A digest of events, trends, issues, ideas and journalism from and about rural America, by the Institute for Rural Journalism, based at the University of Kentucky.
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Georgetown University graph, from 2022-2023 American Community Survey data
President Donald Trump has a big agenda that needs big funding. To pay for Trump's plan, GOP members are considering axing chunks of federal Medicaid spending, which could "put the residents of small towns and rural communities and their health care systems at serious risk," report Georgetown University researchers.
Rural Americans who are non-elderly adults and children "are more likely to rely on Medicaid/CHIP (Children's Health Insurance Program) for their health insurance," researchers explain. Medicaid reductions could be especially harmful for:
Children in Arizona, Florida, North Carolina, Virginia, South Carolina, California, Minnesota, Georgia, South Dakota and Alaska.
Adults in Arizona, New York, Washington, Texas, Kentucky, Virginia, Louisiana, Oregon, South Carolina and Montana.
Medicaid reductions would be particularly harmful for rural children in 10 states. (Georgetown University graph, from 2022-2023 American Community Survey data)
Part of the reason many rural residents rely on Medicaid is because their incomes tend to be lower and they lack "access to employer-sponsored health insurance, meaning that public coverage such as Medicaid and the Children’s Health Insurance Program fill an even more critical role in these areas than in other areas of the country," according to the Georgetown University report. "While uninsured rates have come down significantly since passage of the Affordable Care Act, they remain higher in small towns and rural areas."
Siphoning millions in Medicaid funding to pay for other priorities "poses a very severe threat to rural communities," researchers add. "Hospitals and other providers in rural communities are already operating on tighter margins and disproportionately rely on Medicaid for their patient revenues. . . . Large cuts will have dire consequences for communities that are already struggling."
Developing an effective and repeatable treatment for addiction sufferers has proven elusive -- until now. A rural jail in Maine has a solution that could save thousands of lives.
Addiction medicine specialist Alane O’Connor is leading a pilot program that "offers a monthly injection of the drug Sublocade to addicted inmates," reports Kristina Samulewski of The New York Times. The drug works through a time-release mechanism that curbs opioid cravings for a month. O'Connor presents her case for jails as drug recovery centers on the Times' podcast, "The Opinions." An edited synopsis of her discussion is shared below.
The state of Maine is overwhelmingly rural. It also has "one of the highest rates of opioid use disorder in the nation. And people who are incarcerated have an even higher rate, because often times the two go in tandem," O'Connor explains. "Jails are an incredible opportunity to help people enter recovery. It’s a time where motivation is often very high, but I think we don’t do a very good job, really, across the country in giving people access to the treatment that they need."
In response to the opioid epidemic's extreme reach in Maine, O'Connor suggested that Somerset County Jail try a different approach for treating inmates with opioid addictions. "I proposed an alternative medication, which I had been using in my community practice since 2017," O'Connor adds. "It’s not a pill. It’s actually an injection into the abdomen, and it’s called Sublocade."
Sublocade is gradually and continuously released into a recovering addict's system. Other opioid drug treatments can include daily methadone and/or Suboxone pills, which people can opt not to take. Sublocade does not offer a choice.
"If I have a patient that I’m prescribing Suboxone to and they don’t have that medication tomorrow or the next day, they are going to get very sick," O'Connor explains. "Sublocade slowly dissolves out of the system, and so patients will start to feel some symptoms after five or six weeks. But there isn’t this cliff that ends where people get very, very sick."
O'Connor says, "I’ve never, ever met anyone who said, I want to grow up and be addicted to drugs and end up in jail. It’s just not a reasonable thing to even think. And yet, I think society believes that patients can just make the choice to stop using tomorrow. And if they don’t have the appropriate medical treatment, that’s just a totally unreasonable expectation."
When Somerset County Jail's Sublocade treatment results were compared with another rural Maine jail where inmates received a daily pill of Suboxone, the results were striking. O'Connor notes, "We found that people treated with Sublocade were almost three times as likely to continue treatment when they leave the jail, relative to folks who were treated with the daily medication. . . . The most important finding was that we had no deaths in the people that were treated in the Sublocade pilot . . . In the comparison jail, unfortunately, there were four deaths."
