UPDATED: NRA's tax returns show declines in revenue, assets, member dues; longtime leader says he's quitting

Illustration by Elizabeth Brockway, Daily Beast via Getty

Despite its reputation as an organization with a powerful political reach, the National Rifle Association has been on a downward spiral sparked by declining revenue, internal fighting and alleged mismanagement. "Over the last several years, the NRA has experienced a public implosion, as the group loses members and revenue amid serious accusations of mismanagement and corruption," reports Roger Sollenberger of The Daily Beast. 

NRA's popularity and power began to slide more than a decade ago. Sollenberger writes, "The gun rights group's tax filings and political spending over the last 15 years provides some of the clearest evidence of its downfall. . . . Its most recent tax return, filed in November of this year for 2022, reveals dramatic declines along almost every conceivable metric: revenue, assets, member dues, lobbying, and political spending — with conversely sharp increases in legal costs and deficits."

The New York Times also reported that "On the eve of a legal battle in New York, Wayne LaPierre told board members on Friday that he would step down as the longtime chief of the National Rifle Association" effective Jan. 31. The Times reported that LaPierre "has led the organization for more than three decades. But his resignation came as he faced his gravest challenge yet, a corruption trial in Manhattan amid a legal showdown with New York’s attorney general, Letitia James. Jury selection has already begun and opening arguments were scheduled for early next week."

In 2010, the NRA wielded a powerful lobby. But in the wake of extreme gun violence in the U.S., 15 GOP senators "repudiated the NRA, passing the first meaningful gun control package in decades," Sollenberger writes. "That could be a signal of the NRA's demise, but it also could be interpreted as a reaction to the surging gun violence that continues to this day."

Regardless of why and how political favor and donor sentiment have changed, "The NRA today is in a dismal state. On the income side, 2022 was the fourth year in a row that revenue fell, marking its weakest fundraising year since at least 2008," Sollenberger reports. "Membership dues are at all-time lows, according to available public data, and staffing is at the lowest point since those costs began their downward plunge in 2016." 

Despite those numbers, NRA spokesman Billy McLaughlin said in a statement to the Daily Beast that the NRA remains the largest and most effective gun rights organization. 

A small town in Texas struggles to manage immigration numbers -- its first responders are often overwhelmed

Migrants walk along concertina wire on the U.S. side of the
border in Texas. (Photo by Paul Ratje, The New York Times)

Emergency workers and town officials in Eagle Pass, Texas, have been overwhelmed by the thousands of immigrants who require rescuing from Rio Grande River perils, heat exhaustion or the physical demands of wrangling with border obstacles, as they attempt to cross into the U.S., reports Edgar Sandoval of The New York Times. "This week, a delegation of 60 Republican congressmen, including House Speaker Mike Johnson, gathered in town at the edge of the Rio Grande to call for the Biden administration to stem the immigration surge."

Eagle Pass is home to a border patrol station, but the town is not equipped to handle the number of people crossing. "Many [immigrants] are in urgent need of medical attention when they arrive — help that is only available through a city that is already straining to meet the needs of its own 28,000 residents," Sandoval writes. "The city has had to assign one of its five ambulances full-time to transport injured migrants from the river's edge."

Eagle Pass, Texas (Wikipedia maps)

Meanwhile, the cost of aiding, treating and managing migrants is straining the town's fire department and law enforcement. The Fire Department is "spending about $150,000 a month on ambulance costs responding to migrants alone. . . .That figure does not include overtime, costing more than $30,000 a month, Sandoval reports. "The Eagle Pass police chief, Federico Garza, says his small police force of 74 officers is often diverted from everyday duties to respond to calls of migrants idling on a corner or crossing through a backyard. The sheer number of calls 'can be overwhelming,' he said."

Texas has "long been at the center of U.S. immigration policy," Sandoval adds. "But the area has turned into a key point of friction this year between Republican leaders and the Biden administration, as Gov. Greg Abbott of Texas openly defied federal authority and set up state law enforcement patrols, concertina wire and floating buoys along the border in a bid to keep new migrants out of the state."

In January, the flow of immigrants into Eagle Pass slowed, but some of the efforts hurt the town's economy. "The recent closure of an international crossing known locally as Bridge 1 crippled a local economy that benefits from a steady stream of Mexicans who legally cross every day to eat at restaurants, fill their gas tanks and commute to work," Sandoval reports. "The closure over the holiday season cost the city about $1 million, Rolando Salinas Jr., the mayor of Eagle Pass, said."

