Friday, March 15, 2019

News outlets and associations in several states band together to cover news at their under-covered state capitals

In an era when news outlets are losing staff and statehouse coverage is getting skimpy, publications in several states are teaming up to cover news in their state capitals, Christine Schmidt reports for the Nieman Journalism Lab at Harvard University.

Capitol News Illinois, launched in January by the Illinois Press Foundation, counts 250 newspapers in its membership. Collaboration helped everyone, according to Sam Fisher, head of the Illinois Press Association (IPF is the IPA's educational arm). "We were looking at which parts of the state [were news deserts] to see what we could do, but the biggest news desert was at the Illinois capital," Fisher told Schmidt. "That particular news desert impacted every newspaper, every area, every corner of the state of Illinois."

Most states have similar problems. The number of full-time statehouse reporters in the U.S. dropped by 35 percent between 2003 and 2014, according to a Pew Research Center analysis. In 2014, seven in 10 newspapers that undergo circulation audits (about two-thirds of the dailies) had no full-time statehouse reporter, and that number is likely higher today, Schmidt reports. Efforts like Illinois' also serve weeklies, few of which use wire services and don't send reporters to capitals regularly.

Other states have created similar initiatives, such as "the Oregon Capital Bureau, started by three local publishers; Spotlight PA/PA Post, foundation-supported collaborations between Pennsylvania’s local outlets of various media; and the 11-year-old combined Miami Herald-Tampa Bay Times statehouse bureau as the latest united-front state government coverage," Schmidt reports. "CNI is part of IPF and its content can freely be used by any of its member newspapers, while the Oregon and Florida collaborations are between individual for-profit news organizations and Pennsylvania’s was spurred on by a group of foundations."

The statehouse bureaus are producing high-value stories and plenty of them; Fisher said as many as a quarter of CNI's stories ends up on local papers' front pages, and the bureau produces four to eight stories per day, Schmidt reports. CNI is considering collaborating with local TV news and radio.

Book about community journalism and poverty in Appalachia wins award from Appalachian Studies Association

Clay Carey and his book (Berea College photo collage)
The News Untold: Community Journalism and the Failure to Confront Poverty in Appalachia, is the winner of this year's non-fiction Weatherford Award, given by Berea College and the Appalachian Studies Association. It sounds like must reading for journalists in Appalachia and rural America.

Author Michael Clay Carey "shows how the local media within Appalachia tends to favor stories boosting community business interests and tends to ignore poorer residents, seemingly seen as part of a natural process," the award announcement says. "This local media thereby reinforces the idea of an overarching 'culture of poverty' and displays a lack of awareness of inequality within Appalachia and between Appalachia and the rest of the country. By looking at these stories, or lack of stories, and by putting them in a larger theoretical frame, Carey suggests how the factors behind poverty, as well as possible solutions, might be described."

Carey is an assistant professor of journalism and mass communication at Samford University in Birmingham. He was a reporter and editor at several newspapers in Tennessee for 10 years, and covered the state as a correspondent for USA Today.

Runners-up in the nonfiction category were John M. Coggeshall’s Liberia, South Carolina: An African American Appalachian Community, Karida L. Brown’s Gone Home: Race and Roots through Appalachia, Tom Hansell’s After Coal: Stories of Survival in Appalachia and Wales.

The fiction award goes to Silas House of Berea for his newest novel, Southernmost. This novel takes on the story of a disastrous flood, which many Appalachian communities have dealt with over the years, and weaves in a treatment of religious faith and gay rights in rural America.

The Weatherford Awards honor books that “best illuminate the challenges, personalities, and unique qualities of the Appalachian South.” They commemorate W.D. Weatherford Sr., a pioneer and leading figure in Appalachian development, youth work, and race relations, and of his son, Willis D. Weatherford Jr., who was president of Berea.

In wake of award-winning exposé, state official says Oregon should overhaul handling of insanity defendants

"The state of Oregon needs to overhaul the way it handles people found guilty except for insanity and better track what happens to them once they are released from state jurisdiction, the head of the agency that supervises such defendants said," Les Zaitz reports for the Malheur Enterprise in Vale. "In an interview, Alison Bort, executive director of the Oregon Psychiatric Security Review Board, acknowledged gaps in the system for treating and discharging people found criminally insane and said the state Legislature should consider appointing a state task force to weigh reforms."

Les Zaitz
Zaitz, working with ProPublica, brought the issue to light in 2017 with his "Deadly Decisions" package, about a state hospital's release of a man later arrested for murdering two people. The package earned the Enterprise a 2017 Investigative Reporters & Editors Award in the Freedom of Information category, and the Institute for Rural Journalism and Community Issues' 2017 Tom and Pat Gish Award. (Nominations for the 2018 Gish Award are due April 15.)

Bort, who took over the agency last June, said she has proposed a task force to "examine four areas: how defendants get into the system, their treatment while under state jurisdiction, the process for early discharges and then dealing with people once they have been freed," Zaitz reports.

Experts: Obama administration didn't do enough to curb fentanyl epidemic, now leading cause of opioid deaths

Opioid deaths in the U.S. (Washington Post chart)
Deaths from the powerful synthetic opioid fentanyl have been skyrocketing since 2013, but experts say the Obama administration did not take the threat seriously despite warnings and a mounting death toll.

Eleven national health experts wrote a private letter to high-ranking Obama administration officials in May 2016, begging them to declare fentanyl a national public health emergency. That would have given the administration more funding, resources and flexibility in targeting the problem, but it didn't act, Scott Higham, Sari Horwitz and Katie Zezima report for The Washington Post.

"The decision was one in a series of missed opportunities, oversights and half-measures by federal officials who failed to grasp how quickly fentanyl was creating another — and far more fatal — wave of the opioid epidemic," the Post reports. "Fentanyl has played a key role in reducing the overall life expectancy for Americans. If current trends continue, the annual death toll from fentanyl will soon approach those from guns or traffic accidents."

The numbers are sobering: more than 67,000 people died of synthetic opioid-related overdoses between 2013 and 2017, most related to fentanyl. "In 2017, synthetic opioids were to blame for 28,869 out of the overall 47,600 opioid overdoses, a 46.4 percent increase over the previous year, when fentanyl became the leading cause of overdose deaths in America for the first time," the Post reports.

Part of the problem was that federal officials didn't realize fentanyl needed different strategies to fight it, rather than being lumped in with all anti-opioid efforts. It was also difficult to understand the current scope of the epidemic since Centers for Disease Control and Prevention data collection lags at least a year. Also, it was relatively easy for foreign countries like Mexico and China to sneak fentanyl into the country: U.S. Customs and Border Protection didn't have enough staff or equipment to catch fentanyl shipments, and until 2018, the U.S. Postal Service didn't require monitoring of international packages, the Post reports.

