Rural areas had fewer options, paid higher premiums on 2017 Obamacare exchanges

In areas with only one or two health insurers offering plans on government marketplaces—predominantly rural areas—people paid higher premiums, says a study by the Robert Wood Johnson Foundation and the Urban Institute. The study found that all of Alaska, Alabama, North Carolina, Oklahoma, most of Arizona, and rural areas in several states, only had one insurer to choose from.

The study found that 146 of the 498 rating regions, representing 12.6 percent of the population, "had only one insurer selling non-group coverage through its state marketplace in 2017; 125 had just two insurers." While 34 percent of the population—mostly rural— lives in regions with one or two marketplace insurers, 32 percent—mostly urban—lives in areas with five or more insurers. Researchers found that "lack of competition is strongly associated with higher premiums." (Study graphic: Medium monthly premiums paid based on how many insurer options were available in region)

"In regions with just one insurer, monthly premiums were $451 or higher in half of the silver 'benchmark' plans on which premium subsidies are based," Michelle Andrews reports for Kaiser Health News. "In contrast, in areas where six or more insurers offered plans, monthly premiums were much lower for comparable coverage: Half were $270 or less. Premium growth from 2016 to 2017 also varied substantially based on how many insurers participated in a region: Median premium growth was 30 percent in areas with one insurer versus 5 percent in regions with six or more carriers."

"As insurers finalize plans for participating in the 2018 exchanges, policy experts have speculated that the uncertainty surrounding the Affordable Care Act will lead insurers to continue to pull back from some online marketplaces or exit them altogether, leaving a growing number of people with fewer, pricier options. Insurers in most states have until mid-June to decide, but news has slowly trickled out," Andrews writes. "Aetna announced earlier this week that next year the company will not participate in the individual market in Delaware and Nebraska, the last two states in which it currently sells exchange plans."

Some states allow teens to marry, but not to get a divorce or seek help for domestic violence

In New Hampshire, girls as young as 13 can get married, if they have parental consent and a judge’s approval, Rebecca Beitsch reports for Stateline. In 22 other states, the minimum age to marry is 17 or younger. West Virginia tops the nation in highest rate of teen marriage among children ages 15-17, at 7.1 per every 1,000 people. Texas is second at 6.9. Nearly 60,000 15- to 17-year-old Texans, five out of every 1,000, married in 2014. (Stateline map: Rate of teen marriage by state; for an interactive version click here)

While Stateline doesn't account for rural-urban disparities among teen marriage, Beitsch notes that it is more common in the South, Southwest and West, regions with large rural areas.

Also, a 2015 report by the National Campaign to Prevent Teen and Unplanned Pregnancy using data from 2010, the most recent year data was available at the time, found that for girls 15-19, the rural teen birth rate was one-third higher than in the rest of the country.

For teens, getting out of a marriage, especially an abusive one, can be difficult, Beitsch writes. "In some states, people under 18 are not permitted to get divorced. Most domestic-violence shelters won’t accept people under 18. And because they are legally still children, those who try to escape a marriage may be returned by social services to the parents who approved the marriage in the first place."

New Hampshire legislators recently shot down a proposal to raise the minimum age to 18, Beitsch writes. Rep. David Bates, a Republican who voted against the bill, said, “It’s not that there’s a bunch of screwball legislators wanting 13-year-olds to get married. I don’t think there’s any justifiable rationale to absolutely prohibit someone in those situations from getting that judicial waiver.”

Sessions seeks more 'severe penalties' for drug offenders, reversing Obama-era policy

Jeff Sessions Thursday at the University of
Charleston (Gazette-Mail photo by Kenny Kemp)

Attorney General Jeff Sessions wants federal prosecutors to charge drug offenders "with the most serious, provable crimes carrying the most severe penalties," Sari Horwitz and Matt Zapotosky report for The Washington Post. There had been a push in recent years to direct some defendants towards treatment, rather than incarceration, or lesser sentences. Also, prisons in many states have struggled with overcrowding.

In 2013, then-Attorney General Eric H. Holder Jr. "instructed his prosecutors to avoid charging certain defendants with drug offenses that would trigger long mandatory minimum sentences," reports the Post. "Defendants who met a set of criteria such as not belonging to a large-scale drug trafficking organization, gang or cartel, qualified for lesser charges—and in turn less prison time—under Holder’s policy. But Sessions’s new charging policy, sent to more than 5,000 assistant U.S. attorneys, orders prosecutors to 'charge and purse the most serious, readily provable offense' and rescinds Holder’s policy immediately."

Sessions memo stated: "By definition, the most serious offenses are those that carry the most substantial guidelines sentence, including mandatory minimum sentences. There will be circumstances in which good judgment would lead a prosecutor to conclude that a strict application of the above charging policy is not warranted. In that case, prosecutors should carefully consider whether an exception may be justified.”

Sessions said on Thursday in West Virginia, which leads the nation in deaths from the disproportionately rural opioid epidemic, that the growing push to step away from intensifying criminal prosecution of drug criminals misses the point, Eric Eyre and Jake Zuckerman report for the Charleston Gazette-Mail. Sessions said, “They would say, which is pretty much true, ‘We can’t arrest our way out of this problem,’ and that is true, we can’t. But it is a big political part of it, and people should not diminish the power and effectiveness of good law enforcement. But prevention, I truly believe, is the greatest part of our challenge and, over time, prevention will be the most effective.”

Eyre and Zuckerman note that although Sessions advocated for drug abuse prevention, he was speaking at an event co-hosted by the Drug Enforcement Administration Community and the Anti-Drug Coalition of America, which is funded by the Office of National Drug Control Policy. Trump's budget would cut the office 95 percent.

Competition with social media blamed for demise of online rural news outlet

Lissa Harris, the editor, publisher and sole full-time employee of the Watershed Post, an online news source in the Catskills of New York, announced recently that too much competition from social media has forced her to stop reporting regular community news. She said she will keep the website running, continue to accept long-term display advertising and occasionally post local content when she has the time, but that it will no longer be a business, rather "a labor of love." According to Columbia Journalism Review, the Post has 50,000 monthly readers, half within the region and half from outside.

