Tired of big-city decisions, rural counties in some states work to form their own governments

New Illinois activists encourage residents
to "leave Illinois without moving."

Voters in rural towns and counties are working to break away from their state's blue-voting big cities and create their own governments. The "breakup" process has already begun in Illinois and California and is gaining momentum in "other states where vast swaths of red, rural counties are dominated by a few blue cities," reports Joe Barrett of The Wall Street Journal. "More residents are pushing to break off and form new states. . . . A group called New Illinois State declared itself independent from actual Illinois and passed the first draft of a new constitution."

On Nov. 5, voters in rural Iroquois County, Illinois, "backed the idea of forming a new state with every Illinois county except Cook, home to Chicago and more than 40% of the state’s population," Barrett explains. "The nonbinding resolution also passed in six other counties," which means nearly 33% of the state's counties voted to leave the Chicago area behind.

Location of Iroquois County
in Illinois (Wikipedia photo)

Iroquois County resident and "new state" activist Phil Gioja, explained his motivation to Barrett, saying, "There’s a lot of people in Chicago, and I think that they make a lot of decisions that affect people downstate. It’s just sending a message that ‘Hey, you know, there’s people that would like to be part of the conversation, and often aren’t.’" Still, Gioja "doesn't expect a New Illinois anytime soon."

Even if counties were allowed to form separate states, it's uncertain that new states could financially survive without the funding they receive from bigger city revenues.

Counties working to "divorce" their bigger city counterparts and create new states face potentially messy uphill battles. "Becoming new states would require the consent of the existing legislatures — extremely unlikely in most blue states — as well as Congress," Barrett writes. Paul Preston, founder of the New California State, "plans to petition Congress for statehood based on the argument that the current California government is a one-party communist state, and technically, they have seceded from the Union already.'"

Preston's approach may seem ridiculous to some but "appealing to Congress is a strategy that could work," Barrett reports. Jason Mazzone, a constitutional law professor at the University of Illinois, who told Barrett, "It seems far-fetched. But we live in uncertain times. So if you’ve got the right people in Congress — and I don’t think we do have the right people in Congress — you could do it.”

Some public schools continue to increase the number of vaccination exemptions given to kindergartners

Graph by Kavya Beheraj, Axios, from CDC data

Even before the pandemic years, the number of vaccination exemptions issued for kindergartners entering public schools was on the rise. According to estimates from the Centers for Disease Control and Prevention, when allowances from school years ending in 2012 to 2022 were tallied, the "nationwide median rate of kindergartners with vaccine exemptions nearly doubled," report Alex Fitzpatrick and Kavya Beheraj of Axios. The political debate over Covid-19 vaccinations could be adding to "vaccine skepticism among a relatively small but growing number of parents."

Schoolchildren are vaccinated to "reduce the spread of childhood illnesses — some potentially fatal — that once plagued the country, such as polio," Fitzpatrick and Beheraj explain. To be admitted to public school, children are required to have several vaccinations; however, "exemptions can be given for both medical and non-medical reasons." Some studies have "found an increased risk of infection from vaccine-preventable diseases among exempt children."

The number of exemptions public schools give varies by state, and the primary push to question vaccination requirements is driven by Republicans. Axios reports, "As of 2022, Idaho (9.8%), Utah (7.4%) and Oregon (7%) had the highest median kindergarten vaccination exemption rates. Mississippi, New York and West Virginia were tied for the lowest, at 0.1%. . . .with 85% of Democrats agreeing with such a requirement compared to 57% of Republicans. . . .While Democratic support for vaccine requirements held steady between pre- and post-pandemic years, Republican support took a remarkable nosedive, falling from 79% in 2019."

Despite the increase in parents seeking vaccination exemptions for their children, the number of students who aren't vaccinated remains relatively low. The nationwide median kindergarten vaccine exemption rate has "stayed at 2.5% or higher since 2020, coming in at 2.7% in 2022, the latest year for which data is available," Fitzpatrick and Beheraj write.

Most Americans support the national childhood vaccination program. A Pew Research Center survey revealed that "when it comes to the measles, mumps and rubella shot, 88% of Americans said the benefits outweigh the risks, compared to 10% who feel the opposite," Axios reports. "The share expressing confidence in the value of MMR vaccines is identical to the share who said this in 2019, before the coronavirus outbreak."

Office of Rural Health releases strategic plan to help address health disparities between urban and rural areas

The CDC will will release an updated method for
urban-rural classification in 2024. (Adobe Stock photo)

The Centers for Disease Control and Prevention "unveiled its Rural Public Health Strategic Plan, which outlines the priorities, objectives and outcomes the agency hopes to see over the next five years as it collaborates with stakeholders on how to improve the health of rural residents," reports Liz Carey of The Daily Yonder. This plan is the overarching guide for CDC and its Office of Rural Health to use as it works to address health disparities between urban and rural areas.

