Lack of qualified workers leaves manufacturers struggling to fill jobs; rural drug use is an issue

The manufacturing industry isn't dying, it's changing, with the enterprises flourishing today demanding "a different set of skills than assembly lines of the past," Danielle Paquette reports for The Washington Post. That has led some businesses to struggle to find qualified candidates to fill jobs that pay $20 or more per hour.

Business professor Michael Hicks, at Ball State University in Indiana, said "one reason for the labor shortage is the fear of change," Paquette writes. "Many of the open roles involve computer assistance, which requires job training. Although some companies and state programs will cover the tuition bills, some workers, particularly those who’ve held the same job for decades, are hesitant to take them up on the offer, even if unemployment is imminent and the wages are competitive."

Hicks said another problem is that young people aren't filling the open slots, Paquette writes. "They don’t flock to mid-sized cities like they do to, say, Chicago. The share of employees older than 45 in the skilled trades, for example, is about 25 percent larger than for the broader workforce. Drug use, on the rise in rural counties, also disqualifies a chunk of prospective hires, Hicks said."

The Manhattan Institute, a right-leaning research group, released a report Wednesday "that 88 percent of American manufacturers said they have difficulty finding workers," stating: “There are an estimated half-million more ‘skilled trades’ jobs (i.e., for non-college-educated workers) available than people trained to fill them."

"Although the country added thousands of manufacturing jobs since 2010, the numbers haven't come close to returning to pre-recession levels, a consequence of both trade and technology," Paquette writes. "There were about 17 million manufacturing jobs in 2000, and that number today sits closer to 12 million, according to employment data from the Bureau of Labor Statistics. The shrinkage accelerated in the years after the North American Free Trade Agreement took effect, enabling companies to tap cheap labor overseas and bringing down the prices of consumer goods."

Rule allowing 30-year wind farm permits expected to cause more deaths of bald eagles, other birds

The U.S. Fish and Wildlife Service's rule to give 30-year permits to wind farms could result in thousands of bird deaths, including bald eagles, Laura Zuckerman reports for Reuters. "The newly finalized rule, to go into effect on Jan. 15, extends the current five-year term for permits that allow for the accidental deaths of bald and golden eagles. The permits, which are meant for any activity that could disturb or kill eagles but will mostly apply to wind farms, are required under federal law."

Wind energy companies argued that "they needed the longer permits to provide more stability to investors in the growing renewable power industry," Zuckerman writes. In 2013, Fish and Wildlife "approved a similar plan extending 'eagle-take' permits to 30 years, but a U.S. judge overturned it last year. The judge agreed with conservation groups that the agency had failed to properly assess the impact on federally protected eagle populations."

Fish and Wildlife said the current population of 140,000 bald eagles could "withstand the loss of about 2,000 birds annually" and "could sustain as many as 4,200 fatalities a year without endangering the species," Zuckerman writes. The agency estimates that about "545 golden eagles are thought to perish annually from collisions with obstacles ranging from turbines to vehicles."

Environmentalists, EPA, farm groups argue in court over rule exempting reporting farm emissions

An Environmental Protection Agency rule "exempting most animal feeding operations from emergency reporting requirements for ammonia and hydrogen sulfide was challenged as both too tough and not tough enough, in arguments before the D.C. Circuit Court of Appeals Monday," reports Agri-Pulse. Environmental groups "sued EPA over that regulation, which exempts all but the largest animal feeding operations from reporting ammonia and hydrogen sulfide emissions that exceed 100 pounds in 24 hours."

Attorney Jonathan James Smith of Earthjustice, said the emergency-reporting law doesn't allow EPA to exempt farms, "as EPA did in 2008 when it issued a rule under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and the Emergency Planning and Community Right-to-Know Act (EPCRA)," reports Agri-Pulse.

Smith "emphasized the potential benefits to public health of required reporting, saying that having information about releases helps the public avoid the facilities emitting the chemicals, and can guide state and local agencies in crafting regulations," reports Agri-Pulse. He "also took aim at the size standards EPA used in defining which facilities would have to report—including those with fewer than 700 mature dairy cows, or those with 2,500 swine weighing 55 pounds or more (or 10,000 swine weighing 55 pounds or less)."

Attorney David Chung of Crowell & Moring, arguing for the National Pork Producers Council and the U.S. Poultry and Egg Association, "contended that EPA had no authority to require even large operations to report their releases because there is no evidence that animal waste emissions would ever trigger an emergency response," reports Agri-Pulse. He added that 'reducing emissions is not the purpose of the emergency notification provisions.'”

"That point also was made by EPA in the final rule, when it said it 'believes that state or local emergency response authorities are unlikely to respond to notifications of air releases of hazardous substances from animal waste at farms',” reports Agri-Pulse. EPA, represented by the U.S. Department of Justice, argued "that the environmental groups had not been able to demonstrate legal standing in the case. Even assuming they have standing, however, the two DOJ lawyers said that EPA’s rule was reasonable and avoids unnecessary burdens on federal, state and local agencies, as well as on the farms that do not have to report."

Agri-Pulse is subscription only, but can be viewed by clicking here.

Federal agencies, NPR report surge in black-lung disease among coal miners in Central Appalachia

Progressive massive fibrosis in underground miners
with more than 25 years experience (Coal Workers’
Health Surveillance Program, Ky.,Va.,W.Va,1974–2015)

Black-lung disease is surging among Appalachian coal miners, according to a report by the federal Centers for Disease Control and Prevention and an investigation by Howard Berkes of NPR.

In June, Eastern Kentucky radiologist Brandon Crum contacted the National Institute for Occupational Safety and Health to report a surge in black-lung disease in the coal-mining area. The radiologist, who was not named, said 60 active or former coal mining patients examined in Pike County from Jan. 1, 2015 to Aug. 17, 2016 had radiographic findings consistent with progressive massive fibrosis, the most progressive form of black lung.

"I think the percentage of black lung that we're seeing now here in Central Appalachia is unprecedented in any recorded data that I can find anywhere," Crum told NPR. NIOSH epidemiologist Scott Laney told the network, "We had not seen cases of this magnitude ever before in history in Central Appalachia."

