Poverty grows despite stimulus package; many fall through the cracks and are ineligible for such aid

"Even as average personal incomes rose during the pandemic largely because of government aid, millions of people who didn’t receive such help have fallen into poverty, struggling to pay for food and other basic expenses," Tim Henderson reports for Stateline. "That group, trying to get by with the help of local charities, may have been excluded from the federal payments because of immigration status, lack of time in the labor force needed to claim unemployment benefits, or just red tape in states that have been slow to pay jobless claims." 

The economic stimulus package Congress passed in December has more help for families with mixed immigration status, since those families were excluded from previous stimulus payments. "Immigrants are a large share of the people not receiving aid. Others include people with criminal convictions, new graduates without a work history, and people who have experienced gaps in employment," Henderson reports.

Unemployment payments helped bolster average personal income, a figure that was higher in almost all states in the third quarter of 2020 compared to the year before. "But at the same time, poverty rose more than 2 points nationwide between June and November to 11.7 percent, the fastest jump in history, according to a study by the University of Chicago and the University of Notre Dame. The largest increase previously recorded was 1.3 points between 1979 and 1980, during a deep recession caused by a spike in oil prices," Henderson reports. "The recent increase of 7.8 million more people in poverty hit minorities and those without a college education the hardest, along with residents of states with less effective unemployment systems, said Bruce Meyer, a co-author of the study and University of Chicago professor of public policy."

The unemployment rate declined from 14.7% in April to 6.7% in November, but low-wage restaurant and hospitality jobs have been particularly hard-hit and are still struggling. Several groups are calling for more help for workers who are excluded from typical unemployment benefits, including immigrants or recent graduates "who haven’t built up enough time in the labor force to qualify, and therefore the supplemental payments," Henderson reports. But state revenues have declined during the pandemic, so it may be difficult to pay for such unemployment benefits, which are financed by fees on employers.

Economy drops 140,000 jobs in December

"The economy shed 140,000 jobs in December, a clear indication that the pandemic’s chokehold on economic activity strengthened in the final weeks of last year," Martha C. White reports for NBC News. "In the final jobs report of 2020, Friday’s monthly employment snapshot from the Bureau of Labor Statistics shows a labor market teetering on the brink at the end of a tumultuous year."

The unemployment rate held steady at 6.7 percent; it should be noted that figure only includes people who have actively sought work within the past four weeks; those who become discouraged and leave the labor force don't count. The unemployment rate "really hides the drop in active populations of people [who] have stopped looking for a job, because they know in their sector there might not be any jobs," Ludovic Subran, chief economist at Allianz SE, told White.

"Economists say the numbers lay bare the struggles facing American workers, and represent a mandate for President-elect Joe Biden's administration to accomplish two things: Address the immediate financial needs of these households, and develop a longer-term solution that fosters job growth and protects the workers most vulnerable to disenfranchisement," White reports. "Economists had predicted that worsening Covid-19 infection rates in the winter months could damage economic recovery, even as the promise of a vaccine has spurred hope on Wall Street and propelled the stock market to record highs. President Donald Trump has treated the stock market as a barometer of his term and a proxy for success. Observers predict that Biden will view the nation’s economic health through a markedly different lens."

Though a Democrat-dominated White House and Congress likely means more generous stimulus legislation, economists and business leaders agree that Americans need more than checks. Shovel-ready government projects that need workers could help in much the same way the Works Progress Administration did during FDR's presidency. "One obvious entry point with the potential to draw bipartisan support is infrastructure investment, since years of kicking the can down the road have left roads, railways and bridges around the nation in need of repair," White reports.

USDA report provides an overview of the coronavirus pandemic's impact on rural America

Cumulative confirmed coronavirus cases per 100,000 residents by county on Dec. 7, 2020
(USDA map; click the image to enlarge it.)

Rural Americans have suffered economically and physically because of the coronavirus pandemic, but in some ways have fared better than city-dwellers, according to a new U.S. Department of Agriculture report about the effect of the pandemic on rural America.

Though the virus at first spread most rapidly in large cities, the rural share of Covid-19 cases and deaths increased markedly in the fall of 2020, and in November the rural infection rate passed up the urban rate. 

"By Dec. 7, the regions with the highest prevalence of Covid-19 cases included much of the Great Plains, the upper Midwest, and the Mountain West (especially the northern parts of these regions), and large parts of the South and Southwest," says the report. "Recent growth in Covid-19 prevalence has been especially rapid in the northern Great Plains and parts of the Upper Midwest and the Mountain West. Less affected areas generally include much of the Northeast, the West Coast, and Hawaii—though many exceptions are evident in these regions." Read more here.

Quick hits: online toolkit helps local governments get transportation grants; the effect of rurality on voters

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.

Rural local governments may be able to more easily access grant money for infrastructure projects through an online toolkit hosted by the Transportation Department.

Opinion: Satellite Starlink is better than nothing for rural broadband. Read more here.

Study: Rural hospitals without obstetricians need more training in emergency pregnancy care. Read more here.

Rurality itself had a distinct effect on votes in the presidential election. Read more here.

