Mental Health First Aid for Rural Communities trains laypeople to be the first line of help

Rural residents can help one another work through
mental crisis or illness by learning MHFA.

Mental health care in rural America has always been more challenging to ask for, find and afford than in more populated parts of the country. A program that trains laypeople may offer rural residents in mentally stressful situations or suffering from untreated mental illness the best path toward getting the help they need.

The National Council for Mental Wellbeing’s Mental Health First Aid for Rural Communities works with "people not necessarily in the health professions to give them the tools they need to recognize and respond to the signs of mental health or substance use challenges," reports Liz Carey of The Daily Yonder. The training teaches participants that while they are not there to treat or diagnosis mental health problems, they are equipped with the skills and knowledge to support a family or friend until professional care is available.

A community that adds this training to its safety net toolbox is spending time incorporating a process that makes a difference. Carey writes, "Studies have consistently shown that it works — more than 90 peer-reviewed studies over the past 15 years have shown that MHFA has a lasting impact."

Jamie Hagenbuch, program manager at the Mental Health First Aid at Madison County Rural Health Council in Cazenovia, New York, told Carey, "I think rural communities definitely don’t have the resources that cities and urban communities do, so having the initial skills to be able to recognize if somebody’s becoming unwell and how to approach them and know what resources do exist, as well as being able to navigate them to those resources, is critical."

Mental Health First Aid training can help "anyone in a rural community to spot the signs of someone struggling with a mental health issue and to be able to step in to help," Carey explains. "A study in 2021 of Cooperative Extension agents in Mississippi found that 62.5% of the participants in the MHFA training programs used their skills six months after training."

Individuals interested in getting training can find more information at https://mentalhealthfirstaid.org

The price of hospital services is driving health care costs and insurance premiums to climb nationwide

Patients and employers are impacted by increases health premiums. 
(Graphic by wildpixel/iStock/Getty+ via Conversation CC)

The American public may perceive hospitals as part of their community’s care network, but in reality, many hospitals and specialty clinics are businesses that strive to make a profit. 

As more medical systems in communities of all sizes have consolidated, hospital pricing has become the biggest driver of rising medical costs and steep health care insurance premium hikes.

“Health insurance premiums in the U.S. significantly increased between 1999 and 2024, outpacing the rate of worker earnings by three times, according to our newly published research in The Journal of the American Medical Association Network Open,” write economic experts Vivian Ho and Salpy Kanimian from Rice University in Houston, Texas, for The Conversation. 

Using federal information and data from the Kaiser Family Foundation, Ho and Kanimian found that “the cost of hospital services increased the most, while the cost of physician services and prescription drugs rose more slowly.”

Many hospitals, including those with nonprofit designations, often aggressively price their services and care well above their costs, Ho and Kanimian point out.

“One study found that for nonprofit health systems, the greatest pay increases between 2012 and 2019 went to hospital CEOs who grew the profits and size of their organizations the most,” Ho and Kanimian explain. In contrast, any emphasis on charity care by those systems was not linked to CEO pay. 

Ho and Kanimian suggest a way to help “ensure that nonprofit hospitals make the health of their local communities a top priority by requiring their boards to disclose their executive compensation guidelines for salary and bonuses, similar to the information that for-profit health care companies disclose to their stockholders.” Such a shift could help communities push for better care and lower costs for patients as determinants of executive pay and bonuses. 

Some economists suggest that “hospital prices should be regulated. This approach involves capping prices for health care services at the most expensive hospitals and restricting price growth for all hospitals,” Ho and Kanimian write.

Somalis found refuge in a small Minnesota town, but now they're afraid to leave their homes

A Somali grocery store sign in Willmar, Minn.
(Photo via Federal Reserve Bank of Minnesota)

Over the past 30 years, the small farming town of Willmar, Minnesota, has become home to Somali families fleeing civil war and famine. The community of roughly 20,000 residents has welcomed so many Somalis that "a lively stretch downtown is called 'Little Mogadishu' because Somalis run more than a dozen storefront businesses," reports Joe Barrrett of The Wall Street Journal.

Despite their dedication to family and entrepreneurial contribution, many Willmar Somalis are afraid to leave their homes after "President Donald Trump lashed out against immigrants from Somalia, calling them 'garbage' and saying he doesn’t want them in the U.S.," Barrett writes. U.S. Immigration and Customs Enforcement agents have reportedly intensified raids in Minnesota after Trump's comments. 

Somalis across Minnesota have already been "shaken by a sprawling fraud scandal that has put the state’s Somali community in the national spotlight and drawn Trump’s ire," Barrett explains. Federal prosecutors say dozens of people -- almost all of whom are from the Somali community -- used fake businesses to steal millions from the Federal Child Nutrition Program, beginning in April 2020.

