Report identifies 'hubs’ that effectively strengthen rural communities, gives tips and examples for others

With the needs of rural America increasingly in the news since the 2016 election, many philanthropists, nonprofits, government leaders, and investors have gotten more interested in how they can help address systemic issues in rural areas. A new report from The Aspen Institute's Community Strategies Group aims to give such people practical information and data about rural America along with examples of intermediaries they've dubbed Rural Development Hubs: place-based organizations that are already working to improve rural prosperity and well-being by harnessing both local and outside resources.

"Hubs focus on all the critical ingredients in a region’s system that either advance or impede prosperity — the integrated range of social, economic, health and environmental conditions needed for people and places to thrive," the report says. Here's what sets hubs apart from other organizations; hubs:

• have a regional mindset and pursue regional action.
• help bring together people in the region in a way that local government often can't.
• are rooted in the region, know the region, and are widely and deeply trusted in the region.
• take a long-term view, understanding that many goals may take decades to achieve.
• address multiple causes of challenges.
• look beyond funding and other limitations to look broadly at their regional responsibilities. 
• collaborate and network with other systems, governments, organizations and people.
• create structures, products and tools that foster collaboration.
• translate, span and integrate action between local and national actors.
• innovate and change to become what they need to be to get the job done.
• take and tolerate risk.
• hold themselves accountable to the whole community.

The report identified 43 hubs around the country and details what many are doing to create change in their communities, along with a crash-course in rural policy history.

Words matter when writing about addiction; wrong words increase stigma, impeding recovery; speakers offer advice

Videos of each presentation are available here.

By Melissa Patrick
Kentucky Health News

ASHLAND, Ky. -- The words used to describe drug addiction and those suffering from it can either perpetuate the stigma that is attached to the disease or can help people move beyond it, and journalists have a responsibility to stop using stigmatizing language.

Bishop Nash and Lyn O'Connell speaking in Ashland Nov. 15 at
"Covering Substance Abuse and Recovery: A Workshop for Journalists"

That was the main message of the last two speakers at the Nov. 15 workshop in Ashland, Ky., "Covering Substance Abuse and Recovery: A Workshop for Journalists," sponsored by the University of Kentucky's Institute for Rural Journalism and Community Issues and Oak Ridge Associated Universities.

"Nobody has the power to change language like us," said Bishop Nash, most recently the health reporter at the Herald-Dispatch in nearby Huntington, W.Va., a city that has been called the epicenter of the opioid epidemic. “That's just how it is and I feel it in my heart to do it for my people."

Nash said he, like many other reporters, has had to learn to write differently about addiction, but once he understood the science of the disease and why it was important to not use stigmatizing language, it has been an easy switch.

"It really requires a change of heart," he said. "When you get your heart wrapped around this issue, you really don't have to think about it."

Nash gave credit to Lyn O'Connell, the associate director of community services in the division of addiction sciences in family medicine at Marshall Health in Huntington, for helping him and others in the area understand why the words journalists use to cover addiction matters.

O'Connell, who spoke first, explained that after making regular phone calls to the Herald-Dispatch, including ones to Nash, and asking them to print less stigmatizing headlines, she realized the journalists and their editors just didn't know any better, so she compiled a set of guidelines on how to cover addiction and set out to teach them. O"Connell shared some of those guidelines at the day-long workshop.

Like other speakers at the conference, O’Connell said stigma is what keeps many people with substance use disorders from seeking treatment. She added that it also keeps lawmakers from providing adequate funding for programs to support them.

"So if they see these damaging headlines, it's only going to perpetuate these diseases in our communities," she said. She encouraged journalists to use non-stigmatizing language, and offered four suggestions.

First, she said it's important to use "people-first language." For example, write "an individual with a substance-use disorder" instead of the more stigmatizing term "addict." "Remember that we are talking about a human and we should put the human first in a sentence," she said.

O'Connell also noted the importance of focusing on the medical nature of a substance use disorder. She pointed out that we don't call people with cancer "those cancer people" and asked why would we de-humanize a person with a substance-use disorder, which is a chronic disease, and call them an addict.

She also encouraged using language that promotes recovery. For example, instead of saying "an individual with a substance-use disorder," when appropriate say "an individual in recovery."

It's also important to avoid perpetuating negative stereotypes and biases through the use of slang and idioms, she said. In other words, don't use words like junkie, addict, user, abuser, crack-head.

She also encouraged journalists to move away from writing or saying "substance abuse," which she said has criminal under-tones. Instead, she said be medically accurate and use the term substance use disorder, which is what it is. "I think this is one of the hardest adjustments," she said.

She offered several more suggestions, including making sure you only mention the details of a person's addiction if it is relevant; to never say an infant is born addicted, but to instead say it was born experiencing exposure or withdrawal; and to not ever use the words "clean or dirty" to describe a drug screening, but to instead say it was positive or negative for the substance. She also said to make sure the images and photographs used in a story are accurate and are images that promote treatment and recovery.

She concluded by noting that addiction is a complex, chronic-relapsing disease that is the result of many different factors, and that most individuals in treatment have a history of trauma.

She said, "When we don't consider the entire person in that story, we're missing out on a lot of who that person is, and the back history."

Nash said he initially thought all of these changes would "clog” his writing and that readers would roll their eyes and say, "Oh, the PC police are out." But since, he said he has evolved to writing substance use disorder on first reference because that establishes it as a disease, and then refers to it as an addiction because that is the word his readers understand.

"This isn't about being politically correct," he said. "This is about being right in the science with it."

A person in the audience noted the struggles editors face in trying to fit so many words into a headline and said alternative, smaller words are needed that are also appropriate to use.

"That just speaks to the importance that you should not just be teaching this to reporters," Nash said. "You've got to teach this to editors, you've got to teach this to copy desk people, and the hardest thing is that you've got to teach this to a lot of people who are set in their ways."

Nash recognized that a reporters job is to report, and to not sugarcoat the news, but said there is no reason that the words they use should add to the stigma.

He said, "I believe that state and local journalists in particular have a moral imperative for the greater public good in the communities they serve."

Study: mobile apps could better measure rural road damage, help decide where repair money goes

Rural roads are a vital resource, but many states have decreased funding for rural road upkeep, so it’s important to find cost-effective, reliable ways to keep tabs on their condition. A project from the Illinois state government, spearheaded by college researchers from universities in the state, aims to change that by creating a mobile app to measure road conditions, McCall Macomber reports for the University of Illinois’ Grainger College of Engineering.

Researchers found that most county and town officials were only able to assess road damage by the 'windshield method': looking out the windshield when driving. "This highly subjective method leads to overspending on road repairs. To explore more cost-effective measures and reliable assessments, investigators put two techniques to the test — manual and automatic assessment methods," Macomber reports. "The manual methods involved evaluating both the new Seal-coated Road Condition Index and the Unsurfaced-road Condition Index, which measure seal-coated road surfaces and surfaces on gravel and dirt roads, respectively."