Rural fire chiefs talk about the need for more volunteers. Read more here.

Judges might sentence fewer people to prison if local governments had to pay for their prison stays. Read more here.

A new peer-reviewed paper shows that a cattle farm that practices regenerative grazing improved its soil and lowered its carbon footprint, but requires more land. Read more here.

Pandemic and vaccine roundup: Possible vaccine that needs only refrigeration would be a boon to rural America

Here's a roundup of some of the latest stories on the coronavirus pandemic and vaccine:

This article provides a good overview of the difficulties in vaccinating rural America and how they can be addressed. Read more here.

A new coronavirus vaccine in the late stages of testing could help rural residents get vaccinated, since it only requires refrigeration. Read more here.

Vaccine distribution is difficult in many rural areas. That's why one rural Michigan doctor has been making 140-mile round trips in his own car to deliver the vaccine to rural hospitals. Read more here.

Bold action is needed to support rural and tribal communities hardest hit by the pandemic, writes a former Obama administration advisor. Read more here.

The Moderna vaccine, which doesn't require ultra-cold freezers, has meant that rural residents in Alabama (and probably other states) can get vaccinated. Read more here.

Rural areas of Oklahoma have fewer resources to deal with a post-holiday coronavirus spike. Read more here.

The politicization of the pandemic has caused many rural health care workers to leave their jobs or leave their towns. Read more here.

NPR has created a tool that allows readers to see how full their local hospital and county overall are, though the dataset doesn't include all counties. Read more here.

Fact-checking what's been said about the Capitol riot

Rumors and misinformation are thick on the ground after yesterday's events at the Capitol (which leadership at The Associated Press says may be called a riot or insurrection). Here's fact-checking:

Before the riot, President Trump held a rally a mile and a half from the Capitol and gave a speech full of falsehoods about election fraud, FactCheck.org reports. Trump falsely claimed that Pennsylvania had 205,000 more ballots than it had voters. But that figure comes from a flawed, partisan analysis based on incomplete and inaccurate data, FactCheck reports. He made numerous other repeatedly debunked false claims about excessive, fraudulent and illegally counted ballots in Pennsylvania, Georgia and Arizona, which you can read about here. Trump also falsely claimed that Vice President Mike Pence could reject Electoral College results.

Trump encouraged his supporters at the rally to walk to the Capitol. The march soon turned destructive, leaving four people dead and forcing members of Congress, staff and journalists to flee as rioters broke windows, ransacked offices, and stole Capitol property.

Here is fact-checking on the siege from PolitiFact:

• Some commentators and legal experts have called the riot sedition. By federal law, sedition is when two or more people conspire to "overthrow, put down, or to destroy by force the Government of the United States … or to oppose by force the authority thereof, or by force to prevent, hinder, or delay the execution of any law of the United States, or by force to seize, take, or possess any property of the United States contrary to the authority thereof."
• Some Trump supporters claimed on social media that those who stormed the Capitol were antifa activists in disguise. But there's no evidence of that, and multiple videos and photographs taken on the scene feature well-known Trump supporters such as Jake Angeli. The Washington Post has a full-scale story knocking down that notion.
• Rep. Matt Gaetz (R-Fla.) said Trump "explicitly called for demonstrations and protests to be peaceful." Trump told his supporters "I know that everyone here will soon be marching over to the Capitol building to peacefully and patriotically make your voices heard." But Trump also said during his speech, "You'll never take back our country with weakness. You have to show strength and you have to be strong. We have come to demand that Congress do the right thing."

AP: Capitol event was riot or insurrection, not coup attempt

What happened at the U.S. Capitol Wednesday? A protest? A riot? A coup attempt? The choice of descriptions is important for journalists, and a memo from a John Daniszewski, vice president for standards at The Associated Press, provides valuable guidance. –Al Cross, director and professor, Institute for Rural Journalism and Community Issues

    

Colleagues,
    We are being questioned about the correct language to apply to the protesters backing President Donald Trump in Washington and the dramatic events taking place today at the U.S. Capitol.
    AP style in the event of civil disturbances allows editors and journalists to choose the term that in their judgment best applies. So far, our main story has spoken of a “chaotic protest aimed at thwarting a peaceful transfer of power,” a “melee” and a “raucous, out-of-control scene.”
    MOB, RIOT OR INSURRECTION OK: Considering that armed protesters broke into the building, overwhelmed Capitol police, interrupted the process of certifying Electoral College votes and forced the evacuation of the vice president of the United States and members of Congress, “protest” may be too mild a word for the action without surrounding it with strong adjectives and context, such as “violent protest” or “rioting protesters.” Calling it a “mob” or a “riot” would also be appropriate, especially when the protesters’ actions were wild, widespread, violent and uncontrolled. The term “insurrection,” meaning the act of rising up against established authority, could also be justified.
    NOT A COUP: Some people and broadcasters are calling the protesters’ action a “coup” or a “coup attempt,” meaning a sudden, organized seizure of political power or an attempt by a faction or group to seize political power suddenly outside of the law. We may of course quote others alleging a coup or attempted coup, but so far AP has not seen conclusive evidence that the protesters’ specific aim was to take over the government, so at this stage we are avoiding the term in AP copy unless attributed.
    As always, journalists should look at the events with an open and dispassionate mind and decide what language best applies. When in doubt, consult managers and senior news leadership.