PMF cases in the region are "more than 10 times what federal regulators report," NPR reports, based on "data from 11 black lung clinics in Virginia, West Virginia, Pennsylvania and Ohio. "The true number is probably even higher, because some clinics had incomplete records and others declined to provide data." The CDC report says, "The actual extent of PMF in U.S. coal miners remains unclear." Under the law, NIOSH can only test working miners, and many of them are reluctant to be examined for fear that a black-lung diagnosis would disqualify them from jobs with other coal operators; the last employer of a miner with black lung pays the benefits, Berkes notes.

The CDC did not identify the mining practices that led to the increase in cases, but slope mining and the economy were suggested as possible reasons, Bill Estep reports for the Lexington Herald-Leader. Slope mining "involves using a continuous mining machine to cut through hundreds of feet of sandstone to reach coal seams, the report said," Estep notes. "Sandstone in Eastern Kentucky contains a high level of quartz, so slope mining could expose miners to hazardous dust with a high concentration of breathable crystalline silica, the report said."

It also was suggested that "many miners didn’t seek examinations for the disease early in their careers for fear of losing a job or not being able to get a job, but have come forward more recently because the region has lost thousands of coal jobs and the miners are getting tested in order to seek benefits," Estep writes.

Berkes reports, "New and tougher federal limits on mine dust exposure fully took effect in August, and they get even tougher when there's excessive silica. Simple black lung and PMF can take a decade or longer to develop." The coal industry's decline may put the benefits in doubt. "The fund is nearly $6 billion in debt. It has taken on 1,000 claims that were covered by self-insured mining companies until they went bankrupt. And the coal excise tax that supports the fund is set for a 50 percent cut in two years."

Map by Alexandra Kanik, Ohio Valley ReSource

Fact checking Trump's choice to lead EPA on climate change, fracking and the Clean Power Plan

Scott Pruitt arriving at Trump Tower
Dec. 7 to meet with Donald Trump

Scott Pruitt, President-elect Donald Trump's choice to head the Environmental Protection Agency, "has made some questionable claims related to global warming, fracking and the Clean Power Plan," Vanessa Schipani reports for FactCheck.org.

Pruitt said in May, "Healthy debate is the lifeblood of American democracy, and global warming has inspired one of the major policy debates of our time. That debate is far from settled. Scientists continue to disagree about the degree and extent of global warming and its connection to the actions of mankind." Schipani writes, The truth is that about 97 percent of climate scientists "agree that global warming is occurring and that at least half of it is due to human activity."

Pruitt also said the Clean Power Plan "will 'significantly increase electricity prices," Schipani writes. "Whether the price change is 'significant' is a matter of opinion, but the Energy Information Administration estimates that prices under the plan would range from a 7 percent decrease to a 7 percent increase between 2025 and 2040, depending on the region."

Pruitt said in April, "I am concerned that this project is politically motivated and ignores the EPA’s three previous failed attempts to link hydraulic fracturing to water contamination. In addition, the U.S. Department of Energy has investigated hydraulic fracturing’s potential harm to water supplies and found no evidence linking the drilling technique to groundwater contamination." Schipani writes, "scientists didn’t have enough data to reach a definitive conclusion about the link (or lack thereof) between fracking and water contamination across the country then—and they still don’t now. More research must be done to confirm or refute whether water contamination involving fracking is widespread." (Read more)

Rural Mainstreet Index highest since June, but still negative for 16th straight month; crop prices low

The Rural Mainstreet Index for December reached its highest level since June, but remained below 50 on a scale of 100 for the 16th consecutive month, indicating continued economic weakness in the 10-state region from Illinois to Wyoming that 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 December index is 42.9, up from 36.6 in November but down from 43.9 in June. Goss said: “Weak farm commodity prices continue to slam Rural Mainstreet economies. Over the past 12 months, livestock commodity prices have tumbled by 19 percent and grain commodity prices have slumped by 11.5 percent. The economic fallout from this price weakness continues to push growth into negative territory for seven of the 10 states in the region."

Goss notes that farmland prices declined for the 37th straight month. He said bank CEOs "expect loan defaults to rise by 5.6 percent over the next 12 months. This estimate is up slightly from 5.4 percent recorded in July of this year. Bankers expect holiday sales for Rural Mainstreet retailers to expand by a scant 0.4 percent over 2015 levels."

Hydroponic farming could be a solution in areas that lack water; critics say it's not organic

A hydroponic operation
(KBIA photo by Kristofor Husted) 

Who says you need fertile soil to farm? Hydroponics, which is farming in water instead of soil, is catching on in parts of the world that lack the necessary landscape for traditional farming, Seham El Oraby reports for Reuters. Outside Cairo, farmer Amr Bassiouny says he is growing salad greens "using 90 percent less water than traditional methods, and at the same time obtaining better yields." He told Reuters, "This is important in Egypt because we have scarce water resources, so you're able to grow large quantities with much less use of resources."

Hydroponics isn't a new idea, but it is catching on in areas like Cairo, where unlicensed construction following the nation's 2011 uprising led to an estimated loss of 90,000 acres of farmland over a three-year period, El Oraby writes.

The success of hydroponics could be a solution in the U.S. in areas where drought has decimated water supplies. But a battle is an ongoing about whether or not crops grown through hydroponics can be certified as organic, Kristofor Husted reports for KBIA in Columbia, Mo.

Hydroponic farmers "contend their system protects soil by not even using it. If they grow produce without the synthetic fertilizers and pesticides barred in organic production, they say, they should be allowed to market their goods as organic," Husted writes. "That’s a problem for many farmers who say soil is the essential ingredient for organic production. Many organic farmers say that from its very inception, organic farming was built on nurturing soil health. And some are worried that cheaper produce harvested year-round from hydroponic farms in warehouses will undercut organic prices."

Youth suicide is increasing in rural areas but declining in metros; Utah paper takes a look

Youth suicide rates are higher in rural areas, where young people often deal with isolation, limited transportation, a lack of mental-health providers, the stigma of undergoing mental-health care, more access to guns, and high rates of poverty and substance abuse, Lois M. Collins and Lauren Fields report as part of a series on teen suicide for the Deseret News in Salt Lake City.