Location of Willmar within Kandiyohi 
County (Wikipedia maps) 

Willmar leaders don't see the scandal as a fair representation of the Somali population living in the U.S. Willmar's mayor, Doug Reese, told Barrett, “I can honestly say I haven’t encountered any bad Somalis. I mean, there’s probably some, but by and large, they’re good people.”

If Willmar's Somalis were forced to leave, it would deeply wound the town's economy. Rollie Nissen, a 79-year-old Willmar Republican leader, told Barrett, "I don’t think [Trump] should be painting with a broad brush. We should get rid of the people who are here illegally, not ship everybody back to Somalia or Mexico or Venezuela.”

After pandemic supply troubles left tribes without meat, some decided to invest in their own slaughterhouses

Workers cut steaks at Three Rivers Meat Company, whose majority 
owner is the Choctaw Nation. (Photo by Todd Price, Offrange)

U.S. meat supplies for Indian populations were unreliable during the pandemic, which led at least 18 Native American tribes to invest in building their own slaughterhouses, reports Todd Price for Offrange.

The Osage Nation in northern Oklahoma was one of the first tribes to decide that "they would build their own USDA-inspected meat processing plants," Price explains. Other Oklahoma tribes, including the Cherokee Nation, Choctaw Nation, Miami Nation, and Muscogee Nation, have also invested in their own meat plants.

Before the pandemic, many tribes owned land, raised livestock, or oversaw marine tracks. Following the pandemic-era slaughterhouse closures and meat supply bottlenecks, "Many tribes recognized the urgency of taking control of their food supply so they could always ensure their people would be fed," Price reports. "An estimated 18 tribes now operate plants that process meat and seafood."

Although slaughterhouses are expensive to build and have slim profit margins, Native tribes use "vertical integration" to leverage benefits. Price explains, "They own the animals and then sell the meat to their casinos or food assistance programs. And they do not always define success in dollars like a private business. Bringing good jobs to rural areas and meat to food deserts is part of the goal."

For tribes, being able to raise and process enough food to feed their people isn't just about making sure no one goes hungry. "It is also an important step towards food sovereignty — controlling the food supply and deciding what they will eat," Price reports. "And sovereignty, the power to govern themselves, is a right that tribes have long fought to preserve."

Flora & Fauna: Masked bandits evolve; 2-purpose turkeys; foraging stats; whales' aging secrets; birds can help farmers

Perhaps one day, urban raccoons will be pets.
(Adobe Stock photo)

Racoons are masked, cute, and affectionately known as "trash pandas," and they are proving to have a real knack for evolving to live alongside humans, reports Axios. "The same evolutionary forces that turned wolves into domesticated dogs over thousands of years may now be reshaping urban raccoons, recent studies suggest." Marcie Logsdon, who works closely with wildlife rehabbers, told Axios, "Raccoons have adapted incredibly well to our presence. . . [They are] bold enough to raid garbage cans but polite enough" to avoid altercations with people.

An agrivoltaic 'trial flock' enjoys solar panel shade.
(Photo by Evan Carpenter, Offrange)

These turkeys have it made in the shade as they peck and strut under solar panels, unwittingly being prepared as a holiday dinner while also participating in a "dual-use agrivoltaic system," reports Jake Zajkowski for Offrange. Evan Carpenter, who is raising the "trial flock," will share bird and energy outcomes with "project collaborators United Agrivoltaics and Cornell University, to study the feasibility and business model of Carpenter’s project to scale dual-use income land."

In the Mid-Atlantic forests of the U.S., researchers Amy Wrobleski and Eric Burkhart explored regional fungi foraging and shared some of their findings with The Conversation. "We learned that harvesters use the mushrooms primarily for food and medicinal purposes. . . . Over 800 harvesters reported that, collectively, they foraged 160 species of wild mushrooms. . . . Morels and chicken of the woods were the two most popular. . . .Other popular species were hen of the woods, oysters, lion’s mane, black trumpet, honey mushroom, turkey tail, bolete, reishi, puffball, chaga, shrimp of the woods and Dryad’s saddle." Mid-Atlantic fungi can be found here. 

Bowhead whale and calf (NOAA Fisheries photo)

At full-grown, a bowhead whale can weigh 88 tons, which is roughly the weight of 15 elephants. But that's not the only outrageous bowhead fact -- the whale can live to be 268 years old. "Some whales caught in the late 1900s had old harpoon points lodged in their blubber that dated to the mid-1800s," reports Carl Zimmer of The New York Times. "A study published in the journal Nature offers a clue to how the animals manage to live so long: They are extraordinarily good at fixing damaged DNA."