But the manual methods were time-consuming, expensive, and often meant closing lanes to traffic. "The researchers then shifted their focus to automated methods, where they used three mobile apps to measure the roughness of rural roads. They tested several variables to determine the effectiveness of the apps, including road material, vehicle type, speed and even the cellphone mount," Macomber reports. "Ultimately, researchers found that apps were an effective, cost-saving real-time technique to determine road roughness conditions."

The research team is working on creating an app to report on rural road conditions. "This project is a first stepping-stone to automate low-volume or rural road condition data. The use of cellphones to collect pavement distress data is currently state of the art, and the state of Illinois is at the forefront," said researcher Mohammad Imran Hossain, a Bradley University professor.

After three years of decline, cost of Thanksgiving meal about the same as last year, says new Farm Bureau survey

In the past year, the price of the average Thanksgiving meal for 10 has remained virtually unchanged since last year; the cost went up one penny to $48.91 this year, shaking out to less than $5 per person. That’s according to the American Farm Bureau Federation’s 34th annual survey. This year’s leveling off of Thanksgiving prices comes after three years of decline in cost since 2015.

The study assesses the prices for the most common dishes on the Thanksgiving table. And though the overall cost of the meal remained steady, there was notable fluctuation in individual items. The turkey, for example, cost about $1.30 per pound, 4 percent less than last year and the lowest price since 2010. Other items measured include stuffing, sweet potatoes, rolls with butter, peas, cranberries, a veggie tray, pumpkin pie with whipped cream, and coffee with milk, Morning Ag Clips reports. Cubed bread stuffing and canned pumpkin pie mix also declined slightly from last year.

"The Thanksgiving price survey opens the door to a deeper dialogue about how food is produced and how prices remain so stable despite volatility in the farm economy this year and severe weather hampering planting and harvest," AFBF Chief Economist John Newton said. "Americans continue to enjoy the most affordable food supply in the world, but most don’t realize only 8 cents of every dollar consumers spend on food goes to farmers."

Most Americans were surprised to learn that farmers get so little of the share from food prices, according to a new AFBF survey, and three-quarters of respondents said they were more interested in learning more about how their food is produced. According to survey results, 88% of respondents said they trust farmers, Morning Ag Clips reports.

Book offers practical tips to help small towns thrive

A new book, Total Town Makeover, highlights examples of small towns that are thriving and offers ideas for how other towns can also nurture growing local economies and vibrant communities.

Author Andrew McCrea is no stranger to small-town life. A fifth-generation rancher and farmer in northwestern Missouri, he’s also the host of award-winning radio show “The American Countryside.” In his book, McCrea offers practical tips for improvement that range from broad, policy-based notions to smaller, everyday suggestions, Sara Schafer reports for AgWeb:

• Does your town have an endowment or other sources of funding to provide seed money for projects or matching funds for grants? Just as a person needs a savings account, endowments serve much the same purpose for a community.
• Do you have a group leading the way, or are separate groups pulling in different directions? Try to form a coordinating group or clearly define what each individual group hopes to accomplish.
• Does the community have short- and long-term goals? Have they been written down and shared? People want to have an idea of the vision before they buy in.
• Are you using newspapers and social media to communicate? Provide progress updates. Show pictures. Build momentum. Social media allows you to connect with people who might not live nearby but have a connection to the town and will support your efforts.
• Improve the town’s culture by making a commitment to smile more and compliment and praise others. It might be a specific person or group that lead the way in building a positive and proactive culture.

It’s important for small towns to thrive, McCrea told Schafer. “There’s more than hope residing in rural America . . . There are qualities in these areas that can’t be experienced anywhere else. Qualities worth preserving not for the sake of nostalgia but for the sake of a better future for all.”

Quick hits: Colorado town tries to attract new teachers; how big-box retailers can revitalize health care

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

A small Colorado town is trying innovative ways to attract new teachers, CBS News reports. Watch the video here.

How big-box retailers can revitalize health care. Read more here.

A Federal Communications Commission report says rural-urban broadband gap is narrowing, but data should be taken with a grain of salt, since it's self-submitted by internet providers. Read more here.

The gap in rural-urban pediatric mortality rates is widening, according to a Health Affairs report. Read more here.

In-depth report describes civic impact of decline of local news media with case studies, including one with rural flavor

Greg Barnes, a former reporter for the Fayetteville Observer,
still sends the paper news tips. (Photo from PEN America report)

A new report "paints a grim picture of the state of local news in every region of the country," Julie Bosman summarizes for The New York Times. "The prelude is familiar to journalists: As print advertising revenue has plummeted, thousands of newspapers have been forced to cut costs, reduce their staffs or otherwise close."

The report is from PEN America, a nonprofit focusing on freedom of expression for writers of all stripes. Titled "Losing the News: The Decimation of Local Journalism and the Search for Solution," it draws on Penny Abernathy's ongoing national research at the University of North Carolina and uses several case studies to make its points, including one of a rural county and a larger, adjoining county in the Tar Heel State.

"For many Americans—especially people of color and residents of poor communities or remote rural areas—inadequate local news coverage has been the norm for decades," the report notes. Now those shortcomings have spread: "At a time when political polarization is increasing and fraudulent news is spreading, a shared fact-based discourse on the issues that most directly affect us is more essential and more elusive than ever."

The rural-oriented case study is of Robeson and Cumberland counties in North Carolina. In 2015, Sanderson Farms decided to put a chicken-processing plant in Robeson, population 20,000, rather than Cumberland, pop. 320,000, due to public outcry spurred by robust coverage in the Fayetteville Observer and friendlier coverage by The Robesonian, circulation 5,000: "Like so many local outlets, it has changed ownership several times in recent years and its newsroom has been subjected to significant cuts; today, it’s owned by Champion Media" and has three and a half news reporters.

The report says Robesonian Editor Donnie Douglas "is able to stack the opinion page with criticism of the county board, which he says is composed of 'crooks—and I don’t use that word lightly.' But he has to pass on more ambitious stories. Even if he’s intrigued, he says, he’ll often think, 'That story is probably too big for us.' . . . Scott Bigelow, a longtime Robesonian reporter and editor who now works there part-time, attributes the newspaper’s general dearth of agricultural reporting to the fact that no one has covered that beat full-time for years."

But things are also worse at the Observer, which was North Carolina's largest independently owned paper until it was bought by GateHouse Media in 2016. Former reporter Greg Barnes "says that toward the end of his three decades there, his job had essentially become filling holes for the rapidly diminishing staff instead of doing the sprawling investigations that had long been his trademark," the report says. "Those who care about the future of Fayetteville and Cumberland County say they worry about what happens when a respected, independent publication no longer has the strength to push back against government or conduct comprehensive investigations. John Malzone, a prominent Fayetteville developer, laments that the Observer is a shell of its former self."

