Friday, November 19, 2021

What's in the Build Back Better bill for rural America

Today the House passed a $2 trillion social spending and climate bill 220-213, with all Republicans and one Democrat, Rep. Jared Golden of Maine, opposed. It goes to the Senate, where changes are likely to satisfy Democrats Joe Manchin of West Virginia and Kyrsten Sinema of Arizona. 

"The package retains most of its original major elements, including funding for clean energy, universal prekindergarten, subsidized child care, and billions more for health care, affordable housing and elder care," The Wall Street Journal reports. "Many of these programs are set to expire within several years, a deliberate effort to lower the package’s top-line price. Making the programs temporary as opposed to permanent also represents a bet by Democrats that future voters will vote for candidates who promise to renew them. The package would be financed by changes to the corporate tax code, including a new corporate minimum tax, while raising taxes on high-income individuals."

Here's some of what's in it that affects rural America:

  • $555 billion for climate, including "$320 billion in 10-year expanded tax credits for residential and utility-scale renewable energy, transmission, electric vehicles and clean-energy manufacturing; $105 billion to boost resilience to the effects of climate change, such as wildfires and droughts; $110 billion to grow U.S. supply chains for renewable energy technology; and $20 billion to motivate the government to purchase cutting-edge energy technologies," the WSJ reports.
  • $200 billion to extend the expanded child-tax credit through 2022.
  • About $200 billion for four weeks of paid parental, sick or caregiving leave, starting in 2024.
  • $150 billion for providing at-home medical care for seniors and disabled Americans.
  • $18 billion for "job-promoting investments to ensure those living in rural America, on tribal lands, and our insular areas have access to clean water and reliable and efficient renewable energy, says the Agriculture Department. "This funding will also support investment in renewable biofuels infrastructure important to farmers and our fight against climate change, and flexible funding for rural community growth." That includes $9.6 billion in debt relief for farmers and $1 billion for farmer loan modifications. It also includes more than $1.3 billion in assistance and support for underserved farmers, ranchers and foresters.
  • $2 billion for agricultural research and infrastructure. Click here for a detailed breakdown.
  • $5 million through Sept. 30, 2031, for audits and other oversight to make sure USDA spends all that money on what it's supposed to. USDA has been widely criticized for sparse oversight.
  • About $27 billion for programs to help prevent and fight forest fires, restore forests and promote tourism in under-served areas. That includes the creation of a Civilian Climate Corps, modeled after the Civilian Conservation Corps of the Great Depression.
  • $28 billion for conservation, including support for farmers.
  • $10 billion for child nutrition programs, which would make 9 million more children eligible for free school meals.
  • $200 million for additional pandemic relief payments to frontline grocery workers.
  • pathway to legal residence, but not citizenship, for undocumented immigrants. About 7 million of the 11 million undocumented in the U.S. could apply for work permits, permission to travel abroad, and state driver's licenses. "To qualify, immigrants must have arrived before Jan. 1, 2011, and lived here ever since. Work permits would be valid for five years, and could be renewed one time, extending protections through September 2031," The Washington Post reports.
  • Restoration of more than 400,000 green cards that went unused because of bureaucratic or pandemic-related delays.
  • A fee on methane emissions and funding to help facilities lower such emissions.
  • Enhanced subsidies for health insurance through Affordable Care Act exchanges would be extended through 2027. They are now set to expire after 2022. "The changes would mean more people would continue to remain eligible for subsidies and lower-income people would also continue to see more generous subsidies," the WSJ reports.
  • Subsidies in 2022-25 for the 4 million uninsured Americans in the 12 states that haven't expanded Medicaid under the Affordable Care Act.
  • Many Medicare recipients would pay less out of pocket for health care, and the program would cover hearing care for the first time.
  • Consumers with private insurance would never have to pay more than $35 for insulin before a deductible is applied.
  • A $2,000 a year cap on out-of-pocket costs for the voluntary prescription drug benefit, starting in 2024.
  • More than $18 billion for the first three years for universal pre-kindergarten. "After that, the program would be funded with a 90% federal, 10% state split in the fourth year, then 75%-25% in the fifth year and 60%-40% in the sixth year. The program would end after six years," WSJ reports. A coalition of conservative religious groups opposes the measure, saying a non-discrimination clause could disqualify them.
  • About $100 billion over three years to address child-care shortages and raise workers' wages by building new facilities, training teachers, and subsidizing low- and middle-income families' child-care expenses. "After the first three years, the entitlement expands to nearly all families. It guarantees that no family making less than 250% of their state’s median income would pay more than 7% of their income on child care," the WSJ reports. "Families making less than 75% of their state’s median income would pay nothing. The program ends after six years."
  • For the first time, the federal government would be able to negotiate the prices of some medications covered by Medicare. The measure would begin with 10 drugs starting in 2025 and will increase.
  • $150 billion for affordable housing, including $65 billion to repair public housing, $35 billion for rental assistance and $15 billion for affordable housing grants through the Housing Trust Fund. The plan will also provide down-payment assistance for first-time home buyers whose parents are also not homeowners.
The bill is notable for how much funding will go to rural and agricultural interests. The American Farm Bureau Federation opposes it; President Zippy Duvall said in a statement the bill would hurt rural America because it "raises taxes and spends more taxpayer money at a time our country can afford to do neither."

However, a diverse group of conservation, agricultural, and sporting groups voiced their support for the bill. Conservation funding in the bill "underscores the central role that farmers, ranchers and private forest owners play in addressing the climate crisis," Aviva Glaser, the National Wildlife Federation's senior director of agriculture policy, said in a statement. "This transformative investment into popular and effective USDA conservation programs and practices will create jobs, support rural communities, reduce emissions, and create benefits for soil, water, and wildlife.

