, 75 percent of respondents said they agree or mostly agree that you can't believe much of what you hear from the mainstream media. Also, 67 percent have no or little confidence that the people who run our government tell the truth to the public.

When asked if "Most politicians are more interested in winning elections than in doing what is right," 90 percent of respondents agreed. Also, 88 percent said political events are more like entertainment or theater than something that should be taken seriously, 86 percent said they vote without putting much thought into the issues and 84 percent believe Wall Street and big businesses profit at the expense of ordinary Americans.

Many rural families struggle to put enough food on the table, even if they have jobs

Storm Lake resident loads food at a drive-by pantry. (AP photo)

Job figures make Storm Lake, Iowa, look like "a picture of economic health," Scott McFetrigde reports for The Associated Press. The town of 11,000 has a 3 percent unemployment rate, "but there's a growing problem . . . one that's familiar to rural areas around the country. Thousands of working families and elderly residents don't have enough money to feed themselves or their children." This problem is still a harsh reality for many rural residents, even after the Census Bureau announced last month that the national poverty rate decreased from 14.7 percent in 2014, to 13.5 percent in 2015.

"Finding a job isn't the problem in Storm Lake, which is hours from Des Moines and Minneapolis. It's finding one that pays enough to cover the bills," McFetridge writes. "Tyson Foods' turkey and pork processing plants are Storm Lake's biggest employers — more than 2,700, many of whom are immigrants attracted by wages of $15 an hour or more. But many also have large families, and paychecks are eaten up by big grocery bills, heating and cooling costs and higher-than-expected rent due to increased demand for housing that hasn't been met by new construction."

Storm Lake responded to the poverty spike with a mostly volunteer effort, handing out free food -- eggs, cereal, vegetables, juice -- at local pantries and different parts of town to help residents, AP reports. "More food pantries have opened in Storm Lake in the past couple years, and the Food Bank of Iowa has tripled deliveries since 2012 to more than 90,000 pounds in the last fiscal year. That figure doesn't count private donations made."

Hermelinda Gonzalez, who relies on food from a monthly drive-up pantry to feed her seven children despite her husband's construction job, told AP: "You struggle to live one day at a time, to stretch the budget. I don't know what we'd do without this."

"Not having access to enough food is more severe in isolated counties than urban, metropolitan areas — 64 percent of the counties with the highest rate of food insecurity for children are rural, according to data from national anti-hunger group Feeding America," McFetridge reports.

Superintendent Carl Turner told AP that about 60 families with children in Storm Lake middle school rely on food from the curbside pantry, and will soon open one for the high school. "We've seen the need," Turner said. "It's about academic achievement. It's really difficult for children to achieve at a high level if there's hunger."

Federal judge gives EPA 14 days to rate effects of Clean Power Plan regulations on coal jobs

The Environmental Protection Agency has been ordered to study the effects of President Obama's  Clean Power Plan regulations on jobs, Ken Ward reports for the Charleston Gazette-Mail. A federal judge in West Virginia said Monday that EPA has "14 days to submit a plan for completing the study of both the general jobs impact of air-pollution rules and the specific effects of such regulations on the coal industry."

U.S. District Judge John Preston Bailey "cited a section of the federal Clean Air Act which states that the EPA 'shall conduct continuing evaluations of potential loss or shifts of employment which may result from the administration or enforcement' of the law, including 'where appropriate, investigating threatened plant closures or reductions in employment allegedly resulting from such administration or enforcement'," Ward writes. "Bailey noted that Congress required such evaluations 'to provide information which could lead the EPA or Congress to amend . . . prior EPA actions'."