"This is a massive institutional failure, and I don’t think people have come to grips with it,” John P. Walters, chief of the White House Office of National Drug Control Policy between 2001 and 2009, told the Post. "This is like an absurd bad dream and we don’t know how to intervene or how to save lives." The Post package provides a comprehensive history of the issue and includes excellent multimedia features.

Series examines big role of volunteerism and nonprofits in rural life; story is a good example for other rural papers

Rappahannock County, Virginia
(Wikipedia map)
A nonprofit local news initiative in northern Virginia, the Foothills Forum, has produced with The Rappahannock News an excellent three-part series examining the outsized role nonprofits and volunteers play in rural Rappahannock County.

"Strange as it may sound, kindness can get complicated. That’s true especially in a community like Rappahannock, where many hope that if the bucolic views can survive, so can its rural soul. But that’s becoming more fanciful as the county goes through a demographic and economic transformation that has clearly made it older, but also has widened an income and culture gap," Randy Rieland reports for the News. "Which, in turn, can make doing good a touchy matter. There are insinuations that fancy fundraisers 'aren’t the Rappahannock way.' Concerns that 'Benevolent Fund' might sound 'too patronizing.' Worries that events can seem designed only for what’s been described as 'PLUs' — 'People Like Us.'"

Matthew Black, president of the Rappahannock Association for the Arts and Community, said there can be tension between longtime residents and newcomers. "There’s this uneasy alliance between people who have lived here a long time and folks who are coming in, people who have chosen this place," Black told Rieland. "They bring a lot of money. They generate taxes. They donate their time and energy. But how do you have that without attitudes starting to rub up against each other. Those are the fault lines."

"This is a story that could be done in any town or county in this country, regardles of migration patterns, and is an example to follow," said Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog.

Thinking About Health columns: Pitfalls of association plans, and a heads-up for seniors about Medicare

Trudy Lieberman
Association health insurance plans -- those offered to members of a local business, social group or trade association -- are becoming more common these days, but consumers should beware of their pitfalls, Trudy Lieberman writes for her Thinking About Health column for the Rural Health News Service, supported by several state newspaper associations.

The plans became less common after the Patient Protection and Affordable Care Act passed because many didn't conform to ACA rules (many were scams). Insurers were no longer allowed to charge women or people in certain occupations more for plans, for example. But rule changes by the Trump administration last year allowed more employer groups and associations to offer such plans, which typically offer skimpier benefits for lower premiums, Lieberman writes.

"According to Kevin Coleman, who has founded associationhealthplans.com to provide facts and figures about the new market, as of early March, 28 plans were being offered in 13 states. Coleman says if there are 50 in 16 states by the end of the year, he would consider that a successful result," Lieberman writes. "Coleman says that so far, plan sponsors claim they typically pay between 23 and 29 percent less to cover those insured than before."

But association plans achieve those savings by excluding people likely to need medical services, not covering things like mental health or maternity, and/or charging high deductibles and coinsurance. "Remember, it’s the interplay among four factors that determines how much your health insurance really costs: the deductible, the amount you pay until insurance kicks in; coinsurance, the percentage of the price of a medical service you pay yourself; the copayment, a flat amount you pay for a service; and the premium," Lieberman writes. "Too often people look only at the premium."

In another recent column, Lieberman reminds readers that seniors have until March 31 to make changes to their Medicare plan."It’s also a good time for those who will soon be turning 65 to begin thinking of their options and learn what the rules are once they make their selections," Lieberman writes. "Until the end of March, if you have a Medicare Advantage plan, you are allowed to switch to another Medicare Advantage plan. Or you can drop a Medicare Advantage plan, return to traditional Medicare and buy a Part D stand-alone drug benefit, says Tricia Neuman, a senior vice president of the Kaiser Family Foundation and a Medicare expert."

Thursday, March 14, 2019

April 15 is deadline for nominations for Tom and Pat Gish Award for courage, tenacity and integrity in rural journalism

Nominations for the Tom and Pat Gish Award for courage, tenacity and integrity in rural journalism are being accepted through April 15. To nominate a candidate, send a detailed letter explaining how the nominee shows the kind of exemplary courage, tenacity and integrity that Tom and Pat Gish demonstrated at The Mountain Eagle in Whitesburg, Ky., for 51 years. Documentation does not have to accompany the nomination, but is helpful in choosing finalists, and additional documentation may be requested or required. Send your nominating letter and initial documentation to Al.Cross@uky.edu or 343 S. Martin Luther King Blvd., #206,  Lexington KY 40506-0012.
Tom and Pat Gish

The Institute for Rural Journalism and Community Issues named the award in 2005 for Tom and Pat Gish, who died in 2008 and 2014, respectively. Their son Ben is editor and publisher of the Eagle and serves on the award selection committee. The Gishes withstood advertiser boycotts, business competition, declining population, personal attacks, and even the burning of their office to give their readers the kind of journalism often lacking in rural areas, and were the first winners of the award named for them.

The Institute seeks nominations that measure up, at least in major respects, to the records of the Gishes and other previous winners. The award has gone only to newspaper people, but rural broadcasters and online journalists are eligible. Past winners have been the Ezzell family of The Canadian Record in the Texas panhandle; Jim Prince and Stanley Dearman, current and late publishers of The Neshoba Democrat in Philadelphia, Miss.; Samantha Swindler of The Oregonian for her work at The Times-Tribune in Corbin, Ky., and Jacksonville Daily Progress in Texas; Stanley Nelson and the Concordia Sentinel in Ferriday, La.; Jonathan and Susan Austin of the now-defunct Yancey County News in western North Carolina; Landon Wills of the McLean County News in Kentucky; the Trapp family of the Rio Grande Sun in northern New Mexico; Ivan Foley of the Platte County Landmark in Missouri; the Cullen family of the Storm Lake Times in Iowa; and Les Zaitz of The Malheur Enterprise in eastern Oregon.

