Op-ed argues that the popular narrative about rural Californians is false; in fact, rural communities are doing well

Lounging dairy cows in Kern County (Photo by Brian van der Brug, L.A. Times)

Many rural Californians don't fit the current narrative of conservative, angry Americans who feel left behind. Elizabeth Currid-Halkett and Marley Randazzo encourage readers to take a closer look at how rural is socially and politically defined and what that might mean more broadly for rural America in their Op-Ed for the Los Angeles Times, "Rural California isn't what you think it is."

A popular rural narrative, they contend, is that rural Californians voted for Trump in 2020, because "they are poor, angry and feel left behind by the political establishment and educated urban elites." But, scrutiny dispelled much of this storyline. "In fact, many rural areas in California are doing well economically. Also, their vote for Trump is misunderstood. With Trump again a viable presidential contender, politicians, policymakers and the public should shift their lens upon rural areas."

A more "nuanced" approach that reconsiders what many thought was rural California or even rural America would bring more understanding. "Rather than dismissing rural Americans and assuming their politics, we ought to take the time to understand these complex communities. Our country's future depends on it," Currid-Halkett and Randazzo write.

They note researchers and government policy writers use dozens of ways to define rural; however, "most folks think of places beyond the city limits, layered with farms, dirt roads and humble main streets," but in California, that's not the case. "Much of Fresno County may appear to Angelenos as rural with its expansive farmland. However, Fresno has an urban population of about 900,000, meaning the county qualifies as a medium-sized metropolitan area according to Department of Agriculture standards."

Nor does living in rural California mean barely scraping by. "Our analysis of recent census data reveals that rural Californians are substantially more likely than their urban counterparts to own their own home and be employed," Currid-Halkett and Randazzo add. "Rural California's unemployment rate is 3% compared with 4.2% for metro areas. Against the backdrop of a housing crisis, homeownership in rural California is more than 70%, while just 55% for our cities."

Political opinions about rural residents are also riddled with misconceptions. "Although Trump won 10 of California's 13 rural counties in 2020, the data show that some rural margins were razor thin," they note. "Over the past five years, one of us spoke to dozens of Americans, finding that not only are rural Americans not angry at liberal elites living in cities but that they share many of the same values. When asked about democracy, equality, immigration and other important issues of our time, rural Americans were in line with what their urban counterparts expressed. They conveyed, however, a wariness toward being told what they should think and say."

Flooding can cause caskets to float away and headstones to disappear as climate change hits cemeteries

A coffin juts out of a riverbank.
(Courtsey photo by Judy Blair Berry)

Climate change can mean prolonged or repeated flooding in some areas unprepared for submersion; graveyards and cemeteries are experiencing unearthed remains and floating caskets, reports Dinah Voyles Pulver of USA Today. "Thousands of graves have been disturbed in cemeteries nationwide in the past 30 years. Flooding, erosion and other climate-related weather disasters have been reported in at least 21 states and 15 countries over the past three decades. Coffins have washed away, and bones have been exposed in big cities and tiny hamlets."

Cemeteries have long struggled with neglect and upkeep expenses, but extreme weather has amplified the problem. Judy Blair Berry and her husband told Pulver of a prime example. The couple was "motoring along the Pearl River in Copiah County, Mississippi, when she looked up from the boat to see a casket jutting out of the bank above the river. Pieces of gravestones lay scattered on the shore. . . . Mississippi, and its neighbors to the north are among the states in the eastern half of the United States experiencing more rainfall extremes since the 1990s, including increases in the number of days with more than an inch of rain."

Families have had to rebury loved ones, and state and local governments, the Federal Emergency Management Agency and cemetery associations "are already spending millions to preserve cemeteries and build seawalls, and relocate or rebury remains," Pulver reports. "Perhaps nowhere have the effects of climate change had more impact on cemeteries than in Louisiana. At least 11 hurricanes have pummeled the Bayou State since 2002, disturbing thousands of graves and washing away hundreds of vaults and caskets. . . . At least a dozen cemeteries in southern Louisiana parishes have succumbed to rising seas and sinking land, The Associated Press has reported."

Pulver explains, "Water can infiltrate a burial site in several ways, and each type of casket, whether it's sealed, unsealed or inside a vault, can develop issues. . . . Options are available to help protect cemeteries and have been used at some locations in the U.S., including adding seawalls and stabilizing shorelines. A more complex and expensive step also has been needed in some cemeteries: moving the graves to safer locations."

Emergency medical services aren't considered 'essential' in some states; 4.5 million people live in 'ambulance deserts'

Many states have yet to declare EMS as an 'essential service.'

(Photo by Ian Taylor, Unsplash)

If you're having an emergency, you can call 911, but that doesn't mean there's an ambulance or paramedics nearby to come to your aid. "Most states don't declare emergency medical services to be an 'essential service,' meaning the state government isn't required to provide or fund them," reports Nada Hassanein of Stateline. "Now, though, a growing number of states are taking an interest in recognizing ambulance services as essential. . . .Experts say the momentum might be driven by the pandemic, a decline in volunteerism and the rural health care shortage."

Smaller towns and out-of-the-way places face the most complex struggles. "The lack of EMS services is acute in rural America, where EMS agencies and rural hospitals continue to shutter at record rates, meaning longer distances to life-saving care," Hassanein writes. Longtime paramedic Brenden Hayden, chairperson of the National EMS Advisory Council, a governmental advisory group within the U.S. Department of Transportation, told Hassanein: "The fact that people expect it, but yet it's not listed as an essential service in many states, and it's not supported as such really, is where that dissonance occurs."

