Disease-carrying ticks a growing problem in rural America

Disease-carrying ticks are a growing problem in rural America, and experts say climate change is a big reason why. "Public health officials say ticks are emerging earlier and staying active longer because of climate change and land use changes, resulting in a rising risk of infection carried by the parasites, reports Melissa Patrick of Kentucky Health News.

"There are more tick-borne disease cases every year," Dr. John Aucott, director of the Johns Hopkins Lyme Disease Clinical Research Center, said during a June 8 Association of Health Care Journalists webcast. "This is an insidious epidemic. It hasn't been as dramatic as Covid-19, so it has crept up on us."

The Centers for Disease Control and Prevention says the total number of tick-borne diseases reported to it rose 125% in 15 years: to 50,865 in 2019 from 22,527 in 2004. "These numbers are generally considered to be underestimated because most aren't reported to the agency," Patrick reports. "For example, the CDC estimated that between 2010 and 2018 the number of Americans with Lyme was closer to 467,000 based on an analysis of health insurance records."

As the climate warms, ticks can live longer each year and reproduce more, and hat makes for larger tick populations and expanding tick habitats, Liz Carey reports for The Daily Yonder. 

Moreover, the number of tick species that can cause medical problems is increasing, according to Ohio State University extension agent Tim McDermott. "The number of species that are medically important is expanding too, he said. About 20 years ago, he said, there was only one tick species, the deer tick, in Ohio that could potentially make you sick," Carey reports. Now there are five, and they carry everything from Lyme disease and Rocky Mountain spotted fever to the increasingly common Powassan virus.

Not only are there more ticks in more places and more kinds of tick that can harm people, but a larger percentage of ticks are infected with diseases, says the CDC. "McDermott said while the risk of tick bites is rising, and the number of ticks carrying diseases is high, there are ways to protect yourself," Carey reports. "One way is properly managing tick habitats, through mowing and keeping your yard clear of brush, tall weeds, and grass. Another is to wear appropriate clothing – light-colored, long-sleeved shirts and long pants tucked into socks or boots – and to apply tick repellent on skin, clothing, and footwear."

NNA awards announced; upstate N.Y. nonprofit does well; pandemic is prime topic for columns that serve as editorials

This story was updated Oct. 8, 2022.

The National Newspaper Association, the main organization for weeklies and small dailies, has announced the winners of its 2022 Better Newspaper Contest. A list is here. Some that stand out:

The awards for Best Investigative or In-Depth Story or Series went to the Sioux City Journal of Iowa, which won the daily division with "Stolen lives: The epidemic of missing and murdered Indigenous women," by Dolly Butz; The Maine Monitor of Hollowell, which won among non-dailies of 10,000 circulation or more for "Maine lawyers were given thousands of cases they were ineligible to handle," by Samantha Hogan and Angel Philip; The Highlands Current, a nonprofit in New York's Hudson Highlands, which won for a series on infrastructure; and The Ark of Tiburon, Calif., which won the small-paper category for "Policing and diversity" by Hannah Weikel and Shayne Jones. 

This Adobe Stock photo ran with each story in the series.

The Highlands Current won the sole Civic and Community Service Award for Brian PJ Cronin's "Hunger in the Highlands" series. The judges said the series went "deep into the local nuances of not only the community's problem with food insecurity but also the efforts to find solutions and the people at the forefront of those solutions. The emphasis of this coverage is firmly on making a difference, and the series shows how newspapers can use our roles in our communities to support real results."

Bill Tubbs' editorial; click to enlarge or download

Pandemic commentary scored big in the contest for Best Serious Column, which in many community newspapers serves as an editorial. The award for in newspapers of 12,000 circulation or more went to Rebecca Miller of Farm and Dairy in Salem, Ohio, for a column on her feelings about the pandemic. The judges said, "Readers walk away learning something about the 'primal scream,' farming, and the newspaper's staff. It also wove in some valuable words concerning the importance of local news." Second place went to John Nagy of The Pilot in Southern Pines, N.C., for "Why George Washington Chose a Vaccine Mandate" for his troops.

In the 6,000-12,000-circulation category, the winner was Jennifer Simon of the Wyoming Tribune Eagle for "Toxic masculinity a big reason for spread of Covid." In the 3,000-6,000 category, Bill Tubbs of The North Scott Press in Eldridge, Iowa, won for "Our oath must be to principles, not personalities," reflecting on the attack on the Capitol by laying out the oaths he had taken in his life, starting with Cub Scouts. Cronin and his Highlands Current colleague Chip Rowe won second and third places. The small-paper category was won by Carrie Pitzer of the Stanton (Neb.) Register for her column about an interview with a woman in an assisted-living facility who had seen no one but staff for a year.

In the Editorial contest, the Tribune Eagle won the daily division, the Beaumont Examiner of Texas won the large non-daily category, The Taos News won the 6,000-10,000 category for "Why public officials won't get a pass with this paper." The N'West Iowa Review of Sheldon won the 4,000-6,000 category; Moonshine Ink of Truckee, Calif., won the 2,000-4,000 category; and The Journal of Crosby, N.D. won the under-2,000 category.

The Pilot won for best editorial page in papers of 6,000 or more circulation, and the Tribune Eagle was second; among smaller papers, the Review was the winner, the North Scott Press was second, and The Alamance News of Graham, N.C., was third.

Awards for Best Reporting on Local Government went to the Tribune Eagle (over 15,000 circulation), the Photo News of Chester, N.Y. (10,000-15,000), The Taos News of New Mexico (6,000-10,000), The Standard Banner of Jefferson City, Tenn. (4,000-6,000), Virginia Lawyers Weekly (2,000-4,000) and the Crosby Journal. The judges said most entries in the next-to-last category were about government meetings, and "The stories that stood out often went into depth beyond the meeting: How does the story impact the reader?"

The Tribune Eagle won the General Excellence award for dailies. The winners among large non-dailies were the St. Louis American, The Taos News, the Review and the Steele County Times of Blooming Prairie, Minn. The Taos News won for best website and video journalism. For a PDF list of winners by category, click here; for an Excel file, click here. For an Excel list of winners by paper, click here.

In Appalachia, the shift to the Republican Party gets local; coal and social issues are key factors; media may be too

Harlan County Judge-Executive Dan Mosley announced he was becoming a Republican.