Why do we do journalism? For the sake of a 'healthy, self-governed republic' of a free people, longtime reporter writes

Amid the latest round of buyouts and layoffs at the St. Louis Post-Dispatch, for which he works, longtime Washington, D.C., reporter Chuck Raasch writes, "I have come to love many of my journalism colleagues the same way soldiers love brothers and sisters in arms," and his headline asks, "Why do we do this thing called journalism?" Raasch answers his own question, but first he writes:

Chuck Raasch
"Being under constant scrutiny from an educated public, and hostility from puffed-up politicians, and partisans armed with keyboard courage, is not the same as getting shot at on the field of battle. But I have had a close journalist friend die in war and another spend time in an Iranian prison. I’ve had my life threatened on the job. Dying doing our jobs is not a foreign concept to journalists, and our brothers and sisters who were killed in Annapolis last summer will always be in our memories.

"Journalists’ reputations are always under assault, never more than today. It comes with the territory, given that our messy role in a vibrant republic is to ask the questions others whisper under their breath. We persist when prevaricators try to get you to look away. We’re a pain to power because, as we all know deep down, the world could be a better place if those in high places always acted in a way that would benefit more than just themselves. . . . Those of you about to summon the keyboard courage to rip these folks’ life work: In crowing over the challenges to community journalism, all you are really doing is contributing to the erosion of community."

Then comes the answer: "Journalism, done right, is a calling like law or the ministry or medicine. We are always there when you need us, even if you don’t think you do. There’s a reason colleagues in despotic regimes are jailed and killed. . . . Why do we continue to put out our very best every day, with dwindling resources in an ever-more-complicated world, while in the name of transparency we open up our very own platforms to those who insult our intelligence and question our allegiance to God and country?

"We do it for you. We do it precisely for the freedoms of our biggest critics. We’re here to call out when the meandering and pandering drift into the lanes of unfairness, bigotry, racism, intolerance and corruption. A healthy, self-governed republic cannot exist without us, on whatever 'platform' we do it. Why do we do this? Why, when the church hides its bad actors and other professions require whistleblowers to ferret out wrongs, are we drawn to a calling that lays its product out there every day to be picked apart and its practitioners to be so publicly scrutinized? It’s because we know that you know that you depend on us, even if you don’t always think you need to pay for us. . . . You depend on the institutions you decry when you need them the most. And that is the best compensation for the good intentions of real journalism for a free people."

There's more, and it's worth reading, sharing and re-publishing. Get the entire column here.

U.S. farmers plan to sow 85 million acres of soybeans this spring, despite failure to sell much of last year's crop

"U.S. farmers are gearing up to plant what could be their third-largest soybean crop ever despite failing to sell a mountain of beans from their last harvest due to a U.S.-China trade war that remains unresolved," Mark Weinraub reports for Reuters. "The U.S. government estimates farmers will have 900 million bushels, or approximately $8 billion, of last year's soybeans in storage silos around the country when they start harvesting the next crop."

Before the trade war, China was the United States' biggest soy customer, buying $12 billion a year; now sales are negligible, despite recent promises from China to buy more as trade talks continue.

So why are farmers planting more soybeans this year? Because it's the best of several poor options, they say. Easy alternatives such as sorghum and corn are also entangled in the trade war, and repeatedly planting corn in the same field requires extra fertilizer and fuel. Farmers are also stuck with expensive specialized equipment for growing, harvesting and storing soybeans. 

"That means farmers will plant soybeans in the hope that the trade war ends, or that they will be compensated by another bailout or crop-insurance schemes," Weinraub reports. "The USDA expects soybean prices will fall in 2019 due to tariffs and rising supply. But soybean futures prices have performed relatively well, considering the disruption to markets from tariffs. The price is up 5.3 percent since China imposed a 25 percent tariff in July. That means many growers have made a slim profit from seeding soybeans."

Rural-urban political divide driven recently by big-city Dems, not rural Republicans, Daily Yonder analysis says

The chart shows the percent of the two-party vote Republicans and Democrats received in congressional (red and blue lines) and presidential elections (red and blue bars) from 2006 to 2018. (Daily Yonder charts; click on image for larger version)
Navel-gazing news stories about the rural-urban divide have become common, and some of the writers seem to believe that rural communities caused this rift by becoming more conservative. "When we look at the numbers, however, we see it’s not just a rural phenomenon," Bill Bishop and Tim Marema report for The Daily Yonder. "The gap is growing in the other direction in major urban areas. Since 2006, at least, the nation’s largest central cities have grown more Democratic while rural areas got more Republican."

Bishop and Marema analyzed House and presidential election results by six classes on an urban-rural scale from 2006 through 2018. Votes for Republicans and Democrats were virtually even across the scale except in the heavily Democratic big cities. "Over the next six election cycles, Democrats continued to gain in these central-city counties. Republicans gained majorities in smaller cities or in suburbs of medium-sized cities and in rural counties. The two parties battled in the suburbs of the major metropolitan areas, where over 29 percent of voters lived in 2018," Bishop and Marema report. "The political division wasn’t rural versus urban. It was big-city Democrats versus everybody else."

In the 2018 House races, "The gap between rural and urban areas shrank a tiny bit even as both geographies got considerably more Democratic," Bishop and Marema report. "In other words, 2018 didn’t see an increase in the rural-urban gap. This election saw a Democratic comeback in rural areas and an increasing concentration of Democratic voters in central cities."

President Trump appears to be losing some ground in rural America, and so may his party be. In a Washington Post poll earlier this year, rural voters' approval of Trump's job performance dropped by 38 points to a net of +8. It's unclear whether Democrats can take advantage of this trend, though. Most Democratic voters are suburban and urban, and increasingly so. If it's a numbers game, Bishop and Marema write, "The Democratic Party has less reason to consider voters outside the nation’s largest cities because fewer Democrats live there."

Pennsylvania creates college with satellite campuses and video conferencing to help rural area access education

It's hard for residents in rural northwestern Pennsylvania to earn a college degree while staying local. In some towns the nearest campus is more than 70 miles away. So the state Department of Education came up with a solution, launching Northern Pennsylvania Regional College in 2017.

"The two-year regional college differs from typical schools with its 'nontraditional delivery system.' Instead of having one central campus where all students go, there's a network of satellite classrooms in schools or libraries across the region, where students and instructors connect through real-time video conferencing," Min Xian reports for WITF, a multimedia news outlet in Harrisburg. "The school hopes to be an answer to the two big obstacles rural students in Pennsylvania face: cost and access."

One instructor can interact with multiple classrooms full of students; there are 18 classrooms in nine northern counties now. The college's founding president, Joseph Nairn, told Xian that the college is much more affordable because it doesn't have to pay for a cafeteria, gym or residence halls. 

The college isn't accredited yet, but Nairn says it will be by the end of 2019. It currently enrolls 83 students, and expects to have 150 next year, Xian reports.