The case was brought by Robert E. Murray, CEO and owner of Murray Energy Corp., the largest independent coal producer in the U.S., an outspoken foe of the regulations, Ward writes. Murray said in a statement: “This is a great day for coal miners in the United States, and for all citizens who rely on low-cost electricity in America. We will continue to vigorously pursue this lawsuit, and all of our litigation initiatives, in order to protect the lives and livelihoods of coal miners and their families, to defend the rule of law, and to preserve reliable and low-cost electricity in our country.” (Read more)

Medical students in Illinois receive hands-on training to respond to grain-entrapment incidents

Confined-space incidents—typically, entrapment in grain bins—have become more common in recent years. They slacked off last year, but remain a concern for agribusiness. In 2015 there were 24 reported incidents of grain entrapment and 47 total confined-space incidents, 25 of them fatal, according to Purdue University's 2015 Summary of U.S. Agricultural Confined Space-Related Injuries and Fatalities. In 2014 there were 70 confined-space incident reports—the highest total since 2010—and 38 grain-entrapment cases.

University of Illinois School of Medicine at Rockford
student getting grain entrapment training.

Students at the University of Illinois School of Medicine at Rockford are getting hands-on experience in responding to such incidents, Courtney Bunting reports WIFR-23 in Rockford. "Serious and even fatal accidents on farms are a more common problem than many people realize and medical professionals often lack the training they need in order to properly respond to them."

That's why organizations like Stateline Farm Rescue are using simulations as a training technique for these emergencies, Bunting reports. Mark Baker, a coordinator for Farm Rescue, told Bunting, "A lot of these accidents are gonna be a lot more complicated than what we probably are trained for, so that's what we're trying to bring to the table is understanding that maybe additional training is needed."

UI, which already offers a Rural Medical Education Program that specifically educate students to work in rural areas, is in the process of adding a nursing component for fall 2017, Bunting reports. "It will be a 4-year program aimed at meeting the need for rural communities to have more available healthcare nearby." (Read more)

Rioting and trespassing charges dropped against advocacy journalist covering pipeline protests

Rioting and trespassing charges have been dropped against a advocacy journalist covering the Dakota Access Pipeline protests. Amy Goodman, of the liberal radio show Democracy Now!, said a judge in Morton County, North Dakota (Wikipedia map) refused to formalize charges against her for participating in a riot while covering the North Dakota protests, Andrea Perez reports for the Reporters Committee for Freedom of the Press. Misdemeanor criminal-trespass charges had already been dropped.

"Goodman’s coverage caught images of protesters attaching themselves to construction tools in hopes of causing delays, but also showed Dakota Access Pipeline security guards physically assaulting nonviolent protesters, pepper-spraying them and allowing guard dogs to bite some of them," Perez writes. "Throughout the seven-minute video, Goodman is heard narrating the unfolding events, conducting interviews and occasionally appearing in front of the camera."

Goodman said: "I came back to North Dakota to fight a trespass charge. They saw that they could never make that charge stick, so now they want to charge me with rioting. I wasn’t trespassing, I wasn’t engaging in a riot, I was doing my job as a journalist by covering a violent attack on Native American protesters."

1/4 of low-income students opt out of activities due to cost; rural kids are more likely to be poor

Middle and high school students from lower-income families are more than twice as likely to opt out of school sports, arts and clubs, says the University of Michigan's C.S. Mott Children’s Hospital National Poll on Children’s Health. The poll found that 27 percent of students from households that make less than $60,000 cite a decreased participation because of costs, compared to 12 percent from households that make more than $60,000. Also, 24 percent of students from households making less than $60,000 say cost leads them to not participate at all, compared to 11 percent from households that make more than $60,000.

The study report didn't have a rural-urban breakdown, but incomes are generally lower in rural areas. In 2013 nearly 2.6 million children under 18 outside metropolitan areas were living in poverty, a rate of 26 percent, double the rate in metropolitan areas, according to the Economic Research Service of the U.S. Department of Agriculture.

The poll, conducted in May by GfK Custom Research, asked 666 parents with at least one child in middle or high school to list their child's school sports, arts and clubs/other activities for the 2015-16 school year. Participants were asked: "Has your child ever received a waiver or scholarship for school participation fees?" and "Has the cost of school activities caused a drop in participation for your own child(ren)?"