A Utah Department of Health report found that suicide is the leading cause of death among the state's residents 10 to 17. The state ranked eighth nationally in youth suicide in 2012-14, with rates tripling from 3 per 100,000 people in 2007 to 8.5 in 2014, says a separate health department report. "Fourteen percent of teens say they’ve thought about suicide, while nearly a thousand a year survive self-harm or suicide attempts (not necessarily the same thing), some living with varying degrees of damage." (Deseret News graphic)

The problem is greatest in rural areas, reports the Deseret News. "A 2015 study comparing teen and young adult suicides in all U.S. counties from 1996-2010 showed suicide rates in rural communities were nearly double those of urban areas—and the gap is increasing." (Deseret News graphic)

"Experts theorize that the same features that make rural life special can be both protective and risky: Wide-open space is great if you’re riding horses, but awful if you’re trying to reach a mental health specialist," reports the Deseret News. "A tight knit church community is life-affirming, unless you feel you aren’t included. And it’s nice to know everyone until you’d like some privacy."

A 2014 Pew Research Center report found in rural areas 51 percent of households own a gun, compared with 36 percent of suburban and 25 percent of urban homes, reports the Deseret News. An American Foundation for Suicide Prevention report found that "firearms were the most common suicide method in 2014, accounting for half of U.S. suicide deaths." Kimberly Myers, co-chair of the Utah Suicide Prevention Coalition and prevention coordinator in Utah’s Division of Substance Abuse and Mental Health, said "gun owners are not more likely to try to kill themselves, but guns are especially lethal so there’s less opportunity for rescue."

Opiate addiction leading to high rate of children in state care; Vt. sees record for adoptions in 2016

Vermont adoptions (Free Press graphic)

The opiate epidemic has led to a growing number of rural children being taken away from home, April McCullum reports for the Burlington Free Press. Vermont, one of the most rural states, has processed a record number of adoptions in 2016, partly because of an increasingly high number of children in state care, mostly because of opiates and other drugs, and partly because of an initiative to find children permanent homes.

Vermont this year has processed 217 adoptions, as of last week, and 17 more are expected to be finalized by the end of 2016, McCullum writes. "An additional 12 adoptions were completed with a child's relatives through a process known as a conditional custody order." Chief Superior Court Judge Brian Grearson told McCullum. “It’s not a record that anybody wants to beat. I mean, it’s reality. . . . If that’s the best result for a child, it’s important that it be done as soon as possible. I wish we could be talking about something other than a record number of adoptions."

Karen Shea, interim deputy commissioner for the Family Services Division at the state Department for Children and Families, said "Young children remain the largest group in state custody today," McCullum writes. "As of Dec. 1, Vermont had custody of 1,328 children, she said. More than 500 of them were infants, toddlers and preschool-aged children. Just over half the children who enter state custody are eventually returned to a parent's care, Shea said. That statistic, known as the reunification rate, rose from 44 percent in 2015."

Will Trump's presidency derail Michelle Obama's fight to promote school nutrition, curb obesity?

First Lady Michelle Obama has focused on getting
children to eat healthier and to fight obesity 

Donald Trump's presidency could threaten First Lady Michelle Obama's eight-year battle to promote nutrition and make available healthy school lunches for all children, Caitlin Dewey reports for The Washington Post. Her policies have been credited with contributing "to several positive trends, including the overall obesity rate among young people leveling off in recent years" and improving children's diets. Obesity rates among children are higher in rural areas.

Obama "has spent the past eight years championing anti-obesity initiatives, pushing an aggressive policy and public-outreach agenda that has played a part in changing how millions of Americans, particularly schoolchildren, eat," Dewey writes. "In a 2010 speech announcing her signature program, 'Let’s Move!,' Obama described her goal as nothing less than 'solving the problem of childhood obesity in a generation'.” She also helped push for the passage of the Healthy, Hunger-Free Kids Act, which required the lunch program revise its nutritional guidelines for the first time in 15 years.

"But now that Trump will soon take power—Trump of the deep-fried taco bowl and 20-ounce Porterhouse fame—lobbyists, activists and outgoing administration officials fear that the president-elect, and his and his advisers’ skepticism of government regulation, will uproot the healthy-food movement Obama has championed," Dewey writes. Trump’s agricultural advisory committee includes Texas Agriculture Commissioner Sid Miller, who reintroduced deep-fryers to that state’s schools. Miller is on the short list for agriculture secretary.

"Advocates fear that three achievements could be on the chopping block: rules that require chain restaurants to put calorie counts on menus, stricter nutrition standards for school lunches, and an update to the nutrition labels that appear on packaged foods," Dewey writes. "All three were championed by the first lady and enacted by Democratic majorities in Congress."

The School Nutrition Association, a powerful industry group which had been an important supporter of the Healthy, Hunger-Free Kids Act, "reversed course over concerns that the new standards were expensive and unpopular with students," Dewey writes. Schools complained that students refused to eat the healthier foods, forcing them to be trashed. (Read more)

USDA issues rules to help small livestock farmers

The Grain Inspection, Packers and Stockyards Administration (GIPSA) of the U.S. Department of Agriculture on Wednesday released its Farmer Fair Practices Rules, which are designed to protect small farmers, a USDA press release said. Agriculture Secretary Tom Vilsack said, "For years, American farmers have been calling for protections against the most damaging unfair and deceptive practices confronting family farms across the country. Poultry growers in particular are vulnerable to market risks and concentration in the processor market. All too often, processors and packers wield the power and farmers carry the risk."

Included in the proposal is an interim final rule that says "it is not necessary to demonstrate that an unfair practice harms the entire market in order to prove a violation of the Packers and Stockyards Act," states USDA. "Such overly broad interpretations have put family farmers at a disadvantage for decades when pursuing their rights under the Act."

There is also a "proposed rule regarding unfair practices would clarify what GIPSA views as practices that clearly violate the Act and would establish criteria to protect the legal rights of farmers," USDA says. A third proposal "would establish criteria that GIPSA would consider in determining whether a live poultry dealer has engaged in a pattern or practice to use a poultry grower ranking system unfairly."

Industry response to the rules was mixed. Zippy Duvall, president of the American Farm Bureau Federation, said in a statement: "These proposed rules will strengthen GIPSA’s ability to evaluate business practices in the poultry industry and better protect individual farmers from discriminatory treatment. America’s chicken farmers have long called for greater transparency and a level playing field in our industry, and we appreciate USDA’s efforts to hold companies accountable and give farmers a voice.”