EMS services struggle partially because "there isn’t a sole federal agency dedicated to overseeing or funding EMS, with multiple agencies handling different regulations, and some federal dollars in the form of grants and highway safety funds from the Department of Transportation," Hassanein explains. "By contrast, police departments are supported and receive funds from the U.S. Department of Justice along with local tax dollars, and fire departments are supported by the U.S. Fire Administration, although many underserved areas also rely on volunteer firefighters to fill gaps."

"About 4.5 million people across the United States live in an 'ambulance desert,' and more than half of those are residents of rural counties, according to a recent national study by the Maine Rural Health Research Center and the Rural Health Research & Policy Centers," Hassanein adds. "The researchers define an ambulance desert as a community 25 minutes or more from an ambulance station."

What's going on with the latest Covid-19 vaccines? Here are answers to frequently asked questions.

Updated Covid-19 vaccines from Pfizer/BioNTech and Moderna have rolled out to pharmacies. The Food and Drug Administration approved the mRNA vaccines for everyone 6 months and older. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted 13-1 to recommend that everyone 6 months and older should get the shots, and the CDC endorsed that recommendation.

Lori Robertson and Catalina Jaramillo of FactCheck.org, a service of the Annenberg Public Policy Center at the University of Pennsylvania. Robertson and Jaramillo compiled a list of common questions and answers about the vaccines, and here's a condensed version of their report:

How are these updated shots different from the last one? All of the Pfizer/BioNTech and Moderna Covid-19 vaccines — the originals, the bivalent boosters and the latest updates — use the same mRNA technology to trigger an immune response to the spike protein of SARS-CoV-2, the virus that causes Covid-19. The spike protein is what the virus uses to enter cells.

The difference between the versions of the vaccines is in what type of spike protein they prompt the body to make. The mRNA in the 2023-2024 vaccines instructs cells to make the spike protein of omicron variant XBB.1.5. The variant became a concern at the end of last year, when the CDC projected it made up 40.5% of new CCovid-19 cases in the U.S., a figure that rose to nearly 90% by early March.

Who is eligible to get an updated vaccine? Everyone 6 months of age and older is eligible for these vaccines.The FDA said those age 5 and older can get a single dose of either mRNA vaccine if at least two months have passed since the prior Covid-19 vaccine dose. Unvaccinated people can also get a single dose. Children ages 6 months through 4 years who previously were vaccinated are eligible to get one or two doses, depending on which vaccines they have received and when. Children in this age group who haven’t been vaccinated against Covid-19 can get three doses of the latest Pfizer vaccine or two doses of Moderna’s. . . . Those who are immunocompromised can also receive additional doses.

What evidence supports the use of the updated vaccines? The FDA said it approved and authorized the latest formulas of the vaccines based on its evaluation of manufacturing data and data showing the immune response to these vaccines against prevalent variants is similar to that of previous versions of the vaccines against prior variants.. . . . The FDA is using a similar approach to the annual influenza vaccines, which are tweaked each year to combat the influenza strains expected for that season. Flu vaccines are approved each year without clinical studies because the changes, compared with prior vaccines, are small and because it wouldn’t be possible to test the vaccines each year in people before the flu season.

How effective are they? We don’t have vaccine effectiveness data for the updated vaccines specifically, but data on similar, previous vaccines show they were quite effective at preventing severe disease. And the research. . . .by Moderna and Pfizer/BioNTech shows the updated version increases neutralizing antibodies against the new and emerging variants.

How safe are they? Moderna’s clinical trial for the latest vaccine showed that the percentage of participants reporting mild side effects, such as pain, swelling, headache, fatigue and muscle aches, was similar to or, in many cases, lower than the reporting rates for the prior Covid-19 vaccines. But, the safety evaluation of this formula is based on hundreds of millions of doses of Covid-19 vaccines administered over the past few years.

Are the shots still free, and where can I get one? The vaccines are no longer provided by the federal government for free, but private insurance companies, Medicare and Medicaid, and some CDC programs will cover them.

For more detailed explanations and questions, read the full article here. 

When Americans no longer trust each other, the problem can be deadly. It hits rural areas the hardest, study shows

An unhealthy mistrust has spread across the U.S.
(ProMarket photo, University of Chicago)

Not being able to trust our neighbors or our country's leaders not only feels rotten, it can lead to physical illnesses. "People died in the pandemic because they didn't trust the government or their neighbors to do the right thing," reports Frank Morris of KCUR in Kansas City. "And it's not getting better. Today, distrust is making people sicker, especially where health care is fragile across giant swaths of rural America. . . . Tom Bollyky, director of the global health program at the Council on Foreign Relations, said while the worst of the pandemic has passed (for now), the United States' deadly epidemic of mistrust is raging unchecked."

Bollyky was the lead author of a large study published in The Lancet this year, "taking a fine-grain look at Covid death and infection rates across the United States and the many factors that contributed to the differences," Morris writes. Bollyky told him: "This pandemic has been less about the microbe spreading around and more about the people to which it's spreading. It's about us, and how we feel about each other, and how we hang together as a community."