For many years in Eastern Kentucky, voters trended Republican while remaining registered as Democrats, partly because switching parties on or after Jan. 1 disqualifies you from your new party's primary in that year. But "The politics of coal, culminating in Donald Trump’s 2016 race against Hillary Clinton, and a Democratic Party often seen as out of touch helped spur the trend" to Republican registration, not just GOP voting, reports Austin Horn of the Lexington Herald-Leader. "It’s also nationwide and statewide. Democrats are losing ground all over rural America."

Horn starts with the 2021 video from Harlan County Judge-Executive Dan Mosley, in which he "listed all the qualms he had with perceived shortcomings of Democrats being discussed nationally and in coal country hubs like Harlan" and announced he was switching from Democrat to Republican. "Every single partisan elected official followed suit," and "A raft of citizens followed suit. In February when Mosley switched, Democrats in Harlan County outnumbered Republicans by 3,000. In less than a year and a half, Republicans flipped it, and now outpace Democrats by 2,000. The Democrats didn’t field a challenger this fall for Mosley’s next four-year term, either."

The shift began with Barack Obama and coal, political commentator Al Cross told Horn: “There was always that feeling that Democrats looked out for the interests of working people, like coal miners. Well, then Obama came along and declared war on coal – and it really was a war on coal – and the Republicans completely turned that around. You had people who used to despise coal operators being on the same side as coal operators, defending their mutual interests.”

"Cross pointed to a poll conducted across two years – in 2007, just before the Great Recession and Obama’s first term, and 2011," Horn reports. "In 2007, only 17% of survey respondents in traditionally Democratic Harlan and Letcher Counties said they thought “conservation/environmental rules/zoning laws” were a bad thing for the community. In 2011, 33% responded affirmatively Only 37% of the same respondents in 2007 thought “resources should be used to create jobs rather than conserved.” 52% answered affirmatively in 2011."

Some say the shift was abetted by changes in the news media. Tom Sexton, a leftist podcaster, blamed "the decline of local media – a well-documented trend across America – so voters take their cues only from national sources constantly berating national Democrats or Republicans without speaking to the issues," Horn reports, Quoting Sexton: “The sort of death of local politics, and by extension local journalism, has created this atmosphere where nobody is paying attention to local policy or anything. It’s just like, ‘I’m going to take my rhetorical cues from what’s going on the national level,’ whereas before there was a lot more color to those local races. Who was going to do what for people in the community was a lot more pertinent.”

Horn reports, "Tres Watson, a seasoned conservative political operative who previously served as spokesman for the Republican Party of Kentucky, agreed that 'as local media fades away,' voters are more often bombarded with messages about how radical prominent national members of either party are."

Motorcyclists trying to raise awareness about suicide with cross-country trek from North Dakota to Texas

Route of the motorcycle ride

Tomorrow, more than 50 bikers from around the U.S. will kick off a four-day, 1,700 cross-country motorcycle ride in an effort to "bring greater attention to the tragedy of suicide in this country, to break the silence that surrounds it, and to start a discussion on how to prevent it," The Canadian Record of Texas reports.

The "Wish You Were Here Ride" is the brainchild of North Dakotan Mike "Cisco" Maples, who lost his son to suicide four years ago. "An hour before he killed himself, he was laughing and joking with us," Maples said. "There were no warning signs. I still can’t wrap my head around why."

Maples, an Army veteran, said he's also lost friends to addiction and PTSD, and began researching mental health statistics. He discovered it's the top cause of death for young Americans, but that stigma often keeps people from reaching for help, the Record reports.

"Nobody is talking about this ... I decided we’ve got to do something," Maples said. "Being a parent … nobody talks about the person who has died by suicide. It is an uncomfortable subject … because it is an unnatural death."

That's why the bike ride will cut through the middle of the U.S., starting from West Hope, N.D., on the Canadian border, to Tres Laredos City Park on the Mexican border. "We are riding right down the middle of America to help raise awareness for suicide prevention," Maples said. "The heartland… it’s America. It’s everywhere. What better way to go."

The ride will function as a fundraiser, too; all money raised will go to support the ND Suicide Prevention Coalition.

Quick hits: Many fireworks displays canceled; fewer of us drink milk; rural Texas students fight local book bans

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.

Communities across the nation are canceling their Independence Day fireworks displays because of wildfire hazards, supply-chain issues and worker shortages. Read more here.

In a town near Uvalde, Texas, teachers have carried weapons since 2013. Parents say they feel safer. Read more here.

An LGBTQ high school student in rural Texas organized students to fight the local school board's book bans. Read more here.

A recent study says that lack of water costs families, communities and the U.S. economy $8.58 billion each year. Read more here.

Bird-flu outbreaks are slowing down, but the U.S. Department of Agriculture is urging poultry farmers to be ready for a possible resurgence in the fall. Read more here.

Consumption of fluid cow's milk is continuing a downward trend that is proving difficult to reverse, according to a new USDA report. Read more here.

Supreme Court sharply limits EPA's ability to regulate CO2 from power plants, saying Congress didn't authorize it

Coal-fired plant in Winfield, W.Va. (Bloomberg photo by Luke Sharrett)

"The Supreme Court on Thursday sharply cut back the Environmental Protection Agency’s ability to reduce the carbon output of existing power plants, a blow to the nation’s chances of averting catastrophic climate change," report Robert Barnes and Dino Grandoni of The Washington Post.

Ruling in a lawsuit filed by the State of West Virginia, Chief Justice John Roberts wrote for the 6-3 majority, “Capping carbon dioxide emissions at a level that will force a nationwide transition away from the use of coal to generate electricity may be a sensible ‘solution to the crisis of the day. But it is not plausible that Congress gave EPA the authority to adopt on its own such a regulatory scheme.”

In dissent, Justice Elena Kagan wrote, “The Court appoints itself — instead of Congress or the expert agency — the decisionmaker on climate policy. I cannot think of many things more frightening.” The Post notes, "The court was considering the powers granted by the Clean Air Act, which was written decades ago, before climate change was widely recognized as a worldwide crisis."

 
Senate Republican Leader Mitch McConnell of Kentucky, another major coal state, said in a statement that EPA issued the greenhouse-gas regulations “without any clear congressional authorization” and the court “confirmed that only the people’s representatives in Congress — not unelected, unaccountable bureaucrats — may write our nation’s laws.”

The regulations never took effect, because the Supreme Court blocked them, but EPA's "emission-reduction goals were met ahead of schedule because of economic conditions that made coal-fired plants more expensive," the Post reports. "The administration and environmentalists were stunned when the Supreme Court took the case" from West Virginia, because the Court of Appeals for the District of Columbia had ruled that a more lenient Trump administration plan intentionally misread the law. "As a result, the Trump rules were struck, the Obama rules were not reinstated and the Biden administration has yet to formulate its plan," the Post reports.