Chicken industry spends big to fix tough or squishy breasts

"Chicken companies spent decades breeding birds to grow rapidly and develop large breast muscles," Jacob Bunge reports for The Wall Street Journal. "Now the industry is spending hundreds of millions of dollars to deal with the consequences ranging from squishy fillets known as 'spaghetti meat,' because they pull apart easily, to leathery ones known as 'woody breast'."

There's some evidence that the traits, which pose no risk to consumers, are side effects of selecting for hens that grow to slaughter weight twice as quickly as hens 50 years ago. But researchers and breeders are still trying to figure out the exactly what led to the traits. "While there are some factors linked to the occurrence—including bird weight, feed ingredients and the time of year the bird is grown—even a combination of these factors will not necessarily produce the same issues consistently," a Tyson Foods spokesperson told Bunge. Tyson owns Cobb-Vantress, one of the two breeding firms that supply most of the breeding stock for the world's chicken companies. 

It's in the poultry industry's best interests to figure out what causes the substandard chicken breasts, since culling them is a considerable expense. 'Spaghetti meat' can be found in up to 5 percent of breast samples. 'Woody' meat is present in about 10 percent, and white striping occurs in about 30 percent, researchers found. None of these traits was widespread before 2010, but major chicken producers are now spending an estimated $200 million annually to find and quash them. And the U.S. Poultry and Egg Association has spent $500,000 over the past three years on research to find the cause of the problems and identify nutrients that could lessen them, Bunge reports. 

Some restaurants and grocery chains, like Wendy's and Whole Foods, have switched to buying slower-growing chickens to improve quality. The smaller chickens cost more, but a Wendy's spokesperson told Bunge that the switch was worth it; customer comments improved.

Wednesday, March 13, 2019

Why is medication to prevent HIV so hard to find in rural South? Stigma, poverty, racism, ignorant doctors . . .

Rate of people with HIV per 100,000 in 2017. (Map by AIDSVu)
A prescription medication called Truvada can protect users from HIV infection, but it's difficult to find in the rural South. That's a big part of the reason the South had about 20,000 new HIV diagnoses in 2017, more than the rest of the U.S. combined, Lenny Bernstein reports for The Washington Post. "Stigma, poverty, inadequate access to health care and lingering racial bias" are also reasons the South have a disproportionately large share of HIV infections.

The Trump administration says it wants to reduce HIV transmission by 75 percent within five years and at least 90 percent by 2030, but it's unclear how that will be implemented. President Trump's proposed 2020 budget would fund a program targeting HIV transmission in the rural South, but would also slash funding for Medicaid, which most people in poverty, some of them with HIV, depend on. Beyond that, it's unlikely the budget will pass in Congress as is, Bernstein reports.

Bernstein writes that the most effective way to fight HIV transmission is to increase access to Truvada (to prevent infection), and antiretrovirals to lower the viral load of already infected people so they can't transmit the disease. "Theoretically, you could end the epidemic tomorrow if you did that," Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and one of the architects of Trump's plan, told Bernstein.

But in 2015, a third of primary-care doctors surveyed said they had not heard of Truvada, according to the federal Centers for Disease Control and Prevention. "Persuading many more people to take the drugs will require more federal money for health clinics as well as for education and outreach to certain groups, especially black men who have sex with other men. At current rates, half that group will be diagnosed with HIV infection," Bernstein reports.

Maple season is arriving in New England; demand for natural syrup has turned cottage industry into a big business

Agriculture Secretary Sonny Perdue and Vermont Gov. Phil
Scott, flanked by Vermont "Maple Ambassadors" Mark Turco
Jr. and Michelle Poulin, tap a maple. It's still too cold to tap
trees for sap in northern New England. (Maple News)
The business of tapping maple trees for their sap, and using it to make a sugary syrup, has become big business, thanks to increasing demand for natural syrup. Not long ago, "sugaring" was "largely a sideline for dairy and small-scale farmers that fell at a nice spot on the calendar. Now it's become virtually industrialized" with state-of-the-art technology and continues expansion, reports former New Hampshire agriculture commissioner Steve Taylor, who was long among the tree-tappers.

"Operations that once had 2,500 taps may now have 35,000; Somerset County in northwestern Maine has recently seen new operations spring up with 100,000 or more taps, often run by Quebecers who want to get around the provincial quota system," Taylor writes in an email to The Rural Blog. "So the industry is now headed in the same direction as dairy, with production outstripping demand and brokers and other bulk purchasers carrying over inventory from last season and imposing limits on what producers can bring them. The bulk price five years ago hovered close to $3 per pound, now it has settled at below $2." A gallon weighs 11 pounds.

Perdue listens as Kevin Harrison of Georgia Mountain Maples
 explains the workings of his processing system. (Maple News)
Another indication of the industry's size may have been last week's visit by Agriculture Secretary Sonny Perdue to "160,000-tap Georgia Mountain Maples, tapping the ceremonial first tree of the 2019 maple season with Vermont Gov. Phil Scott and a group of second graders from a nearby school. It was the first known visit of a sugarhouse by a U.S. agriculture secretary in modern history," Peter Gregg reports for Maple News, a trade journal he started a few years ago – itself another indication of the industry's growth.

Bruce Bascom of Bascom Maple Farms, New Hampshire's top producer, also sells supplies and equipment, and told The Rural Blog that part of the business has reached "a soft spot" due to low prices. "People invested in maple for a lot of emotional and irrational reasons," he said, but the number of taps keeps growing 7 to 10 percent a year as consumption is goes up about 7 percent annually, and he voiced confidence: "In the next 12 to 15 years, the industry's gonna double again." He said it has been boosted by heavy promotion from the Quebec industry and a growing desire of U.S. consumers for natural syrup rather than the "chemical concoctions" sold under popular brands.

Green New Deal has created much buzz, but is light on details, and doesn't specifically mention rural America

Like President Trump's proposed budget, the Green New Deal is unlikely to pass in Congress but it reveals the priorities of its supporters. The non-binding resolution, sponsored by Rep. Alexandria Ocasio-Cortez, D-NY, and Sen. Ed Markey, D-Mass., calls for broad reforms intended to address climate change and societal inequality but doesn't provide much specific policy, Jan Pytalski reports for the nonprofit news outlet 100 Days in Appalachia.

So how would the Green New Deal affect rural America? Republican lawmakers have tried to position it as an anti-rural bill, saying that its focus on lowering greenhouse gas emissions means it's anti-animal agriculture (since livestock emissions and waste are a potent source of methane).