Morris reports, "Covid death rates varied wildly between states. The government tracked these rates as deaths per million people. New Hampshire lost 218 residents per million to Covid during the research period. New Hampshire has the highest rate of interpersonal trust in the U.S., as measured by long-running surveys testing trust between individuals. . . . Covid-19 was almost twice as deadly in Missouri as it was in New Hampshire. Almost a dozen other states fared even worse, partly due to distrust."

The pandemic years didn't just erode interpersonal trust, it decreased Americans' faith in vaccines overall. Brock Slabach, chief operations officer at the National Rural Health Association, told Morris, "And then, to add insult to injury, we have lower rates, for example, of childhood immunization that directly comes out of the pandemic and mistrust in vaccines generally. And so we're going to see childhood diseases that we thought we'd eradicated returning."

During and continuing after the pandemic, patient-doctor trust plummeted, and that distrust could make the next pandemic worse. Slabach told Morris: "Through the pandemic, we've added this issue of mistrust in the very professionals that for centuries we've valued as an important source of information for health and healthcare. . . . If we have another health crisis, this will come right back because we've not addressed some of the underlying issues. And so we're still going to be facing higher rates of disease, higher spread of death because of this misinformation and the lack of trust that we have in those areas of our system that know what to do in response."

Loneliness has increased across the U.S.; it shortens life expectancy, but there are solutions

Loneliness can lead to premature death.
(Photo by Andre Frueh, Unsplash)

Loneliness is a feeling as old as time, but it can lead to poor brain health and shorter life expectancy. According to America's top public health official, Surgeon General Vivek H. Murthy, loneliness is "as harmful as smoking 15 cigarettes a day and more lethal than consuming six alcoholic drinks a day," opinion columnist Nicholas Kristof writes for The New York Times as part of a series titled "How America Heals," aimed at finding ways to fix this problem.

Chronic loneliness cuts deeper than sadness; researchers have linked it to strokes, heart disease, dementia, inflammation and suicide. Kristof writes, "It's also more dangerous than physical inactivity, obesity and air pollution, Murthy says. . . . It breaks the heart literally as well as figuratively." The physical and societal problems that result from loneliness are so harmful Murthy issued a rare advisory in May with a framework to rebuild social connection and community in the United States.

Research also shows Americans have been growing lonelier. A majority of adults (58%) report experiencing loneliness, according to a Morning Consult survey commissioned by The Cigna Group, a health insurance company. Why did loneliness increase? Kristof says the trends toward larger homes and longer working hours have left less time to share meals, and he notes studies that show social media has led to people being more lonely. Pets and talking robots have been suggested as solutions, he writes, but "It seems that there's something to be said for friends who are living, breathing human beings."

Kristof writes that there are ways to build connections that bind us together, including some approaches taken in the United Kingdom, which he says "is the pioneer of these efforts, having established the post of minister for loneliness in 2018. Britain oversees public-private partnerships that collectively knit millions of people together with programs like nature walks, songwriting workshops and community litter pickups.

"That's because if the researchers are correct, social isolation probably kills far more people in the West each year than terrorists and murderers, and it costs the public enormous sums in unnecessary health costs," Kristof writes. "Countermeasures can make a huge difference: One review of 148 studies concluded that social connections increase the odds of an individual's surviving over roughly the next seven years by about 50 percent."

Surgeon General Murthy offered a strategy to address loneliness that begins with building infrastructure that enables social connection: physical infrastructure such as parks and libraries, and social infrastructure to weave together volunteers or enthusiasts with similar interests. Britain can serve as a model for this, Kristof writes. He cites a town that has trained more than 1,100 volunteers to be "community connectors" who engage people and encourage them to join events or participate in programs. "Solutions to loneliness are like that — little nudges to encourage us to mingle the way we evolved."

Family-based residential addiction treatment centers are successful, but the model struggles to be viable

Despite successes, these centers struggle.
(Photo by Jordan Whitt, Unsplash)

Even with higher success rates, family-based residential addiction treatment centers remain the exception; centers in rural areas are rarer still, with waiting lists ranging from two to six weeks, reports Christina Saint Louis of KFF Health News. Recovering Hope Treatment Center in eastern Minnesota's Kanabec County is the state's only rural residential treatment center and "one of only five providers in the state that offer family-based residential treatment, allowing women to enter the program while pregnant or to bring one of their children younger than 5 with them for the duration of their stay."

Research supports the success of family-centered approaches to addiction treatment, but costs, lack of funding and staffing struggles prevent the model from becoming the standard of care. "And because of that complexity, families in rural areas are less likely to find such a residential treatment program in their communities," Saint Louis writes. "Meanwhile, maternal opioid-related diagnoses have increased nationwide. From 2010 to 2017, the rates of women with those diagnoses at delivery increased by 131%, and babies born with withdrawal symptoms increased by 82%, according to the Centers for Disease Control and Prevention. The increases disproportionately affected rural areas."

Women receiving residential treatment tend to have Medicaid, which has lower provider reimbursement rates, contributing to centers limiting or reducing services to cut costs. Saint Louis adds, "Women in the center's residential program previously spent up to an average of 40 days in high-intensity care at the beginning of their treatment, but that time span is now closer to 30 days to contain costs due to those low reimbursement rates."

Family-based care allows children to stay at the center but adds child care and schooling limitations, according to Ashley Snyder, a licensed drug and alcohol counselor at Recovering Hope. Snyder told Saint Louis, "If you don't provide family services, the parents run the risk of losing their kids."