Researchers analyzed three myths that often put rural education at a disadvantage. (Getty Images photo via The Conversation)
A lack of attention paired with stereotyped ideas about what rural communities are like can harm rural education systems. "Rural education often can seem like an afterthought to policymakers and scholars. . . even though 20% of the nation’s students are educated in rural schools," write Sheneka Williams, Darren Dubose and Kimberly Clarida for The Conversation. "As scholarswho studyrural education, we compiled a list of three facts about rural education accompanied by the myths that would help policymakers better design programs to support rural students. "
The second myth centers on the idea that rural communities "lack the knowledge or resources to educate their youth," they write. "Policymakers often fail to include rural communities’ cultural capital when they develop textbooks, teacher training plans and education policies. By cultural capital, we mean the knowledge, skills, education and advantages that people inherit and use to achieve success in society."
When rural cultural capital is ignored, smaller schools can suffer. In fact, the current system often penalizes rural schools for being smaller.
The third myth: The majority of rural students are underachievers. They write, "Students in rural areas meet the same measures of success as in urban ones – especially in the early years. . . . Graduation rates among rural students are higher than those of non-rural students. . . . Their academic success is too often overlooked by researchers and educators. . . . Policymakers fail these students, who have college-going rates that are lower than in urban areas."
Rural schools and communities need to be recognized for their advantages and rich resources. They add, "We believe debunking myths and recognizing the diverse strengths of rural communities would help ensure that all students across the nation, including those in rural areas, can attain long-term educational and economic success."
This little monkey let herself out the door and headed to the highway. (Jefferson County Sheriff Office photo via AP)
Every job has its challenges, but most employees aren't tasked with apprehending a tutu-clad spider monkey. "The spider monkey was spotted at the intersection of two highways near the small town of Otto, Missouri," reports Heather Hollingsworth of The Associated Press. "The monkey had been staying at a nearby home when it managed to open a door and get outside. . . . The local sheriff's office said the capture was ‘bananas.'"
U.S. health professionals often experience on-the-job mental stress, which can cause high rates of depression, anxiety, stress, suicidal ideation and burnout. In response, some employers hired furry "stress-reliever" employees to buoy their staff and cheer their patients, reports John Daley of Colorado Public Radio. "A pair of dogs, tails wagging, had come by a nearby nursing station, causing about a dozen medical professionals to melt into a collective puddle of affection. A yellow Lab named Peppi showered nuzzles and kisses."
Some horse lovers spend years hoping to one day own their very own horse. The federal government has a plan to help make their dreams come true. "Adopting a wild horse or burro can be intimidating — how do you tame them? But a new $25 million BLM grant aims to help with gentling and finding long-term homes," reports Lena Beck of Ambrook Research. "The goal of this funding is to help whittle away at the bottleneck of horses and burros that live at BLM holding facilities — over 60,000 animals — stuck in limbo. . . .The BLM estimates this award can help place an additional 11,000 horses and burros."
A Monstera plant basks in the limelight. (Lancaster Farming photo)
The Monstera plant has always been an overachiever, and this year its
self-promotion has paid off. "Each year, the National Garden Bureau
selects a 'Year of the Plant' in each of six categories — annuals,
edibles, perennials, bulbs, shrubs, and houseplants," reports
Susan Marquesen for Lancaster Farming. "For houseplants, the bureau
deemed 2025 the 'Year of the Monstera. . . . Monstera is commonly known
as split-leaf philodendron, cut-leaf philodendron, and Swiss cheese
plant, due to the structure of its leaves."
When it comes to extreme pepper experts, there's really only one place to go -- New Mexico State University's Chile Pepper Institute. "It's the only research institution in the world solely dedicated to chiles," reports Anne Ewbank for Atlas Obscura. "The center’s roots go back to the school’s first horticulturist, Fabian Garcia, whose influence on spicy, pepper-bearing foods and products was seminal." Garcia created the New Mexican chile pepper." Caliente! She's so cute! One of us at The Rural Blog can't stop watching her video. Meet Poppy the pygmy hippo. Poppy was "named by 116,000 fans worldwide. . . . a tribute to her mom, Iris," reports CNN. Iris and Poppy live at the Metro Richmond Zoo in Virginia where they spend their days exploring, swimming and entertaining their doting fans. Poppy was born on Dec. 9 to parents Iris and Corwin.
Sarah Campbell Kier, from Valdosta, Ga., relies on home delivery. (Photo by Nada
Hassanein, Stateline)
Independent pharmacies have long served as a vital resource for rural and underserved communities. Despite their contribution to regional health, many are facing financial stress or have closed.
Barnes Drug Store, an independent pharmacy in Valdosta, Georgia, is an example. Barnes has "been serving the community for a century," reports Nada Hassanein of Stateline. "The family-run business used to have six pharmacies. It now has just one. . . . Independent drugstores are closing at an alarming rate — about one a day in 2023 — squeezed by the huge companies that reimburse pharmacies for costly medications."
