Friday, April 05, 2024

Opioid settlement payments to state and local governments can now be tracked with this online tool

KFF Health News tool, from BrownGreer data
Beginning in 2022, state and local governments started receiving opioid settlement funds from companies that made, sold or distributed prescription opioids. Tracking the flow of opioid money into communities can now be done using a new online database from KFF Health News, report Aneri Pattani, Lydia Zuraw and Holly K. Hacker. "Determining how much money has arrived is the first step in assessing whether the settlements will make a dent in the nation’s addiction crisis."

The database reflects only the largest settlement so far, $26 billion to be paid by pharmaceutical distributors AmerisourceBergen (now called Cencora), Cardinal Health and McKesson, as well as opioid manufacturer Janssen (now known as Johnson & Johnson Innovative Medicine). The $26 billion will be paid over two decades, KFF News reports. "As of late February 2024, more than $4.3 billion had landed in government coffers."

This first piece does not include settlements with other drug manufacturers and retailers, such as Walmart, Walgreens and CVS. Data from these companies will be added in July, according to BrownGreer, the settlement firm that gets the money and makes the payments. It is not handling some additional settlements, such as the agreement between Kentucky and four Midwestern states with regional supermarket chain Meijer.

Other settlements, including with OxyContin manufacturer Purdue Pharma, are pending.

Cows and people are susceptible to H5N1 avian flu; scientists are still learning how the disease moves

Big cats can contract H5N1.
(Photo by M. Foskett, Unsplash)
Amid outbreaks of H5N1 avian flu in birds and other wildlife species, the disease has now infected cows and humans. "Texas health officials reported that an individual who had been in contact with cattle has contracted H5N1 avian flu, only the second case ever recorded in the U.S.," reports Helen Branswell of STAT. "The individual's only symptom is eye inflammation — infection of the conjunctiva, the tissue surrounding the eye. . . .The infected individual was treated with the influenza antiviral oseltamivir, sold as Tamiflu."

Confirmed H5N1 outbreaks in cattle have been reported in Texas, Kansas and Michigan, alongside presumed cases in New Mexico and Idaho. "The virus doesn't kill the cattle, but milk production is lowered, and the animals' feeding is reduced," Branswell explains. Previously, cows weren't considered susceptible to H5N1, which is deadly for birds and has been contracted by numerous mammals, including big cats, bears, foxes, donkeys, goats and dogs.

Earlier versions of H5N1 have proved more deadly for humans, but as the disease has evolved, it "seems to trigger human infections less frequently than earlier versions of the virus did. And when human cases caused by this strain occur, they are typically mild," Branswell reports. "But people who have studied influenza — and this virus in particular — for years do not know what to make of its movement into so many different animal species."

Richard Webby, an influenza virologist who heads the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals at St. Jude Children's Research Hospital in Memphis, Tenn., "called the infections in cows 'a head-scratcher,' saying he would not have figured cattle to be on the list of animals susceptible to this virus," Branswell writes. Webby added, "​​This particular version of H5 is teaching us a number of things we thought we knew weren't right."

Many high school graduates are choosing vocational training for trades that pay well and don't require 4-year degrees

Trade education is less expensive and offers good wages.
(Photo by Robert Lambert, Unsplash)
For decades, U.S. high school graduates who wanted to make a decent living went to college, but as skilled labor numbers have dwindled and higher education costs have soared, Generation Z is donning tool belts and embracing the trades, reports Te-Ping Chen of The Wall Street Journal. "Skilled trades are newly appealing to the youngest cohort of American workers. . . Rising pay and new technologies in fields from welding to machine tooling are giving trade professions a face-lift, helping them shed the image of being dirty, low-end work."

The cost of a college degree has made it less appealing to some high school graduates. "Enrollment in vocational training programs is surging as overall enrollment in community colleges and four-year institutions has fallen," Chen writes. "The number of students enrolled in vocational-focused community colleges rose 16% last year to its highest level since the National Student Clearinghouse began tracking such data in 2018."