Two-thirds of rural counties and three-fourths of metropolitan counties were in the Covid-19 red zone last week

New coronavirus infections, in ranges by county, June 21-27
Map by The Daily Yonder; click on the image to enlarge it or click here for the interactive version.

New coronavirus infections were stable in rural America last week, but nearly 1,300 of the nation's rural counties, about two-thirds, were in the federal red zone. Red-zone counties are those with at least 100 new infections per 100,000 people. The high proportion of red-zone rural counties indicates "that they were having difficulty containing the spread of the coronavirus," Tim Marema reports for The Daily Yonder. The number of red-zone rural counties last week was "10 times higher than the number of rural counties than were in the red zone at the end of the Omicron surge in late winter." In comparison, more than 80% of metro counties were in the red zone last week.

"Despite the growth in the number of red-zone counties, the overall infection rates in both rural and metropolitan counties have remained relatively stable. That could be an indication that vaccinations and mitigation practices are helping contain the virus," Marema reports. "Another factor could be a reduction in the reporting of infections because of more at-home testing for the virus." Click here for more charts, regional analysis, and county-level interactive maps from the Yonder.

Supreme Court rules that states can prosecute non-Native Americans for crimes against Natives on tribal lands

On Wednesday the Supreme Court ruled that Oklahoma—and by extension all other state governments—can prosecute non-indigenous people for crimes committed against Native Americans on tribal lands. 

The 5-4 decision in Oklahoma v. Castro-Huerta "cut back on the high court’s ruling from 2020 that said a large chunk of eastern Oklahoma remains an American Indian reservation," Mark Sherman and Ken Miller report for The Associated Press. "The first decision left the state unable to prosecute Native Americans accused of crimes on tribal lands that include most of Tulsa, the state’s second-largest city with a population of about 413,000."

A state court later ruled that "the Supreme Court decision also stripped the state of its ability to prosecute anyone for crimes committed on tribal land if either the victim or perpetrator is Native American," Sherman and Miller report. "That would have left the federal government with sole authority to prosecute such cases, and federal officials had acknowledged that they lack the resources to prosecute all the crimes that have fallen to them. But the high court’s new ruling said the state also can step in when only the victims are tribal members."

Conservative justice Neil Gorsuch joined the court's three liberal members in dissent, writing that the ruling "allows Oklahoma to intrude on a feature of tribal sovereignty recognized since the founding."

Cherokee Nation Principal Chief Chuck Hoskin Jr. said the Supreme Court "ruled against legal precedent and the basic principles of congressional authority and Indian law," Sherman and Miller report. He said the court "failed in its duty to honor this nation’s promises, defied Congress’s statutes and accepted the 'lawless disregard of the Cherokee’s sovereignty,'" quoting in part from Gorsuch’s dissent. Republican Gov. Kevin Stitt is a member of the Cherokee Nation, but his efforts to return legal jurisdiction to the state have strained relationships with tribes, Sherman and Miller report.

Papers avoided pandemic 'extinction event' but more challenges loom, especially for family owners, expert says

There was good news in the State of Local News 2022 report from the Local News Initiative at Northwestern University, but bad news is still happening and it could get much worse, the director of the initiative said as he and a fellow researcher discussed the report Wednesday.

The loss of 360 newspapers since late 2019 was about double what longtime researcher Penny Abernathy expected, but the good news was that many observers thought the pandemic “could be an extinction-level event and it didn’t turn out to be that way,” said her co-researcher, Tim Franklin, director of the initiative and senior associate dean of the Medill School of Journalism.

Tim Franklin

During the pandemic, Franklin said, newspapers lost 40% of their advertising revenue but saw a 50% increase in digital subscriptions: “That showed the interest and the need for local news.”

But Franklin worries that inflation, led by skyrocketed prices for fuel and newsprint, “means it’s gonna be really tough sledding over the next year or two” for newspapers. Add to that the prospect of a recession, and “This could be a really pivotal moment for a lot of folks, but this could also accelerate the movement from print to digital.”

Hundreds of pivotal moments await family-owned weekly newspapers, which need buyers but don't want to sell to chains. Elizabeth Hansen Shapiro of the National Trust for Local News, which tries to keep newspapers in local hands, asked about the “time horizon” for family owners who need to find acceptable buyers. Franklin said the head of an unnamed press association told him two months ago, “This is urgent, we need to move fast; publishers are scared in many cases because of the economic situation.” Franklin added, “He was echoing sentiment from a lot of folks.”

The report by Abernathy and Franklin has a warning: "If current trends continue unabated, by the end of 2025, we will have lost a third of newspapers and almost two-thirds of journalists employed two decades ago in local newspapers, with only 600 or so news sites attempting to fill the gap."

AP probe of vote-fraud claims wins Public Service prize in Sigma Delta Chi Awards; weekly papers can publish it

Screenshot of interactive graphic by The Associated Press showing analysis of votes in six states

The Associated Press's comprehensive investigation of vote-fraud claims in the six battleground states that decided the 2020 presidential election won the top award for Public Service Journalism in the 2021 Sigma Delta Chi Awards of the Society of Professional Journalists.

At the request of the Institute for Rural Journalism and Community Issues, publisher of The Rural Blog, AP is allowing non-member weekly newspapers to publish the mainbar and other stories, which are still timely, given the congressional hearings into the Jan. 6, 2021, attack on the U.S. Capitol.

Other SDX Public Service awards went to Maine Public Radio for its reports on health-care mistreatment in the state prison and to KETK of Tyler, Texas, for "A Parent's Guide to Mental Health."

From Quiet Dell to the bloody sands of Iwo Jima: Last surviving World War II Medal of Honor winner dies at 98

Hershel "Woody" Williams

The last surviving Medal of Honor recipient from World War II died Wednesday, June 29. Former Marine Warrant Officer Hershel Woodrow "Woody" Williams, who won the medal for heroism on Iwo Jima, was 98. He died at the Department of Veterans Affairs medical center bearing his name in Huntington, West Virginia.

"Williams went ahead of his unit . . . and eliminated a series of Japanese machine-gun positions," The Associated Press reports. Earning the nation's highest military honor made him a prominent advocate for veterans, and may have also kept him from suffering post-traumatic stress disorder.

"Receiving the Medal of Honor was actually the lifesaver because it forced me to talk about the experiences that I had, which was a therapy that I didn't even know I was doing," Williams said during a 2018 Boy Scouts recognition ceremony in Fairmont.