Fiona Morgan, a news consultant based in North Carolina, told PEN America, “Many community newspapers have never done the kind of accountability reporting associated with bigger newspapers. Not all local papers see it as their role to question authority in that way. You’ve always had news deserts even in places where there are outposts. Some local newspapers have been failing to provide aggressive accountability coverage for a long time, especially in rural communities. Where there’s no competition, there’s no pressure to do better.”

Democratic debate recap: Buttegieg wades into corn-vs.-oil feud, Warren wants public service jobs for federal lands

Last night 10 presidential hopefuls took the stage in Atlanta for a debate hosted by The Washington Post and MSNBC. Here are a few rural themes the candidates discussed:

• Mayor Pete Buttegieg of South Bend, Indiana, criticized the trade war with China, saying "We shouldn't have to pay farmers to take the edge off of a trade war that shouldn't have been started in the first place." Farmers' bailout money is insufficient, he said, adding that hardship waivers for oil refiners are hurting the ethanol industry. He spoke in favor of breaking up large agribusiness monopolies, and said farming should be a key way of fighting climate change.
• Rep. Tulsi Gabbard of Hawaii promised to end the cash bail system and enact prison and sentencing reforms.
• Former Vice President Joe Biden questioned competitor Tom Steyer's bona fides as an environmentalist and criticized his past involvement with the coal industry.
• Sen. Elizabeth Warren of Massachusetts advocated increased public-service opportunities: "I want to bring in 10,000 people who want to be able to serve in our federal lands to be able to help rebuild our national forests and national parks as a way to express both their public service and their commitment to fighting back against climate change."
• Warren also criticized the federal government for not building more affordable housing. She has a plan for 3.2 million new affordable housing units, she said.

Read the complete transcript here.

Crop-insurance deadline delayed as harvest problems and farmers' struggles continue; land prices go negative

As U.S. farmers conclude a difficult crop year, the outlook remains troubling. The downturn in agriculture echoes the one that led to the 1980s farm crisis, Farm Credit Administration Chairman Glen Smith told the House Agriculture Committee on Tuesday. The FCA regulates farm lenders.

Smith said the farm-lending system is "safe and sound" but officials are "very concerned and closely monitoring some weakening in credit quality." At a subcommittee meeting, he also compared the current economic climate to that of the early '80s, "citing economic trends like falling farm income, rising debt-to-asset ratios and concerns about the value of farmland," Ryan McCrimmon reports for Politico's Morning Agriculture. "Farmland values remain largely stable across the country. But that could change, Smith warned in his written remarks to the committee, if larger amounts of farmland go up for sale — like if farm bankruptcy rates continue ticking upward." Smith also noted the role of trade wars in agricultural instability in the late '70s and early '80s.

Meanwhile, abnormally wet weather continues to slow harvests, making it likely that some crops won't be harvested this year at all. "Instead, a good deal of corn in Northern states will likely have to wait until the spring of 2020 to be harvested, while soybeans left over winter might not be harvested at all," Ray Grabanski reports for Successful Farming. "That is going to lead to harvest losses much greater than factored so far into USDA numbers" estimating production.

Within the next two weeks, the corn harvest will be about 76 percent complete and soybeans 91% complete. It's not likely to go much higher, Grabanski writes: "Most of the corn not harvested never made maturity, and therefore is still very wet (25% to 35% moisture) and it is not economical to harvest now (and no propane is available to dry it)." And very wet soil, or snow, will block soybean harvests. But, Grabanski notes, China is buying more soybeans, so commodity prices could go up quickly if the trade war ends.

Almost three-quarters of the rural bankers surveyed for Creighton University's Rural Mainstreet Index reported negative economic impacts from the trade war. The RMI is a monthly survey of bank CEOs in rural areas of a 10-state region where agriculture and energy are essential to the economy: Colorado, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota and Wyoming.

The overall index has been barely above growth-neutral for three of the past four months, buoyed by higher grain prices and trade bailout payments, writes Ernie Goss, the Creighton economist who compiles the report. However, prices for land continued to slide. "The confidence index, which reflects bank CEO expectations for the economy six months out, slumped to 36.5 from September’s 42.9, and continues to indicate a very negative economic outlook among bankers," Goss reports. This is because of the trade war with China and uncertainty about when or if the U.S.-Mexico-Canada Agreement, replacing the North American Free Trade Agreement, will pass.

One banker complained to Goss that it was hard to make predictions because this year's planting and harvesting data isn't known -- or, if known by the Agriculture Department, isn't being made public.

Because of the delayed harvest, USDA is granting most farmers a second extension on crop insurance premium due dates, Dan Looker reports for Successful Farming. Normally, payments on spring-planted crops are due Sept. 30 and begin to accrue interest Oct. 1. USDA announced in August that it would defer interest until after Nov. 30; now it says farmers have until Jan. 31 to make interest-free payments on crops planted last spring. But if their payments are even a day late after Jan. 31, they'll be charged the retroactive interest that would have accrued since the original due date of Oct. 1.

On National Rural Health Day, a call to adopt a broader perspective on the diversity and complexity of rural America

Today is National Rural Health Day, and while many articles might cover familiar topics like the opioid crisis or maternal health, "We want to challenge conventional wisdom and prompt fresh thinking about rural America, the drivers of health, and the role of community and economic development in both. From what we are learning, this broader lens is central to realizing health equity and a better rural futures," Katharine Ferguson and Katrina Badger write for the Robert Wood Johnson Foundation.

Rural America is far more diverse and complex than the stereotypes suggest, as shown by two projects, they write. The first is the American Communities Project's "A New Portrait of Rural America", which focuses on the geographic, demographic and socioeconomic diversity of rural America. The second is the foundation's Life in Rural America polls, with data on the complex economic and health issues in rural America. The polls and accompanying report were produced in partnership with Harvard University's T.H. Chan School of Public Health and NPR.

Click here for more information about National Rural Health Day and activities observing it.

Students: Leverage rurality for college admission with 'your take in your place and how your place ... created your take'

Tara Kaprowy

Rural high school graduates aiming to go to college might feel insecure about their small-town backgrounds, but it can be a huge bonus in writing an application essay, writes an essay coach living in rural Kentucky.

Colleges and universities want more diverse student populations, including rural students, Tara Kaprowy writes for The Sentinel-Echo, a thrice-weekly newspaper in London, Ky. She offers prospective college students some practical tips on how to nail the application essay with an honest, vibrant treatment of where they come from.