New law aims to help local governments switch to more secure .gov URLs, including tech support and fee waivers

"Local governments are in line to get additional federal help shifting to web addresses that end in .gov under legislation that was part of the giant spending and coronavirus relief package President Trump signed into law at the end of the year," Bill Lucia reports for Route Fifty. "Many local governments around the country still rely on .com, .org or .us addresses. This can make it harder for online users to tell if they’re visiting an official government website, and it creates an opportunity for 'spoofing,' where bad actors create imposter sites."

Spoofing can create all kinds of problems for local governments, which are increasingly vulnerable to ransomware and hackers. "A fake government website might be used to point people to an incorrect polling place on election day, or it might falsely promise to register a person for a coronavirus vaccine appointment if they enter personal information, such as their Social Security number," Lucia writes.

The federal government administers access to the the .gov domain. Local government organizations can claim a .gov URL through the DotGov program for $400, but the cost can be a barrier for small governments, especially when it's far cheaper to buy URLs and hosting space elsewhere, Lucia reports. That's possibly why fewer than 10 percent of all eligible local governments have a .gov web address. Under the new law, the federal government may waive the fees. Also, local governments that move their websites to a .gov address will be eligible for federal grants to cover migration costs. 

The new law transfers oversight of the program from the General Services Administration to the Department of Homeland Security's Cybersecurity and Infrastructure Security Agency. It also calls on CISA "to develop an outreach strategy to support local governments in migrating to the .gov domain, and to provide technical information on how to make the switch," Lucia reports.

"It’s unlikely the URL will be a huge help when it comes to shielding localities against some of the serious cyberattacks they’ve faced in recent years, such as ransomware incidents. These episodes commonly arise from phishing, in which public employees are enticed to click on malicious links," Lucia reports. "But it would be possible for federal authorities to implement certain cybersecurity measures that would apply specifically to .gov websites, a potential benefit for local governments, especially those lacking information technology staff."

Mental-health advocates worry pandemic could drive rural suicide surge, especially among Native American teens

Mental-health advocates say they worry the pandemic may cause (or may already be causing) a spike in suicides in rural areas, especially among Native American teens on reservations. "In a typical year, Native American youth die by suicide at nearly twice the rate of their white peers in the U.S. Mental-health experts worry that the isolation and shutdowns caused by the Covid-19 pandemic could make things worse," Sara Reardon reports for Kaiser Health News.

Just as with rural areas in general, "poverty, high rates of substance abuse, limited health care and crowded households elevate both physical and mental-health risks for residents of reservations," Reardon reports. Suicide is often a taboo topic among Native Americans. But mental-health programs meant to address the topic among reservation residents are having difficulty operating during the pandemic because of social distancing and lack of broadband access. 

"For rural teenagers, in particular, the isolation caused by school closures and curtailed or canceled sports seasons can tax their mental health," Reardon reports. "Teen suicides tend to cluster, especially in rural areas. Every suicide triples the risk that a surviving loved one will follow suit."

Every person who dies by suicide has an average of six survivors. But in small tribal communities, that number is more like 25 to 30, according to Karl Rosston, suicide prevention coordinator for the Montana Department of Public Health and Human Services.

Covid death rate in December nearly double in rural areas compared to biggest cities; see county-level data

Deaths related to Covid-19 in rural counties in 2020
Daily Yonder map; click the image to enlarge it or click here for the interactive version.

"Rural counties helped lead the way in making December the pandemic’s deadliest month on record, ending the year with an emphatic reversal of the urban-focused manner in which the pandemic began in the U.S. in early 2020," Tim Murphy and Tim Marema report for The Daily Yonder. "More than 16,000 Covid-related deaths were reported in December in nonmetropolitan (rural) counties, about a fifth of the total 73,578 deaths that occurred in the U.S. last month."

Last year, 51,221 rural Americans died from Covid-related causes, and all but 10 of the 100 counties with the highest cumulative death rates were rural. December was the deadliest month on record, accounting for one-third of all coronavirus deaths in 2020. "In nearly 700 counties, the number of Covid-19 deaths doubled or worse during the month," Murphy and Marema report.

Click here for more data and analysis from the Yonder, including charts and interactive maps with county-level data.

Prioritizing prisoners for virus vaccine sparks controversy

As states decide how to roll out vaccines for the novel coronavirus, giving priority to prisoners has proved controversial. 

"The very nature of jails and prisons—people living in close quarters with restricted movement and limited options for social distancing—has made them more susceptible to the coronavirus than much of the rest of society,"  David Montgomery reports for Stateline. "But even though long-awaited vaccines are finally at hand, prisoner advocates fear that public antipathy toward inmates and politicians’ reluctance to make them a priority will delay or restrict the drugs’ arrival behind bars."