Whitney Kimball Coe, director of the Center for Rural Strategies, told 100 Days that "rural does not appear to be mentioned at all" in the GND, and wants rural communities to have a crucial role in crafting policies that would affect them. She noted that many rural communities are already pursuing renewable energy and conservation initiatives, and cautions federal lawmakers not to "disregard the work that has already been done at the local level by putting a federal plan on top of it."

Pytalski writes, "Here in Appalachia, economic identity is based around extractive economies, putting these concerns right in the crosshairs of the Green New Deal. But the vague promises of the GND proposal and lack of direct involvement with the rural communities presents a problem to many rural organizers." Erin Bridges, fundraiser for the Sunrise Movement, a think tank that helped craft the GND, told Pytalski that a more detailed plan to come will have "a special eye for communities that have historically relied on fossil fuels, because we know we need to ensure economic security and healthy communities for those who have been on the frontlines of extraction for so long."

The nation's largest labor group disapproves of the GND because of that transition, which would mean thousands of Americans losing jobs in the extraction industries, Jack Crowe reports for National Review. The AFL-CIO sent out a letter Friday criticizing the proposal's lack of concrete policy: "We will not accept proposals that could cause immediate harm to millions of our members and their families. We will not stand by and allow threats to our members’ jobs and their families’ standard of living go unanswered."

Tuesday, March 12, 2019

Next deadline to change your Medicare plan is March 31; Rural Health News Service writer offers advice

If you're on Medicare, you can change some of your health-insurance arrangements this month, Trudy Lieberman reports for the Rural Health News Service.

Trudy Lieberman
"It’s also a good time for those who will soon be turning 65 to begin thinking of their options and learn what the rules are once they make their selections," writes Lieberman, a nationally recognized health-care journalist.

"Until the end of March, if you have a Medicare Advantage plan, you are allowed to switch to another Medicare Advantage plan," she reports. Or you can drop an Advantage plan, return to traditional Medicare and buy a separate drug benefit under Medicare Part D.

"What you cannot do, if you have traditional Medicare along with a stand-alone drug plan, is switch to a new drug benefit that might let you save more money on your prescriptions," Lieberman writes. "You can do that only during the open enrollment period in the fall."

Lieberman notes that if you switch to traditional Medicare, "You might have trouble buying a Medigap policy to fill in holes in Medicare coverage." Only four states require Medigap insurance to be issued: New York, Connecticut, Massachusetts and Maine.

Why would you want to switch? "If you have an Advantage plan that has a drug benefit built in as part of the coverage but you believe you can do better with another plan’s drug benefit, then you might want to do the math," Lieberman writes. "Too many consumers fail to do their shopping for the drug benefit."

Here's another reason: "Research is beginning to surface that shows Medicare beneficiaries with high medical needs may have trouble accessing care in some Medicare Advantage plans. Medicare defines those with high needs as people who have three or more chronic diseases and a functional limitation in activities of daily living or in performing routine daily tasks.

The inspector general of the Department for Health and Human Services "reported last fall that those with Medicare Advantage plans sometimes had trouble getting claims paid under those plans, or they reported other problems getting help from the plan," Lieberman writes.

Permian Basin is fueling continued rise in U.S. oil exports, set to overtake Saudi Arabia's by end of 2019

Wikipedia map also shows county lines
The oil boom in the Permian Basin is "perhaps the hottest" on the planet, and is the primary driver behind the United States' huge increase in production and exports in recent years, Steve LeVine reports for Axios.

The Permian Basin is producing about 4 million barrels of oil every day, which contributes to the roughly 8 million barrels (and rising) of crude oil, natural gas liquids and other petroleum products the U.S. exports every day. According to Rystad Energy, by the end of the year, the U.S. is projected to overtake Saudi Arabia's 9 million barrels of combined petroleum products exported daily, Ben Geman reports for Axios.

The U.S. will increase daily oil production by 4 million barrels by 2024, accounting for about 70 percent of global oil production growth over the next five years, according to a new report by the International Energy Agency. Most of that will be from the Permian Basin, Geman reports.

Bloomberg's Javier Blas tweeted a video of what the boom looks like up close: a miles-long stream of service vehicles and tanker trucks on US 285, which runs through the heart of the Permian Basin:
U.S. Route 285 between Orla and Pecos in Texas (Bloomberg video by Javier Blas)

Rural nonprofits roll out free smartphone app to help create a national, crowdsourced map of rural internet connectivity

Three rural nonprofit organizations are teaming up in an attempt to create a more accurate picture of rural internet connectivity. They say the Federal Communication Commission's map is flawed and Microsoft's estimation may be biased, Bryce Oates and Tim Marema report for The Daily Yonder.

So, the Rural Community Assistance Partnership, the National Association of Counties, and the Rural Local Initiatives Support Corporation worked with the Measurement Lab to create the TestIT smartphone app, which invites rural residents to test internet speed wherever they are and submit the results to add to a nationwide database. The organizations plan to publicly share the collected data but won't share contributors' personal information, Oates and Marema report.

The app will measure both fixed (DSL, cable and fiber) and cellular networks; that matters, Oates and Marema report, because the rural-urban connectivity gap isn't as pronounced on cellular networks, according to Oklahoma State University rural economist Brian Whitacre. The app will also log results when the user tries to test internet speed and can't connect to a network at all.

Nathan Ohle, executive director of RCAP, told Oates and Marema that the partnership hopes to use the data to push lawmakers for better broadband build-out funding. Connectivity (or the lack of it) makes a big difference for rural communities, he said: "If you’re looking for a job, if your business is in the community, if you are a farmer looking to download crop-yield data, all of those things have an impact on your daily life if you don’t have access to high speed broadband."

Trump budget, dead on arrival, would cut many programs that help rural areas, increase spending on veterans

Spending increases and decreases in President Trump's
proposed budget (Chart by The Washington Post)
Though the 2020 budget President Trump unveiled on Monday is dead on arrival in Congress, it's a good indicator of his priorities. "In short, Trump wants more spending on the military and veterans and less spending on education, housing, welfare, transportation and science," Heather Long reports for The Washington Post.

"USDA’s Rural Development branch is targeted for a 12 percent cut, and the bulk of rural housing and economic development programs would be scrapped altogether," Ryan McCrimmon reports for Politico's Morning Agriculture. "That includes funding for home repairs or direct home ownership loans for low-income families; initiatives to help farm workers find housing; and programs to preserve affordable housing in rural areas and help low-income residents pay rent."