"Not only will you get to write about something that you know, your rural background may not be obvious in any other part of your application," Kaprowy writes. "That means you’ll get to showcase another essential side of yourself, which is exactly what a personal statement is for."

And rural doesn't have to mean living on a farm, she writes. "You don’t have to have a dad who’s a farmer to write about your rural life. You don’t need a tractor, a horse or a Meemaw who cooks the best fried green tomatoes and lets them dry on newspaper. What you’re after is your take in your place. And how your place has created your take."

Report gives state-level data about rural students, schools

More than 9.3 million students attended a rural school last year, but many rural schools have fewer resources and get less attention than their suburban and urban counterparts, according to the newest edition of Why Rural Matters, a report released every two years by the nonpartisan, nonprofit Rural School and Community Trust. The report contains state-level data about the nation's rural students during the 2016-2017 school year. Some key findings in the report:

• Rural-urban education gaps persist despite continued talk from politicians and some occasional bold promises.
• Nearly one in seven students nationwide attended a rural school in 2016-17 (rural is defined using the three main rurality measures employed by the Census Bureau).
• More American students attend rural schools than in the nation's 85 largest school districts combined.
• Nearly one in six rural students lives below the poverty line. One in seven qualifies for special education. One in nine has changed residence within the past year.
• Most rural students attend school in a state where rural students make up less than 25 percent of public school enrollment. More than a quarter of rural students live in states where rural students constitute less than 15 percemt of overall enrollment.
• The median enrollment for rural school districts is 494 students. In some states, the average is far lower: in Montana, North Dakota and Vermont, more than 90 percent of rural districts have fewer than 494 students. 
• Rural students were much less likely than the national average to pass Advanced Placement courses.
• Rural high school students were more likely than the national average to take dual enrollment courses for college credit.
• Though many states provide rural school districts with a disproportionately large share of funding, 12 states provided disproportionately less funding: Nebraska, Vermont, Connecticut, Iowa, Rhode Island, Wisconsin, Michigan, Massachusetts, California, Ohio, Minnesota and New Jersey.

How a tiny Montana town became a major Amazon hub

Kristal Graham in the Selltec prep center in Roundup, Montana. (Photo for The Verge by Josh Dzieza)

Roundup, Montana, has one traffic light and fewer than 2,000 residents. It's the last place you'd imagine as home to a major shipping hub. But every day in Roundup, thousands of packages from major retailers like Walmart and Target, are unboxed, repackaged, and sent out to Amazon customers and shipping hubs. The town is "home to a growing industry of prep centers, businesses that specialize in packing goods to meet the demanding requirements of Amazon’s highly automated warehouses," John Dzieza reports for The Verge.

It started in 2015 when rancher Kristal Graham began buying goods from other retailers and selling them for a profit on Amazon Marketplace. "This sort of arbitrage is common and has helped Amazon both expand its catalog and sap its competitors. It’s hard for companies like Nike to refuse to sell on Amazon or for competitors like Target to lure customers away with steep discounts when someone like Kristal can just buy their wares and resell them at a markup," Dzieza reports. "Amazon has made buying stuff so frictionless and habitual, delivery so fast — and for Prime members, free — that many shoppers don’t bother checking prices anywhere else."

Roundup, Montana (Wikipedia map)

But Amazon only accepts products if they're packaged a certain way, so resellers must cover up old barcodes and prices and add new ones, or bubble-wrap glass, for instance. "As Kristal’s business grew, she needed help with all this unboxing and re-boxing, so she started looking for a prep center. There were about 15 at the time, she says, mostly in New Hampshire, Oregon, and Delaware, which have no sales tax," Dzieza reports. "That way, sellers can enter the address of their prep center when they buy from Target’s website and pad their margins by a couple percent. Montana has no sales tax either, Kristal mused, and there wasn’t a single center in the online directory. Sensing an opportunity, she decided to give prepping a try. She chose a name — Selltec — and put it up on the directory, too."

Business went so well for Selltec that others in Roundup decided to open up their own prep and ship
businesses. "There are now nine women in the preppers’ group chat, soliciting advice and swapping tips on how to best package goods for Amazon. Several more are scheduled to apprentice. Between Selltec and the splinter group, every day Roundup receives 3,000 to 4,000 Amazon-bound packages — about double the number of people who actually live there," Dzieza reports. "The preppers are one part of a vast, informal, and mostly hidden workforce that stocks Amazon’s shelves. The majority of goods sold on the site come from third-party sellers, many of whom got their start going to brick-and-mortar stores looking for products to buy and resell."

There are now more than two million third-party sellers on Amazon competing against each other on price and customer ratings. With profit margins so thin, resellers sometimes go to extreme lengths to compete, including using software that scrapes content from other retail sites to find potentially profitable products, Dzieza reports.

"The women in Roundup are mostly bemused by their role in this system. They did not expect when they came to Roundup to be a way station on a highway of thousands of consumer goods. Jobs here of any sort are hard to come by, much less ones that give them the flexibility to go herd cattle, or care for ailing family, or work from an off-the-grid house miles from town," Dzieza reports. "Unlike many people who have found a niche feeding Amazon’s viciously competitive marketplace, the prep center women are welcoming to newcomers. Amazon sellers will engage in elaborate sabotage to undercut their rivals in selling $5 socks, but the preppers have as many customers as they can handle anyway, so they’re happy to pass on inquiries to whoever’s new."

How brands and marketing play into the political divide

WSJ chart with data from Simmons National Consumer
Study, 2004-2018; click on the image to enlarge it.

The old saying "vote with your wallet" has taken on a deeper meaning in recent years, as brands
increasingly signal political stances they hope will play well with their target audiences. Deliberate stances, as well as the random vagaries of retail, have led to some brands being supported more by Republicans and some by Democrats.

An example: Democrats are more likely to wear Levi's jeans and Republicans are more likely to wear Wranglers. "There is no simple explanation behind those consumer moves. Some of it is due to social and political stances companies are taking, such as Levi’s embrace of gun control. Some is tied to larger geographic shifts in the political parties themselves, as rural counties become more Republican and urban areas lean more Democratic. Wrangler is popular in the cowboy counties of the West and Midwest while San Francisco-based Levi’s resonates more with city dwellers," Suzanne Kapner and Dante Chinni report for The Wall Street Journal. "Together those factors are combining to create a new, more partisan American consumer culture, one where the red/blue divisions that have come to define national politics have drifted into the world of shopping malls and online stores."

Since the 2016 election, companies have begun to weigh in more deliberately on partisan issues like immigration, gun control, and gay rights. Richard Edelman, chief executive at public relations firm Edelman, told Kapner and Chinni: "Consumers are not just voting in elections, they are voting at the stores by choosing brands aligned with their values."