The National Pork Producers Council said the rules "would have a devastating effect because they will increase the risk of lawsuits by farmers," Dan Charles reports for NPR. The National Chicken Council and National Cattlemen's Beef Association called the rules unnecessary, Chris Clayton reports for DTN The Progressive Farmer.

The rules could be halted by the Trump administration or Congress, where reaction also was mixed, Clayton reports. House Agriculture Committee Chairman Michael Conaway (R-Texas) criticized the rules, while Sen. Charles Grassley (R-Iowa) "said the rules were not as strong as he wanted, but he said they were a step in the right direction."

For-profit, rural-heavy college that lied about graduation rates and loans is making restitution

Daymar College locations; six in Kentucky
including the two in Louisville, have closed.

Students who attended a for-profit college accused of lying about graduation rates and loans will begin receive restitution checks, Kentucky Attorney General Andy Beshear announced Wednesday. For-profit institutions such as Daymar College draw their students disproportionately from rural young adults.

Then-Attorney General Jack Conway sued Daymar in 2011, saying it coerced students into buying overpriced textbooks and misled them about credit transfers, financial aid and job opportunities. The school agreed last year to pay $1.2 million to about 3,500 students. Default rates on student loans are highest at for-profit colleges and community colleges. Daymar, with sites mostly in small towns, had the highest default rates in Kentucky.

"As part of its settlement, Daymar has already forgiven $11 million in student debt to nearly 6,500 students who qualified. The average loan forgiveness amount was $1,700," Beshear's office said. He said the average restitution amount for students who attended a Daymar campus in Kentucky between July 27, 2006, through July 27, 2011, and filed a claim is approximately $345.

Daymar had 11 locations in Kentucky. Five remain open, with two still enrolling new students. Daymar also has been located in Indiana, Ohio and Tennessee.

Federal judge says sending checkoff funds to state beef group was unconstitutional

"A U.S. magistrate judge sided with R-CALF USA in a First Amendment dispute over the use of beef checkoff funds," reports Agri-Pulse. "The case was filed after the Montana Beef Council used checkoff funds to support advertisements for North American beef, a move that riled up the membership of country-of-origin-labeling stalwart R-CALF," an acronym that stands for Ranchers-Cattlemen Action Legal Fund, United Stockgrowers of America.

"The findings of the magistrate back R-CALF’s claim that checkoff funds being sent to a private entity—the Montana Beef Council, in this case—is an unconstitutional violation of their members’ rights," reports Agri-Pulse. "In an alert to its membership, R-CALF called this a win 'an important first victory in our case'." However, there is still expected to be further review in the court system. 

"R-CALF also notes that if the U.S. District Court adopts the magistrate’s findings and recommendations and orders a preliminary injunction, 'the government must stop allowing the Montana Beef Council to collect and spend producer checkoff dollars unless the council first obtains permission from each cattle producer to keep and use their checkoff dollars.' The government now has 14 days to object to or appeal the magistrate judge’s findings or recommendations," Agri-Pulse reports. Agri-Pulse is subscription only, but can be viewed by clicking here.

Trump, who promised to revive coal, keeps naming natural gas advocates for key cabinet positions

Even though President-elect Donald Trump has promised to revive the coal industry, his selections for three key cabinet positions all favor natural gas, the main cause of coal's decline, Curtis Tate reports for McClatchy Newspapers. That could spell bad news for people in struggling coal communities, especially in Appalachia, where Trump won handily largely on the strength of his pro-coal stance. "Trump won handily in coal-producing regions that have been hardest-hit by the transition from coal to natural gas, especially those in Kentucky, West Virginia, Ohio and Pennsylvania," Tate notes.

Trump has tabbed Oklahoma Attorney General Scott Pruitt to lead the Environmental Protection Agency, ExxonMobil CEO Rex Tillerson to be secretary of state and former Texas Gov. Rick Perry for energy secretary. Tate notes that all three oppose President Obama’s Clean Power Plan, "which would reduce carbon-dioxide emissions by a third by 2030, primarily by taking aim at coal-fired power plants. But all three men have been big promoters of the production of natural gas through hydraulic fracturing, and the resulting abundance of cheap natural gas has displaced a large volume of coal in the nation’s power sector."

"Pruitt, one of the first state attorneys general to take the Obama administration to court over the Clean Power Plan, testified before a House of Representatives subcommittee earlier this year that natural gas had done more to cut carbon emissions than any federal regulation," Tate notes. "Tillerson projected that global demand for natural gas would rise by 65 percent from 2010 to 2040, diminishing the importance of coal worldwide."

"Perry, who was governor of Texas from 2001 to 2015, oversaw a massive shift from coal to natural gas that’s still occurring," Tate writes. "In 2010, the two fossil fuels generated about an equal amount of the state’s electricity. By 2015, natural gas fueled 48 percent of Texas power, while coal had slipped to 28 percent, according to the Electricity Reliability Council of Texas." (Read more)

More than 4 million Americans, mostly in rural areas, drink water not properly tested for lead

Millions of Americans, mostly in rural communities, are being exposed to potentially harmful drinking water, Laura Ungar and Mark Nichols report for USA Today. An investigation by the newspaper and its Gannett Co. partners found that "about 100,000 people get their drinking water from utilities that discovered high lead but failed to treat the water to remove it." In some cases, local, state and federal officials were aware of the dangers and many of the utilities "took more than a year to formulate a treatment plan and even longer to begin treatment."

The report also found that about 4 million people "get water from small operators who skipped required tests or did not conduct the tests properly, violating a cornerstone of federal safe drinking water laws," the reporters write. "The testing is required because, without it, utilities, regulators and people drinking the water can't know if it's safe." (USA Today map: Percentage of each state's small water-utility customers who draw water from a system that has failed to properly test for lead since 2010)

Also, "in more than 2,000 communities, lead tests were skipped more than once," USA Today reports. "Hundreds repeatedly failed to properly test for five or more years. About 850 small water utilities with a documented history of lead contamination—places where state and federal regulators are supposed to pay extra attention—have failed to properly test for lead at least once since 2010."

One problem is that regulators have a history of leniency "with small water systems because they lack resources, deeming some lost causes when they don’t have the money, expertise or motivation to fix problems," the reporters write. "The nation’s Safe Drinking Water Act allows less-trained, often amateur, people to operate tiny water systems even though the risks for people drinking the water are the same."