As an indicator of how tough establishing a residential addiction center is, North Dakota's state Department of Health and Human Services has been "trying to establish a family-based residential treatment option like Recovering Hope since 2020. The state has been without one since April 2019, when its lone provider shut down," Saint Louis reports. "The department has issued three requests for proposals seeking providers to offer a treatment model that allows children to live with a parent undergoing residential treatment but didn't receive any responses."

Deadline today to qualify for a subsidized reporter from Report for America, who could be a local recruit

By Al Cross

Director emeritus, Institute for Rural Journalism, University of Kentucky

Report for America has become well known for sending promising young journalists to news outlets all over the nation, including rural areas. But did you know that a news outlet selected for the program may recommend a preferred candidate for consideration as their reporter or photographer?

We learned about that possibility during the webinar we hosted with Earl Johnson, RFA's vice president for recruitment. It could appeal to rural news outlets that may want their journalist to have some familiarity with the region.

Johnson said local news outlets may be aware of good reporter candidates who have served as interns or worked previously in their newsroom, or perhaps for other outlets, who could be good reporters for them. In such cases, he said, if selected as a host newsroom with RFA, the news outlet may recommend a reporter as a preferred candidate to fill their corps member position.

The preferred candidate would still be required to apply to RFA and be selected for the program. This approach allows newsrooms to partner with RFA to identify the best reporter candidates from rural communities. Preferred candidates can include current part-time newsroom staffers—journalists the newsroom has wanted to bring on full time but hasn’t been able to—but they can’t be current full-time staffers.

RFA says successful newsroom applicants get:
● Service-minded reporters, photographers and videographers
● Diverse, hand-picked candidates from a pool of early-career and experienced journalists
● Subsidized salary support for the reporter: 50% the first year (up to $25,000), 33% the second year
● Local fundraising coaching and resources, including the opportunity for fiscal sponsorship to accept donations
● Extra training and mentoring for journalists

For more information, contact the recruitment team at recruitment@reportforamerica.org

How low will it go? Farmers worry over Mississippi River levels and fear repeat of last year's crop-transportation crisis

Towboats line the shore near Cairo, Illinois, where the Ohio
flows into the Mississippi. (Photo by Chris Kenning, USA Today)

As the Midwest grain harvest nears, farmers are hoping for higher water levels on the Mississippi River. But as time goes on, that does not look likely, and farmers fear a repeat of last year's expensive crisis. "Last fall, drought led to about 40 days of critically low water in parts of the Mississippi that hadn't seen it in years –grounding barges, stalling traffic, blocking river ports at the height of harvest season and causing an estimated $20 billion in losses, according to AccuWeather," reports Chris Kenning of USA Today. "As this year's harvest approaches, the river is again on the decline."

How far the river will drop is uncertain, but "Mississippi water levels have been falling since June. The Ohio River, which usually has more volume than the Mississippi at their confluence, "dropped almost 10 feet in the last two weeks of August. Levels are predicted to fall farther in the coming weeks," Kenning writes. Margy Eckelkamp of Farm Journal reports, "Most notably, fewer barges are being connected to form a single unit. And barges are being loaded to lighter weight." Soy Transportation Coalition Executive Director Mike Steenhoek told Eckelkamp: "When you start diminishing both the depths that barges can sink to and the number of barges you can put together, that changes the economics of barge transportation, which certainly impacts our competitiveness. . . . It's a movie sequel that none of us wanted to watch."

"With 61% of the Midwest classified as abnormally dry or in drought as of late August, most of the Mississippi is expected to face low water in September that will most likely affect industry and navigation, according to the National Integrated Drought Information System," Kenning reports. "That's worrying farmers who ship grains such as soybeans on the river to New Orleans and, from there, around the globe – relying on lower costs that help keep it competitive for the global export market. They fear another year of backups and spiking costs that eat into profits."

The forecast doesn't look hopeful. David Welch, a National Weather Service hydrologist at the Lower Mississippi River Forecast Center, told Kenning, "Right now, there's no rainfall in sight that will turn things around." Kenning notes that nearly 60% of U.S. grain exports use barges, which are "less expensive than trains, can each carry 70 semi-trucks worth of grain. Industry officials said it's a key reason U.S. soybeans are globally competitive. Last year, stymied barge traffic meant nearby granaries filled up, leaving some farmers scrambling for more expensive or distant storage options."

Using data and art, new study helps to determine how much people are willing to pay for improved watershed quality

Researchers used visual and textual descriptions when asking survey participants
about watershed quality. (University of Wisconsin illustration; click on it to enlarge)

How much are people willing to pay for a healthier watershed? More than researchers thought, a new study from the University of Wisconsin found. UW researchers teamed up with the Environmental Protection Agency to develop and use "a method to gauge the value of improvements in watersheds protected by the federal Clean Water Act. Their results, which surveyed thousands of residents of three major river watersheds in the United States, were published recently in the Proceedings of the National Academy of Sciences," reports Chris Barncard of UW News.

Daniel Phaneuf, a UW professor of agricultural and applied economics and an author of the new study, told Barncard, "From the perspective of economics, human well-being can be generated by a lot of different things. At a fundamental level, we're interested in measuring how much households are willing to trade off spending on other things in order to have better environmental quality."

To design practical research tools, study researchers worked with ecologists using data from 19,000 sites across three river basins— the Upper Mississippi, Ohio and Tennessee rivers--their goal was to clearly "show" study participants what scientists meant by watershed "improvement." Phaneuf told Barncard: "We wanted this to be meaningful and understandable to everyone, so we didn't use technical terms like 'biological condition gradient.' We worked with ecologists and graphic artists to create ways to represent these differences in biodiversity and visual conditions and the sort of human activities — like boating, swimming or finishing — each level of the BCG may actually represent."