New rural coronavirus infections up 10% last week while Covid-related deaths fell about 20%

New coronavirus infections, in ranges by county, Nov. 6-13
Map by The Daily Yonder; click the image to enlarge it or click here for the interactive version.

Rural counties reported about 117,000 new coronavirus infections Nov. 6-13, a 10 percent increase from the previous week. "Rural counties were evenly split between those that had better infection rates compared to two weeks ago and those that had worse," Tim Murphy and Tim Marema report for The Daily Yonder. "Twenty states saw an improvement in their rural infection rates, while 27 had worse rates last week ... In 38 states, the rural infection rate was higher than the urban infection rate."

Rural counties saw about 2,100 Covid-related deaths last week, down 20% from the week before. "The rural death rate remains two times higher than the metropolitan death rate, a trend that started in mid-August," Murphy and Marema report. Click here for more charts, regional analysis, and county-level interactive maps from the Yonder.

New HGTV show, a spinoff of popular 'Home Town,' picks six towns for home, business and public projects in each

Six American towns will get a makeover next year on a new HGTV show featuring Ben and Erin Napier, hosts of the popular "Home Town" series.

In the spinoff, called "Home Town Kickstart Presented by People," the Napiers will bring in an all-star cast—including Nate Berkus and Ty Pennington—to do three types of projects in each town: "refresh the home of a local hero, give a small business a beautiful upgrade and reinvigorate a public space to enhance the residents’ quality of life and engender community pride," according to a press release.

Thousands of towns applied when HGTV announced the series in January. The winners are: Buffalo, Wyoming; Cornwall, New York; Winslow, Arizona; LaGrange, Kentucky; Thomaston, Georgia; and Minden, Louisiana.

La Grange residents are delighted about the prospect, Dakota Sherek reports for WDRB in Louisville. The community of around 10,000 is the seat of Oldham County, northeast of Louisville.

"It's certainly a fantastic achievement for our city," La Grange Mayor John Black told Sherek. "We've been working on this, these things, for years. We continue to working on making this a vibrant, cool town, and with what HGTV does, we just couldn't be more happy and excited they're going to come here and see us."

Quick hits: Invading armadillos, in search of Appalachian-friendly therapy; National Grange reelects president

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 heather.chapman@uky.edu.

"Infra," short for infrastructure, is an ancient prefix and the new shorthand work for supporting structures that undergird American society, not just roads and pipes. Read more here.

Betsy Huber has been reelected for a fourth term as president of the National Grange, the oldest agricultural and rural advocacy organization in the U.S. Read more here.

Armadillos, whose habitat has expanded north because of climate change, have besieged a town in western North Carolina. Read more here.

Are Appalachian foodways at risk of being lost forever? Read more here.

Culturally sensitive therapists could play a key role in easing Appalachia's mental-health crisis, writes one Eastern Kentucky resident. Read more here.

Thursday, November 18, 2021

'The First Amendment is having a nervous breakdown' as info overload masks truth, journalism-review editor writes

Gateway Journalism Review illustration by Steve Edwards
By William H. Freivogel
Gateway Journalism Review

230 years after its ratification, the First Amendment is having a nervous breakdown.

Billions of bits of information and misinformation flood the public sphere every day leading people to throw up their hands because they can’t figure out what or whom to believe.

Bedrock principles of Enlightenment philosophers and great First Amendment champions, Justices Oliver Wendell Holmes and Louis Brandeis, are no longer certainties. We’re not sure anymore that truth will emerge from the marketplace of free expression or that a democracy can depend on free speech to disinfect public debate and find the path forward.

The consequences of information chaos are frightening. Thousands, maybe tens of thousands of Americans are tricked by misinformation about vaccines and end up getting seriously ill and dying. A large part of the electorate believes former President Donald Trump’s lies about the 2020 election and seems energized by the false claim to take back power. Many Americans are not outraged by Jan. 6 – the riot, insurrection, coup – when Trump tried to block the peaceful transition of power that is fundamental to democracy and never before has been challenged as he challenged it.

A year ago GJR called the election a “stress test” for American democracy and said, “The transfer of power has happened so many times we take it for granted, Yet with this self-absorbed man in the White House nothing can be taken for granted.” It seems Vice President Mike Pence needed the advice of former Vice President Dan Quayle to stand up to Trump. Even the chairman of the Joint Chiefs of Staff feared a coup.

As part of its annual First Amendment celebration, GJR called on some of the best First Amendment thinkers in St. Louis to write about the health of the First Amendment and 1A controversies bubbling around us – from the fields of Washington University, to the school boards of Webster Groves and Kirkwood, to the Missouri Legislature to the governor’s mansion in Jefferson City,

Mark Sableman, one of St. Louis’ leading media lawyers, who has spent a lifetime defending the media, writes that it’s time to rethink protection of anonymous speech, rethink the extraordinary legal protection that allows Facebook to send users to ideological extremes, and reconsider Enlightenment assumptions.

As he put it, “Legal thinkers need to move on from simplistic Enlightenment assumptions about human rationality. We know from modern neuroscience and physiological research that humans are far more irrational and susceptible to manipulation than our Enlightenment forbearers realized, and that psychologically targeted and high-emotion content often leads people astray.”

Claire McCaskill, former Missouri senator turned MSNBC/NBC commentator, told Jo Mannies, retired dean of political reporters in Missouri, that all public-school students should be required to take media literacy in the seventh grade. She pointed out that candidates for office are no longer expected to tell the truth or to have any experience in government. Former President Donald Trump broke those molds.