Researchers found that the average annual cost per student—including equipment, travel, private lessons, fees, special events—was $302 to play sports, $218 for arts (such as music, theater or yearbook) and $124 for clubs. Ten percent of lower-income and 3 percent of higher-income families received a waiver for activity fees. (USDA graphic: non-metro poverty rates 2010-14)

Cheap natural gas, not air-pollutuion regulation, is main reason for coal's decline, researchers say

Cheaper natural gas, not regulation of air pollution by President Obama's Environmental Protection Agency, is the main reason for coal's decline, says a study by Case Western Reserve University published in The Electricity Journal. The study, which used data from the U.S. Energy Information Administration, academia, specialized energy consultants, Wall Street analysts and publicly available information of the electric utilities and gas industry, found that natural-gas prices were cheaper than coal for electric generation in nearly every month from January 2012 to January 2016.

While consumption of coal has dropped since Obama took office—declining 23 percent from 2008 to 2015—researchers found "the drop in those years to be correlated with the shale-gas revolution, as gas production increased by a factor of more than 10 and its price dropped in half. And, due to the continuing—and in some cases accelerating—technological and economic advantages of gas over coal, the decline in coal is expected to continue at least decades into the future." (Case graphic: benchmark natural-gas price in past four years)

Also, researchers note that new air-pollution regulations were not implemented until June of this year, meaning that "power plants, which use 93 percent of the coal produced nationally, have been operating under the same EPA regulations signed into law by President George H.W. Bush in 1990." However, utilities have made choices about closing power plants or retrofitting them for gas based in part on the scheduled implementation of the new rules. Also, the study did not calculate the effect of earlier EPA water-pollution rules that increased costs for surface coal mines.

Mingguo Hong, associate professor of electrical engineering and computer science at Case and co-author of the study, said: "Some people attribute the decline in coal-generated electricity to the EPA's air-quality rules, even calling it 'Obama's war on coal.' While we can't say that the EPA rules have no impact—as, for example, discouraging the building of new coal power plants because of the expectation that tougher air-quality rules will clear the courts—the data say the EPA rules have not been the driving force." (Read more)

Hurricane Matthew flooding leads to renewed scrutiny of factory farms and animal waste lagoons

Washington Post graphic

The large number of animal carcasses and waste flooding North Carolina's waters in the wake of Hurricane Matthew is renewing the criticism of factory farms, Arelis R. Hernández, Angela Fritz and Chris Mooney report for The Washington Post. Flooding is thought to have killed several thousand hogs and several million chickens and turkeys.

Mae Wu, an attorney with the Natural Resources Defense Council, told the Post, “What this flooding does is really bring to light all the human health and environmental consequences of letting them have these open pits of waste just sitting out there."

The North Carolina Pork Council, which accused its most vocal critic, the nonprofit advocacy group Waterkeepers Alliance, of having "deliberately exaggerated the environmental impact" from hog lagoons, "announced on Friday that there’d been zero waste pits breached and just 11 flooded," the Post reports.

"The presence of mass-scale swine and poultry lots and processing plants in a sandy floodplain—a region once dotted by small tobacco farms—has long posed a difficult dilemma for a state where swine and poultry represent billions of dollars a year for the economy," the Post reports. "The sheer size of many operations is mind-boggling; the world’s biggest hog-processing plant, the Smithfield Foods facility located in the town of Tar Heel, slaughters 30,000 animals a day. In a statement, Smithfield said none of its farms had suffered 'a lagoon failure' as of Thursday afternoon."

"During Hurricane Floyd in 1999, hog lagoons across the eastern part of North Carolina broke open and dumped tons of liquid and solid waste into the storm waters," the Post reports. "That material flowed downstream, eventually settling in coastal estuaries."