"Along with watershed maps, the researchers took visual and textual descriptions of the stepwise differences in levels of ecological integrity to a survey group of 2,000 households across the river basins, presenting each one with maps describing current conditions in watersheds both in their area and farther away and maps describing improvements from potential remediation projects in those areas," Barncard explains. "They asked an overarching question for each cleanup scenario: How much more would you be willing to pay in taxes every year — ranging from $20 to $750 — to make this improvement happen?"

The healthier the watershed improvements would be, the more residents were willing to pay. "Respondents were willing to pay about $300 annually for one-level improvements in BCG in a nearby watershed, pushing closer to $500 if the changes would meet a Level 2 designation—a swimmable waterway just one step away from a natural state," Barncard reports. Phaneuf told him: "That's not so much of a surprise. People put a lot of value on the watersheds they get to see and enjoy. What may be a surprise, though, is that people are willing to pay even when it's not in their backyard. That is something that the EPA is quite interested in."

The 'rock-and-roll president' may surprise you

Presidential candidate Jimmy Carter and Gregg Allman, Feb. 2, 1976.
(Photo by Jerome McClendon, Atlanta Journal-Constitution via AP)

Which president loved rock and roll the most? Bill Clinton? Barack Obama? Some say it was Jimmy Carter.

"Before Bill Clinton wailed on a saxophone on The Arsenio Hall Show or Barack Obama invited Stevie Wonder and Prince for a private show at the White House, Jimmy Carter stood in a field, hands on his hips, clad in a T-shirt promoting the Allman Brothers Band's Win, Lose or Draw album," recalls Melissa Ruggieri for Oxford American. "It was July 1976, and Carter, feathered hair blowing in the wind, was gunning for the presidency. But there he was supporting a quintessential Southern rock band, one of his favorites, in front of the traveling national press corps."

Carter was an original diehard fan. Ruggieri writes, "Prior to a 1975 Allman Brothers benefit concert for Carter's campaign, the presidential hopeful introduced the band to a crowd in Rhode Island by remarking, 'Anybody who wants a president who doesn't like music like this, and who doesn't like people who make music like this, should just simply vote for another man,'" Ruggieri writes. "So much about this peanut farmer from teeny Plains, Georgia, was an anomaly from the start: Georgia had never produced a successful presidential candidate, and the humble Carter had never held a national office, making him a mystery to much of the country. . . . Publicly embracing the sweet and sour songs of a group of long-haired Southern firebrands wasn't a typical move for a politician.

"Maybe it wasn't apparent at the time, but Carter was positioning himself as the rock-and-roll president, the one history will remember as not only a connoisseur of the rock music of his home state, but also as a student of Bob Dylan's lyrics, a devotee of Willie Nelson's warble, an admirer of Aretha Franklin's searing soul, and a scholar of Dizzy Gillespie's mesmerizing bebop," Ruggieri writes. "While the Allmans and Carter shared an everlasting mutual affection, the band wasn't the only Southern mainstay to play at the White House. In 1978, the Atlanta Rhythm Section, the soft-rock toe-tappers 'Imaginary Lover' and 'So Into You,' performed at a cookout on the South Lawn. Johnny Cash and his family visited frequently."

"Carter's affiliation with musicians was never about a photo opportunity or a cynical underground ploy to court voters. . . . His allegiance was born out of devotion to the art," Ruggieri writes. "Carter, the Allmans, and others were small-town Southern men bringing their messages to the national stage. America took notice. . . . At the end of the Rock & Roll President documentary, Carter sits pensively in his home in Plains, circa 2018, while Lynyrd Skynyrd's 'Simple Man' plays in the background. It's a fitting coda. . . . 'Music,' he says, 'is the best proof that people have one thing in common.'"

Reflecting on the pandemic as Covid-19 comes back, Iowa editor writes: 'This is a lot for any nation to absorb'

Art Cullen

As U.S. pharmacies roll out updated Covid-19 booster vaccines, it might be a good time to look at how much the pandemic still alters daily life around the planet. The trauma and changes brought on by Covid-19 still cast a long shadow, Iowa editor Art Cullen writes for his Storm Lake Times Pilot.

"It's impossible to forget: I was on the phone one dank morning in the spring of 2020 with brother John, who lives just a block east. We were isolating at home, trying to figure out what to do with the newspaper. Should we just shut it down? . . . We decided we couldn't quit. . . . . We're okay now, but the thought of it still traumatizes me. . . . People were dying every week. Some businesses never came back.

"We're still living it. The latest iteration of Covid spreads as classes resume. The psychological trauma persists. Friendships eroded through isolation and political extremity. Eating habits changed from dine-in to carry-out. Church attendance dropped even farther. . . . Shocks to the food system continue to ripple. . . The pork and poultry industries are beset by trouble as supply chains work out the huge whipsaws of the past four years. Food prices have moderated but continue to fire inflation sparked by the pandemic shutdown.

Cullen writes that changes go well beyond the United States. "The pandemic rewired world trade. China is reeling. Brazil has become the most-favored soybean trader with Asia. . . . These are huge changes that have not been fully digested. . . . 