Prisons are seeing unusually high infection rates. "Approximately 20 percent of all inmates in state and federal prisons have been infected, a rate more than four times as high as that in the general population, according to a recent analysis by the Associated Press and the Marshall Project," Montgomery reports. "Nationwide, at least 275,000 prisoners have been infected and more than 1,700 have died, according to the report."

Prisons and jails have been a major vector of community coronavirus transmission, especially in rural areas where prisons tend to be located. That's because it's not just incarcerated people getting infected; prison and jail workers also often carry the virus back home with them, Montgomery reports.

Trump administration guts Migratory Bird Act, bars some studies from consideration in public-health rule-making

"With only two weeks left in office, the administration published a rule Tuesday that spares industries and individuals from prosecution or penalties under the Migratory Bird Treaty Act if their actions, such as development or failure to cover tar pits, results in bird deaths," Darryl Fears reports for The Washington Post. "If the deaths were unintentional, the U.S. Fish and Wildlife Service says in the rule, there will be no enforcement."

"The move, by the Department of the Interior, came a day after the Environmental Protection Agency finalized another regulation that had long been sought by fossil fuel companies and other major polluting industries: A measure that effectively bars some scientific studies from consideration when the agency is drafting public health rules," Lisa Friedman reports for The New York Times.

President-elect Joe Biden will likely overturn the policies, according to a senior official on the transition team who called the last-minute rollbacks an "unrelenting assault" on the environment, Friedman reports. However, reversing the measures won't be quick or easy. "In the case of the bird rule, conservationists and oil industry executives alike have said that was precisely what the Trump administration intended," Friedman reports. "The industry has long sought to be shielded from liability for killing birds unintentionally in oil spills, toxic waste ponds and other environmental disasters."

Survey: more Americans say they want to live in rural areas

"An increasing number of Americans would prefer to live in a town or rural area as opposed to a city or the suburbs, a new Gallup poll found," Andrea Noble reports for Route Fifty. "A survey taken last month found that, if given the choice to live anywhere, 17 percent of Americans would prefer to reside in a town and 31% would prefer to live in a rural area. That’s compared to results from a 2018 survey, that found 12% of Americans would like to live in a town and 27% would like to live in a rural area." 

City dwellers' desire to get away from crowded cities during the pandemic may be partly responsible for the increasing interest in rural living. Two-thirds of people recently surveyed said they'd consider moving to a rural area if pandemic work-from-home policies were permanently adopted, Noble reports.

The influx of new remote workers could help struggling local economies, but rural areas would have to ensure robust, affordable broadband availability to attract newcomers.

Teachers struggling with mental health during pandemic

"Since summer, experts have warned that the mental health of the nation’s teachers — a category dominated 3 to 1 by women — could suffer when school resumed. That prediction appears to be bearing out. Many say their psychological well-being is suffering in ways they’ve hardly ever experienced," Shefali Luthra reports for The 19th, a non-profit online newsroom that reports on gender and policy. "The burden is most acute for teachers who are mothers, and steering both their students and their own children through online learning." 

Rural school districts are more likely than their suburban and urban counterparts to hold in-person classes, but many have been forced to go to distance learning models because of rising Covid-19 cases. Some districts continue attempting to return to in-person classes but are then obliged to go back to distance learning after new cases arise, Luthra reports.

"Between the unpredictability, the isolation and the newfound challenges in reaching their students — who mental health experts worry are also struggling — what little mental health support is extended to teachers feels like nowhere near enough," Luthra reports. "Last August, the National Education Association, a major teachers union, found that 28 percent of educators said the pandemic made them more likely to leave teaching. A study from Louisiana tracked early childhood educators’ mental health last spring, finding that rates of depression almost doubled, with more than a third of those educators indicating depressive symptoms. In a survey run from August to September by the National Board for Professional Teaching Standards, the vast majority of teachers reported working longer hours, and only a quarter said their school offered adequate support for mental health." That level of stress is unsustainable, say mental-health researchers.

Urban hospitals could take severe rural Covid-19 patients by transferring less-acute patients to rural hospitals

Percent of hospitalized Covid-19 patients in rural
vs. urban hospitals in the U.S. (N.C. Rural Health
Research Program chart; click to enlarge)

A pair of new studies show that rural hospitals had slightly higher percentages of Covid-19 patients than urban hospitals in the last quarter of 2020, but that rural hospitals had a greater percentage of beds available than urban hospitals. The upshot: rural Covid-19 patients with severe cases may have a harder time being transferred to urban hospitals because of limited urban bed availability. But urban hospitals could free up some beds for very sick rural Covid-19 patients if rural hospitals accepted transfers of less-acute urban patients. The studies were conducted by the North Carolina Rural Health Research Program at the University of North Carolina at Chapel Hill. 

The percentage of Covid-19 hospital patients was 4 to 6 percentage points higher in rural areas than in urban hospitals in that time period, according to the first study, based on data from the Department of Health and Human Services. That raises concerns about rural hospitals' ability to continue operating efficiently. Rural and urban hospitals saw about the same percentage increase in Covid-19 patients over the last quarter of 2020, according to the second study (from 10% to 25% in rural hospitals and from 6% to 20% in urban hospitals).