Lissa Harris

Harris wrote in a column March 12: "We have a great local audience that is hungry for news. But I feel the writing is on the wall for digital display advertising, our main revenue stream for supporting online news. I see more and more small businesses taking money they would once have spent with local news outlets, and spending it on digital ads—not on local websites, but on promoted Facebook posts and Google keyword advertising."

She writes, "As a business person, I can’t argue with that. It works. The titans of the web have huge and increasing reach, even in our rural communities. They have sophisticated tools for targeting likely customers by geography and demographics. They have products that a business owner can buy for $5 with a few clicks of a mouse, products that require no human time investment on the other end for design or sales or customer support. What they don’t have is reporters."

"Facebook is a powerful marketing tool," she writes. "It’s a powerful community information tool—something we saw first-hand during the Irene floods in 2011, when social media played a vital role in keeping people informed in a crisis. But Facebook is not going to cover a government meeting, or dig into data buried in paper records, or call an official to check up on a fishy-sounding rumor, or ask pesky questions about matters of controversy. For that, you need reporters—and they need to be independent, they need to be paid."

"I have been telling fellow reporters for years that we’re not competing with each other, we’re competing with social media," she writes. "I wish that weren’t true. I wish I had lost this fight to my fellow local news publishers. There would have been a certain curmudgeonly nobility to a contest between print weeklies and digital media, with the old guard emerging victorious over us geeky upstarts. But the rest of the local news media landscape is struggling as well. Several local weeklies have folded since we started the Watershed Post in 2010, and others are alive but fragile. Layoffs and cutbacks have claimed decades’ worth of newsroom experience at our regional dailies."

Offshore wind farms approved in Maryland would be nation's second and third largest

Deepwater Wind's block island wind farm
(HANDOUT photo)

The Maryland Public Service Commission on Thursday approved ratepayer subsidies to support a pair of wind power projects off the coast of Ocean City, Scott Dance reports for The Baltimore Sun. The commission said "the two projects—together expected to cost more than $2 billion—would position Maryland as a national leader in offshore wind energy." If built, they would be the nation's second and third largest offshore wind farms, behind one approved earlier this year between Long Island and Martha’s Vineyard.

"U.S. Wind, a subsidiary of Italian energy and construction company Toto Holdings SpA, plans to build 62 turbines at least 14 miles off the coast of Ocean City, a $1.4 billion project expected to start operating in 2020," Dance writes. "Skipjack Offshore Wind LLC, a subsidiary of Rhode Island-based Deepwater Wind Holdings LLC, plans a $720 million project including 15 turbines at least 20 miles off the coast, to launch in 2022." Deepwater, the company behind the only completed offshore wind farm, in Rhode Island, is developing the largest wind farm proposed earlier this year.

The Maryland wind farms "are expected to prevent emissions of hundreds of thousands of pounds of carbon dioxide and create some 5,000 jobs and $74 million in state tax revenue," Dance writes. "The two companies have until May 25 to accept a set of conditions requiring certain levels of job creation and investment the commission laid out in its decision.

Severely ill bald eagle rescued in New Hampshire in February by snowmobiler soars once again

More than two months after a New Hampshire man snowmobiling rescued a severely ill bald eagle, the four-year-old female took flight on Thursday in Windsor, Maggie Cassidy reports for Valley News in New Hampshire's Upper Valley. Richard Vacca and his friends "were on an end-of-the-season snowmobiling run on Feb. 25 when they spotted the bald eagle face down on the ground. Vacca waited with the bird for about 90 minutes until the game warden, Sgt. Keith Gallant, arrived."

Vacca told Cassidy, "It’s a bald eagle—I didn’t know what to do, but I didn’t want to let it just sit there. Even if it wasn’t going to make it, I didn’t want some other animal to take it. I think it deserved better than that.”

Lauren Adams, lead wildlife keeper at the Vermont Institute of Natural Science, "said the bird was in dire condition and could neither stand nor hold her head up when first discovered," Cassidy writes. She told Cassidy, “When this eagle arrived, she was barely alive, honestly We were very worried about her.” The eagle was treated "for toxicity by giving her IV fluids, nutritional support and other care as she slowly grew stronger."

Georgia governor signs rural jobs law; similar laws fail to see promised revenue

Georgia Republican Gov. Nathan Deal on Tuesday signed a tax credit law that supporters say will create rural jobs and boost economic development, but critics say similar laws have failed to deliver on promised jobs and tax revenues, with investors profiting from the deals even if the businesses they fund never create another job. Utah Republican Gov. Gary Herbert signed a similar law in March, while other states have proposed such laws.

Georgia's tax credit law "provides $60 million in tax credits to companies that invest in businesses in rural parts of the state," Michelle Baruchman reports for The Atlanta Journal-Constitution. "Several state lawmakers who are considered candidates for statewide runs in 2018 supported the measure as an effort to boost parts of the state that have seen rising unemployment rates and slowed growth." (Stateline graphic: Rural jobs bills)

"However, the bill narrowly escaped the chopping block," Baruchman writes. "Lobbyists for national capital companies that could benefit from the incentives pushed the bill through in the final hours of the 2017 legislative session despite criticism from Senate Democrats and Republicans who pointed to the spotty records of similar programs that made big money for the investment companies even if no jobs are created."

Similar laws have caused confusion, Jen Fifield reports for Stateline. "Economists and policy analysts say the programs are so complex, and the promises so appealing, that states typically don’t take a close look at them until it’s too late. Most state offices that have studied the programs have found that the jobs and revenue promised would not materialize, and recommended the programs be shut down, changed or not extended. In some instances, state audits found that the programs lacked transparency and accountability."

'Cultural anxiety' drove white working-class to Trump, says study based on pre-election survey

Cultural anxiety was the main reason white working-class voters, primarily in rural areas, supported Donald Trump for president, says a study by Public Religion Research Institute and The Atlantic. The study, based on a survey from September and October, found that white working-class voters supported Trump based on fear of cultural displacement, their view that a college education lacks value, support for deporting illegal immigrants and because they identified with the Republican party.