McCaskill wondered if an inexperienced businessman in Virginia could win the governorship by courting Trump voters but not embracing Trump himself. We know now that the answer was yes. Glenn Youngkin won partly by attacking the bogeyman of “critical race theory” – even though it isn’t being taught in the Virginia schools.

Mitch Eden, the adviser of the award-winning Kirkwood Call newspaper, knows the antidote to this narrow thinking – uncensored student journalists. Eden asked McCaskill in her zoom interview to support the effort to persuade the Missouri Legislature to pass the Cronkite New Voices bill to overturn Hazelwood v. Kuhlmeier, the 1988 Supreme Court decision allowing principals to censor student journalists in public schools. The decision is one of the most regressive First Amendment decisions of the past half century and 14 states have effectively overturned it.

Maddie Myers, former editor of the Kirkwood Call and a journalism student at the University of Missouri, followed up by sending Eden an email explaining how press freedom for student journalists liberates them to seek the facts. “By not having my voice censored,” she wrote, “I have been able to give a voice to the voiceless and shed light on important issues” such as “intruder drills, inequality in sports, and racial equity.”

That is, if schools are still allowed to use words like “racial equity.”

Academic freedom is under assault from both the left and right at universities. The University of North Carolina balked at giving Nikole Hannah-Jones tenure even after she won a Pulitzer Prize for her 1619 commentary. And a Yale Law School diversity director threatened a student who invited fellow students to a party co-sponsored by the Federalist Society. The diversity director told the student the invitation was “triggering” to Black students partly because “FedSoc belongs to political affiliations that are oppressive to certain communities.”

At Washington University this fall, Fadel Alkilani, student vice president for finance, removed flags that College Republicans had planted on Mudd field to commemorate those who died on 9/11. He said they represented “American imperialism.” Chancellor Andrew Martin condemned the removal of the flags, but then shrank from condemning the wave of Islamophobia directed at Alkilani.

Gregory Magarian – the Thomas and Karole Green professor of law at Washington University and a noted First Amendment expert – called Martin’s failure to condemn Islamophobia “baffling and shameful,” adding that for the university to “embrace the College Republicans’ political view of 9/11 and then to ignore hateful attacks on a student in its charge…cause far greater harm than Alkilani’s errant action to the culture of free speech and open debate on our campus.”

When Missouri’s governor starts a criminal investigation of the St. Louis Post-Dispatch because it has performed its watchdog role and disclosed a security breach in state records on teachers, he not only shows he doesn’t understand the role of the press as a watchdog, but also that he doesn’t understand computer coding, Sableman and Post-Dispatch lawyer Joe Martineau told GJR.

And the importance of whistleblowers has been illustrated in recent weeks as whistleblowers at Facebook disclosed that Mark Zuckerberg chose profits over civic duty by pushing users toward the political extremes. A recent story described how a 2018 change in Facebook algorithms in Poland destabilized that country. Social media has been almost as effective as Vladimir Putin in destabilizing democracies, including our own.

Yes, let’s celebrate the First Amendment this year and next and every year after. But we can’t take it for granted or assume it will automatically lead us to truth and the right path for our democracy. We can’t let our democracy’s future rest on Dan Quayle telling Mike Pence the right thing to do in the face of a mob chanting, “Hang Mike Pence.”

All of us as citizens are going to have to work hard to become media literate, to check our sources, to shun prejudices and ideologues and to see through the manipulation of master demagogues who would upend our entire, wonderful experiment in order to grab back the power of the White House.

William H. Freivogel is editor of Gateway Journalism Review, formerly the St. Louis Journalism Review. The full version of this article was first published in GJR's Fall 2021 print edition.

Rural Americans are the most likely to say pandemic is over, least likely to take precautions; do news deserts play a role?

The Atlantic/Leger poll conducted Nov. 5-7. Click the image to enlarge it or click here for the rest of the report.

Though the coronavirus remains entrenched in rural areas, rural Americans are more likely than their suburban or urban peers to have rejected or given up on social distancing, masking and/or vaccinations. "They feel, in short, that the pandemic is 'over,'" Olga Khazan reports for The Atlantic. According to a recent Atlantic/Leger poll, "people in rural areas are most likely to feel like things are 'back to normal' where they live—45 percent thought so, compared with 30 percent of urbanites and 36 percent of suburbanites. Rural Americans were also the least likely group to say they wished their neighbors would be more cautious about Covid-19."

Rural Americans were less likely than suburban or urban residents to say most adults they know are vaccinated against the coronavirus, and more likely to say they socialize indoors with unmasked friends, Khazan reports. State and community laws were more likely to foster rural Americans' attitudes: Only 27% of rural residents said they have to wear a mask to work, and rural schools and daycares were less likely to require kids to wear masks or require kids to stay home if they have Covid-19 symptoms.

"For a lot of people who aren’t wearing masks or getting vaccinated, they think that this has just been blown out of proportion, and that people are just too fearful and need to go about their lives," Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials, told Khazan.

"Among the rural unvaccinated, this is a false sense of security. Covid is spreading rapidly in rural areas, which is worrisome because rural people tend to be older, poorer, and in worse health to begin with," Khazan reports. "If they do get sick, they have less access to hospitals—more than 100 rural hospitals have closed since 2013. The Covid-19 death rate in rural America is now twice the death rate in urban areas. And the longer that pockets of unvaccinated Americans remain, the greater the likelihood that new variants will take hold and spread elsewhere."

But, Khazan notes, policy makers may not have tried hard enough to understand rural Americans' viewpoints on the pandemic. And it's difficult for many rural counties to get accurate information, especially since many lack health departments and local newspapers. "Of course they feel abandoned, and at this point, defiant," Khazan writes.