The second report says the tighter bed restrictions in urban areas could limit rural residents’ ability to get advanced services if urban hospitals limit or reject transfer patients. Conversely, the greater percentage of open beds in rural hospitals could help urban hospitals expand capacity if rural hospitals accepted transfers of patients with less need for acute care. At least one state, Colorado, is already doing this.

One third of rural counties lack a pharmacy listed in coronavirus vaccination plan; more could be added

Nonmetropolitan county HHS vaccination partnership pharmacy availability
RUPRI Center for Rural Health Policy and Analysis map; click on the image to enlarge it.

Almost one-third of rural counties don't have a pharmacy partnered with a chain or network that's participating in the federal government's coronavirus vaccination program, according to a new study. 

"The study from the Rural Policy Research Institute's Center for Rural Health Policy and Analysis found that 750 of the 1,962 nonmetropolitan counties in the study do not have a pharmacy that is listed in the federal Health and Human Services vaccine distribution partnerships," Tim Marema reports for The Daily Yonder. "The combined population of those rural counties is about 5.6 million, according to the study, or about 13 percent of the rural population."

HHS said in November the vaccine will be distributed through chains such as Rite Aid, Walgreens, Kroger, Walmart, and independent pharmacy networks such as Good Neighbor Pharmacy, Marema reports. Such locations make up 60% of the pharmacies nationwide.

An HHS announcement said other regional chains and independent pharmacies could be added to increase access to underserved areas. However, even if all pharmacies that could provide vaccines were included in the plan (see below), 326 counties still wouldn't be able to distribute the vaccine that way, Marema reports. And 110 rural counties have no pharmacy at all. 

Nonmetropolitan county pharmacy vaccination service availability, including HHS partners and other pharmacies with immunization capability. (RUPRI Center for Rural Health Policy and Analysis map; click on the image to enlarge it.)

Mail delays, possible postal-rate hike threaten rural papers

Almost all rural newspapers are delivered by mail, and deliveries have slowed lately because of postal workers' pandemic illnesses, increased package volume, and systemic financial challenges to the U.S. Postal Service. The threat of postal-rate increases of 7 to 9 percent in 2021 and 2022 for publishers, as a result of a Postal Regulatory Commission decision in 2020, is adding to local publishers' anxieties.

"The U.S. Postal Service has been under siege for months as record volumes of holiday packages and election mail ran up against a spike in coronavirus cases within its workforce, leaving the agency severely short-staffed. Nearly 19,000 workers were in quarantine at the end of 2020 after becoming infected or exposed to the virus, according to the American Postal Workers Union," Jacob Bogage reports for The Washington Post. "That has left hundreds of small publishers struggling to deliver their products, according to the National Newspaper Association, undercutting their advertising revenues and subscriber bases, and depriving the largely rural communities they serve of crucial news coverage. Some news operations have even called on reporters and editors to deliver papers." NNA is the main lobby for U.S. community newspapers.

NNA Chair Brett Wesner, a publisher in Cordell, Okla., said in a press release that rural newspapers, like the Postal Service, are "fighting valiantly against enormous odds" to serve their communities. "There are paths to help us all and save our communities from the worst ravages of this era," Wesner said. "They all lead to Congress, which must address the need for funding universal mail service as it continues to examine financial backing for small businesses until the nation pulls out of this challenging time."

Democrats must acknowledge that red states have liberals pushing for change, writes author-journalist Silas House

Silas House

When Kentucky writer and journalist Silas House travels the country to promote his books, people often take out their anger at Sen. Mitch McConnell on him.  

"Time and again, I’ve been called out for his presence in the Senate—during Q&As in front of a thousand people and in whispers at the signing table after events. For all of these people, I was the living embodiment of every voter in the state who had betrayed them. I can’t blame them for hating McConnell. Hardly anyone has done more to impede our democracy, and empower Donald Trump, than him," House writes for The Atlantic. "I am ashamed of McConnell, but I am never ashamed to be a Kentuckian. My state is a complicated, beautiful place with a rich heritage and people who have contributed a huge amount to the American experiment. I will defend the state to all outsiders, even as I complain about its flaws."

House isn't the only red-state resident to face such criticism, he writes: "Sometimes it feels as though all citizens of red states are lumped together, as if everyone here, especially those in rural areas, is the same. In early December when McConnell shot down the $908 billion stimulus plan, Twitter lit up with hatred for Kentuckians." House was troubled not just by the vitriol, but by the way angry tweets painted Kentuckians as hicks, hillbillies, and other derogatory terms. 

"These volatile responses trouble me, not only because I don’t like being reduced to a stereotype, but also because that response feeds the GOP rhetoric I hear at home: The liberals just think you’re deplorable, so why not flex your muscle any way you can to spit in their faces?" House writes. 

He tells Atlantic readers something they may not know but need to: "Tens of thousands of us here in Kentucky are fighting for progressive causes, even as we are forced to defend ourselves against other liberals in the country who should be supporting us. I’m not organizing a pity party. Instead, I’m issuing a warning: Everyday Democrats need to see beyond the electoral map to acknowledge the folks pushing for liberal ideas even in the reddest of areas. If they don’t, the cultural divide will grow only wider."