What have been the leading causes of death in your county? Study maps 21 major causes, 1980-2014

Researchers from the University of Washington and the Erasmus University Medical Center in the Netherlands have charted county-level data for 21 major causes of death in the U.S. from 1980 to 2014. The study, published in The JAMA Network, found that "geographic regions with elevated mortality rates differed among causes." For example, the map below shows that mortality rates from self-harm and interpersonal violence were particularly high in southwestern counties and in Alaska.

The study includes information on communicable, maternal, neonatal, nutritional and noncommunicable diseases and injuries. Below, a screenshot of the study's interactive map shows where substance-abuse disorders are most prevalent. Leading the way is Rio Arriba County, New Mexico, which is home to the Rio Grande Sun, which has extensively covered the issue, as well as Dakotas counties with large Native American populations and in Central Appalachia.

Listed: 80 rural hospitals that have closed since 2010; mainly in states that didn't expand Medicaid

Researchers at the University of North Carolina-Chapel Hill have charted the 80 rural hospitals that have closed since 2010. It's no coincidence that many of them are in the South, largely in states that refused to expand Medicaid under federal health reform. Texas leads the way with 13 rural hospital closures since 2010, Ayla Ellison reports for Hospital CFO. Eight have closed in Tennessee, six in Georgia and five in Alabama and Mississippi. None of those states expanded Medicaid.

A UNC study published in September in the journal Health Affairs found that rural hospitals are more likely to turn a profit in states that expanded Medicaid. For example, rural hospitals in non-expansion states had mean operating margins of − 0.18 percent, compared to 1.03 percent in states that expanded Medicaid. "In contrast, urban hospitals in non-expansion states were, on average, more profitable than those in expansion states, with mean operating margins of 6.92 percent and 3.51 percent, respectively." (UNC graphic: Operating margins for hospitals)

The study backs the long-standing complaint of rural hospitals that "they were hurt by the lack of Medicaid expansion, which leaves many of their patients without insurance coverage and strains the hospitals’ ability to better serve the public," Shefali Luthra reports for Kaiser Health News. The study shows that "all hospitals generally fared better under the larger Medicaid program, but there’s more at stake for rural hospitals when the state expands coverage." 

"Rural hospitals serve more low-income people—who weren’t eligible for insurance before, but who got covered after the health law took effect," Luthra writes. "And rural hospitals are historically more likely to operate at a loss than are urban ones. So the chance to see increased revenue is greater than in a city-based hospital."

Trump picks Montana's congressman to lead Interior Department, on advice of eldest son

President-elect Donald Trump has picked U.S. Rep. Ryan Zinke of Montana for interior secretary, partly because the Republican hit if off with Donald Trump Jr., Juliet Eilperin reports for The Washington Post. The two are avid hunters. Rep. Cathy McMorris Rodgers (R-Wash.) met with Trump Monday and had been the leading contender for the position.

Zinke, an ex-Navy Seal, "has defended public access to federal lands even though he frequently votes against environmentalists on issues ranging from coal extraction to oil and gas drilling," Eilperin writes. "This summer, he quit his post as a member of the GOP platform-writing committee after the group included language that would have transferred federal land ownership to the states. Trump also opposes such land transfers, but the provision made it into the official Republican platform."

"Zinke recently criticized an Interior Department rule aimed at curbing inadvertent releases of methane from oil and gas operations on federal land as 'duplicative and unnecessary'," Eilperin writes. At the time he said: “Clean air and clean water are absolute top priorities when we talk about responsible energy development; however, the final rule issued by the Obama administration does nothing to further protect our resources. This rule is a stark reminder that we need to invest in infrastructure projects like the Keystone pipeline, so we don’t need to flare excess gas.”

Zinke, who has a reputation as being a "straight shooter," during his time in Congress "established a 3 percent voting score with the League of Conservation Voters," Eilperin writes. "But he has broken ranks with the panel’s GOP majority on occasion, opposing a measure by Rep. Don Young (R-Alaska) that would have allowed each state to buy up to 2 million acres in U.S. Forest Service land to boost timber production. He has also pushed for full funding of the Land and Water Conservation Fund, a high priority for outdoors groups."

Fracking report drops line saying no evidence of widespread, systemic impact on drinking water

The Environmental Protection Agency on Tuesday released the Obama administration's final report on the impacts of hydraulic fracturing on drinking water, eliminating a controversial phrase from a 2015 study that said researchers found no evidence of "widespread, systemic impacts" to drinking water supplies. An EPA panel in August said the report, which they called inconsistent, should be revised. Earlier this month Marketplace and American Public Media reported that the controversial phrase was added only after a meeting with White House officials.

Tuesday's report replaced "widespread, systemic impacts" with "a far more guarded statement: 'Hydraulic fracturing activities can impact drinking water resources ... under some circumstances,'" Mike Soraghan reports for Energywire. The report left the industry "seething about political interference, while environmentalists were crowing that they had known it all along."

"The announcement of the 2015 draft report had similarly cited 'specific instances' in which oil and gas activity had 'impacted drinking water resources'," Soraghan notes. "But the assertion was overshadowed by EPA's apparent conclusion that drinking-water contamination wasn't a problem. It's not clear how much any of this matters now, with an incoming Republican administration and a GOP-controlled Congress. Both have made clear that they want less regulation of fossil-fuel production, not more."

Thomas Burke, an EPA deputy assistant administrator and science adviser, said in a conference call, “There are instances when hyrdofracking has impacted drinking-water resources. That’s an important conclusion, an important consideration for moving forward,” Devin Henry reports for The Hill. “Burke added, however, that when it comes to a 'national, systemic conclusion' about the impacts of fracking, 'That’s a different question that this study does not have adequate evidence to really make a conclusive, quantified statement.'”

Crisis is a good time for states to re-focus efforts to help rural communities, says N.C. expert

Ferrel Guillory

A crisis, such as the coastal destruction caused by Hurricane Matthew, showcases the need for assistance in rural communities that are already struggling to survive, opines journalism professor Ferrel Guillory, director of the Program on Public Life at the University of North Carolina School of Media and Journalism, on his blog Friday with Ferrel. Congress has approved about $300 million in recovery assistance for North Carolina. It has yet to be determined how much will go to Eastern North Carolina communities hit by post-hurricane flooding.