A record 100,000-plus Americans died from drug overdoses in first year of the pandemic; fentanyl fueled the increase

Percent change in predicted drug overdose deaths from April 2020 to April 2021
CDC map; click the image to enlarge it or click here for the interactive version. Click here for county-level data.

"The U.S. drug epidemic reached another terrible milestone Wednesday when the government announced that more than 100,000 people had died of overdoses between April 2020 and April 2021. It is the first time that drug-related deaths have reached six figures in any 12-month period," Dan Keating and Lenny Bernstein report for The Washington Post. "The new data shows there are now more overdose deaths from the illegal synthetic opioid fentanyl than there were overdose deaths from all drugs in 2016."

The provisional data from the Centers for Disease Control and Prevention shows a death toll nearly 29 percent higher than those recorded in the same period a year earlier. "The financial, social, mental health, housing and other difficulties of the Covid-19 pandemic are widely blamed for much of the increase," Keating and Bernstein report. Click here for county-level data.

The Biden administration is trying to combat the crisis with a focus on harm-reduction provisions, including "trying to increase distribution of the overdose antidote naloxone and fentanyl test strips to users, to keep them alive while the government expands prevention and treatment programs," Keating and Bernstein report. "But administration drug czar Rahul Gupta conceded that naloxone distribution is uneven across the country, depending on rules in different states. He offered a model law, suggesting some states could improve access to the drug by adopting it." The administration wants Congress to allocate $11 billion in the 2022 budget for anti-drug programs.

Journalism tax credit back in the Build Back Better bill

A provision supporting local news is back in Democrats' Build Back Better bill, Farnoush Amiri and Tali Arbel report for The Associated Press. The Local Journalism Sustainability Act was removed earlier this month as the White House and Congress tried to reduce the cost of the $1.85 trillion social-spending bill.

The provision, estimated to cost $1.67 billion over the next five years, entails "a payroll tax credit for companies that employ eligible local journalists. The measure would allow newspapers, digital news outlets and radio and television stations to claim a tax credit of $25,000 the first year and $15,000 the next four years for up to 1,500 journalists," Amiri and Arbel report. "The provision put in place guardrails to try to keep money from going to partisan sites that masquerade as local news or fake-news operations while casting a broad net about which organizations are considered legitimate local news outlets, whether they are hedge fund-owned chains, nonprofit, print, digital, radio or TV."

Though some top Republicans have derided the measure—Rep. Steve Scalise of Louisiana called it a scam in a recent tweet—more than a dozen House Republicans support it, AP reports: "The proposal’s fate ultimately hinges on how Congress proceeds with the broader legislation, which has only attracted Democratic support and has become bogged down by divisions in the House and Senate. Notably, it is one of the few provisions to which House and Senate Democrats have already agreed." And that may be one reason it's back in the bill.

New rural coronavirus vaccinations fell 4% last week, while metropolitan counties' rate dropped 20%

Vaccination rates as of Nov. 11, compared to national average and adjusted to account for vaccinations not assigned to specific counties. Map by The Daily Yonder; click the image to enlarge it or click here for the interactive version.

The pace of new rural coronavirus vaccinations fell for the fourth straight week last week. Nearly 159,000 rural residents completed their vaccinations during the week of Nov. 5-11, a 4 percent decrease from the week before, Tim Murphy and Tim Marema report for The Daily Yonder. Just over 1.2 million metro-area residents completed theirs, down 20% from the previous week's 1.6 million.

"As of Nov. 11, 44.8% of the entire rural population was completely vaccinated" against the coronavirus, Murphy and Marema report. "That’s about 20% lower than the metropolitan vaccination rate of 57.0% of the population."

Click here for more charts, maps and regional analysis from the Yonder, including an interactive map.

Latest weapon in farmers' war against superweeds: a 10,000-lb. laser-weeder robot, going to grain crops next year

Photo from Carbon Robotics
Farmers' reliance on herbicides to combat weeds has increased greatly. From 2012 to 2016, about 281 million pounds of glyphosate, an active ingredient in most herbicides, were applied to 298 million acres per year in the U.S., according to the Environmental Protection Agency. "Potential bans on herbicides and the growing number of superweeds have raised scrutiny regarding that reliance," Laurie Bedord reports for Successful Farming. "By creating a 10,000-pound robot with laser power that eradicates weeds, Carbon Robotics is taking on one of agriculture’s biggest challenges."

About the size of a mid-range tractor, the machine uses 20 high-resolution cameras to spot weeds and annihilate them without hurting the crop or soil. It goes about 1-2 miles per hour, and can kill about 100,000 weeds in an hour on crops as high as three feet tall, Bedord reports.

It's currently focusing on weeds for specialty crops such as onions and broccoli, but will likely begin testing on corn, soybeans and wheat in 2022, the company says. 

Wednesday, November 17, 2021

Rural journalists tell how their newspapers, determined to survive and serve the public, made it through the pandemic

This Oklahoma paper expanded into marketing.
"How did so many local news organizations – especially newspapers – manage to survive the pandemic?" Louisiana State University journalism professor William Thomas Mari asks on The Conversation. "Weeklies beefed up their daily online news coverage, business models were blown up, and existing rationales for why journalism matters became more than theoretical to rural journalists," who showed a "determination to survive and serve as a public health lifeline for their communities."

Mari and Teri Finneman of the University of Kansas interviewed "28 journalists across seven states in the middle of the country . . . North Dakota, South Dakota, Nebraska, Kansas, Oklahoma, Arkansas and Louisiana," he reports. "We learned how locally owned and family-owned newspapers made it through Covid-19. . . . There were no easy answers."