Highways are critical for agriculture shipping, need more money and planning for upkeep, says USDA report

High-Volume Domestic Agriculture Highways, as identified by the report. Click the image to enlarge it.

A recent report from the Agriculture Department (with input from the Transportation Department) outlines 10 challenges and opportunities for stakeholders to maintain and improve U.S. highways and interstates that are critical to agricultural shipping.

The U.S. agriculture sector relies heavily on America's highway and interstate system; almost all agricultural freight trips include at least one highway leg. Because highway shipping is so cheap, transportation costs make up only 3% to 4% of overall U.S. agriculture costs. That helps the U.S. remain competitive on the global market with other nations that pay workers less and have lower production costs, the report says.

However, that edge is under threat. Other countries (like Brazil) are reducing their transportation costs, and U.S. freight volume is projected to increase nearly 25% over the next 20 years, according to the report. Moreover, the trucks that ship U.S. agricultural products are increasingly heavy, causing more wear and tear on roads.

Agriculture shipping is largely concentrated on a small number of roads, the report notes: 80% of domestic agricultural highway freight volume moves on 17% of the nation's highway mileage, dubbed High-Volume Domestic Agriculture Highways. Stakeholders must invest more in keeping these HVDAHs well-maintained, the report recommends. County and local governments must be consulted to ensure optimal planning. 

The rural transportation system has been crumbling in recent years as truck loads have increased, but many state and county governments have had a difficult time convincing citizens to support tax increases to pay for maintenance. A recent report from a non-profit supported by road-construction companies said rural roads face a $211 billion backlog in repairs. Rural local governments may be able to more easily access grant money for infrastructure projects through an online toolkit hosted by the Transportation Department.

Picture of U.S. health, especially in rural areas, is not rosy

By Trudy Lieberman, Community Health News Service 

For end-of-the-year columns, it’s customary to recap the events of the past 12 months, usually highlighting a mix of the good and the bad. Because this year has been dominated by health, in particular Covid-19, and my beat is health, it seems fitting to reflect on where we are. Where we are is not good. 

A headline in the Los Angeles Times seemed to sum up the current state of the U.S. health care system: “Bodies pile up, patient care falters as Covid-19 devastates L.A. County hospitals.” In the Times’ story a hospital critical care nurse says, “No one would believe this is the United States.” Indeed, they would not. 

A story from Wisconsin tells us that a hospital pharmacist deliberately destroyed some 500 doses of vaccine. No reason given, at least none the media have reported. This behavior, I dare say, would have been unheard of in 1947 when New York City managed to vaccinate five million people against smallpox in two weeks. 

At the end of 2020, the government’s goal of vaccinating 20 million people against Covid by the last day of December fell way short with only 2.7 million doses administered. In some ways that is hardly surprising, given how chaotic the whole Covid affair has been since the beginning. First, we failed to recognize how lethal the virus was; then we were slow to get testing up and running; next came problems with contact tracing because Americans were reluctant to cooperate. Lab results were delayed. Americans flouted the rules and advice to stay home, and on it went until we find our nation in a very unenviable position at the beginning of 2021. 

Yet the mythology surrounding our health-care system – that it is the best in the world – continues. This year has shown that America, contrary to its self-image, does not have the most effective and efficient health care system in the world. That’s a bitter pill for many Americans to swallow. 

At the end of December, a new study emerged in the journal JAMA Internal Medicine that further deflates America’s standing. It found that wealthy, white Americans generally have better health outcomes than the average U.S. citizen but generally worse outcomes than average citizens in other higher-income countries. In other words, the U.S. continues to spend gobs of money on health care but doesn’t necessarily get a healthier population for its expenditures. Not a lot of bang for the buck! 

Two pieces I wrote this year drove home that point for me. They showed the inadequacy of health care for too many rural Americans even in “normal” times when there’s no virus lurking among us. One woman from a sparsely populated county in central Nebraska recently wrote to tell me about the lack of in-network doctors available to people who join Medicare Advantage plans. Those plans require seniors to use network physicians to get benefits. If they don’t, the result is high out-of-pocket bills. 

If people in those sparsely populated regions don’t have doctors who pass muster with their insurance company, how many go without care? 

Another piece I wrote discussed federally qualified health centers, which serve many low-income communities across the country. Doctors at one such FQHC in western Nebraska serve 17 low-population counties, and patients drive many miles to see a doctor. Those doctors also report that they examine more patients for dental problems than for other medical issues. That speaks to lack of access to oral health care for way too many Americans; another health problem policymakers brush off. 

Although the pandemic has exposed serious flaws in America’s health care arrangements, maybe, just maybe, it will spark a serious national discussion about the kind of health system we want for everyone when the postmortem on Covid-19 is done. 

In the meantime, all of us will have to figure out how to get tested, get vaccinated, and stay safe without a lot of reliable information to guide us along the way. Because so much of the information from the federal government has been politicized, I turned to the website of Britain’s National Health Service www.nhs.uk, which I’ve visited and written about several times. 