"The state faces not only the immediate flood-and-fire crises, but also the long-running 'crises' facing rural communities," Guillory writes. "A pair of Census findings suggests the scope of the challenge: The state’s top 10 cities captured half of North Carolina’s population growth between 2010 and 2015. In the same period, 47 out of the state’s 100 counties had net out-migration; that is, more people moved out than moved in."

"Aside from wind, water, and fire, powerful forces of demography, globalization, and technology have buffeted many of the state’s rural towns and counties," he writes. "The Great Recession dealt a blow to already fragile communities. Some places, situated along four-lane highways or near assets of nature, may prove resilient. Still, when so much manufacturing and warehousing has become automated, even a successfully aggressive business recruitment strategy may not produce enough jobs to distribute throughout distressed rural communities."

Guillory suggests that North Carolina needs a "re-thinking of its economic-development strategy and tactics," that it "should think more in terms of bolstering regional hubs—such as Greenville and Asheville—and connect rural people to their job growth," and that "in some places, the best the state can do perhaps is to manage decline to minimize human hurt." One key is increasing public education opportunities in rural areas, he writes. "To be sure, a strong education inevitably will result in many young people moving away … and then maybe moving back. Education gives them greater capacity for work, for civic participation, for upward mobility."

Guillory is an academic partner of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog, and a former political reporter, editorial page editor and columnist for the Raleigh News & Observer.

Analyses of census and voting data illustrate why Clinton may have wrongly overlooked rural areas

American Community Survey data released last week by the Census Bureau shows that Hillary Clinton "could have concluded—erroneously, in retrospect—that she could have won without appealing to voters in rural areas and small towns," reports Agri-Pulse. Fewer than 20 percent of Americans live in rural areas, with 80 percent living in metro areas, where Clinton was favored to win.

"Trump got about two-thirds of the votes in rural counties and counties with cities under 50,000, performing several points higher than Republican nominee Mitt Romney did in 2012," Agri-Pulse notes, citing the Daily Yonder. "A stunning example comes from a Milwaukee Journal-Sentinel analysis that found Trump won more than 500 Wisconsin towns and villages with a median population of less than 800 that voted for President Obama in 2012, nearly half of them by 20 percentage points or greater." (Census Bureau chart: Trends in urban and rural population; click on image for larger version)

"One popular theory is that the results of the election came as such a surprise because media, pundits, and pollsters were in an information ‘bubble’ and unaware of the depth of discontent outside major cities,” writes Tim Marema of the Yonder. "Although the Census reports do not shed light on Trump’s rural electoral popularity, Marema suggests that they may 'create a leak, if not a burst, in the information bubble.'”

The report says the average age in rural areas is 51, compared to 45 in urban ones. Rural adults are "less likely to be college graduates, are more likely to live in the state where they were born (65.4 percent compared with 48.3 percent), and are more likely to have served in the military (10.4 percent of the population of adults in rural areas compared with 7.8 percent in urban areas)," Agri-Pulse reports.

"Census researchers also compared residents in 704 completely rural counties with their counterparts in counties that were mostly rural and with rural people in areas that were mostly urban," Agri-Pulse reports. "From 2011 to 2015, some 9 percent of the rural population (5.3 million) lived in completely rural counties, compared with about 41 percent (24.6 million) in 1,185 mostly rural counties and about 50 percent (30.1 million) in the 1,253 mostly urban counties. Rural areas had lower rates of poverty (11.7 percent compared with 14 percent) and were much less likely to have large immigrant population. Rural communities had fewer adults born in other countries (4 percent) compared with those in urban areas (19 percent)."

Agri-Pulse is subscription only, but can be viewed by clicking here.

Drug overdose deaths now higher in rural areas than large metros; rise in opiate use to blame

Rise in fatal drug overdoses per 100,000 people (WSJ graphic)

Death rates from drug overdoses in rural areas have surpassed those in large metropolitan areas, reversing a historical trend, Jeanne Whalen reports for The Wall Street Journal. The main reason: the soaring rural opioid epidemic, led by an increased use of fentanyl, a cheap and easy-to-produce and easily available drug that is often mixed with heroin. Whalen writes, "Nationwide, 13,882 drug seizures tested positive for fentanyl in 2015, more than double the 2014 number, according to the Drug Enforcement Administration."

Opiate use has risen dramatically in Appalachia and the Midwest and Northeast, Whalen reports. In Northern Minnesota, for example, "police working for a tri-county task force have intercepted 64.5 grams of fentanyl so far in the third quarter, enough of the deadly narcotic to kill 32,000 people, up from 12 grams in the second quarter."

"In some cases U.S. dealers or addicts are ordering fentanyl or chemically similar drugs online, directly from suppliers in China, which the DEA says produces much of the world’s synthetic opioid supply," Whalen writes. "The agency says a growing number of local dealers have bought pill presses to turn powdered fentanyl into counterfeit painkillers. Chinese suppliers are also sending large quantities of fentanyl or its chemical ingredients to Mexico, where cartels mix the drug into the heroin supply and smuggle it to U.S. cities, says the DEA."

"The big-city dealers who bring fentanyl-laced heroin to the upper Midwest dip in and out of town, and often recruit local addicts to help them hide or sell drugs, making them tougher to catch, police say," Whalen writes. (WSJ graphic: Changes in drug overdose deaths)

Rural and underserved areas could be hurt most if free contraception under health law is eliminated

President-elect Donald Trump's plan to repeal, or alter, federal health reform could cost women free birth control, especially in rural and undserved areas that rely on Planned Parenthood services. Trump's choice to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.), has questioned the need for free contraception.

"Planned Parenthood provided birth control for more that 2 million people last year, 75 percent of those at income levels entitling them to subsidized women’s health care," Sheila Hagar reports for the Walla Walla Union-Bulletin. "A 2015 federal report predicted if government funding for birth control goes away, unintended pregnancies could cost taxpayers more than $100 million over the course of a decade."

In southeast Washington state, for example, "999 people received family planning at the local Planned Parenthood clinic in 2014," Hagar writes. "Within that group, 62 percent used a federal program was designed to ensure low-income or uninsured people can access family planning services at reduced or no cost. One in five local patients was eligible for free or reduced-cost care, and nearly half were between ages 18-25," said Tiffany Harms, spokeswoman for Greater Washington and North Idaho Planned Parenthood.