"Reporters and editors found new ways of paying the bills," Mari writes. "That meant accepting government subsidies in the form of Paycheck Protection Program loans. It meant, for some, going door to door and asking readers to subscribe, or keep subscribing. It meant consolidating newspapers, putting out more online editions, or taking pay cuts. . . . But there was still hesitancy over what newspapers had to do to adapt. Some journalists are uncomfortable with receiving government funding and would rather rely on community support."

The Kingfisher Times & Free Press in Oklahoma, was among the papers that "took on side hustles to bring in revenue, creating ad copy for local business or doing marketing work," Mari reports. "Some papers worked out advertising deals with local businesses as consumers shopped more locally. Local publishers did whatever it took to stay afloat. As some of our initial findings have shown, that showed both opportunity and hesitancy about change."

Letti Lister, the president and publisher of the Black Hills Pioneer in Spearfish, South Dakota, told the researchers, “We’re gonna have to rely less on advertising revenue and more on subscription revenue, and so we’ve got to make sure we’re offering a unique product that they want to pay for.”

"We saw tentative signs of hope, as journalists got financial and moral support from their readers during a fraught election," Mari reports. Amy Wobbema, publisher of the New Rockford Transcript in North Dakota, said, “If anything, it’s rallied the troops, if you will, in our community because they trust us, they know that we’re going to report the news in a timely manner and keep the public up to date.”

Doctors worry that telehealth makes it more difficult for them to detect drug abuse by patients or the patients' risk for it

Telemedicine, or telehealth, has proven its value in the pandemic, but physicians are concerned that it leaves them less able to detect patients' misuse of drugs, a national poll of doctors found.

Quest Diagnostics found that two-thirds of physicians it surveyed "fear they missed signs of drug misuse during the pandemic, and, given how the global health crisis disrupted medical care, anticipate rising overdose deaths – especially those involving prescribed and non-prescribed (illicit) fentanyl – even as the pandemic subsides," the company said in a news release. For the full report, click here.

Quest noted an increase in drug-overdose deaths in the first year of the pandemic, and big increases in non-prescribed fentanyl and heroin among people whose test results it ran early in the pandemic. The poll found that 94% of primary-care doctors "reported seeing more patients experiencing stress, anxiety or other mental-health issues because of the pandemic and fear a correlation between rising mental health issues and prescription drug misuse."

Three-fourths of the 505 physicians surveyed said they believe telehealth limits their ability to determine if patients are misusing prescription drugs, or are at risk for it. The release said "91% of physicians feel confident they can recognize the signs of prescription drug misuse during in-office interactions with patients, but only 50% report the same confidence via telehealth visits."

Quest said nearly half of tested patients showed signs of drug misuse, and a fourth "engaged in drug combining, a particularly dangerous form of misuse," the release said. But about half of physicians "do not follow up with definitive tests when presumptive tests are positive."

The poll also found that only a third of physicians are "very confident" in their ability to properly prescribe naloxone, which blocks opioid overdose, to patients who may be at risk of overdose.

Center of U.S. population is still moving west and south, but not as fast as in recent decades; still in rural Missouri

"Westward movement" has been a feature of America since the first permanent settlements by Europeans, and each time a census is taken, the Census Bureau calculates the center of population, which it says is "a point at where an imaginary, flat, weightless and rigid map of the United States would balance perfectly if everyone were of identical weight." With every census, it has been farther west, but in recent decades it has also headed south. In the last decade, it still headed southwest, but didn't go as far.

The bureau says the center of population is at 37.415725 degrees north latitude and 92.346525 degrees west longitude, just southwest of County Road 303 in Wright County, Missouri, on the waters of Beaver Creek (one of the nation's most common stream names). That's about 15 miles northeast of Hartville, population 613 and the county seat.

"Towns in Missouri have been the population centers since 1980," the bureau says. "The largest movements by miles were between 1850 and 1890, when events like the Gold Rush in California and land speculation in Oklahoma helped spread people farther west." Ron Jarmin, the bureau’s acting director, said “The movement of the center of population helps tell the story of this century’s migration South and West. It helps visualize where we live.”

Google map pinpoints the population center of the U.S. on Census Day, April 1, 2020

The Census bureau also plots the population centers of states, counties, census blocks and census tracts. Where is your state's center of population? The bureau has tracked it since 1880; look here.

Thursday is National Rural Health Day, a time to understand challenges and appreciate rural health-care providers

Thursday, Nov. 18 – tomorrow – is National Rural Health Day, an annual observance conducted by the National Organization of State Offices of Rural Health. The fact that there are such offices, and a federal counterpart, illustrates the longstanding challenges of getting and delivering health care in rural areas.

National Rural Health Day helps explain those challenges to the rest of the country, but it also honors the contributions and sacrifices of health-care providers who choose to work in rural places, many of which have a shortage of providers. They also have older populations that have more chronic conditions, and larger shares of uninsured and under-insured residents.

There is increasing concern about rural hospitals, which are usually important employers in their communities but are increasingly in danger of closing as populations dwindle and some states haven't expanded Medicaid. Ongoing research at the University of North Carolina says 137 have closed since 2010, 97 of them completely. The others were "converted closures," eliminating in-patient care, but offering some services, such as primary care and skilled nursing care.

More information about rural health and National Rural Health Day: https://www.powerofrural.org/wp-content/uploads/2021/05/NOSORH_NRHD_2020_2-Pager_FINAL_020121.pdf.