It is a model of clarity and good information about Covid. For example, the advice for pregnant women and those thinking about becoming pregnant was the clearest I’ve seen. The website also tells visitors when it was last updated and when the next update will be. 

That website shows how much better America could be.

The Community Health News Service, originally the Rural Health News Service, has exhausted its funding and is ending after eight years of work by award-winning reporter/writer Trudy Lieberman. Facilitator Dennis Berens said in a farewell note, "We hope that all of the newspapers we have served will continue to provide solid, verified health information to their readers."

Study: rural neurologist shortage means less-specialized care for many patients; expanded telehealth could help

"A shortage of neurologists in rural parts of the United States means that people in those areas are less likely to receive specialized care for conditions such as stroke, dementia and back pain," Robert Preidt reports for HealthDay. That's according to a newly published study in the journal Neurology.

University of Michigan researchers reviewed one year of Medicare data and identified 2.1 million patients who visited a doctor for a neurological condition at least once during that time. Availability of neurologists ranged from a low of 10 for every 100,000 people to a high of 43 for every 100,000 people, Preidt reports.

"Overall, 24 percent of patients with a neurologic condition were seen by a neurologist, but rates varied from 21% in more rural areas to 27% in more urban areas with the most neurologists. Most of that difference involved patients with dementia, back pain and stroke," Preidt reports. "Among dementia patients, 38% of those in more rural areas saw a neurologist, compared to 47% in more urban areas. The rates for stroke patients were 21% and 31%, respectively." More than 80% of Parkinson's disease patients received care from a neurologist no matter where they lived, and the rate was similar for multiple sclerosis patients.

The study underlines the need to expand access to neurologists in rural areas, possibly through telehealth, said James Stevens, president of the American Academy of Neurology.

USDA wants to let more poultry plants speed up processing lines, despite evidence that has helped spread coronavirus

Washington Post chart; for a larger version, click on it.

"The Trump administration allowed 15 poultry plants to increase slaughter line speeds during the pandemic, an action that boosts production and makes it more difficult for workers to maintain space between one another. It also appears to have hastened the spread of the coronavirus," The Washington Post reports. "Now the outgoing administration is rushing to finalize a rule that would make the faster line speeds permanent and expand them to dozens of other poultry plants."

The 15 plants are "10 times as likely to have coronavirus cases than poultry plants without the line-speed waivers, according a Washington Post analysis of data collected by the nonprofit Food and Environment Reporting Network," Kimberly Kindy, Ted Mellnik and Arelis R. Hernández report. "The Post analysis mirrors academic research that shows more coronavirus cases in counties with plants that have waivers to raise line speeds." President-elect Joe Biden has opposed the waivers.

The U.S. Department of Agriculture "questioned the validity of the conclusions drawn from the research," the Post reports. "The department also said many plants slowed line speeds during the pandemic, causing it to further question a connection between slaughter speeds and coronavirus cases. When meat plants became hot spots in late March and April, local health departments began to shut them down, ordering testing, personal protective gear and social distancing. But the industry petitioned the federal government for help to keep plant doors open, and Trump said plant employees were 'essential workers'. . . . With the backing of the White House — and direct intervention by federal officials with local and state governments — meat plants with active coronavirus cases were able to reopen and remain open. Days after Trump lost his bid for reelection, the USDA sent a proposed regulation to allow all poultry plants to increase line speeds to the White House’s Office of Management and Budget, seeking its approval. The odds of it being finalized before Biden’s inauguration appear slim, experts say, but past administrations have used methods to successfully push through such last-minute proposals, often referred to as midnight regulations."

The USDA's Economic Research Service recently released an overview of the pandemic's effect on rural meatpacking plants. Read more here. 

New federal nutrition guides, which influence school lunches and food stamps, ignore experts' calls for less sugar, alcohol

New federal nutritional guidelines unveiled last week, which influence everything from school lunches and military rations to food stamps, ignored scientific advisers' calls to lower recommended sugar and alcohol intake. Agency officials said there wasn't enough evidence to advise stricter limits on sugar and alcohol, but emphasized that people should cut back on both.

"The updated guidelines are the first to include dietary advice for infants, toddlers and pregnant women," Ryan McCrimmon reports for Politico's Weekly Agriculture. "They also have a broader theme of encouraging consumers to “make every bite count” by choosing nutrient-rich foods and beverages, with five categories — fruits, vegetables, grains, dairy and protein — accounting for 85 percent of daily calories.

The Department of Agriculture and the Department for Health and Human Services have jointly released updated guidelines every five years since 1980. The federal government hired an independent panel of 20 doctors, nutritionists and public-health experts from major academic institutions to assist in creating the new guidelines. The Dietary Guidelines Advisory Committee "suggested the guidelines should take a harder line against added sugars, but USDA and HHS decided to keep the Obama-era advice that individuals try to not consume more than 10 percent of their calories from added sugars," Helena Bottemiller Evich reports for Politico. "The committee had recommended dropping the limit down even further to 6 percent."