"Sixty-eight percent of white working-class voters said the American way of life needs to be protected from foreign influence," Emma Green reports for The Atlantic. While only 27 percent of white working-class voters said they favor a policy of identifying and deporting immigrants who are in the country illegally, 87 percent of them supported Trump during the election. Also, "54 percent of white working-class Americans said investing in college education is a risky gamble, including 61 percent of white working-class men."

Survey respondents who reported being in fair or poor financial shape were actually 1.7 times more likely to support Hillary Clinton, compared to people in better financial shape.

PRRI graphic; click on it for a large version

"White working-class voters who say they often feel like a stranger in their own land and who believe the U.S. needs protecting against foreign influence were 3.5 times more likely to favor Trump than those who did not share these concerns," the study found. "White working-class voters who favored deporting immigrants living in the country illegally were 3.3 times more likely to express a preference for Trump than those who did not." Also, "white working-class voters who said that college education is a gamble were almost twice as likely to express a preference for Trump as those who said it was an important investment in the future."

PRRI graphic; click on it for a large version

White working-class voters—people without college degrees or salaried jobs—make up one-third of American adults and more than half of all rural Americans, Green writes. The largest white working-class populations are in the Midwest, where Trump won handily. Overall, 64 percent of white working-class voters supported Trump, compared to 32 percent for Clinton.

Senate, with help from Republicans, votes to uphold Obama-era methane regulations

In a 51-49 count, the Senate on Wednesday voted to "uphold an Obama-era climate change regulation to control the release of methane from oil and gas wells on public land," Coral Davenport reports for The New York Times. Methane is 200 times more potent as a greenhouse gas than CO2 but breaks down in the atmosphere much more quickly.

The Senate vote blocks "a resolution to repeal the 2016 Interior Department rule to curb emissions of methane," Davenport writes. The vote was actually decided by Republicans, with Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Susan Collins of Maine breaking with their party.

Votes by Graham and Collins were expected, but McCain's came as a surprise, Davenport notes. President Trump had sent Vice President Mike Pence to the Senate floor in anticipation of needing him to be the deciding factor in case of a tie vote. McCain said of his vote: “Improving the control of methane emissions is an important public health and air quality issue, which is why some states are moving forward with their own regulations requiring greater investment in recapture technology,” he wrote. “I join the call for strong action to reduce pollution from venting, flaring and leaks associated with oil and gas production operations on public and Indian land.”

Sen. John McCain (photo by Win McNamee, Getty Images)

McCain "did say he would support an effort by the Trump administration to rewrite the Obama rule," Davenport writes. "Had Congress repealed the Obama-era rule entirely, the administration would have been precluded from issuing any similar regulation under the terms of the Congressional Review Act."

Scientists blame climate change for shrinking Montana glaciers, say they'll disappear soon

Climate change has reduced the 37 glaciers in Montana's Glacier National Park and two on nearby U.S. Forest Service land by 39 percent since 1966, with some glaciers having seen reductions as much as 85 percent, says a study by the U.S. Geological Survey and Portland State University.

Daniel Fagre, a research ecologist with the USGS's Northern Rocky Mountain Science Center, told CNN's Steve Almasy and Mayra Cuevas, "The trend right now is that they are inexorably going into their final demise. There is no chance they will go into rebirth. In several decades they will be mostly gone. They will grow so small that they will disappear. They will certainly be gone before the end of the century."

Perimeter of Sperry Glacier in Glacier
National Park in 1966, 1998, 2005 and 2015.
Click on photo for larger version.

Using digital maps from aerial photography and satellites, scientists measured the perimeters of the glaciers in late summer, when seasonal snow has melted to reveal the extent of the glacial ice, in 1966, 1998, 2005 and 2015/2016. They found that of the 39 glaciers, "only 26 glaciers are now larger than 25 acres, which is used as a guideline for deciding if bodies of ice are large enough to be considered glaciers."

Portland State geologist Andrew G. Fountain said, “While the shrinkage in Montana is more severe than some other places in the U.S., it is in line with trends that have been happening on a global scale." Fagre told CNN that "in the mid-1800s there were about 150 glaciers on the land, which was designated a national park in 1910. Rising temperatures caused the others to disappear."

Political divide on media's watchdog role grows significantly since Trump's election

Pew Research graphic; 
click image for larger version.

There is huge divide in how Democrats and Republicans view media criticism of political leaders, especially since President Trump was elected, according to results from March from Pew Research Center's American Trends Panel survey. The survey, which has been conducted every year since 1985, asks participants if they think criticism from news organizations keeps political leaders from doing things that shouldn't be done.

During this year's survey, 89 percent of Democratic respondents agreed, while 42 percent of Republicans did not, Michael Barthel and Amy Mitchell report for Pew Research Center. Early last year, when the same question was asked, 77 percent of Republicans supported the media's watchdog role, compared to 74 percent of Democrats.

"This partisan split is found in other attitudes about the news media, though none in so dramatic a fashion as with the watchdog role," reports the Pew Research Center. "Compared with 2016, Democrats and Republicans are more divided on whether the press favors one side in its political coverage, on how much trust they have in national news media, and on how good a job national news organizations are doing in keeping them informed."

Pew Research graphic;
click on it for larger version.

While nearly half—45 percent—of adults get news from mobile devices, up from 36 percent last year, Democrats are more likely to do so than Republicans, notes the Pew Research Center. "What’s more, an increasing share of Americans also prefer getting news on mobile over a desktop computer. Among those who get news on both types of devices, nearly two-thirds say they prefer mobile."

'Gun gap' has widened in recent years between Republican and Democratic voters

Gun ownership among Republican and Democratic voters was once similar, but has diverged over the past 40 years, Mark Joslyn and Don Haider-Markel of the University of Kansas report for The Washington Post. In 1976, 50 percent of Republicans owned a gun, compared to 45 percent of Democrats. Data from the the American National Election Studies shows that 62 percent of gun owners supported Trump, up from 58 percent for Mitt Romney in 2012 and 52 percent for John McCain in 2008. (Post graphic: Gun ownership by party)

The researchers don't suggest a rural pattern for the data, but there has been a rural shift towards Republican candidates in the past four elections and rural residents are more likely to own guns than their urban counterparts. Also, data suggest a gradual die-off of gun-owning Democrats. (Post graphic: How Republican gun owners voted for president )

The shift in gun ownership began in the 1980s. By 2016, only 23 percent of Democrats reported having a gun in the home, a decline of 22 percent since 1976. At the same time, Republican gun ownership in 2012 was 54 percent, the same figure reported in 1973 and four percentage points higher than 1976.