Rural editor-publisher with racist writings is ejected from Maryland-D.C.-Delaware Press Assn. Hall of Fame

A rural journalist "who helped shape public opinion on Maryland’s Eastern Shore for decades during the mid-20th century has been stripped of one of the region’s top professional honors after a review of his work found writings that were 'viciously racist' and even promoted lynching," The Baltimore Sun reports.

The Maryland-D.C.-Delaware Press Association, which inducted Edward J. Clarke, the longtime owner and editor of the Worcester Democrat, into its Hall of Fame in 1954, "voted last week to terminate that honor after Gabriel Pietrorazio, a University of Maryland journalism student, brought to light editorials written by Clarke that likened the Black suspects in a 1940 homicide to 'a rabid dog,' 'a disease-spreading germ' and 'garbage'," the Sun's Jonathan Pitts reports.

"The work of Pietrorazio, a 23-year-old master’s degree student, is part of 'Printing Hate,' a collaborative research project at the Howard Center for Investigative Journalism," Pitts explains. "Journalism students from seven colleges and universities across the country are reviewing racist media coverage of the past as part of the project. The focus is on the years between the end of Reconstruction and the mid-20th century, a time when more than 5,000 people lost their lives in terror lynchings, most of them Black men and boys at the hands of white mobs, researchers say. Such research centers as the Equal Justice Initiative in Montgomery, Alabama, have shown in recent years that white-owned press outlets routinely played a role in encouraging the practice, either by displaying indifference toward its horrors or using the kind of biased and incendiary language that could foment violence."

Other schools participating are the University of Arkansas and five historically Black institutions: Morgan State University in Baltimore, Howard University in Washington, Hampton University in Virginia, North Carolina Agricultural and Technical State University, and Morehouse College in Atlanta. The effort has produced 30 investigative stories, which are posted twice a week on the Capital News Service’s Howard Center website, on the National Association of Black Journalists’ news site, and on Word in Black, a collaboration of prominent African American news publishers.

Tuesday, November 16, 2021

USDA to allow faster line speeds at some pork plants

The Agriculture Department "will again allow faster line speeds in a select few pork processing plants as part of a pilot project after a federal court in Minnesota vacated a USDA rule earlier this year," Todd Neeley reports for DTN/The Progressive Farmer. The court "struck down a provision of USDA's New Swine Inspection System, or NSIS, allowing for faster harvest-facility line speeds. NSIS was initiated during the Clinton administration and was evaluated at five pilot plants over the past 20 years." USDA told DTN it will let "existing NSIS facilities to apply for up to a one-year trial to operate at increased line speeds." Existing NSIS plants are in Pennsylvania, Michigan, Nebraska, Minnesota, and Oklahoma.

Faster line speeds not only increase injury concerns, but also probably help spread the coronavirus. USDA said participating plants must implement extra worker safety measures as part of the deal. The pilot facilities would experiment with different ergonomics, automation and crewing approaches to see how they can increase productivity without sacrificing safety for workers or the food they process. USDA said it will collect that data from the facilities and share it with the Occupational Safety and Health Administration for input on future rulemaking, Neeley reports.

Small Business Saturday is Nov. 27; here are ways newspapers can support local retailers and artisans

Small Business Saturday, on Nov. 27 this year, is traditionally an opportunity to support local businesses and artisans. It's more important than ever this year, Abha Bhattarai writes for The Washington Post: "Small retailers and manufacturers, already crushed by large national brands during the pandemic, are being disproportionately walloped by delays, shortages and other supply chain disruptions ahead of the holidays. In many cases, they’re losing out to giants like Walmart and Amazon, which are spending millions to charter their own ships and planes to move merchandise. Independent shop owners, who have no such recourse, say they’re often the last in line for products because manufacturers prioritize larger, more lucrative contracts."

Small businesses and local artisans are often the lifeblood of a local newspaper's advertising budget, as Malheur Enterprise Editor and Publisher Les Zaitz noted in his eastern Oregon weekly. And consumers are eager to support local businesses during the pandemic: 72% of people in a recent survey said they plan to make more of an effort to shop locally this Christmas. Here are some ways local papers can promote Small Business Saturday:

  • Write an editorial encouraging readers to buy more Christmas gifts from local businesses and craftsmen.
  • Print tips for small businesses to promote themselves for SBS this year.
  • Invite small businesses to be listed in a local gifts guide, online or in print, for readers' convenience. Don't forget to check local farms to see if they have shops or sell tours or experiences.
  • See if there's a local holiday market being held nearby and promote it.
  • If there isn't a holiday market, why not organize one? Papers can charge vendors a small booth fee, and can hold the event at a local community center or school gym. Such events are not too difficult to organize, especially if the venue already has folding tables or vendors can supply their own. Permits are usually easy to obtain, but check with the local government, especially if vendors will be selling food or drinks. Bonus: this can generate quite a bit of goodwill for the paper locally.

Pandemic roundup: Resources for teachers to identify misinformation; rural Covid patients in ICUs at greater risk

Here's a roundup of recent news stories about the pandemic and vaccination efforts:

The National Association for Media Literacy Education has teamed up with the Thomson Reuters Foundation to provide high-school and college educators with classroom resources on identifying pandemic misinformation. Read more here.

Rural Covid-19 patients in intensive care units are at a higher risk of dying than their urban counterparts, according to a West Virginia University researcher. Read more here.

If you're storing pesticides this winter, read these four safety tips first. Read more here.

It's no accident that Maine and Vermont, the states with the highest percentage of rural population, have some of the highest coronavirus vaccination rates in the country. Read more here.