Fear of losing Planned Parenthood, which offers pregnancy testing, emergency contraception, testing and treatment for sexually-transmitted disease, birth control—including condoms—and medication-induced abortions, has led to sharp increases in appointments, Hagar writes. Nationally, there was a 900 percent increase in demand for intrauterine devices after the presidential election. In Walla Walla, "the regional Planned Parenthood network saw a 71 percent overall increase in appointments for long-acting, reversible contraception procedures since the election. Walla Walla appointments for all services shot up by nearly 50 percent," Harms said.

Maps chart 2015 deaths from opiates by state

The Washington Post has created maps that chart, from 2015, the most opioid deaths, rates for deaths from heroin, synthetic opioids (mainly fentanyl) and natural opioids (such as hydrocodone and oxycodone), with data from the federal Centers for Disease Control and Prevention. (Post map: Age-adjusted opioid overdose death rates per 100,000 people in 2015)

More than 33,000 people died from opioid overdoses last year, a rate of 10.4 per every 100,000 people, Christopher Ingraham reports for the Post. The map above shows that numbers were much higher in some states, such as Kentucky, Ohio and West Virginia (which share the Appalachian region that is plagued by drugs) and some areas of New England, while death rates were lower in Texas, California, the northern Plains states and Hawaii. (Map: Age-adjusted heroin overdose death rates per 100,000 people)

The map above shows that heroin overdose rates are higher in Ohio and West Virginia and some areas of New England, but lower in many states in the South, Southwest, West and Plains, Ingraham writes. (Map: Age-adjusted synthetic opioid overdose death rates per 100,000 people)

"Nationally, the death rate from synthetic opioids is 3.1 per 100,000," Ingraham writes. "But in Rhode Island, it's 13.2; in Massachusetts, 14.4; and in New Hampshire, which has the highest synthetic opioid death rate in the country, 24.1 out of every 100,000 people died from synthetic opiates in 2015." Numbers also are high in Ohio and West Virginia. (Map: Age-adjusted natural opioid overdose death rates per 100,000 people)

Interactive map estimates power plant type that would be cheapest to build in each county

A study by the Energy Institute at the University of Texas at Austin includes an interactive map that shows what types of power plants are cheapest to build in every U.S. county, Brad Plumer reports for Vox. It explains why "natural gas and renewables are likely to provide much of America’s new electric capacity going forward. It also shows why, despite (Donald) Trump’s promises, it will be extremely difficult to build new U.S. coal plants anytime soon." (Energy Institute map: Cheapest power plants to build today in every county, when “availability zones” are factored in (based on where the researchers expect you could physically build a plant)).

Researchers say "they calculated the levelized cost of electricity for power plants in each county—taking into account construction costs, financing, operating costs, capacity factors, fuel, transmission," among other factors, Plumer writes. They also included a calculator that allows users to compare two different power plants side by side, as well as factoring in health and pollution damage from different types of power plants.

Plumer notes a few caveats. "The map and calculator do not incorporate the effects of state regulations in places like California, and they do not include the effect of federal tax credits for wind and solar—the latter currently reduce the cost of renewables by about 30 percent. If you knock down the price of wind and solar accordingly in the interactive map, both become the cheapest option in a few more areas. (The team is working on building in some of those factors as the calculator evolves.)" (Read more)

McConnell says he favors long-term fix for miners' health benefits; mum on pensions

Sen. Mitch McConnell

Senate Majority Leader Mitch McConnell wrote in an op-ed for Kentucky newspapers that he favors a long-term fix for coal miners' health benefits, which Congress recently extended through April 2017 to 12,500 retired miners and their families. McConnell did not mention miners' pensions, which are also at risk due to the coal industry's decline.

McConnell took credit for the fix and wrote: "While it was my preference to include a long-term solution, it was more important to protect the benefits for thousands of my constituents, than to risk any lapse in benefits by fighting for a broader provision. With this legislation, miner-health benefits extend to the end of April, and I’m going to work with my colleagues to ensure they continue after that."

Democrats and the United Mine Workers of America, which opposed McConnell's 2014 re-election, have called the move a temporary fix that doesn't solve the long-term issue, Dylan Brown reports for Environment & Energy News. who In his column, McConnel said he had met with unnamed UMWA members.

Sen. Joe Manchin (D-W.Va.) had threatened to hold up action on the resolution unless McConnell granted a floor vote to his bill to permanently guarantee pensions and retiree benefits for more than 100,000 coal workers and dependents, to be funded by fees coal companies pay to the Abandoned Mine Land Fund.

In his column McConnell mentioned a bill by House Appropriations Committee Chair Hal Rogers (R-Ky.) that would accelerate spending from the fund in areas that have been most hurt by the loss of coal jobs, but didn't officially endorse it.

Military spouses with occupational licenses struggle to find work after a move, despite state laws

State laws to make it easier for military spouses with occupational licenses to find work after a move still present barriers for job-seekers, Jen Fifield reports for Stateline. A report by the Treasury Department found that 35 percent of military spouses—more than 100,000 people—require licenses or certifications for their professions. A survey by Blue Star Families, a non-profit for more than 150,000 military spouses, found that 63 percent of them encountered licensing problems because of a move. The number was 70 percent in 2014.

"Laws were driven by a White House campaign aimed at decreasing the unemployment rate for military spouses, 92 percent of whom are women," Fifield writes. The unemployment rate for military spouses was 23 percent in 2015, down from 26 percent in 2010, says a report by the U.S. Department of Defense. The rate is high because military families move often, about once every two to three years, says a report by the Institute for Veterans and Military Families at Syracuse University. (Screenshot of Stateline interactive map showing how easy or hard it is for military spouses to get a permanent or temporary occupational license in a new state)

Keeping working military spouses happy is key, because spouses cite employment as a top concern and they "are 36 percent more likely to recommend military service to others if they are able to maintain a career," Fifield writes.

"In 29 states, the law provides for three allowances supported by the Pentagon—recognizing out-of-state licenses, issuing temporary licenses and expediting licensing," Fifield writes. "But even in those states, the laws only include spouses in certain circumstances and certain professions, and the state may not be required to provide the allowances. And in many cases, spouses don’t know the laws exist." (Read more)

Rate of babies born addicted to opiates increased twice as fast in rural areas from 2004 to 2013

The rate of infants born addicted to opiates is increasing twice as fast in rural America as in urban areas, says a study published in JAMA Pediatrics. Researchers at the University of Michigan, University of Minnesota, Vanderbilt University, Northwestern University and the Ann & Robert H. Lurie Children's Hospital of Chicago found that "infants exposed in the womb to heroin and other addictive opioids grew more than sixfold in rural communities between 2004 and 2013, versus more than threefold in urban areas," Jeanne Whalen reports for The Wall Street Journal.