The Hershel Woody Williams Medal of Honor Foundation works to establish Gold Star Family memorials in every state, honoring those who have lost a loved one in service. He was also involved in the National Medal of Honor Museum in Arlington, Texas, that is expected to open in 2024.

Wikipedia map

Williams stayed in the military following the war, serving for 20 years in the Marine Corps and Marine Corps reserve. For 33 years, he was a VA service representative.

Williams was born the youngest of 11 children on a dairy farm on Oct. 2, 1923. He grew up in Quiet Dell in Harrison County and was engaged during the war. Ruby Williams died in 2007 at 83; they had two daughters and five grandsons.

Pandemic spurred newspaper closures and mergers; U.S. is losing papers at the rate of two per week, report says

Labeled screenshot of Medill Local News Initiative map; for the interactive version with data, click here.

From late 2019 through May 2022, more than 360 U.S. newspapers closed, says a report today from researchers at Northwestern University, including one who has tracked the numbers for years.

Penelope Muse Abernathy, visiting professor at the Medill School of Journalism and principal author of the report, said at the National Summit on Journalism in Rural America June 3 that the number was about double what she expected. She said today that the losses are mainly in struggling communities, and were driven partly by the pandemic.

“I think it was an opportunity for many of the larger chains to say, you, know, this hasn’t been working and we have hit a precipitous point,” Abernathy said.

Most of the closed merged papers are weeklies, but "We are beginning to lose dailies," Abernathy said today. Many print or have electronic editions three or fewer times a week, "becoming the industry definition of a weekly." She counts 1,230 dailies now, down 16 percent from the 1,472 in 2004. In the 211 counties with no newspaper, only six have a digital journalistic replacement.

The trend "is further dividing the nation into wealthier, faster growing communities with access to local news, and struggling areas without," said a news release from Medill’s Local News Initiative. "Since 2005, the country has lost more than one-fourth of its newspapers and is on track to lose a third by 2025. . . . The United States continues to lose newspapers at a rate of two a week."

The report, “The State of Local News in 2022,” says more corporate and philanthropic funding helped create 64 new digital news sites covering state or local news, but most digital sites are in "digitally connected urban areas with diverse sources of funding," the report says.

About fifth of the U.S., 70 million Americans, live "in an area with no local news organizations, or one at risk, with only one local news outlet, and very limited access to critical news and information that can inform their everyday decisions and sustain grassroots democracy," the release says.

“This is a crisis for our democracy and our society,” Abernathy said in the release. “Invariably, the economically struggling, traditionally underserved communities that need local journalism the most are the very places where it is most difficult to sustain print or digital news organizations.” She noted research showing that, in places without strong news outlets, voter participation declines, corruption increases, misinformation spreads, political polarization increases trust in news media decreases.

"Surviving newspapers, especially dailies, have cut staff and circulation significantly under financial pressure," the release says. "This has sharply reduced their ability to provide news to communities that lose a weekly newspaper, further exacerbating an information gap not only in rural areas, but also in suburbs surrounding a city," the report says.

Large newspaper groups "continue to close or divest underperformers. The most active buyers in recent years have been privately held regional digital chains, such as Paxton Media Group and CherryRoad Media." CherryRoad has promised not to mine rural papers for profits.

The Medill Local News Initiative is a research and development project and website devoted to bolstering new business models. Its Subscriber Engagement Index helps newsrooms track digital subscribers, boost retention and attract new readers. It is run by Tim Franklin, senior associate dean of the school and its John M. Mutz Chair in Local News.

The report will be published on the Local News Initiative site through early August. This is the fifth update since Abernathy first published it at the University of North Carolina in 2016.

Supreme Court decision on football coach's post-game prayer is a game-changer, education-law expert says

This week's Supreme Court decision on a coach's post-game prayer is a game changer for public schools, says University of Dayton professor Charles J. Russo, an expert in education law.

The court has consistently ruled against school-sponsored prayer in public schools, and lower courts have mostly ruled that public-school employees can't openly pray at work even when students aren't involved. But on Monday the Supreme Court essentially affirmed employees' right to pray in the workplace. That could encourage more religious activities in public schools, Russo writes for The Conversation, a site for journalism by academic researchers:

"In Kennedy v. Bremerton School District – the Supreme Court’s first case directly addressing the question – the court ruled that a school board in Washington state violated a coach’s rights by not renewing his contract after he ignored district officials’ directive to stop kneeling in silent prayer on the field’s 50-yard line after games. He claimed that the board violated his First Amendment rights to freedom of speech and freedom of religion, and the Supreme Court’s majority agreed 6-3."

Coach Joe Kennedy said the board violated his rights to speak freely and to freely practice his religion. "The Ninth Circuit twice rejected these claims because it concluded that when he prayed, he did so as a public employee whose actions could have been viewed as having the board’s approval," Russo writes. "Moreover, the Ninth Circuit agreed with the school board that the district had a compelling interest to avoid violating the establishment clause. During oral arguments at the Supreme Court, though, it was clear that the majority of justices were sympathetic to Kennedy’s claims of religious discrimination and more concerned with his rights to religious freedom than the board’s concern about violating the establishment clause."

The case is important "because the court has now decided that public school employees can pray when supervising students," and it "largely repudiates the three major tests the court has long applied in cases involving religion," leaving legal precedent in such cases unclear, Russo writes.

The ruling "also helps close out a Supreme Court term when the current justices’ increasing interest in claims of religious discrimination was on full display, with another 'church-state' case decided in religious plaintiffs’ favor just last week," Russo writes. "And on June 24, 2022, the court overturned Roe v. Wade. The debate over abortion is often framed in terms of religion, even though the court’s holding focused on other constitutional grounds."

Though evangelical Christians call the case a win, Russo questions whether that's so: "The case brings to mind the saying to be careful what one wishes for, because one’s wishes may be granted. By leaving the door open to more individual prayer in schools, the court may also open a proverbial can of worms. Will supporters who rallied behind a Christian coach be as open-minded if, or when, other groups whose values differ from their own wish to display their beliefs in public?"

Health-care roundup: Providers in N.D. discuss challenges; regulations boosting telehealth expansion will expire soon

Here's a trio of stories about rural health care:

At a roundtable discussion Monday, rural health-care providers in North Dakota spoke to state and federal officials about the difficulties they face. Participants "cited workforce issues, regulations and rising costs as three challenges to provide services in rural areas," Masaki Ova reports for The Jamestown Sun. Officials in attendance included Sen. John Hoeven, R-N.D.; Xochitl Torres Small, the Agriculture Department’s undersecretary for Rural Development; and Erin Oban, her North Dakota director.