The plan has four primary focuses: "Engaging with community health partners, strengthening rural public health infrastructure, advancing rural public health science, and improving rural public health preparedness and response," Carey explains. "The plan isn’t regionally or state-specific, but it is a step toward an action plan."

To help all stakeholders develop strategies within the four focus points, "the National Center for Health Statistics, part of the CDC, will release an updated method for urban-rural classification, before the end of the year," Carey reports. "That will make researching rural health issues easier, Katy Backes Kozhimannil, the co-director of the University of Minnesota Rural Health Research Center told Carey. One of the issues facing researchers is determining the rurality of subjects."

Dr. Diane Hall, the director of the CDC’s Office of Rural Health, told Carey, "We really wanted the strategic plan to actually be strategic, but also be actionable. But more than that, we wanted it to be relevant to the lives of people that live in rural communities.”

U.S. Surgeon General outlines ways to address disparities among smokers, including many who are rural Americans

Secondhand smoke harms people who don't smoke.
 (Adobe Stock photo)

Over the past decade, the rate of U.S. adults and teens who smoke has hit its lowest level since 1965, but "disparities remain among the 36 million adults and 760,000 kids who smoke," reports Ken Alltucker of USA Today. U.S. Surgeon General Vivek Murthy released a report that outlined identifiers for those who continue to smoke, which are often the same descriptors used to depict American rural populations: Poorer, less educated, Native American, and lacking access to medical care.

Native Americans, specifically those in Alaska, often live in some of the most remote pockets of the country, where medical access isn't readily available and many residents live in poverty. Alltucker writes, "Smoking is more common among American Indian and Alaska Native people than other racial and ethnic groups. . . . People living in poverty are more than twice as likely to smoke than those who earn non-poverty wages."

Rural populations tend to be heavier smokers than their urban counterparts, and the more rural residents smoke, the unhealthier their broader community becomes. Alltucker explains, "Because cigarette smoking and secondhand smoke kill nearly half a million people each year nationwide, Murthy said an accelerated effort is needed to limit disparities in smoking rates and reduce secondhand smoke."

The report also calls for "limiting the nicotine in cigarettes and other tobacco products to 'minimally addictive or nonaddictive levels,'" Alltucker reports. "Such a move could prevent more than 33 million people from starting to smoke. . ." This change could have a positive effect in rural populations where "kids are also more likely to start smoking at a much younger age and smoke daily, making addiction more severe and smoking harder to quit," the American Lung Association reports.

The Surgeon General's report "cited 2023 research that projected a nationwide ban on the sale and marketing of menthol cigarettes would prevent up to 654,000 deaths in the next four decades," Alltucker reports. But controlling the flow of cigarettes isn't going to happen overnight, and in the meantime, rural access to medical education and smoking cessation programs is needed.

Murthy told USA Today, "What's at stake are the lives of our kids and adults across America. Tobacco is the leading cause of preventable death in the country − 490,000 lives we lose every year to tobacco-related disease. Despite all the progress we've made, that remains the truth today."

Cherokee Nation's mobile drug unit delivers life-saving care to some of its most remote-living members

A tribal member unloads the Cherokee Nation harm-reduction
van. (Photo by Shane Brown, Native News Online via The Guardian.)

A new program in Oklahoma is using a mobile drug unit to distribute harm reduction and drug safety supplies to rural Cherokee Nation members struggling with addiction, reports Elyse Wild of The Guardian. The traveling service is part of the tribe's overall "Native people taking care of Native people" effort to address the severe risks and lack of access facing Native Americans with substance-use disorders.

The drug unit van can be the first point of contact for an addicted tribal member to receive life-saving supplies and education. Coleman Cox, who drives the unit, stops along drug "hot spots" in remote northern Oklahoma and sets up tables "with black bins of naloxone, a drug to reverse opioid overdoses, along with testing strips, clean syringes and wound-care supplies," Wild writes. "The mobile unit typically sees 16 regulars from the community, he says. Some days, no one comes. It all depends on the patterns of drug use and the current drug supply."

The Cherokee Nation "is the largest of the tribes, with more than 450,000 citizens worldwide and 141,000 people living within its sovereign boundaries," Wild explains. "Mobile harm reduction is uniquely suitable for tribal nations. . . where culture and connection are measures of health, harm reduction mitigates the isolation of active addiction." Cox told Wild, "Native people heal as a community.”

With the mobile unit, the Cherokee Nation can reach more remote members who need physical and cultural help coping with addiction. "The effect of culture on addiction health in Native communities is not purely anecdotal," Wild adds. "A doctoral research project conducted by the University of Arizona in 1992 with the Shuswap First Nation community in Alkali Lake, British Columbia, found that employing substance abuse treatment with cultural practices such as sweat lodges, pipe ceremonies, drumming, singing and powwows were instrumental in reducing the tribe’s rate of drug and alcohol abuse by 95% from 1970 to 1985."