For some potential students, work that means sitting at a computer all day isn't appealing, but learning a hands-on trade for good pay seems to offer more rewards. "'Not everyone needs a degree, and it takes the value out of a degree if everyone has it,' says George Belcher, 18, a high school senior in Texas. Belcher long assumed he'd go to college, but. . . he grew curious about life in the oil industry," Chen reports. "This fall, he'll enroll in trade school for $14,000 for a two-year degree and plans to work on an offshore oil rig. 'I love the ocean,' he says. He also likes the idea of working for weeks, then resting for weeks, a schedule typical with such roles."

Overall, many trade-oriented employers see their labor pipelines refilling. "At energy service company Lantern Energy, in Glastonbury, Conn., CEO Peter Callan says in the past year, he has seen more people applying for technician jobs who were on a college track and decided it wasn't ultimately for them," Chen adds. "The overall number of applications the company receives has roughly tripled in the past five years."

After years of negotiating, California has found a way to connect renewable energy sources with their stressed grid

When interconnected, solar energy can help bigger, more
stressed power grids. (APPA photo, Unsplash)
A new agreement in California has brought energy stakeholders together to help the state's taxed grid.

"For years, utilities have grappled with how to handle the ever-growing number of solar and battery systems trying to connect to the lower-voltage grids that deliver power to customers," reports Jeff St. John of Canary Media. "But distributed solar and battery resources can also be enormous assets: By holding back power when the grid doesn't need it and then sharing their extra power during periods of high demand, they can help alleviate grid strains and lower the cost of keeping the grid running for everyone."

The agreement between California regulators, utilities and clean-energy proponents has taken "nearly four years to hash out," St. John reports. "But in mid-March, the California Public Utilities Commission approved new interconnection rules that take into account how, with the right structures in place, solar and solar-plus-battery systems can be more help than hazard to California's overworked grid."

CPUC's new policy allows solar and battery projects to "modulate how much power they send to the grid with the help of either solar inverters whose power-control systems can reduce power output from moment to moment or batteries that can soak up excess solar power and inject it back into the grid later," St. John explains. 

Solving grid-interconnection conflicts is a nationwide challenge. 

St. John rreports, "Utilities have very good reasons to take a conservative, safety-first approach to interconnection. After all, they're responsible for keeping grids safe and reliable — and distributed energy resources represent potential disruptions to those grids that utilities can't directly control."

Quick hits: Wayne County murals showcase 'Walldogs'; a Midwestern state of mind; the eclipse capital is in Illinois

Willie Nelson singing at the first Farm Aid concert in 1985.
(Wayne Walldogs photo via Successful Farming)
Murals in Wayne County, Iowa, stand as a testament to the region's dynamic and resilient history. "Wayne County, a part of the Mormon Trail, where Brigham Young led his followers from Illinois to Utah in 1846, is also known for its excellent hunting opportunities, large Amish community, and well-appointed historical museum," reports Lisa Prater Froust of Successful Farming. "Last year, these historical events and figures were vividly brought to life in 16 murals painted during the five-day Wayne County Walldogs Festival." Not sure what 'walldog' is? Click here.

The Midwestern United States 
(Wikipedia map, from Census Bureau data)
Think you're a Midwesterner? For most residents, the answer depends on geography, but some people have other ideas. "Everyone knows places such as Ohio and Minnesota are solidly in the Midwest. But a recent poll finds that the Midwest is more a state of mind than just a place you can point to on a map," report Ben Kesling and Jennifer Levitz of The Wall Street Journal. "People from Colorado (42%), Oklahoma (66%) and even Wyoming (54%) think they live in the Midwest. . . . Some locals are baffled: 'Who ARE you people?'"