Younger consumers expect brands to take a stand on controversial issues, Procter & Gamble Co. CEO David Taylor told Kapner and Chinni. P&G brand Gillette embraced that expectation with ads questioning toxic masculinity, including a recent one in which a transgender man learned to shave from his father—with a Gillette razor, of course.

Calif. governor blocks new fracking projects pending review

California Gov. Gavin Newsom announced Tuesday that he would not approve any new hydraulic fracturing projects in the state until an independent panel of scientists reviews the permits. "Newsom also imposed a moratorium on new permits for steam-injected oil drilling, another extraction method opposed by environmentalists that was linked to a massive petroleum spill in Kern County over the summer," Phil Willon reports for the Los Angeles Times.

Newsom said extractive industries need scrutiny as the state decreases its reliance on fossil fuels in favor of renewable sources. "This transition cannot happen overnight; it must advance in a deliberate way to protect people, our environment, and our economy," Newsom said in a statement.

In addition to the fracking halt, Newsom plans to consider adopting buffer zones around oil wells in or near residential areas, hospitals, and other places that could exposed to toxic fumes, Willon reports.

"The actions come just weeks after Newsom signed a bill into law revising the primary mission of a state agency that regulates the oil industry, now called the Geologic Energy Management Division, to include protecting public health and safety and environmental quality," Willon reports. "Citing similar safety concerns, Newsom also called Monday for the California Public Utilities Commission to expedite planning for the permanent closure of the Aliso Canyon natural gas storage facility in Porter Ranch. Thousands of families in the northwest San Fernando Valley were forced to evacuate starting in 2015 because of a broken well at the facility that led to the largest known release of methane gas in U.S. history. Residents reported suffering from nausea, headaches and nosebleeds, among other ailments."

Anti-abortion crisis pregnancy centers seek to fill rural maternity care gap

As more and more rural hospitals close or shutter their obstetric wards, rural women often find themselves with few choices for local maternity care. Faith-based crisis pregnancy centers are increasingly presenting themselves as a source for medical care and counseling, Eliza Griswold reports for The New Yorker. Though CPCs often provide practical advice on breastfeeding and government aid, they often use misleading tactics to steer women away from abortion.

CPCs first rose to prominence in the late 1960s as states considered legalizing abortion. CPC owners were provided with pamphlets and other materials, many featuring gory images of aborted fetuses, meant to dissuade women from choosing abortion. "CPCs employed various deceptive techniques to attract women, often advertising themselves as abortion providers. Centers were sometimes established next to abortion clinics and were designed to resemble them," Griswold reports.

After a wave of lawsuits and a 1991 congressional investigation that condemned their tactics, anti-abortion organizations Heartbeat International and Care Net standardized the training and materials for CPCs and presented them as places that offered women medical advice and support. The federal government awarded CPCs millions to teach students abstinence-only sex ed programs in the early 2000's, though such programs have not proven very successful. "In the past decade, CPCs, which are at the forefront of the grassroots anti-abortion movement, have identified a new sense of mission and authority as rural health-care providers have struggled with a lack of funding," Griswold reports.

However, CPCs still often use deceptive tactics to persuade women not to abort. NARAL Pro-Choice America did an undercover investigation last year of 45 CPCs in California and found that CPC employees frequently presented misleading or false information about abortion, claiming that abortion was linked to breast cancer, infertility and miscarriage, for example. However, most women don't go to a CPC for advice about abortion. "These days, as few as four percent of the women who visit CPCs are pregnant and undecided about whether to have an abortion. Most come for social services, including the pregnancy verification required to sign up for maternal and infant Medicaid," Griswold reports.

Local news site finds people who are willing to pay, not just visit, want accountability journalism and 'Civics 101 content'

One of the biggest questions in the news business right now is how to bring in more revenue to pay for journalism. Digital subscriptions enforced by paywalls have become common at larger papers, but less so at smaller ones and online local-news sites. But they can work there, too, if the online Shawnee Mission Post in Kansas is any indication, Christine Schmidt reports for Harvard University's Nieman Lab.

The Post, in the Kansas City exurb of Prairie Village, has three full-time employees: husband and wife Jay Senter and Julia Westhoff, and reporter Leah Wankum; a fourth full-timer will join in January. It has been in business for nine years and has had a paywall for two. "Within three months it "had hit the milestone of 1,000 subscribers at $5.95 per month — the goal Senter had set for its first year," Schmidt reports.

Senter told Schmidt, “We started to look at what was converting people who just visited the page to people who wanted to pay us. The accountability journalism, the Civics 101 content we put out there — that was the kind of stuff that seemed to get people over the hump and giving us money every month. … Things that were on the fires-and-car-accident side of things would get a lot of page views, but didn’t seem to have lasting impact on the way that people live their lives around here.”

Schmidt reports, "More civic-info coverage replaced restaurant closures and car crashes, and the Post has now grown to 2,650 fully paying subscribers. That’s an annual run rate of nearly $190,000. The Post hasn’t tweaked its subscription price much since introducing it — though the first month is now 99 cents — and a 430-respondent subscriber satisfaction survey in January showed that a broad majority is happy with the value that the subscription provided."

Westhoff said many small publishers don't understand the value of their work to the community and don't push locals to acknowledge that. "For us, [introducing the paywall] was at the breaking point of 'We’re going to do this or we’re going to be done'," she told Schmidt. "We are really grateful that it did work out. For us, after having doing the site for seven years, that needed to happen."

Now the publishers "plan to trim their emphasis on advertising next year," Schmidt writes. Because subscription revenue has proven so reliable, the paper will cut the number of display ads by 20 percent next year. "The prices for the remaining ad slots will rise, but the user experience (which will be the same for subscribers and non-subscribers) should improve."

The plan is sensible, she opines: "Business models are different for different markets (and not all local models work in all local markets), but if The New York Times is seeing its digital advertising dip, advertising may not be the boat that a smaller outlet wants to tie itself to."

South Dakota anti-meth ad campaign widely mocked, but governor says it's doing its job by getting people's attention

Part of the ad campaign

South Dakota is getting a lot of attention for a new ad campaign to raise awareness of the state's methamphetamine problem—likely not in the way state officials wanted. The campaign has been widely mocked for making it sound as if meth use is a good thing, Michael Brice-Saddler reports for The Washington Post.

Gov. Kristi L. Noem unveiled the "Meth. We're On It." awareness initiative on Monday, which includes a TV ad, billboards, posters, and a website; an accompanying news release highlighted the fact that meth use among South Dakota teens is double the national average, Liza Kaczke reports for the Argus Leader in Sioux Falls.

"But Bill Pearce, assistant dean at the University of California at Berkeley’s Haas School of Business, said any sincere messaging by the governor was lost by an ad campaign that embodies 'poor strategy and poor execution,'" Brice-Saddler reports. "I can’t imagine this is what they intended to do; any good marketer would look at this and say: 'Yeah, let’s not do that.' . . . I’m sure South Dakota residents don’t like being laughed at. That’s what’s happening right now."