"State environmental officials insist they learned lessons from Floyd," reports the Post. "The previous year, the state had put a moratorium on building new farms with more than 250 hogs and expanding existing large farms. After the hurricane, it bought out 42 hog operations located in the floodplain, essentially removing 103 waste lagoons. Other lagoons were relocated to higher ground and, in some cases, re-engineered to withstand inundation. Yet the effort remains unfinished, with 'at least' 150 facilities that the state never closed, according to Michelle Nowlin, a professor of environmental law at Duke University. Many critics maintain that the moratorium contains loopholes that have long rendered the bill ineffective." (Read more)

South has five of top six states with most gun violence, says study based on various data

Louisiana leads the nation in gun violence, says a study by the Center for American Progress, a left-leaning research organization. The study examined 10 factors, ranking each state on a scale of 1-10 for each of these categories per capita: gun deaths; gun suicides; gun homicides; fatal gun accidents; mass shootings; gun homicides of women by intimate partners; gun deaths among people younger than age 21; law-enforcement officers feloniously killed with a firearm; fatal shootings by police; and crime-gun export rates. All of the data were from 2005-14, except mass shootings (2006-14), fatal shootings by police (2015-16) and crime-gun exports (2010-15). All 10 factors were given equal weight.

Louisiana received a total score of 75. Alaska was second at 66, followed by Mississippi, 61; West Virginia, 60; Alabama, 59; South Carolina, 57; Wyoming, 56; Arizona, 53; and Montana and Oklahoma, 51. Massachusetts and Hawaii tied for the least gun violence, each scoring a 6. Rhode Island had a 9, New York 11 and New Jersey and Connecticut 12. (Center for American Progress graphic: gun violence rankings by state)

In 2014, more than 33,000 people were killed with guns in the U.S., 92 per day. Louisiana led with the highest rate of gun deaths, at 18.78 per 100,000 people. Alaska (18.2 deaths per 100,000) was second, followed by Mississippi (17.49), Alabama (16.79), Wyoming (16.27), Arkansas (15.78) and Montana (15.58). Hawaii had the lowest rate of gun deaths per capita, at 2.88 per 100,000 people. Massachusetts was 3.39, Rhode Island 4.00, New York 4.82 and Connecticut 5.25.

Alaska led in gun suicides (14.21 per 100,000), while Massachusetts was last with a rate of 1.69 per 100,000. Louisiana had the most gun homicides, at 9.75 per 100,000, and Hawaii was last, at 0.54 per 100,000. South Carolina had the highest rate of intimate-partner gun homicides of women; Louisiana led in gun deaths among younger people; Alaska had the highest rate of law officers killed; and New Mexico led in fatal shootings by pol

'Americana' music gains popularity and recognition

Bob Weir performing

"Americana" music is on the rise, with four of its artists—Bon Iver, Bob Weir (formerly of the Grateful Dead), Van Morrison and the Drive-By Truckers—in the most recent Billboard charts top 10 for the week ending Oct. 6, Dan Rys reports for the magazine. Americana has more spots in the top 10 than any other music except rock, a genre for which all four artists also qualify.

The four's popularity reflects a recent trend toward the establishment of Americana music as a distinct genre in a realm often dominated by rock, country, rap and R&B, Rys writes. In 2010 the Grammy Awards added a Best Americana album category—Levon Helm won it that year—and there are now categories for Best American Roots Song and Best American Roots Performance.

In August of 2015, Merriam-Webster officially added "Americana" to its dictionary, "defining it as 'a genre of American music having roots in early folk and country music.'" Rys writes. "And in May, Billboard announced the re-branding of the Folk Albums chart following in-depth dialogue with industry contacts, writing the chart would 'spotlight the middle ground bridging country and rock: organic, roots and acoustic-based groups and solo singer-songwriters.'"

Jed Hilly, executive director of the Americana Music Association, told Rys, "I think it's burgeoning in the commercial marketplace for a community that already existed in a non-commercial marketplace. I think that the fact that there's a word in the dictionary, there's a Grammy Award, [now] there's a place for these artists who don't necessarily fit in the mainstream commercial boxes, but do have artistic similarities can call home." (Read more)