Pluto was demoted to one of dozens of dwarf
planets. (NASA photo via Nat Geo)
In 1930, a farm boy turned astronomer from Streator, Illinois, Clyde William Tombaug, discovered Pluto, which was designated our solar system's ninth planet, but then in 2006, Pluto got demoted. "Mike Brown, CalTech professor of astronomy and author of How I Killed Pluto and Why it Had it Coming, crashed the party and took away Pluto's planetary classification," reports Eric Alt of National Geographic. "Ever since the worlds of science and pop culture have debated Pluto's fate. . . . the matter seems far from settled."

Some news sources say the U.S. economy is recovering from the dark days of the pandemic, with most measures reporting a healthy rebound despite inflation's hold on grocery and housing costs. That's one picture. Talk to a local pawnbroker, and you'll hear a different report. "Accumulating pawnshop inventory means fewer buyers than sellers – a sign that for the lowest-income Americans, times remain tough," reports Lauren Villagran of USA Today. "Some Americans – people with retirement plans, savings and stock holdings – may gripe about inflation and the economy, but they're doing all right. Others are surviving pawn to pawn."

Location of Mikanda in Jackson
County, Illinois. (Wikipedia map)
The U.S. eclipse capital is the unassuming southern Illinois town of Mikanda, Illinois, pop. 500. It has been "blessed by the cosmos for the second time in under 10 years," reports Hunter Bassler of KSDK in St. Louis, Missouri. "Mikanda is the exact intersection for both the 2017 and 2024 eclipses, an astronomical wonder that rarely ever happens in such a short time span, according to NASA. . . . Village officials are preparing for bigger crowds this year."

Rainbow over Cheesebox Butte. Cheesebox Canyon is a popular Bear Ears hiking trail.
(Photo by Stephen Trimble, Writers on the Range)

Without knowing the region's history, Bear Ears National Monument evokes thoughts of strength, softness, and beauty. Dive deeper into the story of this 1.36 million-acre site in southeast Utah, and a timeline of battles, historical power dynamics and unresolved conflict emerges. "The political tussle over this stunning expanse of red rock canyons exemplifies all the cultural dissonance in the rural West," writes Stephen Trimble in his opinion for Writers on the Range. "White residents never envisioned challenges to their political power. But in 2009, the feds came down hard on generations of casual pothunting by local white families. Then, after a century of oppressing their Indigenous neighbors, lawsuits strengthened Native voting rights."

Tuesday, April 02, 2024

Survey shows many Americans think grocery stores and restaurants -- but not farmers -- are overcharging them

In November 2023, The Rural Blog excerpted this question: "Is Chris Stapleton the one thing that America can agree on?" A new review of what people think of their food supply shows another topic most Americans agree on: food and staples are too expensive, and farmers aren't the primary problem.

University of Illinois and Purdue University agricultural experts examined the February Gardner Food and Agricultural Policy Survey results to "explore U.S. consumers' perceptions of firm size and pricing strategies of four important players in the food system — farmers, food manufacturers, grocery stores, and restaurants," Farmdoc Daily reports. The survey aims to include broader public opinions on food, from supplies to how food tastes.

As part of the survey, participants were asked  “Do you think any of the following groups in the food system are too big (i.e., have too much control or share of the market)?"

Gardner Food and Agricultural Policy Survey, February 2024

"The majority of consumers are concerned about the size of food manufacturers and grocery stores, with 67.8% and 51.6% indicating that these types of players in the food system are too big," Farmdoc reports.

Survey researchers also reviewed whether participants who felt food systems were too big fell along party lines. They did not. They noted, "We find that the majority of consumers across political parties thought food manufacturers and grocery stores were ‘too big’—highlighting that concerns about firm size have become a priority across party lines."

Gardner Food and Agricultural Policy Survey, February 2024

Consumer participants were asked which, if any, food provider was overcharging the public. Researchers wrote, "We find that over 70% of consumers think that restaurants, grocery stores, and food manufacturers are overcharging them. Far fewer (21.9%) thought that farmers were overcharging consumers."

Gardner Food and Agricultural Policy Survey, February 2024

For more details on survey questions and answers, Farmdoc Daily provides a readable pdf here.