The state's Department of Social Services has paid Minneapolis ad agency Broadhead Co. nearly $450,000 for the campaign. The contract allows for up to $1.4 million in payments. Social media immediately blew up with posts and tweets mocking the ads, but Noem declared the campaign a success because she believed it's fulfilling its mission of raising awareness, Kaczke reports.

Noem "might have added that the campaign only continues a tradition of weird South Dakota marketing," Nat Ives writes for The Wall Street Journal. "It follows a campaign seeking long-term residents that set a pretty low bar (“Why die on Mars when you can live in South Dakota?”) and a safe-driving push themed “Don’t Jerk and Drive.” The state canceled that one after complaints."

Love the campaign or hate it, but one thing's for sure: a lot more people are talking about South Dakota's meth problem this week than last week.

Navajo and Hopi tribes scramble to find new revenue after closure of coal-fired power plant, largest in Western U.S.

Navajo Generating Station employee Alex Tsinnjinnie
at work. (AZ Republic photo by Mark Henle)

The Navajo Generating Station, the largest coal-fired power plant in the West, stopped making electricity Monday after 45 years, Ryan Randazzo and Shondlin Silversmith report for The Arizona Republic.

The 2,250-megawatt plant's closure is a deep blow to the economies of Native American tribes. The plant is in Page, Ariz. (pop. 7,247), on Navajo Nation land and most of the employees were Navajo or Hopi. Plant jobs paid much better than most other jobs nearby, and revenue, taxes and royalties from coal made up most of the Hopi budget and a third of the Navajo operating budget, Laurel Morales reports for Arizona State University's Cronkite News. 

Hopi Chairman Timothy Nuvangyaoma estimated that as much as 85 percent of his tribe's general fund budget will be affected by the closure, at least a $12 million revenue loss. Navajo leaders estimated at $30 million to $50 million decline in coal revenues for 2020, Randazzo and Silversmith report. Leaders for both tribes are considering ways to make up the shortfall, including mineral and land development, casinos, renewable energy ventures, and tourism.

The plant had been problematic for years because of the pollution it generated. In 2014, the Environmental Protection Agency struck a deal with the plant's owners to keep it running at two-thirds capacity. Then area utilities voted to close the plant two years ago; they co-own the plant with the U.S. Bureau of Reclamation. The owners, along with the Navajo and Hopi tribes, tried to keep the plant running, but Arizona's federal Salt River Project, which owns the largest share of the plant, announced a year ago it would close the plant if a buyer could not be found. CEO Mike Hummel said the station was closing because it's cheaper to produce electricity from natural gas and renewable energy sources and easier to comply with air-quality regulations, Randazzo and Shondlin report.

Before operations began winding down two years ago, the plant employed 750 people, nearly all Native Americans. Most of the miners have been laid off, though some will work on reclaiming the land. Most plant workers have transferred to new Salt River Project jobs, many in Phoenix—a four-hour drive away. Some plant workers turned down the SRP jobs because they didn't want to leave their communities, Morales reports.

Report: more than 2 million Americans lack clean water

More than two million Americans lack access to clean water, according to a new report by clean-water advocacy non-profits DigDeep and the U.S. Water Alliance. The U.S. doesn't have a reliable, central data source to track how many Americans lack access to water and sanitation, according to the report. So DigDeep founder George McGraw commissioned experts from around the country to piece together the data.

The problem disproportionately affects rural residents, especially Native Americans on reservations, and those in substandard housing, the report found. Because African American and Latinx populations are more likely to live in substandard housing, they're disproportionately affected too.

Moreover, states and local or tribal governments are increasingly on the hook to pay for water system improvements. "Today federal funding for water infrastructure is a small percentage of what it once was. Across the country, 44 million people are served by water systems that recently had Safe Drinking Water Act violations," Lauren Morales reports for NPR.

Native Americans are the worst off, according to the report. Out of every 1,000 Native American households, 58 lack plumbing, compared with three of every 1,000 white households, Morales reports. Navajo Darlene Yazzie said she has to drive nine miles away to access fresh water, and the price is going up soon. She has a windmill-powered well, but the well is dry when the wind isn't blowing, she told Morales. "Yazzie said the windmill water isn't safe for humans anyway. Officials told her arsenic and uranium levels are too high. Yazzie and many others give the water to their animals, even though they plan to eat them," Morales reports. But it's often prohibitively expensive to build water pipelines to remote tribal nations in the Southwest: the Indian Health Service estimated it would cost $200 million to provide basic water and sanitation access to the Navajo Nation.

The problem isn't limited to reservations. Martin County in rural Eastern Kentucky has gained national attention because its water system is so terrible. Things got so bad there that state regulators ordered the water district to sign a contract giving control to outside management by tomorrow or face serious financial penalties. "State regulators placed the blame squarely on the district’s past and current management, saying officials made 'little to no effort to repair and replace aging infrastructure in order to maintain an adequate level of service to its ratepayers,' failed to keep adequate financial records, and failed to hire a permanent general manager," Will Wright reports for the Lexington Herald-Leader.

Local foundation buying only newspaper in wealthy D.C.-area county to save it after investors' $2 million falls short

Fauquier County, Virginia (Wikipedia)

"In a last-ditch effort to save the county’s only newspaper, the owners of The Fauquier Times essentially have agreed to give the weekly to a journalism foundation," Don Del Rosso reports for Fauquier Now, an online news site in the Virginia county, which is in the Washington, D.C., metro area and is "one of the fastest-growing and highest-income counties" in the U.S., Wikipedia says.

The Times, The Prince William Times, some specialty magazines and Piedmont Media websites are being sold for $1,000 to the Piedmont Journalism Foundation, headed by Boisfeuillet “Bo” Jones Jr., former publisher and CEO of The Washington Post.

The nonprofit status will allow the newspapers to accept tax-deductible contributions, said Landon Butler, "who helped manage Piedmont Media and headed its board," Del Rosso reports. The foundation’s other board members are attorney Georgia Herbert of The Plains, a Fauquier town, and Jessica Tuchman Matthews, former head of the Carnegie Endowment for International Peace.

"The foundation will support the company and local journalism, explained Mr. Jones, noting it funded and provided at no cost to Piedmont Media in-depth stories on rural broadband and the opioid crisis," Del Rosso writes. "The foundation also shared the opioid-crisis series with Fauquier Now."

Piedmont Media's 45 stockholders had bought the papers from Peter Arundel and put about $2 million into the company over the last three years, "according to sources," Del Rosso reports. "Warrenton resident Les Cheek, who bought 15 shares at $1,000 apiece, got the news in a phone call last Thursday from Piedmont Media LLC board member Trevor Potter," who summarized a memo that said “the headwinds for print journalism are very strong in a negative direction,” Cheek said. “And, that basically the investors and managers had basically exhausted their capacity to raise any more funds for the paper in its current business model.”