A new study found that 78% of American adults either believe or are aren't sure about at least one of eight false statements about the pandemic or coronavirus vaccination. Unvaccinated adults and Republicans are the most likely to believe misconceptions. About 64% of unvaccinated adults believe or aren't sure about at least half of the eight false statements, compared to only 19% of vaccinated adults. Meanwhile, 46% of Republicans believe or are unsure about at least half of the statements, compared to 14% of Democrats. Read more here.

A recent study found that the incidence of rural Republican voters was the strongest variable correlating with higher per-capita Covid-19 cases. Read more here.

Rural residents exposed to big-city TV news are more likely to follow pandemic safety guidelines. Read more here.

Covid skeptics who organize online are increasingly driving public health professionals from their jobs. Read more here.

The pandemic has driven many teachers to quit. Seven of them talk about why. Read more here.

Electric cars could help coal in some states

In coal country, electric cars are often derided as an impractical symbol of renewable energy, but the notion has an ally that might seem odd but isn't: the coal industry. 

In North Dakota, one of the nation's largest coal-producing states, "The thinking is straightforward: More electric cars would mean more of a market for the lignite coal that produces most of North Dakota’s electricity, and if a long-shot project to store carbon emissions in deep underground wells works out, it might even result in cleaner air as well," Will Englund reports for The Washington Post. "As many parts of the country attempt to shift their energy production away from fossil fuels and toward solar, wind and other renewables, what’s happening here shows how the electric car revolution might play out in parts of the country far less friendly to either clean cars or clean energy." Read more here.

Better than telemedicine? Program brings specialty training to rural health-care providers to help patients directly

A virtual mentoring program, Project ECHO (which stands for Extension for Community Healthcare Outcomes) aims to equip rural medical providers with more specialized expertise.

University of New Mexico internal-medicine physician Sanjeev Arora has spent "nearly two decades building the program, which now trains far-flung providers across the U.S. and other parts of the world," Erin Brodwin reports for Stat. "Every week, ECHO participants — often rural nurse practitioners or medical assistants — assemble over video conference to present a challenging patient case to a group of their peers and a team of ECHO specialists. It’s a chance to ask questions and get advice on care, including how to address social factors like housing and transportation. The work fills what experts see as a gaping need for specialty care in remote communities, where traditional forms of telehealth have failed to make inroads."

Arora calls the novel approach tele-mentoring, in a nod to its close cousin, telemedicine. "Rather than giving a single specialist a fish by connecting them to a rural patient, ECHO teaches multiple rural providers to fish by giving them the skills they need to treat scores of local patients," Baldwin reports.

Though telehealth has become more common in recent years, especially during the pandemic, it still can't help many rural patients who lack broadband and can't locally access specialists. The tele-mentoring approach is one way around that problem, according to RAND Corp.'s Ryan McBain. In 2019 McBain was the lead author on a systematic review of 52 studies about Project ECHO, Baldwin reports.

Monday, November 15, 2021

Hospitals given semi-annual grades based on patient-safety metrics; post-op sepsis, other issues included for first time

Screenshot of Leapfrog page for Hazard Appalachian
Regional Healthcare Medical Center in Hazard, Ky.
A nonprofit group has released its semi-annual report grading hospitals for patient safety. The Leapfrog Group, based in Washington, D.C., rated 2,901 general acute-care hospitals, the most ever. The twice-yearly grades are based on more than 30 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. The safety guide is the only hospital ratings system based exclusively on a hospital's ability to prevent medical errors and harm to patients.

The group doesn't grade critical-access hospitals, since they don't have to report quality measures to the federal government. It also doesn't grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

For the first time, the report includes performance grades for post-operative sepsis, blood leakage and kidney injury. A news release notes that post-operative sepsis can result in "suffering, disability and sometimes death" for an estimated 160,000 Americans a year. It adds that sepsis in all settings kills over 270,000 people a year and is the costliest condition in U.S. hospitals. Further, it says that Black people are twice as likely as white people to be diagnosed with sepsis.

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says. The site offers details on each measure under headings titled Infections, Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

Click here to see how your local hospital—and its neighbors—have scored.

3G networks to shut down next year, disproportionately hurting rural seniors, poor; FCC is asked to stall the move

Rural Americans will be disproportionately affected when 3G wireless networks start shutting down in February. The move, meant to free up resources for 5G networks, will cut off phone and internet access for those who depend on the networks, and will also hamstring devices and services including life-alert systems, sensors that track school buses, court-ordered breathalyzers for convicted drunk drivers, and more, Cat Zakrzewski reports for The Washington Post. Nearly 20 percent of Americans were still on 3G networks as of 2018, according to market analysis firm OpenSignal. However, there is little current data on how many Americans still rely on devices that can only connect to 3G networks.

"Consumer advocates are urging the Federal Communications Commission to slow the change," Zakrzewski reports. "Older and low-income Americans are more likely to be affected by the shift, these advocates say. If they don’t upgrade in time, their phones and life-alert devices won’t be able to call 911 or other emergency services, government regulators warn."

Phone carriers don't want to slow the transition because they've warned about it for years and are trying to make sure their customers don't lose wireless access. Also, the old networks are far less profitable than newer networks. "AT&T, which plans to shutter its network in February, says it has reached out to affected customers and provided them with discounted or in some instances free phone upgrades," Zakrzewski reports. "Other networks, including T-Mobile, have delayed their shutdowns until slightly later to accommodate people who still haven’t upgraded: T-Mobile will shut down Sprint’s 3G network on March 31, 2022; Verizon has said it will shut down its network on Dec. 31, 2022."

The pandemic has complicated efforts to carry out the transition. Seniors, who often need technical support the most, have been leery of admitting service technicians from wireless carriers or home-alarm companies, and backed-up supply chains and a computer-chip shortage have made it difficult to replace old devices, Zakrzewski reports.