Student absenteeism rose sharply after the pandemic and shows no signs of improving; teachers are absent more, too

Kids need more classroom time to learn.
(Photo by Kenny Eliason, Unsplash)
Even before the pandemic, getting kids off to school wasn't easy. But in post-Covid period, school attendance has sunk for many reasons, and efforts to get students and families to return to their previous routines have failed.

"Perhaps no issue has been as stubborn and pervasive as a sharp increase in student absenteeism, a problem that cuts across demographics and has continued long after schools reopened," report Sarah Mervosh and Francesca Paris of The New York Times. Across the United States, an "estimated 26 percent of public school students were considered chronically absent last school year, up from 15 percent before the pandemic. . . .Chronic absence is typically defined as missing at least 10 percent of the school year, or about 18 days, for any reason."

Across all demographic measures, fewer kids attend school regularly, but lower-income communities face the largest number of absences. The Times reports, "Around 32 percent of students in the poorest districts were chronically absent in the 2022-23 school year, up from 19 percent before the pandemic."

Once the engrained family routine of getting up, getting dressed and getting to school was broken, families found new ways to manage mornings without school, and past habits have not returned for many. Katie Rosanbalm, a psychologist and associate research professor with the Center of Child and Family Policy at Duke University, told the Times, "Our relationship with school became optional."

Despite many families' apathetic response, returning students to the classroom is vital for learning and student success. "Today, student absenteeism is a leading factor hindering the nation's recovery from pandemic learning losses, educational experts say. Students can't learn if they aren't in school," Mervosh and Paris write. Adding to the problem is an increase in teacher absences.

Many parents and educators wonder if the degree of absenteeism and different attitudes toward education are the new normal. "Bringing about meaningful change for large numbers of students remains slow, difficult work," the Times reports. 

In Montana, the cost of living and lack of affordable housing and child care contribute to growing workforce shortages

Rural Montana is a 'canary in the coal mine' for severe 
 labor shortages in needed sectors. (N. Fouriezos photo)

Across the country, the need for a younger workforce to fill a wide range of positions is reaching a critical point, but particularly for rural areas. Students and potential workers face a range of obstacles that prevent them from filing those roles, reports Nick Fouriezos of The Daily Yonder. In Montana, medical, academic and labor professionals are working to address these issues.

Lindsey Flather from Bitterroot Valley, Montana, is the kind of student Montana's new strategies aim to help. Fouriezos writes, "A working mother in her thirties, Flather decided to pursue a new career in health care. . . . And she is urgently needed. In Montana, 52 of 56 counties — including Ravalli County — are considered medically underserved, and nearly half of the state’s nurses say they plan on retiring or leaving the profession in the next five years."

Like many of her fellow students, Flather has faced long commutes for classes, a lack of child care options, and juggling to make work and school mend together. "At the same time, employers are desperate to get more people through these workforce pipelines," Fouriezos explains. "They, too, are challenged by geography, says Rebecca Conroy, the chief transformational officer at Bitterroot Health, a regional hospital in western Montana."

Yet even when needed professionals, such as medical assistants, graduate they often can't afford to live in the county where they are needed most. "The median rent in Hamilton, Bitterroot Valley's biggest town, is now $2,087, up 30% over the previous year," Fouriezos reports. "The lack of affordable housing makes it almost impossible to recruit out-of-towners, and the in-town workforce is drying up. The talent pipeline is thin, Conroy says. And the pressure is only growing."

"Employers like Conroy are the canaries in the coal mine of a growing talent shortage nationwide. So smoothing the route to jobs like medical assisting has become a key focus of Montana’s government and educational infrastructure," Fouriezos writes. "The state’s colleges recently partnered with the national nonprofit Education Design Lab to interview Conroy and local business leaders statewide about how they might create new educational opportunities, like a set of micro-credentials to allow people to build key skills in shorter courses over time."