The "gun gap" between Republicans and Democrats peaked in 2012 during President Obama's victories, with a 30 percent difference between Republican and Democratic gun owners, the researchers write. The gap was 24 points during Trump's presidential run, the second-highest percentage since 1976.

They note that the Republican-Democratic gap remains "after controlling for conventional predictors such as voters’ party identification, ideological leanings, educational attainment, demographics and place of residence."

Services help find younger owners to take over for rural business owners looking to retire

A growing number of services match rural entrepreneurs nearing retirement with younger people looking to run a business to ensure that a small town doesn't lose much-needed services, Chris Farrell reports for Next Avenue, a Forbes magazine news service for people over 50.

RedTire logo

Farrell cites RedTire, housed at the University of Kansas Business School, which "brokers succession deals in the state’s rural areas free of charge. ... The Center for Rural Entrepreneurship, based in Lincoln, Neb., works with communities across the country and in Canada to boost their attractiveness to a new generation of potential small business owners. Many of these outfits also provide services and resources to help the new business owners succeed."

As an example of how RedTire works, when Dr. Steven Epler, a former dentist in Yates, Kan., was ready to retire after 35 years, he turned to RedTire in the hope that his practice wouldn't have to shutter, Farrell reports. "RedTire did a valuation, outlined the steps for Epler to transition the dental practice to a new owner and matched him with young dentist, Dr. Matthew Standridge, who had opened his first office in Eureka, Kan. in 2012." Earlier this year, Standridge merged the offices into one facility.

Liz Templin, community economics educator at the University of Minnesota Extension, "identified 358 businesses in rural Minnesota that sold from 2008 to 2012 and then surveyed 176 of the ones that were still around three years later," Farrell writes. She found that 87 percent of the new business owners had either maintained or increased the number of employees, 69 percent had increased sales volume and 68 percent boosted their customer base.

There are some obstacles, Farrell notes. "Rural small business owners are often reluctant to open up their books. One reason: family members may be on the payroll and their personnel expenses are paid by the business. Also, older owners of rural small businesses usually don’t carry debt. That’s smart personal finance, but a signal to potential buyers that the new owners will likely need to invest in upgrading equipment and facilities."

Heart infection on the rise among intravenous drug users in Central Appalachia

Ohio Valley Resource graphic; click on it for large version

A rising number of intravenous drug users in Central Appalachia are contracting a form of heart infection called endocarditis that requires costly, repeated surgery, Mary Meehan reports for Ohio Valley Resource. The endocarditis rate has doubled in the past decade, leading to annual Medicaid spending on treatment of $700 million, according to the Centers for Disease Control and Prevention.

"Endocarditis is a result of bacteria accumulating around and infecting a heart valve. It can appear initially as mild, flu-like symptoms or chest pains and extreme discomfort," Meehan writes. "Emergency surgery to replace heart valves is required in the most extreme cases, but standard treatment involves weeks of sustained doses of antibiotics to make sure the infection is completely cleared."

The CDC says "addicts with endocarditis are 10 times more likely than other patients to die or require a second surgery months after initially leaving the hospital," Meehan writes. "Research has also shown that addicts tend to leave the hospital more often before the weeks-long series of antibiotics that is necessary to complete treatment. In many cases, the patients are in withdrawal from opiate addiction during treatment." Dr. Saritha Gomadam, an infectious disease specialist at the University of Kentucky, told Meehan, "The intense atmosphere of post-surgery care only amplifies the anxiety and pain of withdrawal from opiates."

Kentucky county that put financial hopes in Noah's Ark theme park is sinking in debt

Ark Encounter (Associated Press photo)

A Northern Kentucky county that put its financial future in the hands of a Noah's Ark theme park is sinking in debt. Desperate for a new revenue source, local officials in Grant County "gave hefty land grants and tax incentives to the Ark Encounter, a religious theme park that includes a 'life-sized reconstruction' of Noah’s ship," Alan Greenblatt reports for Governing. "The park opened last July, but due to the tax breaks, it hasn’t translated into any sort of public revenue windfall for the county."

The theme park expects to draw a million visitors annually, but visitors aren't spending as much as local officials had hoped, largely because there are few other attractions in the region to tempt people to stick around after visiting the park, Greenblatt writes. The main problems are a lack of hotels and restaurants to draw tourists into the local business districts, including Interstate 75. County Judge Executive Steve Wood told Greenblatt, “We haven’t had anything really built yet. That was probably wrong on our part.”

Grant County, Kentucky (Wikipedia map)

"The truth is that Grant County’s problems are largely its own fault," Greenblatt writes. "For two decades, county officials refused to raise taxes. Instead, to make up for funding shortfalls, they dipped into reserves, draining them by some $2 million over the past eight years. It was the jail that generated the most serious financial trouble. Deferred maintenance led to serious deterioration, with the state eventually deciding to pull its prisoners out of the county lockup altogether. That led to a substantial drop in revenue, prompting local arguments about whether it made more financial sense to close the jail or clean things up sufficiently to recapture housing fees from the state."

There is some hope, Greenblatt writes. "The city of Dry Ridge has just announced that two new hotels will be built over the coming year, along with some new restaurants. If tourists can be convinced to visit Grant County downtowns when they come to see the boat, that should bring in a few more dollars to help the county balance its books."

Analysis credits rise in white voters, decline in black voters for Trump's presidential win

Click on chart to view a larger version.

Hillary Clinton said last week that she would have won the 2016 presidential election if it had been held 12 days earlier, blaming Wikileaks and FBI Director James Comey, whom President Trump fired Tuesday, for her loss.