Rural hospitals had to adapt to survive during the pandemic, aided by federal funding. Some hospitals hope to keep some of those new capabilities, but may not be able to when the federal public-health emergency order expires—drying up funding with it.

Donald Lloyd, CEO of St. Claire Regional HealthCare system in Morehead, Ky., said the shift to telehealth is likely here to stay. "Before the pandemic, telehealth visits weren’t common at his hospital. Now telehealth visits account for nearly 20% of hospital visits," Liz Carey reports for The Daily Yonder. That goes especially for behavioral health, he said, since more than 80% of such visits to the hospital are via telehealth these days.

Speaking of telehealth: Relaxed regulations during the pandemic allowed health-care providers to more easily prescribe buprenorphine for opioid-abuse disorder. Studies have shown that telehealth prescription visits are at least as effective as in-person visits in keeping patients on their medication, but those regulations will expire along with the federal public-health emergency order. "That could come as soon as October, and the Drug Enforcement Agency, which has sought to clamp down on buprenorphine’s misuse, has already missed deadlines to facilitate virtual access," Krista Mahr and Ben Leonard report for Politico. "The expansion across sectors has been critical in rural areas, where access to licensed clinicians is scarce and social stigma runs high."

Election deniers mostly lose in GOP primaries Tuesday

Tina Peters (Associated Press photo)

Republican primary voters have nominated more than 100 candidates who endorse Donald Trump's claim that the 2020 presidential election was stolen from him, but such candidates didn't fare well, generally speaking, in Republican primaries Tuesday.

The epicenter was Colorado. "In races where the outcome was a tossup, election deniers fared poorly," reports Jesse Paul of The Colorado Sun. "Indicted Mesa County Clerk Tina Peters fared so poorly that she was slated to come in third in the Republican secretary of state’s primary to an Australian immigrant who lives in Yuma County and was making his first foray into politics. Peters, who claimed Tuesday night without evidence that she was the victim of election fraud, was even set to lose in her home county." The winner was Pam Anderson, "a former county clerk who previously led the state clerks’ association and defends the state's mail-in elections system," Steve Peoples of The Associated Press reports.

Also defeated in Colorado was state Rep. Ron Hanks, who "had also promoted lies about the last presidential election" and attended Trump's Jan. 6, 2021 rally, AP reports. He lost to Joe O'Dea, who now faces Democratic U.S. Sen. Michael Bennet. The Sun notes, "Tens of thousands of unaffiliated voters cast ballots this year in Colorado’s Republican primaries, far more than" in 2018,when more races were contested.

"In Mississippi, Trump loyalist Michael Cassidy lost a runoff election to incumbent Rep. Michael Guest, who had voted to create an independent commission to investigate the Jan. 6 attack," AP reports. "Cassidy said in campaign speeches that Guest had done nothing to stop 'the persecution of Jan. 6 political prisoners'." Guest had placed second in the first primary, making him the underdog, so the outcome could signal a shift in voters' attitudes about Trump and his claim.

On the other hand, in a rural-Illinois contest of incumbents matched up by redistricting, "First-term Rep. Mary Miller, who campaigned alongside Trump over the weekend, defeated five-term Rep. Rodney Davis, who was considered more moderate," AP reports. "The primary victory all but ensures Miller will return to Congress for another term, given the heavy Republican advantage in her 15th Congressional District, which is the most Republican district in the state. Miller won just days after describing the Supreme Court’s reversal of Roe v. Wade as 'a victory for white life.' A spokesperson later said she had intended to say the decision was a victory for a 'right to life'."

Thursday webinar will review new federal resource package that is meant to address rural homelessness

The Rural Health Information Hub will host a free webinar at 2 p.m. ET Thursday, June 30, to discuss a new federal resource package meant to help rural communities address unsheltered homelessness. The webinar is free and is expected to last about an hour. Click here for more information or to register.

From the website: "The U.S. Department of Housing and Urban Development (HUD) recently released a first-of-its-kind package of resources to address unsheltered homelessness, with a unique opportunity for rural communities. This Initiative for Unsheltered and Rural Homelessness being made available by HUD strongly promotes partnerships with health care organizations, public housing authorities and mainstream housing providers, and people with lived experience and expertise of homelessness.

"This $365 million package will help communities pursue a public health approach and they can use this opportunity to coordinate and scale up efforts to sustainably solve unsheltered homelessness, create a unified approach with shared responsibility among local governments, homeless services organizations, health care providers and housing agencies.

"Existing Continuum of Care programs can apply, and see Appendix B of the Notice of Funding Opportunity for the rural areas that are eligible for the $54.5 million rural set aside. We encourage health partners to check to see if their area qualifies and connect with the CoC partners. These grants will fund projects for three-years, after which they will be eligible for renewal through the annual Continuum of Care (CoC) program competition."

Population and jobs outside metro areas were boosted by the remote-work surge during the pandemic, but will it last?

Graphs by The Wall Street Journal

"Even in the face of inflation and the risk of recession, the broad economic prospects for rural America may be looking up for the first time in years," with a net gain in population of non-metropolitan counties from mid-2020 through mid-2021, "a sharp shift from the decade preceding the pandemic," report Sarah Chaney Cambon and Andrew Mollica of The Wall Street Journal.

Citing labor-analytics firm Lightcast, they say "Job postings in rural areas increased 52 percent from 2019 through 2021, compared with 11% in big cities." And the Congressional Budget Office estimated that wages grew an average 6.3% a year in rural areas from the end of 2019 through the end of 2021, compared with 5.7% in urban areas. . . . Over the 12 months through April, rural areas logged an average unemployment rate of 4.2%, below the 5.2% jobless rate of big cities."

"Since the pandemic, many are seeing an infusion of remote workers drawn by lower costs, laid-back lifestyles and natural beauty—and worn down by crime and other urban challenges," the Journal reports. "Their presence has helped spur hiring, income gains and home-price growth in rural towns. The question now is whether these transplants are there to stay."

The reporters' object example is Litchfield County, in northwestern Connecticut, two hours from New York City. Realtor Gary Giordano told the Journal, Giordano said. “There's an economic turnaround, for sure. More and more people wanted to leave the city, came up here, bought houses, realized that this might not be a bad place to work.” But for how long, amid high fuel prices and other inflation?

Another sign of the uptick: A website for the region
north of New York City is starting a print magazine.