"This is a lot for any nation to absorb. We are still working through it. . . . Early polling that confirms a general angst over everything — call it the blues or clinical depression. . . . The pandemic casts a shadow over our personal lives, our communities and politics. Supply shocks, inflation, rewriting world trade, and unkinking food supply chain links all are moving parts in this complex machinery. . . . American resilience is amazing. Democracy and justice have prevailed so far," Cullen writes.

"Still, we are not post-pandemic. It colors everything. Gov. [Kim] Reynolds last week rejected the idea of any more lockdowns. 'My answer—not on my watch,' she said. Not that anybody in Iowa was actually suggesting another shutdown. It just shows how the trauma of it still animates us."

News-media roundup: Ark. sunshine; Okla. local-news study; week-long series on Neb. paper's role in community

Open-government advocates in Arkansas quashed efforts to carve large loopholes in the state's Freedom of Information Act, in a special session Gov. Sarah Huckabee Sanders called to do that and to make secret information about her security arrangements. The latter measure passed. Rejected were open-records exemptions for attorney-prepared documents and the "deliberative process" leading to "governmental decisions and policies" and attorney-prepared documents, and a change that would have "made it harder for people to recover legal fees for lawsuits filed under" the act, reports Neal Farley of the Arkansas Democrat-Gazette. Another rejected bill "would have shielded 'records reflecting communications between the governor or his or her staff and the secretary of a cabinet-level department'." The outcome showed "the power of citizen action," writes longtime FOI leader Sonny Albarado, editor of the Arkansas Advocate.

Counties in study (To enlarge the map, click on it.)

"Oklahomans statewide primarily rely on social media and local word of mouth for local news," and "rarely subscribe to local newspapers," media and political-science professors say in a study report after interviewing 352 news consumers in seven diverse counties in the state. The study is the "first qualitative observational study of both news deserts and under-served metro communities statewide in Oklahoma," says the Oklahoma Media Center, a nonprofit that funded the work by Rosemary Avance, assistant professor in the media school at Oklahoma State University, and Allyson Shortle, associate professor of political science and co-founder of the University of Oklahoma’s Community Engagement and Experiments Lab. They say "Small-town residents express more trust in local news when a local person is in charge of it."

"Final edititon of the Norfolk Daily News," trumpeted the main headline in the Aug. 17 edition of the Nebraska paper. "Or is it?" a subhead teased. Under it Kent Warnecke wrote, "The primary role of a headline is to attract a reader’s attention. Chances are, the headline on this story did just that. To be clear, this is NOT the final edition of the Norfolk Daily News. The Daily News will be published tomorrow, next week and into the future. But that isn’t the case elsewhere in the nation, and, as a result, it’s not an exaggeration to say our freedom as citizens is at risk." The story was part of a week-long "Protect the Pillar" series, referring to the news media as the fourth pillar of democracy. One story noted the demise of 16 Nebraska newspapers since 2004. Looks like good material for National Newspaper Week, Oct. 1-7.

How rural hospitals are fighting Medicare Advantage

Medicare Advantage plans may offer more benefits but also
have rules that can limit patients' choices. (Anthem website)

St. Charles Health System in central Oregon has "threatened to cut ties with all Medicare Advantage plans next year, a move that would leave an estimated 26,000 local beneficiaries without access to a hospital less than 100 miles away," reports Nona Tepper for Modern Healthcare.

"A program intended to promote seamless and higher quality care has instead become a fragmented patchwork of administrative delays, denials and frustrations," St. Charles CEO Steve Gordon said in a news release last month.

Tepper reports, "Health systems nationwide appear to share Gordon's consternation, especially those similarly located in rural areas. Rural healthcare providers tend to be disproportionately affected by factors such as reimbursement cuts or denied and delayed payments from Medicare Advantage plans because Medicare enrollees make up most of their patient populations. Cutting off Medicare Advantage plans, or at least declaring that to be a possibility, is a response to the growing market power these carriers have, especially over rural providers.

According to Tepper, "Rural Medicare Advantage enrollment is growing faster than overall enrollment: Since 2010, the share of rural beneficiaries who choose private plans over the traditional program has more than quadrupled, to 40% from 11%, according to KFF survey results published this month.

"Among the 58 publicly known contract disputes between insurers and providers this year, 35—more than half—involved Medicare Advantage carriers, according to data compiled by FTI Consulting. 

"Most conflicts center on how health insurance companies do business more than on reimbursements, said FTI Consulting Managing Director Adam Broder."

Tepper reports: "At Aspirus Health, some Medicare Advantage insurers deny as many as 35% of claims, said Matthew Heywood, CEO of the Wausau, Wisconsin-based nonprofit health system. In response, the 17-hospital chain is renegotiating contracts to include provisions regarding prior authorizations and claims processing times, he said."

The public vs. private power battle revives as some Mainers, sick of poor service and reliability, push for a takeover

A worker inspects a Central Maine Power electricity corridor.
(Photo by Robert F. Bukaty, AP via The American Prospect)

In the 1930s and 1940s, one of the greatest political battles at the state level was between investor-owned utilities and public power, which had as its best allies member-owned rural electric cooperatives. Now, the battle has been rejoined as customers of investor-owned utilities in one of the most rural states try to make them public. "Investor-owned utilities are hardly known for being adored by the public," reports Lee Harris of The American Prospect. "Even so, Maine has two of the least popular in the Northeast. For the past two years, Maine's two privately owned utilities, Versant Power and Central Maine Power, have ranked last in a customer satisfaction survey evaluating utilities' performance in the Eastern United States." (Of note, the ratings for rural electric cooperatives are dominated by large co-ops near cities, suggesting that data on smaller co-ops was too limited to rank them.)