There were many reasons for Clinton's loss; some have cited Trump's landslide in rural areas. But there was a corresponding lack of support for Clinton among some urban voters, particularly African Americans, who had turned out big for President Obama.

Writing on The Washington Post's online "Wonkblog," four researchers note the decline in black voters who voted Democratic in 2012, along with the rise in white Republican voters, many in rural areas. The white-black divide was particularly strong in swing states, which were mostly won by Trump, and perhaps decisive in Pennsylvania, Michigan and Wisconsin, states that had voted Democratic for president since 1988.

Researchers, using data from voter file vendor Catalist, determined that "voter turnout among whites—the racial/ethnic group most strongly in Trump’s corner—increased by 2.4 percentage points in 2016 compared to 2012," write researchers Bernard L. Fraga, Sean McElwee, Jesse Rhodes and Brian Schaffner. The black vote declined by 4.7 percentage points.

In swing states, the black vote declined overall by 5.3 percent, and by 12 points in two key states won by Trump, Michigan and Wisconsin. In Florida, where Trump won by 1.2 points, the black vote was down four points and the white vote was up four points. The Post notes that if white and black voters had cast ballots at the same rate in 2016 as in 2012, then Clinton would have won Michigan, Pennsylvania and Wisconsin, which would have put her in the White House. (Read more)

West Virginia journalist arrested for persistently asking HHS secretary about Republican health bill

Dan Heyman mugshot

A West Virginia journalist was arrested Tuesday for asking Health and Human Services Secretary Tom Price questions about the Republican health-care bill, Samantha Schmidt reports for The Washington Post. When Price was walking through the state Capitol, reporter Dan Heyman of Public News Service followed alongside him and "repeatedly asked the secretary whether domestic violence would be considered a pre-existing condition under the Republican bill to overhaul the nation’s health care system."

Heyman told reporters, “He didn’t say anything. So I persisted.” Schmidt writes, "Then, an officer in the capitol pulled him aside, handcuffed him and arrested him. Heyman was jailed on the charge of willful disruption of state government processes and was released later on $5,000 bail. Authorities said while Secret Service agents were providing security in the capitol for Price and Kellyanne Conway, special counsel to President Trump, Heyman was 'aggressively breaching' the agents to the point where they were 'forced to remove him a couple of times from the area,' according to a criminal complaint," which authorities said, “was causing a disturbance by yelling questions at Conway and Secretary Price."

Heyman told reporters, “This is my job, this is what I’m supposed to do. I think it’s a question that deserves to be answered. I think it’s my job to ask questions and I think it’s my job to try to get answers.” Lark Corbeil, chief executive and founder of Public News Service, defended Heyman, telling the Post, “From what we can understand, he did nothing out of the ordinary. He was doing what any journalist would normally do, calling out a question and trying to get an answer.” For more on PNS, go here.

Life expectancy rates are lower, and are even declining, in some poor, rural counties

Life expectancy varies widely among U.S. counties, and has been decreasing in a few of them, says a study by researchers from the University of Washington and Erasmus University Medical Center in the Netherlands. The study, which used county-level data from 1980 to 2014, found that "life expectancy at birth for both sexes combined was 79.1, but differed by 20.1 years between the counties with the lowest and highest life expectancy." (Study map: Change in life expectancy, by county, from 1980 to 2014; click on image for larger version)

The lowest life expectancy was in counties in South and North Dakota with Native American reservations, the Mississippi Delta and Central Appalachia, researchers said. The highest life expectancies were in counties in central Colorado. Eight of the top 10 counties with the lowest life expectancy are in Kentucky. The other two counties are in Oklahoma and Alabama.

A knot of eight Eastern Kentucky counties had the greatest decline in life expectancy in the United States from 1980 to 2014. In other words, babies born in those counties today are expected, on average, to live shorter lives than their parents, based on recent death certificates. That was true in only five other counties: two in Alabama and one each in Oklahoma, Mississippi and Tennessee.
(Interactive U.S. Health Map by University of Wisconsin Institute for Health Metrics and Evaluation shows that death rates in Breathitt County, Kentucky, are well above the national average. The interactive map can be viewed here.)

Researchers said "people are less likely to live longer if they are poor, get little exercise and lack access to health care," Joel Achenbach reports for The Washington Post. Researchers "said the quality and availability of that health care—for example, access to screening for signs of cancer—has a significant effect on health outcomes."

Mich. students respond to controversial Netflix series with project to help prevent teen suicide

Oxford, Mich. (Best Places map)

In the Netflix series, "13 Reasons Why," based on the novel of the same name, 13 people receive messages from a teenage girl who committed suicide, detailing how each person played a part in her fatal decision. A group of high-school students in Oxford, Mich., have responded to the series with a project, "13 Reasons Why Not," which they hope will help classmates who are struggling and contemplating suicide, Colby Itkowitz reports for The Washington Post.

Each school day since May 1, a student’s recording of his or her painful story has played over the loudspeakers at Oxford High School, Itkowitz writes. Students "volunteered to share vulnerable and difficult stories about their lives, but instead of using their tapes to blame someone for their negative experiences, they single out a person who has been kind to them, who has helped make life worth living."

Riley Juntti, the first student to have her tape played, told Itkowitz, “I think the show accurately depicted what happens in high school … the problem we had with the show is it made it seem like suicide was the only option and didn’t raise mental health awareness and it didn’t give resources. That was very troubling for us; we wanted to fix that with our project.”

Only the students involved in the project knew the tapes were going to be played, Itkowitz writes. In hers, Juntti describes an emotionally and physically abusive relationship and "talks about threats to her and her friends, and how she grew accustomed to hearing that she was worthless or better off dead until she eventually believed it. But then, instead of naming the person who hurt her, she names a friend who 'saw her when no one else did.'" Juntti, who said they have not received any negative response to the project, said that since the tapes have been played, "tardiness has gone down in first period, the hallways are silent and everyone is in their classrooms eager to listen."

The National Association of School Psychologists has recommended that "vulnerable youth, especially those who have any degree of suicidal ideation," not watch the series. "Its powerful storytelling may lead impressionable viewers to romanticize the choices made by the characters and/or develop revenge fantasies."