K4 Ranches photo

When it comes to raising cattle, a horse is a rancher's best friend. "Using horses to check and gather cattle is typically the only option with rugged terrain," reports Maddy Rohr for Drovers. Diamond A Ranch, a division of K4 Ranch in Arizona, employs a large crew with seasonal cowboys and eight camps with full-time cowboys." Sarah Kieckhefer of K4 told Rohr, "A good horse can go where a pickup, ATV or side-by-side can’t. Horses can cover long distances and a horse allows you to move quietly, ease cattle along and reduce stress, which leads to fewer wrecks and better weight retention.”

American rice grower Mike Wagner welcomes thousands of migratory ducks, geese and shorebirds that "arrive on his farmland after harvest every autumn," writes Elizabeth Hewitt for Reasons to be Cheerful. "Over winter and early spring, the birds clean up leftovers from the growing season. Thousands of webbed feet mix up soil and water, leaving the fields ready for planting when they depart in the spring. And their droppings are so rich that Wagner has cut how much synthetic fertilizer he needs for his crop by more than a third."  

Trump announces $12 billion in farm aid, but many farmers don't think bailout checks address bigger challenges

American farmers need more markets. (USDA photo)

The Trump administration announced a $12 billion aid package for U.S. farmers hurt by the president's “long-reaching tariffs,” report Brian Schwartz, Natalie Andrews and Patrick Thomas for The Wall Street Journal. “Much of the aid —$11 billion— will be in the form of one-time payments through the Farmer Bridge Assistance program.” 

International tariff wars, particularly those between the U.S. and China, have contributed to a financially challenging year for American farmers, with soybean farmers bearing the largest losses. “Crop prices have remained low, especially after harvesting the largest crop on record this fall,” Schwartz explains. “Through the first nine months of 2025, farm bankruptcies rose by nearly 50% compared with the same period in 2024.”

Although many farmers need the additional funds to pay down debt and invest in next year’s planting, many see them as a short-term solution. Erin Ailworth, Ilena Peng and Michael Hirtzer of Bloomberg News report, “Growers who have struggled with low crop prices, rising costs, and lost markets, [have called] Trump’s farm aid a temporary fix for deeper economic challenges.”

Missouri farmer Marty Richardson told Bloomberg, “This is kind of a Band-Aid — we need more markets more than we need aid.”

While U.S. soybean farmers suffered from a summer and fall without sales to China, presumably due to Trump’s tariffs, many know the country has been working for years to reduce its dependence on American soybeans. Bloomberg reports, “Trump’s first trade war resulted in China accelerating a diversion of its supply chain away from the U.S. to places like South America. U.S. farmers have lost crucial market share to competitors, particularly Brazil.”

Some American growers don’t think 2026 will be any better than this year. Sam Taylor, a farm inputs analyst, told Bloomberg, “This time next year, we’re going to be having much the same conversation about margins for growers, about the potential need for economic support.”

Farmers can start applying for the aid package next month. WSJ reports, "Agriculture Secretary Brooke Rollins said that the money will start going out at the end of February." 

A Medicare pilot program will use artificial intelligence for prior authorizations. Doctors and lawmakers are alarmed.

Some prior authorization requests are already decided
by artificial intelligence. (Adobe Stock photo) 

A Medicare pilot program that allows private companies to use artificial intelligence to approve or deny medical care requested by their members has some doctors and lawmakers worried. Companies included in the pilot would get paid, "based on how much money they save Medicare by denying approvals," reports Anna Claire Vollers of Stateline.

The pilot, known as the Wasteful and Inappropriate Services Reduction (WISeR) Model, will launch after Jan. 1 in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. WISeR is more likely to impact health care treatments for rural Americans in those states because rural populations often skew older and sicker than their suburban and urban counterparts.

At its core, the WISeR model effectively introduces a prior authorization process into traditional Medicare. Prior authorization is already unpopular with many patients and doctors because it requires members or medical providers to request an insurance company's approval for certain treatments or medications before proceeding.

While some Medicare Advantage and private insurance companies have already deployed AI into some of their prior authorization processes, its use has "attracted intense criticism, legislative action by state and federal lawmakers, federal investigations and class-action lawsuits," Vollers explains. "It’s been linked to bad health outcomes. Dozens of states have passed legislation in recent years to regulate the practice."

The new program has "alarmed many physicians and advocates in the affected states," Vollers reports. In practice, the prior authorization process can create obstacles to care by requiring physicians to spend hours fighting with an insurance company to justify the care they believe their patient needs. At times, medical providers may avoid treatments that would be best because an insurance company is likely to deny them, at least initially.