When freshwater fish are contaminated by 'forever chemicals,' some are no longer safe to eat

PFAS exposure means some freshwater fish are
labeled 'do not eat.' Photo by Andy Wang, Unsplash

A freshwater fish fry may sound like a delectable dinner, but it may no longer be healthy because substances known as PFAS or 'forever chemicals' have polluted many freshwater fish populations. While the Environmental Protection Agency has been working on PFAS drinking water standards, "Some scientists worry that regulations for freshwater fish are lagging," reports Hannah Norman of KFF Health News. "A recent study from The Environmental Working Group found that just one serving of fish can be equivalent to a month of drinking water contaminated with 48 parts per trillion of the common chemical PFOS."

PFOS and PFOA are part of the PFAS family of synthetic chemicals, which were used to make everything from Teflon to fire-fighting foam. Their chemical structure resists environmental breakdown by nature or the human body, which means they "accumulate in the soil, water, fish and our bodies," Norman explains. According to a report from the National Academies of Sciences, Engineering and Medicine, human PFAS exposure is "associated to cancer, low birth weight and decreased responses to vaccines. . . . At least 17 states have issued PFAS-related fish consumption advisories, KFF Health News found, with some warning residents not to eat any fish caught in particular lakes or rivers."

When it comes to PFAS levels in fish, the federal government hasn't provided any dietary guidance. Instead, states are setting limits with alarming variations. Norman reports, "'Do not eat' thresholds for the general population range from 25.7 parts per billion in New Hampshire to 800 ppb in Alabama. . . . While the EPA has tested hundreds of fish for PFAS and found some samples with concerningly high concentrations, it has no plans to provide national fish consumption advisories."

There is a bit of good news. Norman reports, "The Food and Drug Administration tested saltwater fish and shellfish sold in grocery stores — including Atlantic salmon and canned tuna — and generally found far lower levels of PFAS contamination."

Lawmakers in some states are working to provide property tax relief because of soaring home values, increased bills

(Photo by Jennifer Grismer, Unsplash)

Alongside soaring home values, U.S. property taxes have increased, leaving some homeowners struggling to pay eye-popping bills. "The typical home value in Idaho increased from $275,852 in November 2019 to $434,224 this November — a 57% increase over four years, according to data provided by real estate giant Zillow, which tracks the average of the middle one-third of home values," reports Kevin Hardy of Stateline. Property tax rates are "generally set by local governments, not legislatures. But public pressure has compelled lawmakers in several states, including Idaho, to use surplus state revenues to mitigate property tax hikes."

Commenting on the public outcry, Idaho state Rep. Jason Monks told Hardy, "The biggest problem was they just went up so quickly. … I think that's one of the reasons why it became this rallying cry from the people asking for tax relief." Jared Walczak, vice president of state projects at the Tax Foundation, a pro-business research organization, told Hardy: "In virtually every state where the legislature meets this year, property tax relief bills will be filed. This is a front-of-mind issue for many legislators across the country."

However, intervening in property taxes is complex, and failure to do it correctly could leave some coffers empty because the money is being used for tax relief. "The effort across the country to provide property tax relief has sparked some concern that states could go too far, jeopardizing revenue for school districts and local governments," Hardy explains. "And some policymakers worry about overly broad relief that could benefit the wealthiest property owners at the expense of those most in need."

Colorado lawmakers are trying for a measured approach, which is difficult when the state's "landscape ranges from rural ranching communities to booming urban and suburban markets," Hardy reports. Democratic state Rep. Marc Snyder told Hardy: "I've been struggling with this. It's really hard to come up with a statewide solution when you have such a variety of situations in Colorado."

Democratic state Rep. Chris deGruy Kennedy said he "wants to ensure that Colorado's school and fire districts have the revenue sources they need to operate well. But he's wary of tax relief that is overly broad," Hardy adds. Kennedy told him: "I want to make sure that whatever we do to provide property tax or rent assistance is done in the most targeted way possible so that we're actually giving the dollars to the people that need them, rather than doing across-the-board cuts."

Out-of-pocket prescription expenses can be painful -- here are some steps to control costs

Retail drug prices vary. Shopping around can
save money. (Photo by Jake Dockins, WSJ)

Ringing in the new year can mean the costly reset of health insurance deductibles, but understanding new caps and limits on prescriptions can make out-of-pocket expenses more manageable. "The Inflation Reduction Act of 2022 contained some of the most sweeping drug-price provisions ever enacted," reports Peter Loftus of The Wall Street Journal. Beyond the law's changes, there are several steps people can take to "put a lid on drug costs."