'Toxic stress' can speed up aging and lead to other health problems; reducing stress levels can make a difference

Toxic stress can lead to unhealthy conditions.
(Photo by Luis Villasmil, Unsplash)

Not all stress is bad, but how does a person know when stress has crossed from a normal response to a health threat? And what can people do to change those feelings? Lawson R. Wulsin, a psychiatrist specializing in psychosomatic medicine, which focuses on people with physical and mental illnesses, discusses what good and toxic stress look like and what we can do about it in his commentary for The Conversation, a journalistic platform for academics.

One of the harshest truths about stress is that it speeds up aging. "A 2023 study of stress and aging over the life span — one of the first studies to confirm this piece of common wisdom — found that four measures of stress all speed up the pace of biological aging in midlife," Wulsin writes. "It also found that persistent high-stress ages people in a comparable way to the effects of smoking and low socioeconomic status, two well-established risk factors for accelerated aging."

The human body and mind are built to handle daily stresses, considered "good stress." Wulsin explains, "In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. . . . Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects."

While U.S. physicians aren't typically trained to treat stress, maybe they should be. Wulsin writes, "Over the past 40 years in the U.S., the alarming rise in rates of diabetes, obesity, depression, PTSD, suicide and addictions points to one contributing factor that these different illnesses share: toxic stress. Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses."

If toxic stress is the catalyst for so many physical and mental woes, what can individuals do to reestablish healthier stress levels? "The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a self-reported measure of stress," Wulsin adds. "The next step is treatment. This approach, called 'lifestyle medicine,' focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate." 

For a deeper look at causes and treatments, Wulsin's book Toxic Stress will be released in April. For readers who are more interested in a physical explanation of what and where stress systems live in the body, a good explanation of polyvagal theory is here.

New 'On the Front Porch' conversation features author who has written about the resilience of small towns

Elizabeth Currid-Halkett
Tony Pipa from "Reimagine Rural" and Brent Orrell of the American Enterprise Institute will host a discussion with Elizabeth Currid-Halkett author of The Overlooked Americans: The Resilience of Our Rural Towns and What It Means for Our Country on Thursday, April 4, from 10 to 11:30 a.m., E.T. The discussion is part of the "On the Front Porch" series about research on issues involving rural America. 

Despite a common narrative that rural America is poor and detached, Currid-Halkett uses data and interview research to trace how small towns are doing as well as — or better than — cities using homeownership, income and employment benchmarks.

She also shows how rural and urban Americans share core values — even on issues such as racism and environmental sustainability — revealing that the nation is less fractured by geography than many people believe. This session is available online here.

To learn more about struggles and triumphs in rural America, Brookings' offers a podcast called Reimagine Rural. It features Pipa traveling through rural America and explores small-town challenges for residents who live in it. 

Rural counties gain population for second consecutive year

Louisiana had the highest rate of rural-population decline, 0.82%.
Driven by migration to rural areas near major cities, the population of America's rural counties grew in 2023, according to a Daily Yonder analysis of Census Bureau data. "The gain came primarily in counties that are closest to metropolitan areas and was the result of people moving to those counties from other parts of the country or internationally," Sarah Melotte reports.

"From 2022 to 2023, the number of people living in nonmetropolitan (rural) counties grew by 109,000 residents, a 0.24% increase. That’s slightly lower than the 150,000 residents that rural America gained from 2021 to 2022. These gains came after rural America lost nearly 300,000 residents in the 2010s. Meanwhile, metropolitan counties grew by 1.5 million residents from 2022 and 2023, a 0.53% increase in population."

Migration was key to rural population growth, because "rural counties recorded 610,000 deaths and 491,000 births . . . what demographers call natural decrease, which happens when the number of deaths is greater than the number of births." Almost all the rural population growth, 97 percent, occurred in counties that are adjacent to metropolitan areas. Overall, the growth in rural counties was small: 0.24%. Other types of areas gained much more, except the cores of major metros, which gained 0.14%.