Attention must be paid: Rural journalists attend workshop on covering substance abuse and recovery, confronting stigma

"His name was never in the paper. He’s not the finest character that ever lived. But he’s a human being, and a terrible thing is happening to him. So attention must be paid. He’s not to be allowed to fall into his grave like an old dog. Attention, attention must be finally paid to such a person."
–Linda Loman, speaking of husband Willy, title character in "Death of A Salesman" by Arthur Miller

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

Many human beings are suffering terrible things in America today, and not enough attention is paid to them. They are the victims of substance-use disorder, or addiction. Too many of their fellow human beings – their neighbors, even their relatives – don't want to pay attention. "Not my problem," they say. Even when someone dies of an overdose, some say "Better off dead."

Quotes like that were gathered by Jennifer Reynolds and Kristin Mattson of Oak Ridge Associated Universities for their study that showed how the stigma attached to drug use is a big obstacle to addressing the problem in Appalachian communities. It's also an obstacle to news coverage of the issue, so we brought journalists in the region to Ashland, Ky., Nov. 15 for a workshop, "Covering Substance Abuse and Recovery." This is a summary; more detailed reports will follow.

We made sure to include "recovery" in the title to emphasize that there is hope for recovery, and that stories of recovery need to be told, to encourage those who need treatment for substance-use disorder to get it. Reynolds noted a Johns Hopkins University poll that found 30 percent of Americans said recovery from mental illness or drug addiction is impossible, and 50 percent said they would be uncomfortable being friends with someone in treatment.

Kriston Mattson, right, listens as Jennifer Reynolds discusses
their research on stigma's effects on addressing opioid abuse.

"Stigma keeps people out of treatment, and stigma keeps people from getting recovery support," Reynolds told the journalists. She said people who have been in recovery for years are still called junkies or addicts and can't find work, and "A lot of them cited unbalanced media reports as a significant contributor to stigma."

Contrary to the belief of many, she said, addiction is not a result of "weak moral character," but is the result of genetic, community, economic and societal factors. About half of the predisposition to addiction is genetic, but that still isn't completely understood, said Dr. Matt Christiansen of the Marshall University medical school in nearby Huntington, W.Va.

Other factors include adverse childhood experiences, social determinants, parenting and peer pressure, Christiansen said, adding that "Addiction is primarily rooted in trauma," both mental and physical, such as sexual abuse, other forms of abuse and the use of pain medications after surgery.

Even the experts' favored method of addiction treatment, medication-assisted therapy, suffers from stigma applied by people who call it "trading one drug for another," said Dr. David Wolfe and Kelly Whitley of Huntington-based Valley Health Systems. "It's not just the medication," but weekly groups, biweekly individual therapy, blood and urine tests, and medication checks, Wolfe said.

Wolfe and Whitley discussed the many barriers to treatment and recovery, including things that complicate recovery: lack of effective treatment in many rural areas; many rural doctors who could be prescribing MAT but don't, some because of stigma; lack of transportation; shortage of mental-health professionals (mental illness and substance abuse are co-occurring problems, and one can contribute to the other); and personal and professional responsibilities. "Most employers won't let you leave for a couple of hours once a week" for group therapy, Whitley said.

Jacqueline Pitts of the Kentucky Chamber of Commerce, which has tackled the problem in a way that no other state chamber has, said many employers are no longer dismissing employees for failing drug tests, but working to get and keep them in recovery: "I think the stigma is slowly changing."

Pitts said the opioid epidemic is having a significant effect on employers and the economy, and could account for 20 to 25 percent of the lack of workforce participation by Kentuckians. She said the problem isn't defined by any socioeconomic class: "It's people we all know."

Reporting

The workshop began with Eric Eyre of the Charleston Gazette-Mail discussing his Pulitzer Prize-winning investigation of how drug companies funneled vast amounts of opioid pills to small towns in West Virginia, and how his paper and others forced the Drug Enforcement Administration to release the information, including a recent release of data through 2014. "There's an incredible amount of data here, and it's easily accessible," Eyre told the group.

Beth Macy

The keynote speaker was Beth Macy, author of Dopesick: Dealers, Doctors and the Drug Company that Addicted America, recently issued in paperback. She said that after she signed the deal for the book, one editor told her "Your job is to make readers care," and another said "Your job is to impose hope and order to a sad and chaotic story."

The former Roanoke Times reporter said only 20 percent of people with substance-use disorder have access to medication-assisted treatment, so "We've largely left it to the institution of the American family to deal with the worst public-health epidemic in the history of our nation."

Macy, who is teaching in New York and participated in the workshop via GoToWebinar, said the best way to start finding and telling the stories of addiction and recovery is to, as public TV's Mr. Rogers said, "Find the helpers."

She said many relatives and friends of overdose victims aren't willing to talk soon after the tragedy, but putting their names in a "later" file can be a good investment. As moderator, I suggested that journalists watch for deaths that appear to have been caused by overdoses, and make regular checks with coroners; also, families that publish frank obituaries about losing a loved one to addiction can be approached immediately.

Terry DeMio, lead reporter on the Cincinnati Enquirer's Pulitzer-winning "Seven Days of Heroin" series, followed Macy. She has been on the heroin beat for more than five years, and told the journalists, "Some of the best reporting is from the ground up," in homes and neighborhoods. She said some call her an advocate, but she is not: "I'm a reporter. . . . I'm a reporter who carries naloxone," the drug that reverses overdoses.

Deborah Yetter, health and social-services reporter for the Louisville Courier Journal, said in-person contact is better than the telephone, and suggested one conversation starter for people in recovery: "The one thing they always know is . . . the day they got sober."

Yetter said she follows experts' advice to to avoid attributing individual traits to general populations, by work in general information about the topic. She said long stories work: "Readers have told us they stick through to the end because they want to see what happened to this person."

Finally, Yetter said, when it comes to writing about substance abuse, don't forget about tobacco and electronic cigarettes. She said she learned form teenagers how e-cigarettes have become epidemic in high schools.

Sharon Burton displays the first edition of her rural weekly.

The rural journalist on the program was Sharon Burton, editor and publisher of the Adair County Community Voice in Columbia, Ky., which appears to have done more in-depth coverage of drugs and recovery than any rural weekly in the nation -- starting with the first edition of her paper 17 years ago this month.

Burton said she grants anonymity to subjects only "when people are talking about their loved ones," and "I'm not doing stories on people who are in recovery for a short time. That puts pressure on them . . . especially in a small community."