The rural uptick "could be vulnerable to a national economic downturn," and will "depend on how far the back-to-the-office movement goes," Cambon and Mollica write. "In recent months, office re-openings and waning pandemic disruptions have drawn some workers back to urban life." Another real-estate broker, David Sartirana, told them that "There's definitely been a slowing down."

The New York region may not be the best example "Big, dense cities are particularly susceptible to losing residents because they are expensive and employ the largest share of workers in jobs that can be done remotely in sectors such as finance, management and publishing, according to Princeton University economist Lukas Althoff and co-researchers," the Journal reports.

One of the New York transplants in Litchfield County is Kevin Steck, a software engineer who grew up there. "He usually works part of the week from his Winsted house, with views overlooking a 445-acre lake," the Journal reports. "The other part of the week he sets up his laptop in places such as Brinx, a coffee shop in nearby Torrington. The owners there know that he likes his coffee black." Steck likes that: “It feels good; it feels like you’re part of a tightknit community.”

July 4 cookout may cost $10 more than last year's, biggest jump since Farm Bureau began tracking 10 years ago

American Farm Bureau Federation graphic

"The supermarket tally for an Independence Day cookout is a first-hand look at inflation — up by 17% from last summer, with the skyrocketing price of meat a leading reason," Chuck Abbott reports for the Food & Environment Reporting Network., citing the American Farm Bureau Federation's annual report. Volunteer price checkers' data showed that "The groceries to feed 10 people at a cookout would cost $69.68, almost $10 more than last year."

Though the cost increase is still affordable for most Americans, it's the largest jump since the organization began compiling the survey 10 years ago, AFBF chief economist Robert Cryan told Abbott.

"The AFBF shopping list included seven pounds of meat — ground beef, chicken breasts and pork chops — all of it costing at least 30% more than last summer. Meat accounted for half of the price tag for the cookout," Abbott reports. "Also on the shopping list were pork and beans, potato salad, potato chips, hamburger buns, sliced cheese, vanilla ice cream, strawberries and a bag of chocolate chip cookies. All cost more than last year except for the cheese, strawberries and potato chips."

The price of next year's cookout could be even higher. Cryan told Abbott he predicts "significant inflation, between 5 and 9% for the next couple of years." Better make it a pot-luck.

New tool helps rural governments figure out what funding they can get from the $1 trillion infrastructure package

Screenshot of the Bipartisan Infrastructure Law Navigator tool

Last year's infrastructure bill had $1 trillion in funding for state and local governments. A new interactive tool aims to help governments, agencies and other stakeholders figure out who qualifies for what funding.

McKinsey & Co., a top management-consulting firm specializing in corporations, governments and other entities, created the tool for internal use, but released it to the public after it proved helpful to clients trying to navigate the avalanche of information in the infrastructure law. The tool helps users search by agencies, deadlines, milestones, and statutory requirements, Kristi Eaton reports for The Daily Yonder.

The tool should be particularly helpful for rural local governments with fewer resources that can find it difficult to figure out complex federal programs, McKinsey senior partner Adi Kumar told Eaton: "I personally have heard time and time again, from leaders across the country, that small communities, municipalities, local governments, government agencies that lack resources are having a really hard time not only navigating the law, but also cobbling together the resources to attempt to get more resources."

Two convicted for rural-hospital lab-billing scam in 3 states

"Two Miami men were convicted Monday for conning vulnerable addiction treatment patients, rural hospitals and health insurance companies out of $1.4 billion in a health-care fraud scam that spanned Florida, Georgia and Missouri, according to authorities," Omar Rodriguez Ortiz reports for the Miami Herald. "Jorge Perez, 62, and Ricardo Perez, 59, were found guilty of conspiracy to commit health-care fraud and wire fraud, five counts of health-care fraud, and conspiracy to commit money laundering of proceeds greater than $10,000."

To help rural hospitals stay open, Medicare and some insurers reimburse them for laboratory services at higher rates. The defendants exploited that through Jorge Perez's company EmpowerHMS: "They promised to save the rural hospitals from closure by converting them into laboratory testing sites, but instead billed health-insurance companies for fraudulent laboratory testing worth hundreds of millions of dollars in a sophisticated and years-long billing scheme," Ortiz reports. "The plot made it appear that the rural hospitals themselves did the laboratory testing when, in most cases, it was done by testing laboratories controlled by others, the department added." When insurers began questioning the billings, the company would move on to another hospital and leave the one they had used for scams in the same or worse financial shape.

It's only the latest such scheme Jorge Perez has been involved in. A Kaiser Health News investigation in 2019 detailed how Perez and his company, EmpowerHMS, used hospitals in Arkansas, Kansas, Missouri, Oklahoma, Tennessee, and more to perpetrate billing scams. Most of the hospitals EmpowerHMS managed or owned have shut down.

Podcaster's rise and Colorado primary today illustrate increasing comfort with violent rhetoric on the right wing

Joe Oltmann (Photo: Olivia Sun, Colorado Sun/Report for America)

Right-wing podcaster Joe Oltmann regularly hypes up Colorado listeners with violent rhetoric, in one recent instance suggesting that Gov. Jared Polis, a Democrat, be hanged. He said afterward it was a joke, but some listeners may not take him that way. "The violent rhetoric has contributed to such a tense political climate that Colorado Secretary of State Jena Griswold (D) — a frequent target of Oltmann’s denunciations — now travels with a security detail, a first for the office she said," Rosalind Helderman reports for The Washington Post. "Oltmann, a businessman who gained a national profile on the far right after he claimed he had personal knowledge that the 2020 presidential election was rigged, is hardly a fringe figure. He now leads an influential and growing political movement in Colorado that is shaking up the state Republican Party."

His influence will be tested today, as Colorado voters decide whether candidates Ultmann has endorsed will advance to the general election. One is Tina Peters, the Mesa County clerk who was indicted on multiple felonies after allegedly sneaking someone into the county elections offices to copy the hard drives of Dominion Voting Systems machines in an attempt to prove election fraud. "Peters, who has denied wrongdoing, is now running to be the Republican nominee for secretary of state, a position that would give her sway over future Colorado elections," Heldman reports. "Oltmann has embraced her as a rising political star, hosting her on his podcast and appearing at joint public events where she has received wild applause."

Oltmann's rise "shows how the stolen-election myth has vaulted previously unknown figures into positions of prominence within the GOP," Helderman reports. "It also provides a window into the state of the Republican grass roots — where belief that the 2020 election was rigged has become widespread, and comfort with extreme and violent rhetoric is growing." Arizona senator Wendy Davis is another example of a conservative who pivoted to extremist views as a means to gain power.