A 2023 National Institutes of Health study "found that the estimated 15.1 million Americans who rely on independently owned pharmacies are more likely to have lower incomes, live in rural areas, and to be at least 65 years old," Hassanein explains. "Their health is more complicated, and they’re more likely to need one-on-one counseling to juggle multiple medications."
When a small-town pharmacy closes, residents lose "more than another place where they can buy medicine," Hassanein explains. "Experts say independent drugstores are more likely to know their patrons, offer health and medication counseling, and, crucially, serve communities in need."
Rural pharmacies often lose money because of poor drug reimbursement rates. Hassanein adds, "At Springfield Pharmacy in Delaware County, Pennsylvania, owner Chichi Ilonzo Momah estimates that up to 30% of medications she fills are reimbursed for less than what they cost." Larger drugstore chains such as CVS and Walgreens generally receive higher reimbursements.
Some independent pharmacies lobbied for equal reimbursements, but even with bipartisan support, many efforts failed. "Last year, Georgia Republican Gov. Brian Kemp vetoed a bill that would have required the state’s health insurance program for teachers and state workers to reimburse independent pharmacies at the same rate as chain pharmacies," Hassanein reports. "The bill had received bipartisan, almost unanimous support in the General Assembly."
Planting and harvesting are times when farmers need repairs made quickly. (Adobe Stock photo)
The U.S. Federal Trade Commission filed suit recently against farm equipment maker Deere & Co. "alleging it illegally drives up repair costs by forcing farmers to rely on its authorized dealer network," report Leah Douglas and Jonathan Stempel of Reuters. "The lawsuit argues Deere has unlawfully boosted profits by requiring farmers to use its network of authorized dealers for repairs, making it difficult for farmers to use independent mechanics or do repairs themselves."
Over the past two decades, American farmers have invested in advanced-technology farm machinery that has increased their "reliance on high-tech machinery such as GPS-guided combines and tractors," reports P.J. Huffstutter of Reuters.
The suit is part of the outgoing Biden administration's efforts to address "anti-competitive practices in agriculture, ranging from improving the treatment of chicken farmers . . . to increasing competition in the seed sector," Douglas and Stempel explain. "It has also targeted the right-to-repair issue, which cuts across various industries, including smartphones and computers."
Particularly when farmers are planting or harvesting in seasonal windows, waiting for a Deere technician to repair equipment can result in steep financial losses. Reuters reports, "FTC Chair Lina Khan said, 'Illegal repair restrictions can be devastating for farmers, who rely on affordable and timely repairs to harvest their crops and earn their income.'"
"Currently, Deere farm equipment software is solely owned by the company and repairs can only be made through its dealer network," Douglas and Stempel add. The FTC said in a statement, that Deere's repair process has ensured the company "has maintained a 100% market share, allowing it to hike prices."
Given the complaint, it appears last year's signed memorandum of understanding between the American Farm Bureau Federation and Deere & Co. did not live up to its expectations. Reuters reports, "The company said it was expanding self-repair options for farmers in a pilot program."
Trump has made continuous threats against U.S. media leaving reporters apprehensive about his upcoming term. (Adobe Stock Images)
News organizations and journalists are experiencing unease as President Donald Trump reenters the White House, and what that means for them.
During a speech after being named TIME magazine's Person of the Year, Trump referenced the media and "threatened to use the power of his incoming administration to stifle free speech... [and] has made it clear that he will use the apparatus of government to go after his critics," wrote Rob Tornoe for E&P Magazine.
“The media is tamed down a little bit. They like us much better now, I think… If they don’t, then we’ll just have to take them on again, and we don’t want to do that,” said Trump at the New York Stock Exchange.
Writers are aware that their words carry weight, but now there is increasing concern that strong opinions will drive away readers or lead to backlash. Tornoe wrote, “The impact has been felt especially hard by the nation’s editorial cartoonists, who continue to dwindle,” including Mike Luckovich, who has drawn political cartoons for three decades and is a two-time Pulitzer Prize-winning cartoonist.
Besides Trump's threats, the news industry is also struggling with decreasing digital advertising rates, notable algorithm changes at Google, increasing impacts from artificial intelligence (AI) on journalism, and a lack of trust in institutions like news organizations, according to Tornoe.
E&P wrote that in an interview, Luckovich said that while visiting the Pentagon over 20 years ago multiple generals told him that besides whether or not they liked his cartoons they would defend his right to make his point. Luckovich told Tornoe, “To me, that is what America was all about — and I hope it still is.”