The budget would cut USDA’s discretionary budget by $3.6 billion, "or 15 percent from the 2019 estimate, while also slashing by $17.4 billion the funds available to the Supplemental Nutrition Assistance Program," formerly known as food stamps, Kate Rabinowitz and Kevin Uhrmacher report for the Post. "The budget would also reduce federal crop insurance subsidies, with a projected savings of $22.1 billion by 2029."

UPDATE: The cuts "drew consternation from growers and ranchers who are struggling through a multiyear slump in the U.S. farm economy, Jesse Newman reports for The Wall Street Journal. "The proposals were quickly dismissed by some farm-state lawmakers in Congress. The president’s proposed budget is seen more as a list of priorities than draft legislation. . . . Agriculture Secretary Sonny Perdue defended the president’s budget, saying the USDA would do its part to reduce federal spending while maintaining a safety net for farmers, hungry families and others."

The Department of Education would lose $8.8 billion in funding, Rabinowitz and Uhrmacher report. Trump proposes eliminating the Public Service Loan Forgiveness program that pays off student loans for people who work in certain hard-to-fill areas, Long reports. That would make it harder for some high-need rural school districts to find teachers.

The budget would eliminate 29 education programs, including one that funds after-school aid, and one that provides impact aid, Andrew Ujifusa reports for Education WeekImpact aid helps school districts that have lost property tax revenue because of tax-exempt federal property, or who have experienced increased expenditures because they have to teach children who live on federal land such as Indian reservations or military installations that don't pay local property taxes.

The budget would cut $12.5 billion from the Interior Department, eliminating grants to help communities recover from mining operations on public lands and providing under $300 million for the National Park Service to deal with a $12 billion maintenance backlog. 

The Department of Veterans Affairs would receive a 7.5 percent funding increase. "This includes an increase of close to 10 percent for medical care for veterans, much of it to implement a law Congress passed last year to consolidate private-care programs outside VA and make private doctors easier for veterans to access," Rabinowitz and Uhrmacher report. "Other new spending would continue the agency’s massive modernization of its electronic health records, add mental-health services for suicide prevention and expand medical services to female veterans."

Johnson & Johnson targeted by Oklahoma attorney general in lawsuit seeking damages from the opioid epidemic

The big villain in the opioid epidemic has been Purdue Pharma, which pleaded guilty in 2006 to deceptive marketing of Oxycontin, especially in Appalachia, and is the target of many lawsuits. But now an Oklahoma suit alleges that Johnson & Johnson was the "kingpin," Axios reports.

The company better known for Band-Aids and baby powder was "a top supplier, seller and lobbyist, according to a state official leading the legal fight against the companies that helped create the crisis," Bob Herman reports. "The first big trial of the opioid epidemic is set to begin in May in Oklahoma. It will set the stage for similar litigation in other states, as well as the consolidated nationwide lawsuit that has been compared to the tobacco litigation of the 1990s."

Herman adds, "Oklahoma Attorney General Mike Hunter has asked a state court to publicly release millions of pages of confidential documents that J&J submitted during the discovery phase of the case. . . . J&J produced raw narcotics in Tasmanian poppy fields, created other active opioid ingredients, and then supplied the products to other opioid makers — including Purdue Pharma.
The company boasted at the time that one of its opium poppies "enabled the growth of oxycodone," and said the morphine content of a different poppy was 'the highest in the world,' according to investor slides obtained by Axios."

Also, Hunter is alleging that "J&J targeted vulnerable populations, including children and older adults, for painkiller prescriptions," Herman reports. "The state also says J&J funded groups that aggressively advocated for easy access to opioids. J&J has funded several pro-opioid groups, such as the Pain Care Forum. A brochure intended for seniors that was made by a J&J subsidiary also claimed 'opioids are rarely addictive'."

For its part, "J&J urged the Oklahoma court to deny the attorney general's request, saying the state is seeking 'sensationalistic headlines and to poison potential jurors,' Herman reports. "In statements to Axios, J&J said its subsidiaries "met all laws and regulations" and that all allegations are "baseless and unsubstantiated."

California showers bring March flowers: Deserts are in the midst of a 'super bloom' after unusually steady rains

Sight-seers walk among the blooming wildflowers near Borrego Springs, Calif. (Associated Press photo by Gregory Bull)
Parts of the Mojave Desert and the northwest corner of the Sonoran Desert in Southern California are in the midst of a 'super bloom' after unusually heavy rains this winter. Click through for a slideshow from USA Today. Below is Walker Canyon near Lake Elsinore.
Photo by Etienne Laurent, European Pressphoto Agency via Agencia EFE (click on photos for larger versions)

Rural Indiana residents less likely than urbanites to use electronic medical records; lack of broadband one reason

Telemedicine, including online health records, is touted as a way to improve rural health. However, rural residents are less likely to use such technology, according to a study of 34 Indiana counties with high rates of cancer deaths, published in the latest issue of the Journal of Rural Health.

The study by researchers at the Indiana University Cancer Center and the university's Center for Survey Research found that rural patients were less likely to use electronic-health-record messaging systems, less likely to look up test results online, and less likely to use electronic medical records to "look for personal health information for someone else's medical record," which a caregiver might do. There was no significant difference in the use of email, texting or social media for health purposes, or in using electronic health records to ask a health-care provider to refill a prescription.

The availability of high-speed internet service, or lack of it, "emerged as a significant factor" in the use of electronic medical records, the researchers wrote. "Rural broadband has more commonly been discussed in terms of the benefit to economic development, but successful policies to expand broadband access also have the potential to improve health through patients’ access to, and use of, their EMR."

Monday, March 11, 2019

About one rural hospital per month has closed since 2010; independents are at highest risk; CBS takes a long look

A young staff of physicians trained in full spectrum family medicine
work at Kearny County Hospital in Lakin, Kansas. (CBS image)
The featured story on CBS's "Sunday Morning" yesterday was about the closure of rural hospitals, and the 14-minute piece offered a fresh number from the continuing study by the University of North Carolina: 99 hospitals in the rural United States have closed since 2010 – almost one per month – and many of the ones still open are in financial trouble.

"Basically about half of rural hospitals are losing money every year," said Mark Holmes, a professor of health policy and management at UNC-Chapel Hill. CBS Correspondent Lee Cowan asked him, "Is there an end in sight?" Holmes replied, "Every time that I've said, 'I think we're through the worst of it,' we've been surprised. You always have to wonder, who's next?"

The reasons for rural hospital closures vary: loss of population, mismanagement, mergers and lack of Medicaid expansion. Holmes said expansion would have helped some stay open, but reimbursement rates are often so low that hospitals can't break even, Sari Aviv reports for CBS.