"Oltmann’s political organization — FEC United, standing for 'Faith, Education and Commerce' — is less than two years old, but it has been advocating for candidates up and down the Colorado ballot, from key statewide positions to obscure county jobs," Helderman reports. Federal, state and local candidates he supports in a wide variety of offices are all running on platforms focused on the myth of the stolen election. "It’s amazing. Whether they’re running for coroner or sheriff or clerk, their platform is focused on elections," Chuck Broerman, the elected clerk of Colorado’s El Paso County (Colorado Springs) and a former chairman of the county GOP, told Helderman.

"Meanwhile, FEC United has grown more active in local politics, with members showing up at school-board meetings around Colorado to complain about mask mandates in schools," Helderman reports. "During a speech last year, Oltmann bragged that the group had endorsed 53 candidates for school board elections in 2021, and he claimed that all 53 had won. He did not name them."

Some Democrats are promoting Republican election deniers, thinking them easier to beat. "Democrats are behind some of the ads promoting more conservative Republican candidates for U.S. Senate, Colorado governor and the 8th Congressional District," Sandra Fish reports for The Colorado Sun. "The strategy has been criticized by some Democrats, who warn that it could backfire by raising the profile of election deniers and potentially adding fuel to their movement." The triangulating is spurring "a wave of campaign finance complaints and raising ethical questions about some of the political maneuvering," Fish reports.

New data on 'news deserts' coming Wed.; Abernathy says papers' recent closure/merger rate twice what she expected

Penny Abernathy of Northwestern previewed her research at the National Summit on Journalism in Rural America.

The latest research on news deserts will be presented at 10:30 a.m. CT Wednesday, June 29, by Professors Penelope Muse Abernathy and Tim Franklin of the Medill School of Journalism, Media, Integrated Marketing Communications at Northwestern University. Register here to attend.

They will talk about the number of newspapers closed between the pre-pandemic months of late 2019 and the end of May 2022, the hardest hit communities, causes, consequences and solutions. At the recent National Summit on Journalism in Rural America, Abernathy said the rate of mergers and closures during the period was double what she expected, and they are now being seen in affluent communities.

“This is a crisis for our democracy and our society,” said Abernathy, visiting professor at Medill and the principal author of the report. “Invariably, the economically struggling, traditionally underserved communities that need local journalism the most are the very places where it is most difficult to sustain print or digital news organizations.”

Abernathy, who popularized the term "news desert," defines it as "A community, either rural or urban, with limited access to the sort of credible news and information that feeds democracy at the grassroots level and helps residents make wise decisions about issues that will affect their quality of life and that of future generations."

The report will not be made available until the press conference. It will be published on the Local News Initiative site on June 29. This is the fifth update of the report since Abernathy first published it in 2016 at the University of North Carolina.

Despite billions in federal subsidies over more than a decade, many rural areas still await broadband internet

Maps by The Wall Street Journal; click on the image to enlarge it.

"The U.S. government has spent billions of dollars on several rounds of programs to upgrade internet speeds in rural areas over the past decade. Despite those efforts, many residents are still stuck with service that isn’t fast enough to do video calls or stream movies—speeds that most take for granted," Ryan Tracy and Anthony DeBarros report for The Wall Street Journal. "Many communities have been targeted for broadband upgrades at least twice already, but flaws in the programs’ design have left residents wanting."

The Journal analyzed 1.4 million mostly rural census blocks included in nationwide Federal Communications Commission broadband programs over the past decade. The latest one, 2020's Rural Digital Opportunity Fund, awarded internet service providers the right to build out broadband in about 750,000 census blocks. "The Journal's analysis found that more than half of those census blocks—areas with a combined population of 5.3 million people—had been fully or partially covered by at least one previous federal broadband program," Tracy and DeBarros report.

About 70 percent of households with no access to broadband internet are rural, according to a 2019 study by the Purdue Center for Regional Development. That's about 4.8 million people in 2.2 million housing units who don't have internet with speeds of at least 25 megabits per second for download and 3 Mbps upload, according to data submitted by internet service providers.

The FCC launched the Connect America Fund in 2012, awarding bids to telecommunications companies to build out rural broadband that met minimum speeds of 10 megabytes per second for download and 1 Mbps for upload. But big telcos won most of the contracts, and installed relatively cheap and slow digital-subscriber-line service instead of cable or fiber-optic networks and pocketed the difference. DSL met the minimum download speed of 10 Mbps; after major pressure, the FCC increased the definition of broadband to 25 Mbps upload and 3 Mbps upload, or 25/3.

"It’s not surprising that companies made a business decision to do the bare minimum," Carol Mattey, an industry consultant and former senior FCC official, told the Journal.

"In an effort to upgrade as many people as possible with limited funds, the FCC chose to subsidize incremental improvements," Tracy and DeBarros report. "Many of those upgrades quickly became outdated as technology advanced and consumers wanted faster speeds. In other cases, internet providers were allowed to pick which customers to upgrade. This helped ensure companies would participate. It also meant they could take public money while leaving pockets of homes and businesses without access."

The Journal uses Heavener, Okla., a community of 3,000, to illustrate how rural people get left behind even after federal funds are spent to give them broadband access. Many parts of Heavener and surrounding areas have been covered by three different broadband programs over the past decade.

In 2012, Windstream Holdings Inc. won $716,782 to make broadband upgrades in the county. The company installed fiber-optic on a major highway leading into town, but used DSL for the "last mile" connection to homes—something local homes already had, Tracy and DeBarros report. Windstream said moving the fiber line closer to their homes should have improved speeds, but locals said they didn't see any improvement. Later, the company installed a radio tower nearby that delivered wireless broadband to some homes, but many homes couldn't access that, and the speed was still far slower than fiber.

Windstream got another $7.8 million between 2015 and 2021 for broadband buildout, but "FCC rules for those funds didn’t oblige Windstream to serve every customer equally, as long as it served a minimum number of locations statewide," Tracy and DeBarros report. "The company said the money covered roughly half of its operating and capital expenses in very high cost areas of the state where it might not be profitable to offer service without subsidies. It said it exceeded the terms of the FCC program by providing 10/1 Mbps service to more than the minimum required locations."

Heavener residents told the Journal that lack of broadband in the early days of the pandemic made work and schooling nearly impossible for many.