Data from the federal Centers for Disease Control and Prevention shows that suicide rates among women "have increased every age cohort except those older than 75 since 1999, with the largest increase being among girls ages 10 to 14," Itkowitz notes.

Anderson County, Kentucky

UPDATE, June 15: The middle school in Anderson County, Kentucky, banned the book on which the series was based. Part of it was used in an enrichment class last year. “The advertisement of the series played a factor in the decision to no longer use the book,” Supt. Sheila Mitchell told the newspaper. “Also, the manner in which the book was beginning to be used for fall 2016 was not the original intent, so the principal informed the teacher to find other resources to support the concept.”

Rural farmers' markets struggle to adapt to changing consumer needs, but can stay relevant

Farmers market in Bridgeport, W.Va. (Gazette-Mail photo)

Despite a boom in farmers' markets and a movement to buy local and healthier foods, rural merchants are struggling to constantly adapt to changing consumer habits to stay relevant, Max Garland reports for the Charleston Gazette-Mail in West Virginia. According to the U.S. Department of Agriculture's National Farmers Market Directory, there are 8,676 farmers' markets in the U.S., up from 1,755 in 1994. West Virginia has 90.

"Even with the growing number of markets, profit and success isn’t guaranteed, especially in rural areas of West Virginia where resources are limited," Garland writes, citing Parween Mascari, executive director of the West Virginia Farmers Market Association. Mascari told him, “The trend is definitely there, but in rural communities, there are some struggles. It takes some dedication and creative methods to keep them going on a weekly basis.”

Roane County, West Virginia, has found some success in reviving its farmers' market this year, largely because the county does not have a local grocery store, Garland notes. But continued expansion by Kroger, coupled with its recent move to add online ordering, might hurt rural areas, said Faye Looney, an organizer of the market and treasurer of Walton Community Building in Roane County. “I think the trend (of rural farmers markets) is dying,” she told Garland. “But if we don’t do it, what else is there to help the community? Right now it’s still really about trying to get the word out.”

Other rural farmers' markets have added entertainment options to draw customers, Garland reports. For example, the market in Bridgeport, W.Va., has added live music and "the market’s POP (power of produce) Club, which has children interact with vendors and learn about their produce." But the selling point is still fresh food from 50 vendors. Debbie Workman, a member of the market’s board of directors, told Garland, "The goal is to promote healthy food, but in order to do that, we have to bring more people in."

Ticks that have killed thousands of moose in New England and Canada now threaten Alaska

A cow moose in northern New Hampshire
shows hair loss typical of tick-infested animals
 (University of New Hampshire photo by Dan Bergeron)

A tick that has been blamed for killing thousands of moose in New England has now been confirmed in Canada, where it's infecting elk, mule deer and some moose, and is on its way to Alaska, Yereth Rosen reports for Alaska Dispatch News. Scientists have said the ticks, which have killed 70 percent of moose calves in Maine, New Hampshire and Vermont, are aided by warming temperatures and shorter winters that allow the parasites to survive longer.

"The ticks gather in the fall on forest plants, latch onto passing animals and stay there through the winter, swelling to the size of grapes as they feed off their hosts' blood," Rosen writes. "Tens of thousands of ticks can latch on to a single moose. They make the moose itchy, uncomfortable and prone to spending a lot of time and energy scratching, sometimes rubbing away fur, and too little time eating."

Peter Pekins of the University of New Hampshire, one of the lead scientists studying the disastrous impacts of winter ticks on New England moose, said "the average tick load on an infested moose is 40,000," Rosen writes. He said "a load of more than 40,000 ticks will use up a calf's entire blood supply in four weeks." Perkins said, "They get anemic, they have declining weight too, and that's just the end of them."

Sinclair, which owns 173 local TV stations, many in rural areas, will buy Tribune Co.'s 42 stations

Sinclair Broadcasting, which predominately owns small market television stations in rural areas, and has shown evidence of conservative bias, said it "will pay $3.9 billion to buy Tribune Media Company and its 42 local television stations," Todd C. Frankel reports for The Washington Post. Sinclair, which already has 173 local news stations, "will create the largest-single group of local TV stations." Sinclair beat out 21st Century Fox to land the deal.

"Tribune Media said in a statement that it expects Federal Communications Commission’s rules on ownership and antitrust regulations may result in Sinclair selling some stations," Frankel writes. "Current FCC rules limit the national TV audience that any single owner can reach at 39 percent. Regulations also prohibit any owner from running more than two stations in most markets."

"But FCC Chairman Ajit Pai—who was elevated to his post by President Trump earlier this year—has indicated in speeches that he wants to loosen the TV ownership rules," Frankel reports. "Last month, Pai’s FCC reinstated a rule that helps station owners get around the national audience cap. The so-called UHF discount allows stations to count just 50 percent of its audience from UHF stations toward the audience cap. Last fall, the FCC, under President Obama, revoked the UHF cap. Now, with its return last month, stations have more room to stay under the cap."

UPDATE, May 10: The acquisition gives Sinclair "a powerful platform to potentially launch a right-leaning programming service to rival Fox News," Stephen Battaglio of the Los Angeles Times reports. "Sinclair will have a footprint in most of the country's major markets, spanning about a third of the nation's households," including the top three markets: New York, Chicago and L.A. "Sinclair, which has a reputation for injecting conservative commentary in local news, could leverage the cable and satellite retransmission deals for its TV stations to get carriage of a potential new news channel that could skew politically to the right of Fox News," Battaglio reports, adding that analysts told him "Sinclair could also put such a network with national reach on its over-the-air digital multicast channels." "I think they have ambitions to do that," Ben Bogardus, a professor of broadcast journalism at Connecticut's Quinnipiac University who is a former news producer at Sinclair's Washington, D.C., station WJLA, told Battaglio. "They've bought up enough real estate and market share that they can legitimately launch a national news station and they have content to fill it."