Law-enforcement officials have also pleaded with the FCC for more time to update electronic monitoring software for 3G-connected breathalyzers and bracelets for those convicted of crimes involving alcohol, Zakrzewski reports. The FCC hasn't intervened yet, but has done so before when it appeared that phasing out old technology would leave people vulnerable in an emergency.

'Storm Lake' documentary about a rural weekly fighting for its life, and getting support, premieres on PBS Monday night

From left: John, Mary, Tom, Dolores and Art Cullen
Perhaps the best documentary ever done about a community newspaper airs tonight on PBS. "Storm Lake" tells the story of The Storm Lake Times, the northwest Iowa weekly that won a Pulitzer Prize for editorial writing and the Tom and Pat Gish Award for courage, integrity and tenacity in rural journalism in 2017 and continues its potent blend of watchdog reporting, incisive commentary and community spirit.

Editor Art Cullen, who owns the paper with his brother, Publisher John Cullen, said in an editorial column last week that the rollout of the documentary at film festivals and other screenings over the last three months, along with media interviews, has brought "an outpouring of support" for the paper, which has local competition and survives partly because it's a family operation and the brothers are on Social Security and take no salaries.

Art Cullen, Winterset Madisonian Editor Vicki Minor and film
directors Beth Levison and Jerry Risius before a premiere.
"It’s a lovely and true film that is, at its core, about building a diverse rural community through civic engagement," Art writes. "Directors Beth Levison and Jerry Risius certainly portray accurately the struggles that local journalism faces. There was a point in the spring of 2020 when Fearless Leader John and I wondered if the newspaper would go under. Reliving it at 24 frames per second makes my gut spin. The movie suggests the question: What is going to happen to this newspaper and so many others like it, as social media and the pandemic turn the world inside out? We are much relieved to report that the public is responding. . . . A few donations have turned night into day for us."

One example: "A Chinese immigrant said he liked what he heard and wanted to give us enough money to get us through the pandemic. . . . I gave him the address of the Western Iowa Journalism Foundation, which we started to organize in the depths of the pandemic with Doug Burns of the Carroll Times Herald and Lorena Lopez of La Prensa of Iowa in Denison. . . . Just this week, the WIJF received a six-figure grant from a California foundation interested in sustainable agriculture and climate reporting. Note that none of the newspapers take their orders from donors — we don’t even know who most of them are. The givers are supporting us for what we’ve done in the past, trying to report without fear or favor."

Art Cullen schools his readers, now a national audience about the hard facts of local journalism and democracy these days: "Things have to change as digital platforms upended our business model. In the future, we will depend more on readers for revenue than advertisers. We will have to offer more and better digital products to a larger audience that can support local journalism. Everyone in the industry agrees on that. We have to figure out how to pay for it. Philanthropy buys time and the ability to experiment with new forms of information delivery. I understand an old offset press flinging ink, but I do not care to understand TikTok. We need to recapitalize journalism for a new digital generation and keep old goats like me typing in the background. Democracy depends on that successful transformation. Lies and propaganda drove insurrections at state capitols in Minnesota and Michigan, and eventually at the U.S. Capitol. Disinformation meant only to divide and cause fear is keeping people from getting vaccinated against Covid. Never has a common set of facts been more important."

Independent Lens, the PBS series that includes the documentary, posted on its website a list of "feisty community newspapers that are surviving or thriving against the odds:" the Monterey County Weekly (Seaside, Calif.); The Berkshire Eagle in Massachusetts; El Tecolote in San Franciscso's Mission District; The Pilot in Southern Pines, N.C.,; and the East Texas Review in Longview. 

UPDATE, Nov. 19: John Cullen starts a Thanksgiving editorial, "The Storm Lake Times has a lot to be thankful for when we sit down to celebrate Thanksgiving next Thursday." He thanks readers, advertisers, staff, supporters and the filmmakers.

Meaning of census findings on race for policymakers to be discussed in free webinar at 2 p.m. ET Friday

The Census Bureau changed how it gathered information on race and ethnicity in the 2020 decennial census, and that could make a difference in redistricting, research and policymaking. A National Conference of State Legislatures webinar at 2 p.m. ET Friday, Nov. 19, will explore the issue.

From the website: "Between 2010 and 2020 ... the U.S. became more diverse than ever, and Americans began to see their race and ethnicity differently as well. The result: more people than ever identify as 'some other race' and as 'more than one race'." Click here to register or for more information.

Snowplow driver shortage drives up price of snow removal

"A nationwide shortage of plow drivers could make for a lot of difficult travel this winter, as communities nationwide are desperately trying to fill positions before the snowfall," Chris Conte reports for KMGH and KCDO, stations owned by E.W. Scripps Co. that are branded as The Denver Channel.

The shortage is mostly a facet of the years-long commercial truck driver shortage that's hurting everything from supply chains to rural school bus routes, Conte reports. States and municipalities are trying to lure more drivers with high hourly wages and huge bonuses, but with limited success. There just aren't enough drivers, partly because there aren't enough instructors, partly because many commercially licensed drivers retired at the beginning of the pandemic, and partly because driving a snow plow can be lousy, iffy work. Paul Cohen, the town manager in Chelmsford, Mass., told Conte: "For drivers, you don’t know your earnings level because you don’t know the weather. You’re asking someone to commit to you and you don’t know if you’ll have a snowy winter or a dry winter."

Another factor making snow and ice removal more expensive this winter: "The price of road salt has skyrocketed by as much as 31 percent" from last year, Conte reports.