The committee also "recommended in June that the guidelines should urge men to cut back on alcohol by reducing the government’s definition of 'moderate drinking' from two drinks per day to one. (At the time, the panel recommended keeping the definition of moderate drinking the same for women, at one drink per day.)," Evich reports. "Government officials ultimately decided to not adopt the stricter alcohol recommendation, which had sparked furious pushback and lobbying from the alcohol industry.

The dietary guidelines have long been a political football because of their influence over federal nutrition programs, Evich reports.

Del Rio lost its daily paper, then got a weekly, but with a publisher who has little long-term faith in the printed word

Val Verde County (Wikipedia map)

Val Verde County, Texas, has about 49,000 people, and for most of its colorful history (its Judge Roy Bean was "the law west of the Pecos") it had a daily newspaper – until April, when Southern Newspapers cut the Del Rio News-Herald's print schedule from five days to two, citing the pandemic. Then, on Nov. 18, the company published the paper's final edition, turning the county into one of the small but increasing number of "news deserts" that once had daily papers.

"The end of the News-Herald was swift for the staff and a shock to residents, who had somehow expected their newspaper to last forever," reports James Dobbins of The New York Times. "Enter Joel Langton, a 56-year-old military public-affairs veteran who decided to turn an online events website he had started into a 16-page, ad-supported weekly tabloid," The 830 Times, named for the area's telephone code and started a few months earlier as an online events website.

Langton hired two former News-Herald staffers to cover the news while keeping his day job at Laughlin Air Force Base. Karen Gleason told Dobbins, “The 830 Times is a leap of faith. I just want this paper to be a voice for the community, interesting and truthful stories about people in Del Rio.”

The 830 Times at Rudy’s Bar-B-Q, one of about 60 distribution

locations. (Photo by Christopher Lee for The New York Times)

Steven T. Webb, a former Del Rio police officer who won a City Council runoff election in December, "said the fact that only 12 percent of voters turned out in the general election was partly attributable to the News-Herald shutdown." He said social media and word of mouth are "the only way we get the news now."

Social media pose obstacles for The 830 Times. Noticias Del Rio TV, a bilingual Facebook page that also serves Ciudad Acuña, across the Rio Grande, has nearly 85,000 followers, Dobbins reports, while "The 830 Times so far has 3,000 followers. . . . The disparate numbers hint at the obstacles Mr. Langton faces in his push to make The 830 Times succeed in a world dominated by Google and Facebook advertising and competitors with Spanish-language appeal. . . . Langston concedes that his efforts to provide Del Rio with a newspaper it can hold in its hands are probably temporary. He believes the printed word is going extinct."

“Am I gambling on the print product? Yes. I could lose it all,” he told Dobbins. “I hate to tell you this, buddy, but in five or 10 years, newspapers won’t exist anymore.” Dobbins concludes: "He figures he has five years to prove himself wrong."

Local governments face budget challenges in the new year; city-dwellers moving to the country could help

States, cities and counties nationwide are facing budget challenges as the coronavirus pandemic continues to exact an economic toll. Rural areas will likely be forced to deal with the effects for years to come, but the crisis may provide an opportunity for some to address long-neglected problems.

The newly approved stimulus package "does not include a giant new slug of direct aid state and local advocates pushed for. But it will inject billions of dollars into the economy to help businesses and households, including $284 billion for a forgivable loan program to help small businesses cover payroll, a $300 increase to weekly unemployment benefits and $600 one-time payments to many Americans," Bill Lucia reports for Route Fifty. The "$900 billion relief legislation will also pour additional aid into areas linked to state and local government. For example, K-12 schools will receive $54 billion, higher education gets $22 billion, around $14 billion will be sent to struggling transit systems, and billions will be spent on various vaccine-related initiatives."

But state and local budgets will likely struggle at least until economic activity gets back to normal, which will be influenced by Covid-19 vaccination rates, Lucia reports. Areas and states that rely more on oil production and tourism are particularly hurting, as are lower-wage workers, Lucia reports.

"At the local level, it could be well into 2021 or later before the damage the virus has caused to budgets becomes clear," Lucia reports. "There are also questions about the lasting marks for some local economies—for instance, if downtown offices will lose tenants if remote work continues or if businesses like restaurants and venues, hobbled by the pandemic, will be able to rebound.

A recent report from the U.S. Department of Agriculture adds to a growing body of research showing that rural areas will be burdened by the effects of the virus — economic, medical and social — for many years to come," Adam Minter reports for Bloomberg. 

Before the pandemic, many rural areas that relied on tourism and recreation were thriving, especially those with public-private investments in existing assets like classic Main Street buildings, Minter reports. The pandemic halted much of that revitalization, but city-dwellers looking to move to the country could provide an influx of people, jobs and real-estate revenue. 

"Attracting long-term urban relocations would not only help sustain the progress made in creating vibrant rural commercial districts," Minter writes. "It could also renew pressure on Washington to address problems — such as a lack of quality health care or widespread broadband — that were plaguing rural America long before the pandemic. That could help create a virtuous circle, made all the more urgent by the pandemic."