Mainer voters will get to weigh in on a "ballot initiative up in November, backed by Mainers who are fed up with that status quo, aims to take back the monopoly privileges granted to those private utilities and convert them into Pine Tree Power, a nonprofit authority that an independent board would run," Lee writes. "Backers say it would improve reliability and bring down rates. They argue this is a critical time to take back public control of utilities, as Maine embarks on a mass electrification drive that will transform its energy system. . . . Opponents, including some Democrats and utility workers, are skeptical that the authority can deliver the savings it promises, and worry about the risks involved in overthrowing incumbent utilities."

Buying a private electric utility is complicated; however, some communities have succeeded. "Winter Park, Florida, formed a public power utility in 2005, after 69 percent of residents voted in favor of the plan. Since then, it has laid the majority of its electric lines underground, strengthening storm resiliency," Lee explains. "But other cities have struggled to pull off similar de-privatization. Boulder, Colorado, recently gave up on its decade-long struggle to take over its private utility. Maine Gov. Janet Mills, a Democrat, vetoed a similar utility buyout plan in 2021, after the legislature approved a bill that would have taken the proposal to Maine voters."

Enmax and Avangrid have "poured millions into a campaign to prevent Pine Tree Power's proposed takeover," Lee writes. The initiative also faces union resistance. "Workers' biggest concern is that the PTP initiative would cause them to be classified as public employees, potentially weakening the union. Since the 2018 Supreme Court ruling in Janus, public employees have not been required to pay dues to unions representing them, even when the union bargains on their behalf."

Hardrock mining companies pay 'a pittance' for minerals mined from public lands. Some say taxpayers need more.

A copper mine shaft 1,100 feet below the surface near
Superior, Ariz. (Photo by Tamir Kalifa, The New York Times)

Since 1872, mining companies have taken stores of gold and other metals from public lands without paying royalty fees to the federal government. The Biden administration says lawmakers need to "fix the Gold Rush-era General Mining Law so it can better manage the mineral resources buried under millions of acres of public land," reports Lisa Friedman of The New York Times. "A top priority: require companies to pay something in exchange for what they take. Unlike companies that extract oil, gas and coal from federal lands, hardrock miners pay no royalties to the federal government."

Initial plans suggest a 4 to 8 percent fee of the net value of mined materials, which "could translate into as much as $97 million annually and drew sharp opposition from mining operators," Friedman writes. Tommy Beaudreau, the deputy secretary of the Interior Department, told Friedman: "The biggest takeaway from our report is that our 150-year-old-law, the 1872 mining law, needs to be reformed and brought into the 21st century."

Beaudreau heads up a "working group of officials across federal agencies who reviewed policies and regulations for hardrock mining," Friedman explains. "The group found the law did not do enough to steer mineral exploration away from sensitive resources or to promote 'early and meaningful' engagement with tribes or other affected communities. . . . And the law should require mining companies that take resources from public lands to pay something for that privilege. . . .The report stated, [the law] 'fails to provide the American taxpayer with any direct financial compensation for the value of hardrock minerals extracted from most publicly owned lands.'"

While mining operations pay state royalties and taxes, operators on federal land "only pay the U.S. government one-time claim processing fees totaling $60. Many companies also pay an annual $165 maintenance fee per site, according to the report," Friedman writes. Mining companies oppose the change. Rich Nolan, chief executive of the National Mining Association, told Friedman that the changes would "throw additional obstacles in the way of responsible domestic projects and would-be investment, forcing the U.S. to double-down on our already outsized import reliance from countries with questionable labor, safety and environmental practices."

Environmental groups praised the proposed change. Chris Wood, the president of Trout Unlimited, a conservation group, told Friedman, “It’s the only commodity produced off of our public lands where there is no tax or royalty." Friedman reports, "Wood added that money raised from federal royalties could help to clean up an estimated half a million abandoned mines scattered across the American West."

Most people have end-of-life wishes, but don't talk about it; planning for death is less likely in rural areas, study finds

St. David's Foundation graph; click on it to enlarge.

As America ages, more families face end-of-life decisions, and rural Americans are less likely to have their wishes known or followed by family members, reports Liz Carey of The Daily Yonder. "A new study found that while most people have end-of-life wishes, only a little over a third of them actually get them fulfilled. That is even more true with rural residents, researchers said."

Researchers from St. David's Foundation in Texas found that when it comes to end-of-life care, most Texans want to die at home (76%) and not be a burden to their families (77%). "But only one in three people surveyed said their loved one's wishes were honored," Carey writes. "Of those who are least likely to have their end-of-life wishes followed are rural residents, the study found. . . . Only 37% of the survey respondents said their loved ones died at home. Close to half of them (47%) said their loved one faced challenges related to their care – from problems with insurance coverage to facing cultural or language barriers."

Honoring a person's wishes begins with knowing what they are. Andrew Levack, senior program officer with St. David's Foundation, told Carey: "One of the interesting things the study found was how few conversations respondents had with their doctors around plans for end of life. I think people have an idea of what they would like, but it takes some active planning and advocacy to make that happen."

Study researchers noted a common thread of disconnection across the state -- people have end-of-life care desires, but don't voice them. "Most Texans, even older adults, are unprepared for decisions about end-of-life care. The vast majority believe it is important to have their wishes in writing, yet over half have not done so. Similarly, many say they would like to discuss end-of-life planning with their health care provider if they were faced with a serious illness, yet only 17% have had a provider initiate a conversation about it."