Oklahoma law calls for heavy fines, jail time for protesting pipelines

The Keystone XL pipeline is going through Oklahoma

In response to protests in North Dakota over the Dakota Access Pipeline, a new law in Oklahoma calls for steep fines or prison time for people "convicted of trespassing at a critical infrastructure facility to impede operations." Denwalt reports for The Oklahoman. "That includes pipelines, refineries, chemical plants, railways and other industrial sites." The Keystone XL pipeline is going through Oklahoma.

The legislation had an emergency clause, so it became law when signed last week by Gov. Mary Fallin. Violators "could face a $10,000 fine and up to a year in jail if they intend to halt progress of a pipeline or otherwise interfere with operations," Denwalt writes. "The penalty increases to 10 years and $100,000 if the person is successful at damaging, vandalizing, defacing or tampering with equipment. The fine for just trespassing at a critical infrastructure site would be at least $1,000, but the Legislature did not include an upper limit." Organizations also would be held liable for the same acts, with fines 10 times greater.

Also last week, lawmakers approved another bill "that would make trespassers liable for damages to real or personal property," Denwalt writes. The bill's author "said the so-called vicarious liability provision would apply to people who give lodging to those who are later arrested for trespassing. He said the idea for the bill came from actions along the Dakota Access Pipeline."

Map charts county-level data of food insecurity

Feeding America, which calls itself the nation's largest domestic hunger-relief organization, has published a map of county-level food insecurity rates in the U.S. Overall, 42.2 million people, or 13.4 percent of the population, were food insecure in 2015, the last year for which data are available. The highest rate was in Mississippi, where 21.5 percent are food insecure. (Feeding America map of food insecurity; click on it for a larger version. For an interactive version with county-by-county data, click here)

Rates also were high in Arkansas (18.4 percent), Alabama (17.7), Louisiana (16.9), North Carolina (16.5), Georgia and Oklahoma (16.2), New Mexico and Ohio (16), Arizona and Kentucky (15.8), Texas (15.7), Missouri (15.6), South Carolina and Tennessee (15.4) and Florida and Michigan (15.1). A cluster of counties in Alabama, Arkansas, Louisiana and Mississippi have rates above 30 percent. The data also give estimates for the percentage of children in each county who are food-insecure.

The U.S. Department of Agriculture defines food insecurity as "lack of access, at times, to enough food for an active, healthy life for all household members and limited or uncertain availability of nutritionally adequate foods. Food-insecure households are not necessarily food insecure all the time. Food insecurity may reflect a household’s need to make trade-offs between important basic needs, such as housing or medical bills, and purchasing nutritionally adequate foods."

Health bill's potential waiver for coverage of pre-existing conditions would hit areas Trump won

The health bill passed on Thursday by the House would make insurance more costly for pre-existing conditions, which are more common in the South and Midwest, areas where President Trump was the most popular, Max Ehrenfreund reports for The Washington Post. Pre-existing conditions include obesity, heart disease, diabetes, cancers and Alzheimer's disease. According to the Kaiser Family Foundation, at least 30 percent of the population has pre-existing conditions in 12 states won by Trump—Alabama, Arkansas, Georgia, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and West Virginia. (Post graphic: Where Americans have the most pre-existing conditions)

"Obamacare generally requires insurers to charge all their customers comparable prices, with rates varying only by their ages, where they live and whether they smoke," Ehrenfreund writes. "Under the Republican proposal, states could get exemptions from those rules by requesting a federal wavier. Insurers operating in those states could ask potential customers to provide information about their health and charge them different rates based on their answers — although insurers could only charge more for those customers who previously allowed their health insurance to lapse for at least three months."

"It is difficult to tell how many people could pay more if the Republican bill becomes law," Ehrenfreund notes. "If states did not try to waive the rules, patients would continue to have some protections.The insurance lobby would probably urge state officials to ask for waivers, because screening out the sickest applicants would allow insurers to bring down their costs. Advocates for patients and public health would oppose waivers, and if those groups prove to be politically weaker in red states, then it would be more likely that consumers with preexisting conditions in those states would pay more."

South Texas landowners ready to outlast Trump with long battles in court over border wall

End of a border fence in Hidalgo, Texas
(New York Times photo by Matthew Busch)

South Texas landowners whose property is slated to be taken for the U.S.-Mexico border wall are on a mission to stall the construction in courts for years, or until President Trump is no longer in office, Ron Nixon reports for The New York Times. It's not the first time Texans have taken on the government concerning a border wall and eminent domain.

In 2006, at the urging of Congress, President George W. Bush, a former Texas governor, "signed the Secure Fence Act, which mandated building physical structures to stop illegal crossings by people and vehicles," Nixon writes. "Nearly 700 miles of wall and fencing was ultimately built, mainly on federal land in California and Arizona. But the government has taken very little land in Texas, which has 1,254 miles of the border with Mexico, most of it privately owned."

Currently, more than 90 lawsuits "involving landowners opposing the federal seizure of their property in South Texas remain open from 2008," Nixon notes. "Property owners have the support of many Texas politicians in a state where land ownership has an almost mythic resonance, and their opposition to a border wall could delay any construction by years while lawsuits wind through the court system."

U.S.-Mexico border (Washington Post map)

"Trump’s proposed wall would run through a vast swath of the Rio Grande Valley," an area the Border Patrol has identified as a priority for new border fencing, Nixon writes. Last year in the Rio Grande Valley, Border Patrol agents "seized 326,393 pounds of marijuana, second only to the agency’s Tucson sector. It also seized about 1,460 pounds of cocaine, the most of any sector. Nearly 187,000 illegal border crossers were apprehended here in 2016, the most of any Border Patrol sector."

Locals "are well aware that their land has become a major point of transit for drug traffickers and smugglers, and some have been victims of crime," Nixon writes. "But they also believe that the border is already heavily patrolled, by drones, federal agents and the local authorities, and contend that a wall would have mainly a symbolic value at the cost of their land."

The government has been "able to persuade some landowners to give up land for barriers and walls, many of them balked, forcing the government into court to contest what landowners considered to be the unjust taking of their property," Nixon writes. "Over 300 condemnation cases went to court, records show. In total, the government spent at least $78 million to acquire land where fencing is now in place, according to congressional documents."