So many rural hospitals have eliminated maternity units to save money and reduce risk of lawsuits "that more than half the rural communities in this country now no longer have labor and delivery units, leaving expectant mothers facing long drives at the worst of times," Cowan reported. "But in Lakin, Kansas, population 2,200, they tried something different. The only hospital for miles decided to invest in obstetric care instead, the thinking being that babies can be a growth industry. They get patients in the door, and just as Kearny County Hospital's young CEO, Ben Anderson, had hoped, they stay … and bring along the rest of the family, too. There are no high-priced specialists employed here, not even an OB-GYN. Instead, the hospital is staffed entirely by physicians trained in full spectrum family medicine instead." Anderson said, "This last year we had the first profitable year in probably two or three decades, but we're riding very, very close. We don't have the margin for mistakes."

A recent report from business analysts Navigant Consulting estimated that 21 percent, or 430 across 43 states, are at high risk of bankruptcy or closure. "The states with the highest percentage of rural hospitals at risk are Alabama at 50 percent, Mississippi at 48 percent, Georgia at 41percent, and Alaska and Maine at 40 percent," Alex Kacik reports for Modern Healthcare. "Rural stand-alone hospitals are most at risk, with 60.5 percent having lost money on an operating basis in each of the past five years, compared with 42 percent of their urban counterparts."

Independent hospitals are most at risk because they can lose patients to medical facilities like nursing homes or hospices after acute treatment is no longer needed. Independents have increasingly relied on longer patient stays: "The average weighted length of stay at stand-alone hospitals rose by 6.4 percent between 2012 and 2017 while the average length of stay at system-based hospitals fell 23.5 percent, meaning independent hospitals are reliant on fewer patients staying longer," Kacik reports. "Stand-alone hospitals saw their occupancy rates fall to 43.6 percent in 2017 from 53.9 percent five years earlier, while system hospitals saw their occupancy rates fall to 53.7 percent from 61 percent."

W.Va. manufacturers oppose clean water measure, arguing that West Virginians are fatter and thus harder to poison

The West Virginia Manufacturers Association opposed in November a state measure to tighten water quality standards on the grounds that Mountain State residents are fatter than average and thus more resistant to poisons. Nonetheless, the state House of Delegates passed a bill that included the provision, Erin Beck reports for Community Newspaper Holdings Inc.

The state Department of Environmental Protection released a proposal last year to update about 60 water quality standards, based on recommendations made in 2015 by the U.S. Environmental Protection Agency. The measures addressed pollutants known to cause health problems, but the WVMA asked the joint rule-making committee not to implement the new standards, Beck reports.

The manufacturers argued that "the EPA encourages states to incorporate state-specific science, and that because West Virginians are heavier, their bodies can handle more pollutants, and that because they drink less water, they are less exposed to the pollutants," Beck reports. "They have commissioned a worker to gather that state-specific information."

The Senate Judiciary Committee voted last month to give the WVMA until October to gather that information and present it to the DEP, Beck reports.

Rural Ky. press creates works of art with handcrafted books; school in Colorado teaches the next generation how

Gray Zeitz of Monterey, Ky., prints pages on a press from 1915; all the type is hand-set (CBS image)
If you're an author and want your book printed by Larkspur Press, you might have to wait a while. Say, a year and a half to two years. That's because Gray Zeitz, who lives in rural Monterey, Ky., does the whole thing by hand: setting type, printing pages through a 100-year-old press, sewing pages together and creating the covers, Barry Petersen and Sari Aviv report for CBS News.

The finished editions are highly sought after and go from $20 apiece to $150 for special editions. Ellen Glasgow, who sells Larkspur books at her Capital Gallery of Contemporary Art in nearby Frankfort, said the quality of the books is evident: "The paper is so sensual; that is something you really want to touch, and you really want to turn the pages. And then the type is so beautiful."

Zeitz believes hand-made books can mean something more to readers: "I think that if you read a book that's carefully made, and well-designed, you're able to get more out of it than reading a book that is just mass-produced," he told CBS.

"While Zeitz is one of the last people in America still earning a living from making books by hand, a new generation is learning the ancient craft, at the American Academy of Bookbinding in Telluride, Colorado, one of only two such schools in the U.S.," CBS reports.

Sunday, March 10, 2019

AP uses paper GateHouse closed as example of troubles of local journalism, but says 'This isn't a hopeless story'

This was the last home of the Waynesville Daily Guide. (AP photo)
"Local journalism is dying in plain sight," David Bauder and David Lieb of The Associated Press write in a story about the decline of local newspapers. It's part of AP's package for Sunshine Week, the annual salute to open government.

The story's central basis is the University of North Carolina's finding that about 1,400 U.S. cities and towns lost newspapers from 2004 through 2015. Most of those were weeklies in suburban areas and non-county-seat towns, especially in areas like the Great Plains that have been losing population. But the story's object example is a county in south-central Missouri that lost its daily paper in September. The example may seem inapt, but is forward-looking, because the Waynesville Daily Guide was closed by GateHouse Media, one of the private-equity firms that have bought hundreds of American newspapers and have a bottom-line focus.

"The death of the Daily Guide raises questions not easily answered, the same ones asked at newspapers big and small across the country," Bauder and Lieb write. "Did GateHouse stop investing because people were less interested in reading the paper? . . . Or did people lose interest because the lack of investment made it a less satisfying read?" A local pastor told AP that he stopped subscribing because “there wasn’t as much information that really made it worthwhile.”

A former publisher said GateHouse “set the Daily Guide up to fail,” but another ex-publisher and the paper's last editor "blame both GateHouse and the community for not supporting the paper. . . . Critics have said GateHouse and some other newspaper companies follow a strategy of aggressive cost-cutting without making significant investments in newsrooms. GateHouse rejects the notion that their motivations are strictly financial, pointing to measures taken in Waynesville and elsewhere to keep news flowing."

Generally, newspaper closures and mergers can be blamed on "revenue siphoned by online competition, cost-cutting ownership, a death spiral in quality, sheer disinterest among readers or reasons peculiar to given locales for that development," Bauder and Lieb write. "While national outlets worry about a president who calls the press an enemy of the people, many Americans no longer have someone watching the city council for them, chronicling the soccer exploits of their children or reporting on the kindly neighbor who died of cancer."

“Losing a newspaper is like losing the heartbeat of a town,” Waynesville banker Keith Pritchard told AP, which reports, "The bank routinely checked the Daily Guide’s obituaries to protect against fraud; Pritchard said you’d be surprised by family members who try to clean out the accounts of a recently-deceased relative."