Beginning in 2023, insulin costs were capped at $35 per month for Medicare recipients. Loftus explains, "You can check the websites of the three main insulin manufacturers — Eli Lilly, Novo Nordisk and Sanofi — to see if the price of your insulin is being cut." If you carry private insurance, the cap does not apply.

The reduction act also "expanded the list of vaccines that seniors enrolled in Medicare Part D can receive at no cost," Loftus reports. Details are available here.

Check with your provider to see if swapping out your costly brand-name drug for a generic is an option. Loftus adds, "There's also a newer category of drugs called biosimilars, which are close copies of brand-name biologic drugs such as Humira, the high-selling drug for autoimmune diseases. . . . Here is the growing list of approved biosimilars."

Take time to compare costs. "Prices for the same drug can vary widely depending on where you buy it," Loftus writes. "For generics, check out the growing number of online discount prescription services. The Mark Cuban Cost Plus Drug Co. offers generic drugs at a 15% markup plus pharmacy and shipping fees by cutting out pharmacy middlemen and negotiating directly with manufacturers. Amazon.com offers various pharmacy services, including one that provides eligible medications for $5 a month, found here."

To read about when to consider skipping insurance and to find links to more savings options, you can read Loftus's full article here.

2023 was a tough year in many ways, but saw significant positive developments in science and medicine

The first pill to treat postpartum depression was
approved in 2023. (Photo by Hollie Santos, Unsplash)

Despite wars, the most mass killings since 2006, and the hottest average temperatures in human history, "2023 also was a year with significant positive developments, including in scientific research and medicine," report Victoria Bisset and other Washington Post staff members. Not only does some good news about the past year provide comfort, the Post points out that "research has indicated that uplifting news can provide an emotional buffer against distressing news and feelings of hopelessness — and even encourage optimism or action." Here are some things the Post listed:

The World Health Organization approved a new malaria vaccine that has been shown to be much more effective than the only previous vaccine against the potentially deadly disease. The U.S. has about 2,000 cases of malaria each year, most of them contracted in other nations.

The Food and Drug Administration approved the first pill to treat postpartum depression, which affects up to one in five women who can "experience intense hopelessness and, in rare cases, psychosis — and it can last for years," the Post notes. "The new drug is taken once a day for two weeks and, unlike the existing treatment of an IV injection that may take as long as 60 hours to administer in a health-care setting, it can be taken at home."

The FDA also approved two gene-therapy treatments for sickle-cell disease, "a rare and debilitating condition that affects around 100,000 Americans, most of them Black. The disease causes extreme, constant pain and can drastically cut the life span of those affected," the Post notes. "Both are intensive, expensive procedures — and require chemotherapy, which has significant side effects. But patients who have received the treatments have spoken of its profoundly beneficial impact on their lives."

Scientists made progress in understanding dementia, the Post reports. One study "suggested that lifestyle habits, including regular mental and physical activity, eating a healthful diet, and regular social contact were linked with a slower rate of memory decline," the Post reports. "Another found that living in areas with more natural green spaces was associated with lower rates of hospital admissions for diseases including dementia, while separate research indicated that the use of hearing aids could cut the risk of cognitive decline by nearly half."

Meanwhile, the FDA approved, for the first time, a drug that modestly slows Alzheimer’s disease. While difficult questions about safety, effectiveness and cost remain, many neurologists say that having a drug that slows Alzheimer’s is nonetheless a milestone after years of failed trials.

Younger people might not think that beef is 'what's for dinner,' so marketers try new ways to promote consumption

With jaunty music playing in the background, beef ads
promote red meat as a way to "elevate" meals. (NCBA photo)

In 1992, the Beef Industry Council launched its marketing campaign: "Beef. It's what's for dinner." In the decades since the mantra's kick-off, beef has remained an iconic American meal centerpiece. However, younger generations might not necessarily share a love of red meat, and the industry is preparing to shift its focus to keep younger consumers eating beef for dinner.

Earlier this year, a study from Tulane University in New Orleans found that "a relatively small number of Americans are responsible for the lion's share of beef consumption — and those eaters tend to skew older and male," reports Matt Reynolds of Wired. Hillary Makens, senior executive director of public relations at the National Cattlemen's Beef Association, "disputes the study's findings. She shared data from the NCBA's beef tracking survey that found that Gen Z and millennials were more likely than older respondents to have reported eating beef the previous day."