Last month, congressional representatives from several states "introduced a bill to repeal the WISeR model. It’s currently in committee," Vollers reports. The program is scheduled to run from 2026 to 2031.

A small university town in southern Illinois 'leads the nation in out-of-state abortion patients'

Adobe Stock photo

Surrounded by farmland and the vast wooded expanses of the Shawnee National Forest, Carbondale, Illinois, has become a central hub for abortion access. 

The small-sized town, which is home to Southern Illinois University Carbondale, is within “driving distance of 10 states with abortion bans,” reports Elizabeth Williamson of The New York Times. “Last year, there were nearly 11,000 abortions in this city of 21,000.”

After the Supreme Court overturned Roe v. Wade, 14 states have banned the procedure. Those bans made “geography an all-important factor in access to the procedure,” Williamson explains. “And placed Carbondale, a liberal enclave in a deeply conservative region, in a complicated position.”

Unlike many of its neighboring states, abortion remains legal in Illinois. Carbondale's location near the southern tip of Illinois makes travel from states such as Missouri, Indiana, Kentucky, Mississippi and even Louisiana possible for women seeking the procedure. Williamson writes, “Illinois now leads the nation in out-of-state abortion patients.”

Although many Carbondale residents support “its status as a safe harbor. . . the sheer number of abortions has also created some unease and worry about a backlash,” Williamson explains. 

One community member told Williamson she was concerned about the negative attention the high number of abortions could bring to the otherwise “quiet community.”

Carbondale has three women’s clinics that perform abortions, but two of the three provide other women’s health services. “Alamo Women’s Clinic only does abortions, both procedural and medication, all on-site,” Williamson reports. “Fewer than five percent of Alamo patients are from Illinois.”

While details of rural health transformation requests aren't available yet, some states are sharing their information

KFF News RHTP tracking map as of Dec. 2. Click to enlarge.

The newly formed federal Rural Health Transformation Program has $50 billion to distribute to states that met its Nov. 5 application deadline; however, a complete picture of which states applied and what they asked for isn't clear because the Centers for Medicare & Medicaid Services have "declined to publicly release the applications," report Sarah Jane Tribble and Arielle Zionts of KFF Health News.

CMS said it isn't allowed to "release grant applications to the public during the merit review process,” KFF News reports. "They've pledged to announce the allocations by Dec. 31."

RHTP was passed as part of the One Big Beautiful Bill Act in July, which drastically cut Medicaid spending and will disproportionately impact rural areas. But RHTP can't be used to "bail out" rural hospitals or clinics. KFF News explains, "The money [must] be spent on transformational ideas."

Although CMS isn't sharing application details, some states have been transparent about their applications. According to the article, a health strategy team at Princeton University tasked with tracking state application summaries found "themes including expansion of home-based and mobile services, increased use of technology, and workforce development initiatives . . ."

KFF Health News is collecting state-by-state application materials and adding them to its mapped repository, which will be updated as information arrives. 

What's on your holiday table? Americans weigh in on Thanksgiving and Christmas meals.

When it comes to holiday traditions, many Americans see special foods and meals as part of the season's delights. Agriculture researchers at the University of Illinois wanted to know if the last few years of food cost increases, inflation woes and recent tariff wars in the U.S. have changed the way Americans set their holiday tables this year. Their lightly edited discoveries are shared below.

University of Illinois graph, data from the Gardner Food and Agricultural Policy Survey, Nov. 2025

Thanksgiving marks the first of several major feasts across the country. The main attraction? Food! More precisely, for many Americans, it means eating turkey. "Of those respondents who typically celebrate Thanksgiving with a meal, the most commonly reported protein source was turkey. A whopping 86.5% of those who celebrate Thanksgiving with a meal said they planned to serve turkey," Maria Kalaitzandonakes, Jonathan Coppess and Brenna Ellison write.

Christmas dinner fare has changed throughout American history; in fact, colonial Americans considered eating turkey a luxury, and many families opted for goose, duck or rabbit. Even with inflation and tariffs, 2025 offers more options for sumptuous Christmas meals. The researchers add, "Of those respondents who typically celebrate Christmas with a meal, turkey (47.9%), pork (47.5%), and beef (39.9%) were the most common protein sources. . . . 22.8% said they planned to serve fish or seafood, 11.1% said they planned to serve lamb."

University of Illinois graph, data from the Gardner Food and Agricultural Policy Survey, Nov. 2025

Of course, price matters: Sixty-nine percent of respondents said they expect food prices to affect their meal plans. Researchers asked consumers to share their strategies for reducing food costs. "The two most commonly reported strategies were shopping for deals on ingredients (45.5%) and shopping ahead of time to spread out ingredient costs (42.1%)."