Geographical isolation and a lack of health care access make rural populations more likely to not have end-of-life plans or discussions. Dr. Kate Tindell, medical director for Austin Palliative Care and Hospice, told Carey: "People have really disjointed health care now. We've sort of lost that sense that there is a captain of the medical ship who is aware of all the moving parts and is giving the patient that guidance. I think that really causes people to not have the kind of relationship that would allow them to have that kind of conversation (about end-of-life wishes) the way they would if they had seen the same provider every single time for 10 years."

October is for estate planning: Start thinking about it, get a free kit and 'plant the first seed'

Photo by Imso Gabriel, Unsplash

Each year, October is designated National Estate Planning Awareness Month, highlighting individuals' need to outline financial and inheritance plans alongside future health decisions. A person doesn't have to be rich to need an estate plan, and although planning may take a bit of time, many resources are free and, once completed, offer peace of mind for individuals and families.

The ETV Endowment of South Carolina website has free resources and encourages everyone to take time to "Plant the First Seed" of their plan: "It is estimated that more than 120 million Americans do not have proper estate plans to protect themselves or their families in the event of sickness, accidents or untimely death. This costs many families wasted dollars and hours of hardship each year that could be minimized with proper planning. . . . No matter your age or income, now is a great time to get started on your plans."

Many Public Broadcasting Service affiliates, public universities, colleges and Cooperative Extension Service offices offer free planning tools with online discussions, attorney guidance, resources and tips to make the process less intimidating. For people who like pen and paper, some PBS stations will mail an estate planning kit to homes for free. Most sites emphasize that you don't have to be wealthy to need a plan, and once completed, people are glad they took the time.

Goldman Sachs commits $100 million to help rural businesses raise capital and expand

Photo by Andrew Kelly, Reuters via ASBN

In a win for rural entrepreneurship, global investment leader Goldman Sachs has committed $100 million to help "rural small business owners raise capital and grow their enterprises" through its 10,000 Small Businesses initiative, reports Colin Velez of America's Small Business Network. "According to the Goldman Sachs website, the company plans to divide the new $100 million among three groups: community lenders funding rural small business owners will receive $75 million; community college courses hosted by the 10,000 Small Businesses organization will receive $15 million; local entrepreneurs will receive the remaining $10 million in the form of grants."

The rural initiative will launch in North Dakota and Arkansas.

The investment will seed entrepreneurship and business growth that addresses rural businesses' unique challenges and vital role in rural community economics and overall health. The release noted how a lack of capital prevents rural business owners from growing their businesses. It cites an "accompanying survey that found only 7% of rural entrepreneurs felt they received adequate support from non-government entities. Limited access to child care, healthcare and labor were also cited as obstacles to expansion," Velez writes. "Noting such individuals employ roughly 65% of their local workforces, the company argued that these conditions are also holding back economic growth."

Rural enterprises often struggle with investment dollars and are "naturally neglected by typical lenders and education institutions, as they represent a smaller portion of the national economy than competitors in more populous states," Velez reports. "If more entrepreneurs were to leverage private and government programs that prioritize small business growth in underserved areas, this could help reverse these tendencies and ultimately ensure wealth is distributed more evenly between different parts of the country." 

The loss of timber jobs left this county awash in poverty, violence and tree poaching

The Guardian illustration

Illegal tree harvesting is not ordinary in some parts, but it can become a person's primary source of income in lands where national parks and environmental concerns have ebbed out timbering employment. "Timber poaching exists at a confluence of this rural economic decline and environmental policy," reports Lyndsie Bourgon of The Guardian. "A number of poachers in Orick, California, detailed their motivations as an alchemy of poverty, lack of opportunity, drug misuse and resentment toward national parks, the federal government and environmentalists. . . . It's a snapshot of how rural communities across North America face de-industrialization, the ways they have failed to transition away from those dependent economies, and the people who remain rooted through the change."

Bourgon writes about Danny Garcia, a man who grew up in Orick, a Humbolt County town along California's Redwood Coast. Garcia was born into a beleaguered rural economy and became a tree poacher. Bourgon writes, "Redwoods National Park was instituted in the 1960s, then expanded in the 1970s, and in the late 20th century, the town was not spared from the Pacific north-west's timber wars. Orick's logging industry began to shrink, then all but disappeared as mills and lumber companies closed or moved." 

Alongside life in rural Orick, Garcia lived with the violence and trauma that often accompanies poverty. "By the early 1990s, Garcia's mother had died by suicide. His grandfather and many of his uncles were killed in logging accidents, traffic accidents and by drowning. Some spent time in prison; some used hard drugs. One of his aunts told me about the assaults she and her friends had experienced in the town from husbands, boyfriends, and other family members."

The sociologist Jennifer Sherman, a professor at Washington State University, studies unemployment's effects on rural communities in California and Washington. She told Bourgon, "Domestic violence is a huge part of my work. It seems to accompany poverty wherever poverty goes." Bourgon reports: "Humboldt leads California in violence against women; in particular, Indigenous women (close to 50% of Indigenous women in Humboldt are victims of domestic violence, according to Humboldt county domestic violence services). . . . Humboldt County averages 50% more domestic violence-related police calls per capita than the rest of California, and of those, close to half include a weapon."