In 2004-13 "the rate of hospital deliveries complicated by the mother’s opioid use grew more than sixfold in rural areas, versus threefold in urban areas," Whalen writes. "Researchers looked at babies who were diagnosed with neonatal abstinence syndrome, or NAS, a condition marked by painful withdrawal symptoms from narcotics, including tremors, high-pitched crying and seizures." 

Researchers found that instances of NAS increased from 1.2 per every 1,000 hospital births in rural areas in 2004 to 7.5 in 2013, Whalen writes. During the same time NAS births in urban areas increased from 1.4 to 4.8. Hospital deliveries complicated by the mother’s opioid use grew from 1.3 to 8.1 in rural areas and from 1.6 to 4.8 in urban areas.

Opiate-overdose deaths were up 13.4% in 2015; heroin deaths surpassed gun homicides

Deaths involving opiates, an increasing problem in rural areas, rose 13.4 percent in 2015, says a report released Thursday by the federal Centers for Disease Control and Prevention. Last year there were 33,091 deaths involving opiates, up from 28,647 in 2014. Overdose deaths involving synthetic opioids other than methadone (typically, fentanyl that was illicitly manufactured), and not from medications containing fentanyl, rose 73 percent from 5,544 to 9,580. Heroin deaths rose 23 percent from 10,574 to 12,990; and prescription-opiate overdose deaths, excluding illicit fentanyl, rose 4 percent from 16,941 to 17,536. Some deaths involved illicit opioids and prescription opioids. (Washington Post graphic: Rise in opiate deaths)

"For the first time since at least the late 1990s, there were more deaths due to heroin than to traditional opioid painkillers, like hydrocodone and oxycodone," Christopher Ingraham reports for The Washington Post. "In a grim milestone, more people died from heroin-related causes than from gun homicides in 2015. As recently as 2007, gun homicides outnumbered heroin deaths by more than 5 to 1." (Post graphic: Heroin deaths have surpassed gun homicides)

Wisconsin reports 200% increase in traffic fatalities involving drugs; is it a national trend?

The opioid epidemic, which is particularly bad in rural areas, has led to an increase in overdose deaths. It's also leading to higher rates of vehicular fatalities. The Wisconsin Department of Transportation says drugs were involved in 149 vehicle deaths in 2015, a 200 percent increase from 10 years earlier, Shamane Mills reports for Wisconsin Public Radio.

At the same time, alcohol-related traffic deaths declined 38 percent. Officials said that 25 percent of all people pulled over for impaired driving are on drugs, Mills reports.

Last year 35,092 people died in crashes on U.S. roadways, a 7.2 percent increase from 2014 when 32,744 fatalities were reported, says the U.S. Department of Transportation. According to the 2014 National Survey on Drug Use and Health, 10 million people aged 12 or older reported driving under the influence of illicit drugs in 2013.

Health of the States project ranks each state on wide range of health outcomes, interactively

The Health of the States study by the Center on Society and Health at Virginia Commonwealth University and the Urban Institute takes a detailed look at the health of each state. The project, which will include eight reports examining each state, ranks states "on 39 health outcomes and correlations between those health outcomes and 123 determinants of health spanning five domains: health care, health behaviors, social and economic factors, the physical and social environment, and public policies and spending." Stateline map ranks each state by mortality rate, from light (good) to dark (poor); other measures are available. Click here for the interactive version.

The report, whose authors say examines more measures than any previous state comparison, "finds a strong correlation between lower spending on public transportation and higher instances of car accidents, and between adult obesity and deaths related to pneumonia," Michael Ollove reports for Stateline. "It also links a shortage of primary care services to higher rates of deaths related to diabetes, heart disease, stroke and pneumonia and to lower life expectancy." It doesn’t offer explanations for the correlations between the 123 factors.

Reports and other interactive maps in the coming months will focus on life expectancy and mortality; birth outcomes; child and adolescent health; sexually transmitted infections; injury fatalities; adult health status; obesity, diabetes and cardiovascular conditions; cancer, lower respiratory disease, influenza and pneumonia, and Alzheimer’s disease.

Democratic Sen. Heidi Heitkamp of N.D. tops Trump's list for ag secretary, Politico says

Sen. Heidi Heitkamp

Democratic U.S. Sen. Heidi Heitkamp of North Dakota is President-elect Donald Trump's top candidate for agriculture secretary, Politco reports. Heitkamp, a member of the Senate Agriculture Committee, "has been a vocal advocate for farmers and broke from her party on several controversial policy issues, including the labeling of genetically modified foods and environmental protection for wetlands and waterways," reporters Josh Dawsey, Andrew Restuccia and Jenny Hopkins write.

If the first-term senator accepted the position it would prompt a special election to replace her, which could lead to a Republican gaining her seat, something a Politico source said is one of the main reasons she is being considered. Heitkamp, who is one of the Senate’s more conservative Democrats and has been known to side with Republicans to please her constituents, met with Trump on Dec. 2. She has declined to comment about it.

"Heitkamp's departure from the Senate would be bad news for Democrats as they try to hold onto every seat in the upper chamber that they can," Dawsey, Restuccia and Hopkins write. "Twenty-three Democrats and the two independent senators who caucus with them, Vermont's Bernie Sanders and Maine's Angus King, are up for reelection in two years, with five of the Democratic races considered competitive. Four others are in states that twice voted against Obama as well as for Trump, including North Dakota."

"Heitkamp replaced retiring four-term Democratic Sen. Kent Conrad in 2012 after beating Republican Rep. Rick Berg by fewer than 3,000 votes," Dawsey, Restuccia and Hopkins write. "She previously worked for nearly 12 years as the director of the Dakota Gasification Co.'s Great Plains Synfuels Plant. She served as North Dakota's attorney general from 1992 to 2000 and made a failed bid for governor in 2000, losing to John Hoeven, now the senior senator from North Dakota."