She said that after her recent series on "The Cost of Addiction," she was invited to an Al-Anon meeting and a Celebrate Recovery meeting, but wasn't invited to a pastors' meeting with subjects of those stories. She said the organizer told her that he wasn't ready for publicity, and that "God had put it on his heart to call pastors together and pray." As a Christian, she said, "It really took a lot of weight off my shoulders."

Earlier, she said, "I'm a fixer. . . . I was really getting frustrated." In conclusion, she said, "The government's not gonna fix this. . . . I'm optimistic because I think I see lights of hope."

Ohio farmers support new state program to reduce fertilizer runoff into Lake Erie that causes toxic algae blooms

A July 30, 2019, satellite photo of Maumee Bay shows a toxic
algae bloom at the western end of Lake Erie. (NASA photo)

"Ohio farmers say they're on board with the state's plans to slow agricultural runoff into Lake Erie, which Gov. Mike DeWine has said is the biggest contributor to toxic algae blooms," Karen Kasler reports for the Statehouse News Bureau, which reports on state government and statewide issues.

Much of the $172 million allocated by the new "H2Ohio" fund will cover startup costs for farmers who agree to start using certain science-based practices that will reduce phosphorus runoff, including soil testing, crop rotation, using cover crops, and allowing buffers at the edge of fields, Kasler reports.

The program is notable because farmers and other agribusiness interests like the Ohio Farm Bureau, which tend to oppose government intervention into agricultural practices, are joining environmental activists and conservationists in supporting the plan. "Farmers had pushed back on an attempt to toughen regulations on agriculture in an executive order from former Gov. John Kasich last year," Kasler reports. "That led to Kasich's decision to fire Agriculture Director David Daniels just before Kasich left office."

Scott Higgins, CEO of the Ohio Dairy Producers Association, said this program is different. "By recognizing the needs to have the financial support to implement some of those best management practices, we now have a much better chance of even coming close to achieving the stated goal that the state of Ohio has set," Higgins told Kasler.

Nonprofit tests voting machines in rural Mississippi it says are more secure and cheaper than many certified systems

Choctaw County, Mississippi
(Wikipedia map)

Amid nationwide fears about election security, a nonprofit is trying to find a better, cheaper way to record votes, and it appeared to do well in its first trial run in rural Mississippi earlier this month, Jessica Huseman reports for ProPublica.

Improving election security is a pressing problem. It's well-known that Russia targeted election systems in all 50 states in the 2016 election, and though states have spent millions on new voting systems, many of the new electronic systems are still vulnerable to hacking because they rely on outdated software.

Mississippi is "one of only a few states in the country to allow the use of voting machines that have not been certified by federal authorities, and the state has no certification process of its own," Huseman reports. The lack of regulation makes it easier to innovate, according to VotingWorks, a new, nonpartisan nonprofit that makes voting machines.

VotingWorks founders Ben Adida and Matt Pasternack say their machines improve security by reintroducing the use of paper, so there's a record of each vote. Also, the machines are inexpensive to make, easy to fix, and easy to set up and take down, they say, which they hope will help reduce often long lines for voters, Huseman reports.

Voters in Choctaw County, population 8,547, were the first to use VotingWorks machines; voters in a single precinct used them during the primary this year, then during a retirees' potluck lunch. County election commissioners "enthusiastically" allowed the company to use the machines all over the county on Nov. 5, Huseman reports. By all reports, things went smoothly; poll workers and voters said voting on the machines was easy and that the machines produced an accurate vote count.

"Adida and Pasternack recognize that there is justified trepidation around proceeding with machines that haven’t been formally certified, but they said that they are confident that their process will result in a more secure, affordable and user-friendly machine," Huseman reports.

David Becker, executive director of the Center for Election Innovation and Research, told Huesman, “Certification can be a double-edged sword . . . "On the one hand, we want and need minimum standards for access and integrity in our voting machines. But on the other hand, certification can be a significant barrier to innovation."

ER telemedicine defines growing rural-urban health gap

Dr. Kelly Rhone with a map of hospitals using Avera eCare. (Photo by Michael S. Williamson, The Washington Post)

"If anything defines the growing health gap between rural and urban America, it’s the rise of emergency telemedicine in the poorest, sickest, and most remote parts of the country, where the choice is increasingly to have a doctor on screen or no doctor at all," Eli Saslow reports for The Washington Post.

Avera eCare Services is a major telemedicine provider; the Sioux Falls, S.D., office "provides remote emergency care for 179 hospitals across 30 states. Physicians for Avera eCare work out of high-tech cubicles instead of exam rooms," Saslow reports. "They wear scrubs to look the part of traditional doctors on camera, even though they never directly see or touch their patients. They respond to more than 15,000 emergencies each year by using remote-controlled cameras and computer screens at what has become rural America’s busiest emergency room, which is in fact a virtual ER located in a suburban industrial park."

Telemedicine is one answer to a growing problem. The number of rural ER patients has increased by 60 percent in the past decade, but rural doctors and hospitals have declined by up to 15%, and many hospitals and standalone ERs are on the brink of bankruptcy, Saslow reports. Access to telemedicine actually helps retain rural doctors, too, since it gives them more support and time off to recharge.

Hooking up to telemedicine can be expensive, though. The standard subscription rate for Avera is about $70,000 a year, and the hospital must be outfitted with fiber-optic cables, cameras, and microphones. Beyond that, the hospital must have (and pay for) broadband access, Saslow reports.

More rural counties say they're 2nd Amendment sanctuaries

Upshur County, Texas (Wikipedia map)

In the past year, dozens of mostly rural and Republican-majority counties across the U.S. have declared themselves Second Amendment sanctuaries, a mostly symbolic affirmation of citizens' right to bear arms that rejects state "red flag" laws that allow law enforcement to confiscate firearms if a gun owner displays threatening behavior. In a sanctuary city or county, local officials say they generally won't ask law officers to enforce gun-control laws, Robert Grant reports for WVLT-TV in Knoxville.

"We don't want our Second Amendment rights to be stripped away from us,"David Campbell, vice chairman of the Effingham County Board, told CNN shortly after the Illinois county passed its sanctuary resolution. "If we protect immigrants with sanctuary cities, why not use similar laws to protect our rights to own a gun?"
Upshur County, Texas, pop. 39,309, became one of the latest to declare itself a Second Amendment sanctuary county last Friday, Ken Hedler reports for the Longview News-Journal. It's the ninth Texas county out of 254 to make the declaration. In Texas, the recent uptick in such declarations could be attributed to threats by Democratic presidential candidates (especially Texan Beto O'Rourke) to impose stricter limits on some firearms.

"It is a symbolic gesture to show the state Legislature we think we ought to be able to protect our Second Amendment rights," County Judge Todd Tefteller said after the 5-0 vote. "It’s more like sending a message, but I don’t have any fear in losing my constitutional rights."