Federal funding aims to accelerate bird flu vaccine development. (A.S)
Despite the limited threat bird flu poses to humans, American pharmaceutical and biotechnology giant Modena received a $590 million federal package to continue its development of a bird influenza vaccine, reports Sabela Ojea of The Wall Street Journal.
The U.S. Health and Human Services Department funding aims to accelerate the company's vaccine research as worries increase about a human bird flu pandemic.
Modena began a "study to generate safety and immunogenicity data of the bird influenza shot in healthy adults ages 18 and older" in 2023, Ojea writes. "The trial included vaccine candidates against two avian influenza viruses, H5 and H7."
Avian bird flu, also known as H5N1, has decimated some global wild bird populations and killed at least 20 million egg-laying chickens in the U.S. during the last quarter of 2024, reports Alexander Tin of CBS News. In March 2024, bird flu infections were detected in U.S. dairy cattle. Since that time, there have been 66 confirmed human cases of H5N1 bird flu in the U.S., including one death from the infection.
Carter was raised on his family's farm in Plains, Ga. (Adobe Stock photo)
Given all the memorial writings about Jimmy Carter, it seems his life as a farmer has faded into the background. But as a president and humanitarian, Carter never forgot his country upbringing, writes Charles Hayslettin his opinion for The Daily Yonder. "Carter’s rural roots ran deep. Born and raised in Plains, Georgia, he understood the challenges facing America’s heartland on a very personal level. This background informed his approach to governance."
As governor of Georgia, Carter "recognized early on that economic growth and environmental protection could coexist when grounded in faithful stewardship of the land," Hayslettin writes. "Upon reaching the White House, Carter elevated rural issues to national prominence. In 1979, he unveiled a comprehensive Small Community and Rural Development Policy, a first of its kind."
As president, Carter worked to address rural health care disparities by supporting the Rural Health Clinic Services Act of 1977. Hayslettin explains, "This landmark legislation increased Medicare and Medicaid reimbursement rates for rural health centers and allowed payment for nurse practitioners and physician assistants in these facilities."
Carter used his uniquely personal understanding of rural life to extend his rural advocacy beyond health care. Hayslettin writes, "He established the Department of Energy and championed renewable energy and conservation as moral imperatives – a focus that had particular relevance for rural energy consumption."
Carter’s rural legacy is marked by an ironic political change that began during his term. Hayslettin adds, "The 1980 presidential election, which Carter lost to Ronald Reagan, marked the beginning of a tidal wave shift in rural voters away from the Democratic Party and toward the Republicans."
Carter was defeated by Reagan in "one of the worst defeats ever inflicted on an incumbent president," Hayslettin writes. "He later described his own presidency as 'mediocre.' But time and history have a way of correcting and perfecting records, as they have done for Carter’s international work and post-presidential work. The same should certainly be true for his efforts to improve the lives of rural Americans."
In one of his first acts as president, Donald Trump declared a national "energy emergency." But the order and its implementation is "a presidential first, and it's unclear what exactly it would entail," reports Camila Domonoske of NPR. Below is a brief synopsis of what Domonoske knows about the "unprecedented action."
A national emergency gives the president "additional powers," Domonoske explains. "A Trump administration official speaking on condition of anonymity said the 'national energy emergency will unlock a variety of different authorities that will enable our nation to quickly build again, to produce coal and natural resources, to create jobs, to create prosperity, and to strengthen our nation's national security.'"
According to the Brennan Center, "which has researched emergency powers, statutes grant the president the authority to suspend some environmental regulations or impose restrictions on crude oil exports," Domonoske writes. "No president has ever declared a national energy emergency.'"
The U.S. has plenty of fossil fuels available and a glut of global supply could depress energy prices. Domonoske reports, "The U.S. is a net exporter of fossil fuels, producing more oil and gas than any other country in the world. . . . Many analysts currently project that the world as a whole is facing a near-term oversupply of oil and natural gas."
However, the pressure on the U.S. electrical grid is a worry. "Trump dd not specifically focus on this concern in his speech, but he could use emergency authorities to try to keep open power plants that are slated to close for economic or environmental reasons," Domonoske adds. "He has historically expressed support for coal plants in particular."
During his inaugural speech, Trump said, "'We will bring prices down," Domonoske reports. "On the campaign trail he repeatedly promised to lower energy prices by 50%. . . . That's an improbable target, analysts say. . . . Policy changes can influence prices at the pump and electricity prices, and a smaller decrease in costs is certainly in the realm of possibility. But it's not simple."