Local police "unanimously express dismay at the loss of a newspaper," AP reports. "Pulaski County Sheriff Jimmy Bench wishes the Daily Guide was there to report on the December death of his 31-year-old son, Ryan, due to a heroin overdose. It would have been better than dealing with whispers and Twitter. . . . Without a newspaper’s reporting, Police Chief Dan Cordova said many in the community are unaware of the extent of the [drug] problem. Useful information, like a spate of robberies in one section of town, goes unreported. Social media is a resource, but Cordova is concerned about not reaching everyone. . . . Coroner Nick Pappas said readers are more suspicious of news releases than they would be of a fully reported news story."

David Woronoff
Near the end of their article, the reporters write, "This isn’t a hopeless story. Dotted across the country are exceptions to the brutal new rule, newspapers that are surviving with creative business plans." They cite the The Pilot of Southern Pines, N.C., which thrives on "revenue raised by side businesses — lifestyle magazines, electronic newsletters, telephone directories, a video production company and a bookstore."

The Pilot's publisher is David Woronoff, who is going into the North Carolina Media and Journalism Hall of Fame next month. The selection committee "felt he set a new standard for community newspapers and earned well-deserved national recognition for excellence,” member Merrill Rose told the Pilot. “That is particularly important in a time when many community newspapers have struggled.”

As digital challenge increases for journalism, paymasters must adapt, be reliable and relevant, and be true to values

By Al Cross
Director, Institute for Rural Journalism and Community Issues, University of Kentucky

"There is no sign that the digital market can support local or even regional journalism at anything like the level it had in print."

For journalists and their paymasters, that is the most chilling line in a review of two very important books about journalism and the news business, because the digital market will keep expanding. The books are about big-time journalism, but the chilling line applies to community journalism, too.

For a decade now, I have said community journalism is the healthiest part of the traditional news business, primarily because most people will always be interested in news about their locality, and digital media have not invaded the local-news franchise of most rural newspapers.

But now I wonder. Americans increasingly engage in online, virtual communities, many of which have little or nothing to do with a locality (West Highland White Terrier owners like me and my wife, for example). The flood-the-zone approach of President Trump and the dominance of social media have placed more emphasis on national news, and the shriveling of many local news outlets has only exacerbated that.

There is less interest in local news, and certainly in local newspapers, most of which still emphasize the print product that provides most of their advertising revenue. That leaves them with a disproportionately older audience that is gradually dying off. And I can see a decline in many rural newspapers that I did not see five years ago.

Paul Starr
I thought about these things as I read a review of Merchants of Truth: The Business of News and the Fight for Facts, by former New York Times editor Jill Abramson, and Network Propaganda: Manipulation, Disinformation, and Radicalization in American Politics, by Yochai Benkler, Robert Faris and Hal Roberts. The review, in the March 21 issue of the New York Review of Books, was written by Paul Starr, a Princeton University professor who co-edits The American Prospect, a liberal magazine. At 3,740 words, the article contains one of the best reasonably short summations of the problems of the news business and journalism, particularly political coverage.

Rural journalists need to care about these issues, because many in our audiences increasingly see local news media as part of a national problem. As Starr says in his opening paragraph, "The entire field has been politically reconfigured, as media outlets identified with different ideological positions provide their audiences with alternative versions of reality. . . . Amid the torrent of lies from the highest reaches of government and disinformation on social media, journalism’s leaders are making unabashed claims that their business is 'truth,' using that word without apology or qualification. But because journalism has not been a lucrative business for some time, its ideals of truth-telling have become harder to uphold."

Starr notes the groundbreaking work by Penny Abernathy at the University of North Carolina, which showed that since 2004, "about 20 percent of newspapers have shut down, while many of the survivors have become what Ken Doctor of Harvard’s NiemanLab calls NINOs (newspapers in name only): diminished ad shoppers with hardly any local reporting. Private equity firms have bought many of these to suck the last profits from them."

As an advocate for rural journalism, I am more worried about the latter phenomenon than the former. Most of the 1,800 newspaper closings (or mergers) from 2004 through 2015 were weeklies in suburban areas and non-county-seat towns, especially in areas like the Great Plains that have been losing population. But the portfolios of private equity firms go deep into the county-seat and local-trade-center newspapers that are the heart of rural journalism in America. The canary in this coal mine is (or was) the Waynesville Daily Guide in south-central Missouri, which GateHouse Media bought, shrank and closed. Its sad tale is told by The Associated Press in a story (excerpted on The Rural Blog) as part of Sunshine Week, the annual salute to open government and journalism's role in it.

Those trends are not part of Abramson's book, and that is only one of its shortcomings. "Several passages in the chapters on Vice all too closely follow other writers’ language; Abramson also got details wrong about a number of young journalists, making them appear inexperienced and unqualified," Starr writes. "There is no excusing these failures, but not every damaged vessel should be sunk." I agree; I suspect Abramson's book beats the traditional news media's mess-up average, which I reckon to be about 5 percent. That's also the error rate for Major League Baseball players.

The other book breaks new ground with a study of study of 4 million political stories from 2015 to 2018, from 40,000 online sources, as well as case studies of conspiracy stories, rumors, and outright disinformation. It "contradicts the idea that there are two symmetrical echo chambers on the right and left," Starr writes.

"On the right," Starr says, the book shows "an insular echo chamber skewed toward the extreme, where even the major news organizations (Fox and Breitbart) do not observe norms of truth-seeking. But from the center-right (for example, The Wall Street Journal) through the center to the left, they find an interconnected network of news organizations that operate under the constraint of established journalistic norms. The result is two different patterns in how falsehood travels.

"On the right, major news organizations amplified stories concocted in the right’s nether reaches . . . False stories originated on the left as well, but they were generally not relayed to a wider public. The right-wing media failed to correct falsehoods or to hold their journalists accountable for spreading them, whereas the rest of the media checked one another, corrected mistakes when they made them, and in several cases disciplined or fired those responsible for errors. These differences contributed to the greater susceptibility on the right, not only to home-grown propaganda, but also to Russian disinformation and commercially fabricated clickbait whenever these were consistent with what the authors call the 'tribal narrative.'"

Yes, most Americans have sorted themselves into political tribes, where members suffer when they don't adhere to their tribe's prevailing set of beliefs. A central mission of journalism is to help the country and its communities overcome such divisions. To do that, it should be mainly about facts, not opinion; be a reliable source of relevant information for its audiences, and be seen as such; and explain how it goes about its work. And all of journalism's paymasters, large and small, must adapt to the digital age while being true to journalism's values.