Newer funding might have better results. The infrastructure bill passed in 2021 included $42.5 billion for rural broadband. "Companies taking those funds will have to provide service at faster speeds than previous federal programs, and the money will come through states instead of the FCC," Tracy and DeBarros report. "Officials said they hope that will help identify which areas are most in need and which providers can best serve them."

Early federal aid in the pandemic helped wealthy, urban hospitals far more than rural ones, Washington Post reports

In 2020, Congress authorized $178 billion in federal aid to help hospitals stay open. And while the money helped hospitals—many rural—stay afloat, data show that the funds "exacerbated the gap between the industry’s haves and have-nots, disproportionately rewarding wealthy hospitals that did not need the money as urgently," Christopher Rowland reports for The Washington Post. "Many institutions reported strong profits and pursued growth strategies without pause."

Rowland illustrates the phenomenon by contrasting the fortunes of a rural hospital in North Carolina and a larger regional hospital nearby. Randolph Health, a 145-bed rural hospital in central North Carolina, "declared bankruptcy in March 2020 and might have closed for good if it had not received $14.5 million in federal emergency pandemic grants. The cash didn’t cover all its Covid-related losses, but at least Randolph could make payroll," Rowland reports.

"The money flowing from Washington was barely enough to keep Randolph afloat — but those funds proved to be a windfall for Atrium Health, a regional nonprofit hospital chain headquartered in Charlotte. Atrium got $617 million in government relief from April 2020 to December 2021," Rowland reports. "The money, along with a soaring stock market and surging payments for patient care, helped it reap more than a billion dollars in surplus revenue last year. Atrium bulked up with two mergers and announced plans for a third during the pandemic. It boosted its CEO’s compensation by 24 percent, to $9.8 million."

A recent report from North Carolina's treasurer catalogued the hundreds of millions of dollars in federal aid given to the state's largest hospitals and contrasted it with their strong financial performance early in the pandemic. Treasurer Dale Folwell told the Post that the hospitals should have used the money for charity care, lower prices or even used reserves to cover pandemic costs and returned the money. But Cody Hand, a senior vice president of the North Carolina Hospital Association, told Rowland it would have put the "entire state bond rating in jeopardy" if larger hospitals had dug into their reserves to deal with increased demand.

"Now that the dust settles, we realize many hospitals got more than what they needed," said Ge Bai, a Johns Hopkins University professor of accounting and health policy management who advised the treasury department on the report.

Why did that happen? "The initial federal bailout formula, hastily put in place by the Trump administration to help hospitals cope with these burdens, bestowed a disproportionate share on wealthier hospitals. Distribution of the first $50 billion was calculated based on each hospital’s 2019 Medicare billings and 2018 overall patient revenue, including payments from private-insurance companies, which pay the highest rates," Rowland reports. "That put weaker safety-net hospitals, which serve higher numbers of uninsured people and low-income Medicaid patients, at a disadvantage. Medicaid typically pays hospitals less than Medicare and private insurance. Later distributions were tailored to favor hospitals hit with the most Covid patients, as well as those in rural communities and with large Medicaid populations. But those rounds of assistance were each smaller than the initial $50 billion, which automatically arrived in the bank accounts of hospitals and physician practices without even requiring an application."

Biden signs extension of pandemic waivers for school meals

Congress has passed and President Biden has signed a one-year, $3 billion extension of pandemic waivers for school meals. "Proponents said the extension would prevent 'a summer hunger crisis' and called for Congress to expand the school food program, rather than limit access," Chuck Abbott reports for the Food & Energy Reporting Network. "The extension allows free meals to all students this summer, increases the federal reimbursement rate to schools for each meal served and gives schools leeway throughout the 2022-23 school year in meeting nutritional standards for meals while they cope with supply shortages."

Thanks to federal aid, school meals have been free to all students since the beginning of the pandemic. But when classes resume in the fall, schools will return to the pre-pandemic system of serving free meals only to children from low-income households unless the school district has a different arrangement, Abbott reports.

Senate Agriculture Committee Chair Debbie Stabenow, D-Mich., "said she was disappointed by the removal, during Senate negotiations, of a provision that offered meals for free in the new school year for children who ordinarily would qualify for reduced-price meals. Revival of the reduced-price category allowed enactment of the extension before the current set of nutrition waivers expires on June 30," Abbott reports. "Elimination of the reduced-price category has been proposed periodically for years. About 6% of students fall into that category and pay up to 40 cents for lunch. Two-thirds of lunches are free to pupils from households with incomes below 130% of the federal poverty line. Children pay a reduced price for lunch if they are from households with incomes between 130% and 185% of the poverty line."

The Food Research and Action Center, an anti-hunger group, said the extension was a "critical first step to help avert a summer hunger crisis" but said more is needed, Abbott reports. "Without access to free school meals, an alarming number of children will be at risk of hunger," said the group in a statement. "As we look ahead to the upcoming school year, we call on Congress to make additional investments in child nutrition programs through the upcoming budget reconciliation to prevent child hunger and support children’s access to free school meals."

Town with 1 resident illustrates depopulation of Great Plains

Elsie Eiler, standing, takes orders at the Monowi Tavern (New York Times photo by Alyssa Schukar)

It's only a coincidence that Monowi, Nebraska, looks like it starts with Greek for "one." The name is reportedly a Native American word for "flower," but it's apropos; the town has only one resident.

In pictures and words, Alyssa Schukar of The New York Times paints a haunting, nostalgic portrait of Monowi and its last resident. Elsie Eiler, 88, still runs the Monowi Tavern 12 hours a day except Mondays. It's been in the family since 1971, but since Eiler has no successor, the last business in Monowi will likely shut down when she retires.

"The town continues to exist only because Mrs. Eiler files the required county and state paperwork every year. On top of bartending and cooking, she is the town’s mayor and tax collector," Schukar reports. Eiler told her, "The bar is the town, and I’m the town We’re all so intermeshed, you can’t quite imagine one without the other."

Wikipedia map of Boyd County, adapted

In the meantime, the tavern serves as one of the last gathering places in 550-square-mile Boyd County, one of many Great Plains counties with long-term population loss, Schukar notes: "About 2,000 people still live in the county, down from a peak of 8,800 in 1910."

Schukar explains the decline to urbanites: "Farm sizes have steadily grown in recent years, as larger, more efficient operations became better suited to survive the industry’s shift to a global market. Small family farms — once the backbone of the local economy — had to expand their operations or get out. Many got out. And without a way to make a living, generations of young people left for jobs in cities. Towns and businesses disappeared in their absence."