States increase efforts to slow down deaths from opioids; fatality toll keeps rising

Sign in Frederick County, Maryland, where
 the landscape is mostly rural (Stateline photo)

States are increasing their efforts to curb opioid deaths, fatal overdoses, especially those involving fentanyl, after earlier measures have failed to stem increases, Christine Vestal reports for Stateline. Fentanyl killed 5,000 people in 2014, 10,000 in 2015, and data for 2016, which will be released in January, is expected to show another steep increase. Opioids have been a particular problem in rural areas, especially Appalachia.

Fentanyl continues to spread to more states, mainly because it's cheap and easy to produce, Vestal notes. It's also 50 times stronger than heroin and is often used with other drugs, such as heroin, to intensify the high. "Even in hard hit states that have been battling fentanyl for more than three years, the death toll continues to spike. Connecticut, Illinois, Maine, Massachusetts, New Hampshire, New York, Ohio, Tennessee, West Virginia and Rhode Island were among the states hit hard by fentanyl as early as 2013."

Some states are resorting to any means necessary to educate the public about the dangers of fentanyl, including billboards and radio and television advertisements, Vestal writes. "And standardized approaches to detecting the presence of the deadly drug and communicating its dangers—to drug users, people in treatment or recently released from prison or jail, and their friends, family and advocates—also are beginning to emerge."

Not much is working to slow down fentanyl overdose deaths, Vestal notes. Dr. Alex Walley, director of an addiction medicine fellowship at Boston Medical Center, told her, “What’s so concerning is that in Massachusetts, where, probably more than any other state, we’ve implemented all of the recommended strategies to address the opioid epidemic, overdose deaths are still surging, largely driven by fentanyl."

Vestal writes, "In general, the U.S. Department of Health and Human Services has recommended that states take three major steps to stem opioid overdose deaths: reduce unsafe prescribing of prescription painkillers, widely distribute the overdose rescue drug naloxone, and provide greater access to opioid-addiction treatment using medications approved by the U.S. Food and Drug Administration."

Free workshop for journalists on covering rural health to be held June 9 in Cincinnati

The Association of Health Care Journalists is hosting a free workshop on covering rural health on June 9 in Cincinnati. The keynote speaker will be Julie Willems Van Dijk, director of County Health Rankings and Roadmaps, an annual measure of vital health factors revealing a snapshot of how health is influenced by where people live, learn, work and play. The registration deadline is May 26.

Five workshops will cover a variety of areas, including "Finding rural health stories: What reporters need to know," featuring Trudy Lieberman, contributing editor of Columbia Journalism Review and Laura Ungar, investigative and enterprise reporter for The Courier-Journal and USA Today. The workshop will moderated by Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog.

Another workshop, "Challenges of keeping a rural health workforce," will include Timothy L. Putnam, president and chief executive officer of Margaret Mary Health and Brent Wright, associate dean for rural health innovation at the University of Louisville School of Medicine. The workshop will be moderated by Melissa Patrick, a journalist for Kentucky Health News, which is published by the Institute for Rural Journalism and Community Issues.

Other workshops are: "How the battle over health reform is impacting rural residents;" "The geographic divide: Reporting on disparities;" and "Covering the opioid epidemic beyond cities." To register for the event click here.

Gannett lets more people go at its papers but says little about it; columnist boils down the conundrum

Gannett has 109 daily newspapers. Its many weeklies are not shown on this map.

Gannett Co. had another round of layoffs at its newspapers last week, but it and the papers are saying little about it, reports David Uberti of Columbia Journalism Review.

"The scope? Gannett executives refuse to say," Uberti reports. "The corporation has foregone such transparency with its latest round of cutbacks, which come a week after a quarterly earnings report in which publishing revenues fell more than 10 percent compared to the same period last year, excluding acquisitions."

The company is cutting 1,000 jobs, including 600 layoffs, ABC News reported. "The cutbacks represent about 3 percent of the workforce at Gannett's local newspaper division." (UPDATE, May 10: Uberti takes a close look at Gannett and its USA Today Network.)

The Anderson (S.C.) Independent-Mail, one of the former E.W. Scripps Co. papers bought by Gannett, was one of the few papers in the chain to cover its own layoffs, announcing a cut a seven newsroom positions but not giving a total: "The bulk of the positions impacted clerical positions and editing. Keeping a strong group of reporters committed to covering Anderson was important, News Director Steve Bruss said."

"The other paper that covered its own reductions, the Las Cruces Sun-News in New Mexico, similarly omitted the number of remaining staffers." Uberti writes. "While the three journalists it lost is minute relative to the more than 3,000 journalists Gannett employs nationwide, such totals can be sizable bites from small newsrooms. The Santa Fe New Mexican, which also covered the layoff news, put the Sun-News’ editorial staff around 10. The paper’s managing editor also announced her resignation on the same day."

Columnist David Waters of The Commercial Appeal in Memphis wrote a column that didn't mention the latest round of layoffs but referred to a long line of cutbacks: "We're still here, Memphis. Still publishing a Memphis newspaper every day, even though we're printing it up the road in Jackson. Still covering Memphis news, even though we no longer publish a separate daily section marked Local. Still part of the largest -- by far -- news gathering organization in the Memphis area, even though we're a quarter of the size we once were. Still committed to local, independent journalism, even though we've had three out-of-town owners in three years." The Commercial Appeal and the Knoxville News-Sentinel were among the Scripps papers briefly owned by Milwaukee-based Journal Media before it sold to Gannett, which had papers in the Nashville area.

Waters boiled down newspapers' struggle to a few big factors and a statement of principles that seem to be in more conflict than ever: "This is a big lug of an enterprise from an analog, old media world run by Main Street, now trying to make its way in a digital, new media world run by Wall Street. . . . The people who run this news organization -- as well as those in Nashville, Knoxville, Clarksville, Murfreesboro and Jackson -- have a fiduciary duty to manage and protect it for the people who own it. The people here in Memphis who work for this news organization believe we have a higher calling to inform and protect the people who rely on it."

Waters' column was accompanied by a promotional video with music that some might find uplifting but others may hear as vaguely funereal: