Without help, the rural maternal care crisis will only get worse, and 'more women and babies will die unnecessarily'

Over the past decade, many rural hospitals have struggled to stay afloat, but even among the surviving hospitals, labor and delivery services have been cut, which forces mothers to travel and increases pregnancy dangers. Dave Muoio of Fierce Healthcare reports, "Over half of the country's rural hospitals aren't offering labor and delivery services, according to a new report from the Center for Healthcare Quality. The center wrote that over 200 rural hospitals across the U.S. stopped delivering babies in the past decade. As of this month, 55% of rural hospitals don't offer these services, and in 10 states, more than two-thirds don't."

Why obstetrical care is getting axed in rural areas comes down to costs. "CHQPR noted that it can be financially difficult for hospitals to staff for 24/7 maternity care and that private and Medicare payments often fail to break even," Muoio writes. "Per hospital cost reports for 2022, over a third of rural hospitals that still provide maternity care logged an overall loss on patient care services. . . . Within 12 states, more than half of rural maternity care hospitals posted patient care losses."

CHQPR graph

The lack of care can prove deadly for mothers and babies. Muoio writes, "The sparse availability of maternity care hospitals forces pregnant women to travel further for a delivery and incur a higher risk of complications and death for the mother and baby alike, the center wrote. Whereas travel time to a hospital with labor and delivery services is often under 20 minutes for those in urban areas, in rural areas, 'the travel time is likely to be at least 30 minutes, and it is often 40 minutes or more,' according to the report."

Stemming the tide of closures will require approaches that work for more remote health care systems. "Any strategy to bolster the rural maternity workforce will also require targeted clinician training," Muoio reports. "To address the financial roadblock, CHQPR urged employers to put pressure on their health insurance plans' to demonstrate that they are paying adequate amounts to cover the cost of maternity care services. Similarly, states should require Medicaid plans to pay adequate amounts for maternity care services.'"

"It is not an exaggeration to say that rural maternity care is in a state of crisis, and a crisis demands immediate action," the CHQPR report said. "Every day that steps are not taken to implement the changes in workforce recruitment and payments described above increases the likelihood that more women and babies will die unnecessarily."

Opinion: Recruiting physicians to rural areas needs to show what communities offer, which goes far beyond money

Rural medicine is often more about relationships than diagnoses,
which is a hard concept to incentivize. (UIC photo)

Student loan reductions and payoffs have not enticed enough graduating doctors to move into rural areas. But when medical providers experience working in less populated places, they often find smaller communities have so much more to offer, writes Arjun V.K. Sharma in his essay for Undark. "Strategies to attract doctors to rural areas can take many forms, but it is hard to imagine any being successful without the doctor seeing the benefits of the community in which they reside."

Government officials, public policy writers and community planners would do well to look at what it takes for a resident to opt to live in a rural location. Sharma explains: "Often, it is interminably fraught — already hard work is made harder, significant others are uprooted, and certain city comforts and sensibilities may be sacrificed. Physicians, then, must rely on forces internally summoned — autonomy, altruism, competence — to propel them forward. These qualities are harder to define and measure, which make them difficult to meaningfully pin to any reward."

"When I left the city for work in a rural hospital, I put those virtues to the test. I was unsettled, initially wading through the steady stream of 'hellos,' 'good mornings,' and 'good nights' from passersby in the corridor, and unsure of how to interact with psychiatric patients who ran a café near their small ward to ease their transition to the world outside," Sharma writes. "And I was uneasy, at times, with the care we provided — even if patients were appreciative of what they received. The same decisions we fashioned in the city — to get antibiotics delivered at home or to get a surgeon to clear out an abscess — came together with fewer resources, and with doctors stretched hundreds of miles apart."

Rural settings offer a space where all people intermingle and get to know each other. And the closeness of being together while all others are miles away "lent a power to something decidedly tangible. Interactions with patients had an unflinching honesty and tenderness about them," Sharma adds. "One morning, an older man with anxiety was referred from the emergency department to a senior physician. They ran into each other at the grocery store and at local hockey games; living down the street, the physician would often check in on him."

Sharma writes. "A connection to a rural identity could be bought with incentives, or it could be learned. . . . It could be lived through simple and heartfelt things: a teary 'thank you,' a firm handshake, or the question, over and again, from patients of your plans to stay. These gestures don’t absolve the system of its responsibility to make positive reforms. But they affirm value and purpose of work that, whittled down by staffing shortages and burnout, can still impact lives our society willfully neglects."

New leadership and dedicated volunteers helped this small Appalachian town 'persevere' after almost losing its charter

Pound, Virginia is slowing rebounding.
(Photo by Megan Schnabel, Cardinal News)

Despite personal battles and an embezzlement scandal, the town of Pound in Wise County, Virginia, is still a town, which for some people is a shocker. "In early 2022, the town, pop. 877 and falling, was facing an existential crisis, brought on by years of infighting and dysfunction, reports Megan Schnabel of Cardinal News in southwest Virginia. "A top General Assembly member — the region's own delegate — had threatened that the state would yank the town's charter. He was tired of seeing stories in the local news about how town council members couldn't get along, about fiscal improprieties, polluted water, misplaced drugs and guns in the police department."

The news that Pound might cease to exist moved some townspeople to buckle down, fight for what was good in the town, and fix past mistakes. "Leabern Kennedy was elected to the town council in 2021 on a platform of changing the status quo, is now the vice mayor and a driving force behind Pound's revitalization," Schnabel writes. Kennedy told Schnabel: "I think we have shocked the world because I don't think anyone expected us to come back. I'm OK with that."

Map by Robert Lunsford,
Cardinal News

Part of Pound's recovery included leadership changes, with elected and hired officials working together. "The town has chosen a new mayor and replaced half its council members. It paid off almost $9,000 in debt and hired a part-time clerk-treasurer," Schnabel reports. Cindy Mullins, a Pound police officer who was hired in 2021, told Schnabel, "So it's going to take some time to pull back out of this and to really fully function again. . . . It goes back to the trust of the people, the trust of the community and other communities at large to be able to look at us and respect us."

The town's budget is small, and every penny counts as town leaders work to set finances right alongside developing tourist attractions along the scenic Pound River. Debbie Hale, a town volunteer, has worked on grant applications. "Hale won a grant to buy four GRIT Freedom Chairs, which look something like a cross between a mountain bike and a wheelchair and allow people with limited mobility to explore off-road. . . . Pound is still dealing with some issues that send up red flags for state and federal grant programs. . . . One problem is capacity. . . . Another challenge: the town’s fiscal history."

"One source of help during the turmoil, and still today, was the Virginia Municipal League. Its executive director, Michelle Gowdy, spoke on Pound’s behalf during legislative hearings over the town’s future," Schnabel writes. "She and her team have helped Pound’s leaders get trained on budgeting, Freedom of Information Act compliance and other municipal matters. . . ."

Chestnut trees were possibly on the cusp of revival, but a lab error undermined that project; future success is unclear

Few chestnuts ever reach maturity.
(Graphic by Adam Dixon, Ambrook Research)

A blight-resistant American chestnut seems a long way off despite years of dedicated scientific research and work to revive it.

The first epic chestnut loss goes back to the early 1900s when a deadly fungus, Cryphonectria parasitica, wiped out "5 billion trees and their 2 billion tons of biomass," reports Lela Nargi of Ambrook Research. But scientists at the State University of New York's College of Environmental Science and Forestry had been working to develop a genetically altered chestnut that could survive the blight, and their work showed progress until a lab blunder set the entire project into a tailspin.

Nargi explains, "This past December, SUNY admitted a major error with a variant known as Darling 58. This caused its research and financial partner, The American Chestnut Foundation, to pull its support of D58. . . ."

Not all chestnut tree supporters agree that genetic modification is the path to the trees' revival, but despite the controversy, SUNY put its first trees in the soil in 2006 and, by 2019, filed a petition with the Department of Agriculture to have D58 deregulated.

Things looked to be going well until the lab gaffe was aired. Nargi reports, "SUNY had goofed up variations of its breeding line. Instead of using D58 to pollinate trees in its research plots, it had accidentally used D54. . . .TACF withdrew its support of the petition and the trees themselves, saying they'd already noticed 'disappointing performance results.'"

Besides using genetic modification trees to bring back the chestnut, two other methods are in the works. "The American Chestnut Cooperators' Foundation seeks to breed resistance into 100 percent American chestnut trees," Nargi adds. "Another, undertaken by the American Chestnut Foundation, is a backcross in which American chestnuts are cross-bred repeatedly with Chinese chestnuts to impart the latter's blight tolerance into a hybrid tree." All the methods have problems, and while millions of wild chestnuts exist, few will reach maturity.

Donald Davis, author of The American Chestnut, told Nargi: "Even people who used to be fans of the American chestnut would say it had its chance, it had its place in history. They say now we need to move on to species that are going to be more likely to survive in new environmental conditions."

Some of the best rural discourse happens 'on the front porch.' Reimagine Rural series features book authors.

This week Tony Pipa from Reimagine Rural and Brent Orrell of the American Enterprise Institute kicked off their new "on the front porch" conversations with authors of recent books on rural America.

The first discussion was with Nick Jacobs of Colby College, whose recent book with Dan Shea, The Rural Voter: The Politics of Place and the Disuniting of America, uses comprehensive data to examine how the deep sense of civic pride among rural citizens collides with increasingly nationalized policy and political concerns. Watch the YouTube recording here.

Future "Front Porch" sessions are on:

• Thursday, February 8, 2 p.m. ET with Kathryn Edin and Timothy Nelson, authors of The Injustice of Place: Uncovering the Legacy of Poverty in America with Luke Shaefer, in-person & online at Brookings.
• Thursday, April 4, at 10 a.m. ET with Elizabeth Currid-Halkett, author of The Overlooked Americans: The Resilience of our Rural Towns and What it Means for our Country, in-person & online. Location TBA.

To hear more about struggles and triumphs in rural America, give Brookings' podcast, "Reimagine Rural" a listen. The podcast features Pipa traveling through rural America -- from Shamokin, Pennslyvania, to Thomas and Davis, West Virginia, and across to Globe, Arizona. Pipa explores small-town challenges with residents who are living it. Throughout these conversations, Pipa examines the ways rural residents are reinventing their towns.

In 1985-2014, suicide rates were highest among workers in lumber, wood and furniture; metal fabrication; and mining

Workers in several rural-oriented industries were found to have the highest suicide rates, in what the authors say is the first study of suicide rates by industry using nationally representative data.

The study looked at 1,943 suicides over 29 years, from 1985 to 2014. It found that age-adjusted suicide rates were highest in the furniture, lumber, and wood industry group (29.3 suicides per 100,000 population), the fabricated-metal industry (26.3 per 100,000), and mining (25.8). Railroading had the lowest rate (5.5), then education, banking, hospitals, and entertainment and recreation. 

Lines extending from numbers indicate possible maximum rates, due to
sample size. (Study graph, adapted by The Rural Blog; click to enlarge)

Most workers in the high-ranking industries are men, which may partially explain their rank. "Male-dominated industries often come with intense pressure, competition, and societal expectations that can significantly impact the mental health of individuals working within them," the authors write. "Male-dominated industries often involve high-stress jobs, long working hours, low pay, and limited work-life balance, all of which can contribute to chronic stress and mental-health problems."

The study, published in the Archives of Suicide Research, was conducted by Ahmed Arif and three other researchers at the University of North Carolina at Charlotte. They note, "Suicide rates in the working-age U.S. population have increased by over 40% in the last two decades," with the latest annual total 48,000. "Between 1999 and 2017, the age-adjusted suicide rate increased from 10.5 to 14.0 per 100,000 population. Although suicide may be linked with characteristics of workplaces and their industries, few studies have reported industry-level suicide rates."

Why study such rates? "Characteristics of the workplace may affect suicide risk," the authors write. "Researchers have identified job stress, low job satisfaction, bullying and harassment, lack of support and resources, poor management practices, and job insecurity as some of the risk factors for suicide linked with the workplace." Also, "There is evidence that workplace suicide prevention is effective."

Many graduating high school students are considering alternatives to college for job training

Some students seek to avoid college because of cost vs.
labor mismatches. (Photo by Nathan Dumloa, Unsplash)

For three generations, going to college and earning a 4-year degree was the coveted path to a rewarding career with a higher income. But the American belief in the "college for all model" has changed, writes Douglas Belkin in an essay for The Wall Street Journal. "So how did one of the crown jewels of American society squander so much confidence so quickly?"

It began with federal student loans to almost any 18-year-old high school graduate, which had a seismic change on higher education enrollment. "Cash and prestige saturated college campuses while alternatives like vocational and technical schools withered," Belkin explains. "Between 1965 and 2011, university enrollment increased nearly fourfold to 21 million as the earning differential between high school and college graduates expanded."

"For middle-class Americans, college made sense as long as a degree generated a large enough wage premium to make the rising cost of the investment worthwhile," Belvin writes. "As that premium became less consistent, the risks of going to college grew and confidence in college as an institution declined."

A college education "is among the largest investments most Americans will make," Belkin adds. The "math doesn't work for a growing number of families. The percentage of students who enrolled in college after graduating high school fell from 70% in 2016 to 62% in 2022. . . . A poll published in 2022 asked parents if they would rather their child attend a four-year college or a three-year apprenticeship that would train them for a job and pay them while they learned. Nearly half of parents whose child had graduated from college chose the apprenticeship."

Changes are also showing up in the workplace. Belkin writes: "In what has been called the 'degree reset,' the federal government and several states eliminated the degree requirements for many government jobs."

Thieves took most print copies of rural weekly with story on alleged rape at police chief's home; increased story's reach

UPDATE, Jan. 20: Mike Wiggins tells the International Society of Weekly Newspaper Editors, "The thief returned all of the stolen newspapers to our office Thursday night, confessed to the crime and was cited for petty theft this morning." The Plaindealer reports that it is not disclosing the thief's relationship to the sexual-assault case, and "The theft was not connected in any way to the three defendants in the case, their families or the Ouray Police Department."

Front page of the latest Ouray County Plaindealer

By Corey Hutchins
Inside the News in Colorado

This week, a front-page story appeared in the small and mighty Ouray County Plaindealer about a 17-year-old girl’s allegations of being raped by teenagers at the home of a police chief.

What happened next? Papers started disappearing from newspaper boxes around the county, said the paper’s owners, Erin McIntyre and Mike Wiggins.

Here’s more from a note to readers in an email Thursday: "All of our newspaper racks in Ouray and all but one rack in Ridgway were hit by a thief who stole all the newspapers. From what we know so far, it seems this person put in four quarters and took all the papers at these racks. It’s pretty clear that someone didn’t want the community to read the news this week. … Whoever did this does not understand that stealing newspapers doesn’t stop a story. We’re not going to stop doing our job, which is to shine light on important issues in our community and keep you informed. This person is not going to shut down the freedom of the press by stealing a few hundred newspapers. Our community won’t stand for it and we won’t, either."

McIntyre also said the young newspaper publishers were working with a printing plant in Montrose to get another press run published on Thursday. “I'll leave it up to you to draw your own conclusions on which story they didn’t want you to read,” she wrote. Online, a backlash was surging.

When news of the alleged newspaper thefts hit social media Thursday afternoon, Colorado journalists began sharing a link to the online version of the rape allegations story, including an editor at the Colorado Sun, Denver Post staffers, prominent Denver TV anchor Kyle Clark, and others. (The Plaindealer made the story free to read on its website; other stories are not.) The Post ran details of the rape allegations, naming two suspects; the story led with news of the stolen papers.

Ouray County (Wikipedia map)

Clark also included a broadcast segment about it on his "Next" show Thursday evening, indicating the sexual assault story was the news someone was trying to suppress. “We have a link to the article at the Next section of 9News.com,” Clark told his audience Thursday evening. “I recommend you read it if for no other reason [than] that because somebody doesn’t want you to see it.”

If that was the case, the pilfered periodicals produced a classic Streisand effect. The online version prominently displayed mugshots of the three young men arrested for suspected sexual assault, including the Ouray police chief’s stepson; the front-page print story did not.

McIntyre said Friday she hadn’t looked at how much traffic the online story generated, but she said more than $2,000 in donations had flowed in to the newsroom since they publicized the thefts. “People are angry this happened,” she said in a text message Friday morning. “Law enforcement is going to catch this person and we plan on pressing charges.” (She pointed to a 2022 state statute that makes the act of interfering with the lawful distribution of newspapers a finable offense.)

“If you hoped to silence or intimidate us,” Plaindealer co-owner Wiggins said, “you failed miserably.”

Flora and Fauna: A working mouse; this hasn't happened since 1803; 'Wicked' the amazing dog

Welsh Tidy Mouse is reporting for the night shift.
(Photo by Rodney Holbrook, Animal News Agency via WP)

A clean shed is a happy shed. At least Welsh Tidy Mouse thinks so. He has been organizing everything from nails to cable ties in 75-year-old Rodney Holbrook's outdoor shed, reports Jennifer Hassan of The Washington Post. "Most of the time, the rodent works alone, though sometimes it has accomplices, Holbrook said. In one clip, he spotted two other mice joining the nightly cleanup."

How can animals survive in an ever-warming world? Adaptation is one way, but can they do it fast enough? "Maybe," writes Brian Owens for Hakai magazine. "Research conducted over the past couple of decades has shown that evolution can occur on timescales similar to those of climate change. . . .There are things animals can do to stack their decks — and people can help."

Cicadas' vibrating noise can reach 100
 decibels. (Photo by B. Nino, Unsplash)

What genus of this insect is exclusive to North America, spends 99.5% of its life underground and becomes one of nature's loudest bugs once it emerges above ground? Magicicada -- also known as periodical cicadas. This spring, much of the eastern United States will experience a cicada extravaganza as "two cicada broods erupt in states from Virginia to Illinois come late April through June," reports Clare Marie Schneider of NPR. "Periodical cicadas have the longest known insect life cycle. . . . The last time the two broods — Brood XIX and Brood XIII — emerged simultaneously was in 1803."

With family grocery bills often topping off at more than $1,000 a month, this spring is a great time to consider growing a garden. "Because we humans developed into thriving species (well... somewhat thriving) when we learned how to grow our own food," writes Nicole Burke of Grow Yourself Podcast. "I'm about to convince you that growing some of your own food is not that hard to do." Don't have the energy or room to plant? Many plants can "breathe" life into indoor living spaces, Janece Maze and Christopher Michel of Country Living report. "The best part of houseplants? The weather's always fine."

Cartoon by Marina Wang, Hakai

How do penguins tell each other apart when they all have the same outfit on? By their spots! "African penguins develop a distinct constellation of spots on their chests, which remain the same throughout their lives," reports Marina Wang for Hakai magazine. "Zookeepers often use these spots to identify individuals. . . To find out if the birds do the same, Luigi Baciadonna, a psychologist at the University of Turin in Italy, and his colleagues designed an experimental series."

Once common in the West, the whitebark pine tree is struggling to survive. "Warmer temperatures, a fungal disease called white pine blister rust, and swarms of mountain pine beetles have killed hundreds of millions of whitebark pines across the West," reports Jim Robbins of Yale Environment360. "Wildfires are taking an increasing toll, and other conifer species are moving upslope in the rapidly changing environment, outcompeting the whitebark for nutrients and moisture."

Wicked is calm, cool and commanding.
(Photo by Stephaniellen Photography, AKC)

Wicked isn't just the name of a blockbuster musical. It's also is the name of a rock-star-quality dog. "Meet Wicked, a three-year-old Doberman Pinscher who clinched the win for the American Kennel Club's 2023 Working Group competition last month," reports Liz Langley of National Geographic. "Exactly the opposite of what her name might suggest, Wicked has a calm but commanding presence. Even when she won Best of Breed earlier in the day, which put her in the Working Group competition, Wicked seemed to be a crowd favorite — every ounce of her compact, muscular body brimmed with energy."

A Rural Blog audience update regarding email alerts

Rural is full of diversity. Trees in Muncy, Penn., pop. 2, 500 (Photo by Venti Views, Unsplash)

Thank you for reading The Rural Blog. We appreciate your interest in news and information about rural issues and communities. For readers who subscribe to our email alerts, those are now being delivered on Tuesdays and Fridays, so please look for them in your inbox. We know that many readers access TRB directly, so please continue to check in regularly for new articles. The site will continue to be updated throughout each week, not just on the days the email notices are delivered. Thanks again for reading The Rural Blog. 

Mass-shooting report aims to help police elsewhere; Uvalde still divided; editor has advice for community journalists

Uvalde County (Wikipedia map)

The Justice Department's Thursday report on the massacre at an elementary school in Uvalde, Texas, is designed to help avoid the mistakes police made, but seems unlikely to heal the divisions that remain in the town of 15,000 and same-named county of 25,000.

“They’re recomending stuff that we already knew,” but “In a lot of smaller towns like Uvalde, police chiefs have to be questioning, ‘What’s in this report?’ . . . Let’s make sure I don’t become that person,” said John Miller, CNN's law-enforcement analyst and former spokesman for the FBI and the New York Police Department.

Miller said a gunman's killing of 19 students and two teachers, and the physical injury of 17 others, was “an incident that was just too big in a place that was just too small.” He said the incdent commander, the school police chief, should have ceded authority to better-equipped agencies. The investigation was requested by then-Mayor Don McLaughlin, a Republican.

Attorney General Merrick Garland, in Uvalde, said “The report concludes that had law-enforcement agencies followed generally accepted practices in an active shooter situation and gone right after the shooter to stop him, lives would have been saved and people would have survived,” rather than letting 77 minutes elapse between their first arrival and their killing of the shooter.

The report was the fullest account yet of the tragedy, but some victims' families said it should have named more names. Andrew McCabe, former FBI deputy director, said on CNN that the purpose of such a "critical indicdent review is not to hold people accountable, but to make a complete statement of facts and say how law enforcement can learn from mistakes."

Victims' families continued to demand action from local District Attorney Christina Miller Busbee, who has said she would wait for the report before taking any action. But they said many of their neighbors want to move on and not "be known as the place with a mass shooting," said Brett Cross, who was a guardian of a child killed in the shooting. "Maybe these people will start taking us seriously." UPDATE, Jan. 19: Sources tell the Austin American-Statesman that a judge has empaneled a grand jury "to consider possible criminal charges against law-enforcement officers. . . . It is unclear what charges the grand jury seated in Uvalde County state district court might consider against the officers, but they possibly include child endangerment or injury to a child, the Statesman confirmed." As for civil suits, in Texas they must be filed within two years of the injury.

Cross told CNN that the Uvalde community remains “very divided,” noting that several officers remain in their positions, some of them elected. “They don’t want to believe that the people grew up with failed our children.” Adam Martinez, father of an injured survivor, told CNN, “If we don’t put pressure, nothing is going to happen. . . . It’s uncomfortable when you have to say people didn’t do their job. . . . You have to go against the grain, and more people have to do that.”

Pedro "Pete" Arredondo, the school police chief, lost his job. In November, "Lt. Mariano Pargas of Uvalde police, who was the acting police chief on the day of the shooting, resigned days before the City Council was set to discuss his termination. He had been placed on leave in July; he stepped down following a CNN report that showed he was told that “eight to nine” children were alive in the classrooms but he failed to coordinate action," the Texas Tribune reported. He was re-elected to the county commission. The Washington Post reported one year after the May 24, 2022, shooting, "The first state police officer disciplined after the massacre was given the option to resign and now works for a local sheriff’s office."

Jan. 21 front page; for a larger version, click on it, or right-click to download.

UPDATE, Jan. 20: The Uvalde Leader-News reports, "On Friday, Jan. 19, a dozen people were selected to serve on a special grand jury that is expected to spend at least six months studying the May 24, 2022, Robb school shooting investigation. About 300 people were summoned to appear at 9 a.m. in the 38th Judicial District Court, and 67 people appeared. Juror turnout has been an ongoing issue for the court. Judge Camile DuBose said in some cases, a mailed summons may fail to reach the intended juror, but some people simply choose not to show up. She said for those who fail to appear, she can summon them to a hearing, where a $100 fine may be imposed on those who have no valid excuse for their failure to appear. For those who don’t show for the hearing, the sheriff’s office may be asked to locate the person and summon them to court."

Julye Keeble of The Leader-News explores possible outcomes: "Police officers are largely difficult to prosecute for inaction, and the law does not require police to risk their lives to protect the public. Per a 2005 U.S. Supreme Court ruling, police officers do not have a constitutional duty to protect others from harm. Few cases against law enforcement for failure to act are presented, and those that are typically fail." Keeble notes the acquittal last year of a school resource officer on charges for failing to protect students at Marjory Stoneman Douglas High School in Parkland, Fla., on Feb. 14, 2018.

"An ongoing debate, particularly seen in the wake of the Robb shooting, is whether police have a moral imperative to take action sooner in mass casualty situations, which often see a delay before an attacker is confronted," Keeble writes. "Though medical findings have not been made public, families allege some of those who died after the attack might have lived if bleeding had been staunched and they received medical treatment. Several Uvalde Police officers who were on the scene within minutes charged forward toward the adjoined classrooms where the attacker was, but were repelled after he fired at them. Two officers were wounded by shrapnel, and though one tried again to move forward, no others would follow. Officers told others the attacker had an AR rifle, and the destructive power of the weapon was likely a factor in guiding police decisions."

Leader-News Publisher Craig Garnett asked Garland at the press conference about the quality of the police response, especially in light of the police response to the mass shooting at the Pulse nightclub in Orlando, Fla., in 2016. That comparison “is not entirely true, and the response was a failure,” said Hugh Clements Jr., director of the Justice Department's Office of Community Oriented Policing Services, which prepared the report.

Garnett's advice to community journalists

For his work on the tragedy and its aftermath, and his first 22 years at the paper, Garnett won the 2023 Tom and Pat Gish Award for courage, integrity and tenacity in rural journalism from the Institute for Rural Journalism at the University of Kentucky, publisher of The Rural Blog. He will receive the award Feb. 29 at the University of Texas-Austin, at a symposium, "Courage, Tenacity, Integrity and Innovation in Rural Journalism." For the audience at the Institute's Al Smith Awards Dinner in October, he had a video message for community journalists, published this week by The Daily Yonder. He said in part:

Craig Garnett

"One of the things we’ve taken away from May 24 is that we didn’t do enough before. We have a wall full of plaques from the South Texas Press Association, the Texas Press Association, but we didn’t do enough. We didn’t ask enough questions. We didn’t hold people running for elected office to account like we should have. We didn’t question people who wanted to run our institutions closely enough. What motivated them? What experience do they have? What would they do in a crisis?

"And we certainly didn’t hold our law enforcement to a high enough standard, the people who swore to protect us. So, we will work harder in the future to do that, to make sure that we know as much as we can about people who intend to lead our community, especially in the aftermath of a tragedy. We want to know how they’ll react. It’s not entirely possible. There are all kinds of things that pop up that you can’t plan for, but you can get a sense of where people’s souls lie and what their commitment is to your community.

"And that’s what I would advise to my fellow publishers in small towns. Pay attention. Pay attention to everything, to those people who run institutions, to the kid who’s slipping between the cracks, who might one day become the same school shooter we had. Be invested beyond what you are now, if that’s possible. I know most of you work your hearts out. But if there’s one thing we would like to do better, it would’ve been that."

In their first 3 years, Biden has sent as much federal money to farmers as did Trump, who likes to talk about his largesse

Politico illustration

Former president Donald Trump "makes hay in farm states like Iowa by reminding farmers of how much money the federal government paid them during his presidency," but President Biden has delivered about the same in the first three years of their presidencies: $57 billion.

So reports Garrett Downs of Politico's Weekly Agriculture, adding, "Nearly half of Trump’s total $109 billion in direct payments were delivered in his final year, 2020." That's when the Department of Agriculture "paid farmers more than $52 billion, an unprecedented sum since USDA began recording farm payment data in 1933. Those tallies don’t include billions in other types of farm support, like crop insurance and loan financing — traditionally the largest types of ag subsidies."

Applying other measures, "Biden has been better for farmers than Trump," Downs writes. "Net farm income has actually gone up since the Democrat entered the White House. On average, net farm income has totaled $165 billion between 2021 and 2023, compared to $94 billion between 2017 and 2019. Farm income reached a record high of nearly $189 billion in 2022. And while it is projected to drop off in 2023 (USDA is still tallying receipts from December 2023), it remains above the 20-year average for receipts."

Looking ahead, Downs notes that Trump is proposing "a universal tariff on nearly all goods," while Biden "is telling farmers that his administration is working to distribute the recent surge in ag profits to farmers across the spectrum, not just the largest ag conglomerates." Joe Glauber, former chief USDA economist, told Downs that Trump’s proposed tariff could bring another trade war and “really hurt U.S. agriculture.”

When that happened under Trump, he used the USDA's Commodity Credit Corp. to send $28 billion in relief to farmers, but Glauber said farmers shouldn't expect another bailout. “I think that’s taking a big leap of faith,” he said. “Those were big, extraordinary payments, and I think it may be naive to think that they would be there year in and year out.”

When it comes to controlling invasive, herbicide-resistant weeds, farmers might be losing the battle

Kochia is also known as burning bush, Mexican firebrush,
mock cypress or tumbleweed. (Cornell photo)

Viruses and bacteria aren't the only things that can develop science-challenging resistances; weeds can also genetically modify to subvert herbicides and spread. "Crop-killing weeds such as kochia are advancing across the U.S. northern plains and Midwest, in the latest sign that weeds are developing resistance to chemicals faster than companies can develop new ones to fight them," report Rod Nickel and Tom Polansek of Reuters. "In many cases, weeds are developing resistance against multiple herbicides, scientists said."

When uncontrolled by herbicides, noxious weeds multiply so quickly that the intended crop gets choked out. Nickel and Polansek write, "Reuters interviewed two dozen farmers, scientists, weed specialists and company executives and reviewed eight academic papers published since 2021 which described how kochia, waterhemp, giant ragweed and other weeds are squeezing out crops in North Dakota, Iowa, Wisconsin and Minnesota as chemicals lose their effectiveness."

While weeds are always part of farming, prolific herbicide-resistant weeds kill crops. Farmers "say their losing battle with weeds threatens grain and oilseed harvests at a time when growers are grappling with inflation and extreme weather linked to climate change," Reuters reports. "Kochia, which spreads as many as 30,000 seeds per plant, can cut yields by up to 70% if left unchecked, according to Take Action, a farmer resource program of the United Soybean Board."

Herbicide development takes years, and many "candidates" fail to make the cut. "FMC plans the 2026 launch of an herbicide to kill grassy weeds in rice crops based on the industry's first new mode of action, a term for how a chemical kills a weed, in three decades," Nickel and Polansek explain. "The herbicide was in development for 11 years. . . . The world's biggest agriculture chemical and seed company, Germany's Bayer, hopes to produce its first new mode of action herbicide in over 30 years by 2028."

There is another answer to the problem. Reuters reports, "Bill Freese, scientific director of the Center for Food Safety in Washington, said farmers should shift away from crops genetically engineered to tolerate herbicides, which lead to plants becoming resistant to multiple chemicals through repeated sprayings. 'It's like this toxic spiral,' Freese said. 'There's no end in sight.'"

As more Americans chose to eat more cheese, farmers look for ways to increase milk fat content

Jersey cows produce milk that is high in butterfat and
has a golden hue. (Wis. Jersey Breeders Association photo)

What's better than cheese? More cheese. That's what many Americans are telling the U.S. dairy industry. But heightened demand for rich-tasting young gouda and spunky blue cheese comes with a catch -- dairy farmers need their cows to produce fattier milk, reports Kirk Maltais of The Wall Street Journal. "Just five years ago, dairy farmer Melvin Medeiros said his herd consisted entirely of Holsteins, which are the black-and-white spotted cows. . . . Now about 70% are brown Jersey cows, which are smaller but produce a fattier milk."

In dairy-producing states such as Wisconsin and Vermont, loving cheese is threaded throughout the culture, but the rest of the country is catching on. "Cheese consumption is at an all-time high, with Americans eating an average of 42 pounds a year in 2022, according to the most recent data available from the Department of Agriculture," Maltais writes. "That is up 17% over the previous decade." Although butter sales declined in 2022, consumption is still up 9% compared to a decade ago. 

Beyond switching cow breeds, what else can farmers do to "squeeze" fattier milk from their herd? It comes down to keeping cows comfortable and providing a richer diet. "Cross-ventilated barns ensure animals don't get too hot," Maltais explains. "Keeping cows cool helps them get fatter — and produce fattier milk. Medeiros adds oilseeds like cottonseed and canola to their feed."

Michael Hutjens, professor emeritus of animal sciences with the University of Illinois, told Maltais, "We're seeing a lot more money invested in fans and sprinklers." Maltais reports: "Hutjens said breeding and genetics could help push up fat levels in milk even more."

Rural Tennessee communities want agreements to ensure that they will benefit from Ford's big electric vehicle complex

Ford and SK's mega EV complex in Tennessee is nearly six square miles.
(BlueOval City photo)

Named after Ford's iconic logo, Blue Oval City is a burgeoning electric vehicle development in Stanton, Tennessee, a rural town of 615 residents, many of whom are working to ensure the massive operation provides regional community advantages.

"The joint venture, between Ford and Korean company SK Innovation, promises 6,000 good-paying jobs for residents of the small, rural communities. . . . Development on such a large scale will, [residents] fear, change the community, suck up water and electricity, and prompt an influx of newcomers and development," reports Katie Myers of Grist. "The towns orbiting Stanton are sitting down with Ford and SK to negotiate a binding agreement that will ensure they benefit from Blue Oval City as much as the companies do."

Community advocates wanted residents to have a say in what benefits the companies provided, including youth facilities and support for road maintenance, alongside binding assurances for responsible plant waste disposal. To empower regional voices, they formed a coalition, which "drafted a list of stipulations, called a community benefits agreement, that it wants Ford/Blue Oval SK to abide by," Myers explains. "CBAs are a contract between a corporation and a coalition of local organizations that gives the community, through binding arbitration, leverage to ensure the commitments are kept."

In Los Angeles, the entertainment industry used CBAs to negotiate for a large sports arena, but a CBA's purpose and power can be broadly applied. Vonda McDaniel, the president of the Central Labor Council of Nashville and Middle Tennessee, "is helping to formulate Blue Oval agreement and plan town halls," Myers reports. "The process has been lively." McDaniel told her: "We haven't had a whole lot of wilting flowers that have shown up at our meetings. . . . The community is feeling a bit squeezed; there's heavy equipment up and down the road every day."

The "squeeze" is understandable. Blue Oval City is a 3,600-acre campus covering nearly six square miles. The complex is slated to open in 2025 and will employ at least 5,700 people. The surrounding towns of Covington, Brownsville and Stanton have an estimated population of 19,015.

Kathleen Mulltigan, who leads the National Labor Leadership Initiative at Cornell University, told Myers: "What we're really trying to do is bring real democracy into the economic realm, because a lot of the work of shaping the economy happens without workers having any voice in it."

The coalition will need Ford and SK to come to the negotiation table. The group plans to "take a complete draft of the agreement in hand early in the new year," Myers reports. "Even if the effort is not immediately successful, community members say, the relationships they've built with one another will only get stronger, leaving possibilities for further organizing open down the road."

Health quick hits: Sacklers could compensate opioid victims, but deny responsibility; blood donations sink to 20-year low

Many family members want the Sackler family to pay for 
their part in the opioid overdose epidemic. (Photo via CNN)

The Sackler family, who owned Purdue Pharma, the maker of the synthetic opioid OxyContin, could "act today to compensate opioid overdose victims," write Regina LaBelle, J.D., and Madison Fields, J.D. in their opinion for MedPage Today. "The family could voluntarily establish a fund to compensate people harmed by Purdue's marketing of OxyContin and allow individuals to choose to release future claims. However, it appears that the family's insistence that they bear no responsibility for the overdose deaths involving OxyContin and their desire to be shielded from future civil litigation [through bankruptcy] will prevent this from happening. . . . Purdue has made the Sacklers one of the wealthiest families in the U.S., with a collective worth estimated at $11 billion."

As blood donations sink to their lowest level in 20 years, the American Red Cross has issued a blood shortage emergency. "There does not appear to be enough donated blood to meet demand among hospitals and patients in need," reports Jacqueline Howard of CNN. "Data from the national organization America's Blood Centers indicates that at least 17 community blood centers have a one-day supply or less. . . . One unit of blood, equivalent to about a pint, is typically collected during a donation, and experts estimate that a single car accident victim can require as many as 100 units of blood."

Mobile medical units can reach more rural residents
in need of addiction care. (HealthAffairs photo)

A new study by the University of Colorado shows that one way to help rural areas fight addiction is to send more mobile methadone clinics to remote areas, reports Julia Milzer of CU Anschutz Medical Campus. "The research focused on the impact of adding new treatment services exclusively to rural Louisiana, where, like in many other remote parts of the country, there are limited care infrastructures and barriers to transportation. . . . The analysis revealed mobile methadone would have a distinct impact in rural communities if these locations were prioritized and recommended operators collaborate with state and local policymakers regarding where to locate them to help maximize their impact." To learn more about mobile methadone, click here.

Family medicine doctors who train in obstetrics could
help fill care gaps. (UIC photo)

A key to solving some of the rural maternal health care shortage could be obstetric training for family physicians. "In the 1980s, about 43% of general family physicians who completed their residencies trained in obstetrics," reports Sarah Jane Tribble of KFF Health News. "In 2021, the American Academy of Family Physicians' annual practice profile survey found that 15% of respondents had practiced obstetrics. . . . In July, the Department of Health and Human Services announced a nearly $11 million investment in new rural programs, including family medicine residencies focusing on obstetrical training."

 Ian Cousins
(Courtesy photo, Undark)

Removing forever chemicals from drinking water is expensive, with consumers the most likely target for paying the bill. Some experts are suggesting a different course to avoid the extreme cost.

The Environmental Protection Agency is set to "finalize an enforceable cap on PFAS in drinking water that will require thousands of utilities around the country to update their treatment methods," reports Charles Schmidt of Undark. Ian Cousins, an environmental chemist at Stockholm University and "one of the world's leading researchers on PFAS exposure, said the public might be better served by a policy that prioritizes hot spots of PFAS contamination."

 

Big non-metro vote gives Trump a majority in Iowa caucuses

Trump, in red, prevails in caucuses. Haley's share in dark red, DeSantis's in pink. (NBC News projects graph)

Donald Trump's majority win in Monday night's Iowa Republican presidential caucuses was driven by rural and small-city caucus-goers, who have him 57 percent of their votes compared to 47 percent of those in cities and suburbs, according to the entrance poll for news organizations. Overall, Trump got 51 percent. Florida Gov. Ron DeSantis, the second-place finisher, did best in suburbs, getting 27%; former South Carolina Gov. Nikki Haley, who finished a close third, did best in cities, with 27%.

Other findings in the poll reflected Trump's rural dominance. He got 55% of white evangelicals, 63% of those with no college degree, and 74% of those who have never been to college. Trump carried every county but Johnson, home to Iowa City and the University of Iowa and the county with "the highest share of voters with bachelor’s degrees of any Iowa county," The Washington Post reports.

Wall Street Journal map, adapted by The Rural Blog; click to enlarge.

UPDATE, Jan. 17: The Wall Street Journal reports, The Republican front-runner saw his biggest improvement over 2016 in counties that reflected his core supporters: older voters, those without a college degree, lower-income voters and evangelicals. . . . One of Trump’s biggest increases in support came in counties with a higher proportion of older voters, growing by an average of nearly 35 points compared with 2016, versus his nearly 27-point increase statewide. Many of those counties are also rural areas, another source of strength for Trump."

Post columnist David Von Drehle writes, "Huge margins among sparse populations gave Trump an appearance of invulnerability. But the closer the race drew to a population center — someplace big enough to have a Costco or a Chick-fil-A — the weaker he appeared. . . . Recent history teaches us that this year’s general election will be won or lost on precisely that ground, not in farm country but in the Chick-fil-A precincts."

Presidential campaigning in Iowa has traditionally been about "championing policies aimed at helping the state’s farm-driven economy. But this year, the Republicans seeking their party’s presidential nomination have largely avoided over-the-top pandering to local priorities — and any such attempts appear not to be as effective as in the past, report Anjali Huynh and Kellen Browning of The New York Times. The main reason is "Trump, who has run in the style of an incumbent, has dominated the state while barely setting foot in it. Though he refers to Iowa farmers in his speeches and talks about how he has poured money into the state, Mr. Trump has eschewed the classic retail politicking that is a mainstay of the caucuses in favor of larger rallies while focusing his message more on national issues. . . . Local issues have instead served more as a differentiator among the candidates competing for second place, rather than part of a winning strategy."