Despite conflicting evidence, one thing is clear, "The beef industry is paying closer attention to younger Americans. The meat marketing agency Midan Marketing has published blog posts calling Gen Z 'tomorrow's meat industry' and urging beef marketers to tout their meat's high protein content to appeal to younger consumers," Reynolds writes. "The rise of marketing beef as 'low carbon' might also be a way for the industry to appeal to younger generations who tend to be more engaged than older consumers with climate change."

Daniel Rosenfeld, a Ph.D. student at the University of California who studies the psychology of meat-eating, told Reynolds, "Unless beef consumption becomes remarkably sustainable, I think younger generations will always have a stronger moral opposition to eating beef on purely environmental grounds."

Tulane study researcher Diego Rose "coauthored a paper sketching out the greenhouse gas reductions that would happen if Americans significantly cut their meat intake," Reynolds reports. Some groups viewed the study's suggestion as anti-beef and claimed that President Joe Biden's climate change policies could limit Americans to "one hamburger a month." Commenting on the polarized interpretation, Rose told Reynolds: "It's silly. You can continue to eat beef but in lower quantities."

Rural communities need to find affordable child care solutions to support sustainability and growth

The lack of child care stifles rural growth.
(Shutterstock photo)

The lack of child care has plagued many U.S. families, but the gap is more prevalent in rural America. "Data collected before the pandemic shows that more than half of Americans lived in neighborhoods classified as child care deserts, areas that have no child care providers or where there are more than three children in the community for every available licensed care slot," reports Jazmin Orozco Rodriguez of KFF Health News. "Other research shows parents and child care providers in rural areas face unique barriers. Access to quality child care programs and early education is linked to better educational and behavioral outcomes for kids." Programs also help parents connect with additional social services that support healthy families.

Without access to affordable child care, rural families will continue to face tough choices that "threaten the sustainability and longevity of rural communities," Rodriguez writes. "The dearth of child care exacerbates workforce shortages by forcing parents, including those who work in health care locally, to stay home as full-time caregivers, and by preventing younger workers and families from putting down roots there."

Affordable child care directly increases family incomes and supplies local businesses with a larger labor pool. Rodriguez adds, "A rural health advisory committee report shows that when center-based care is readily available in a community, the percentage of mothers who use that type of care and are employed doubles from 11% to 22%."

Pandemic-era grants helped rural child care providers stay afloat, but that money has dried up, leaving providers struggling to maintain pandemic-level wages. "The Biden administration requested congressional approval of $16 billion to extend the pandemic-era child care stabilization program," Rodriguez reports. "But it doesn't have enough support to continue the funding, despite nearly 80% of voters supporting increasing federal funding for states to expand their child care programs,"

Without federal dollars, state and local governments are working to support child care policy and funding. "In Alabama, lawmakers approved $42 million last year in the state budget for child care. The Missouri state legislature approved $160 million for child care," Rodriguez notes. "Voters in rural Warren, Minnesota, narrowly approved a half-percent sales tax to support a child care center struggling to stay open."

Census survey shows 'brain drain' continues in rural states, but there are ways to address it

Holding onto and attracting younger residents can
slow or reverse brain drain. (HiveBoxx photo, Unsplash)

Merriam-Webster's defines brain drain as "the departure of educated or professional people from one country, economic sector, or field for another usually for better pay or living conditions." For rural places, the loss of educated younger residents deeply affects the community's ability to thrive. "New data from the Census Bureau's 2022 American Community Survey shows many rural states continue to experience brain drain or an outmigration of individuals with a bachelor's or advanced degree," reports Lisa Faust Prater of Successful Farming. The Center for Public Affairs Research at the University of Nebraska "has been tracking the trend since 2010."

Josie Schafer, director of CPAR, "attributes the outmigration to changing workforce dynamics, including job availability, opportunities, and pay," Prater writes. "Housing is another contributing factor. She says although there are many job openings in the state, 'It is likely they perceive more opportunities elsewhere.' . . . In addition to losing talent, when this segment of the population leaves, they take their taxable income with them."

The survey showed other states, including Wyoming, North Dakota, Minnesota, Iowa, Wisconsin, Michigan, Illinois, Indiana, Ohio, Oklahoma, and Arkansas, had brain drain dilemmas like Nebraska. But if people were leaving these states, where did they go? Prater reports, "States experiencing brain gain, or a net gain of college graduates, include Montana, Colorado, South Dakota (although only 27), Kansas, Kentucky, and Tennessee. Florida showed the greatest brain gain."

While solutions to brain drain may seem daunting, some states and local governments have made gains in plugging the losses. Georgia launched a program in high schools called "Building a STEAM Workforce in Rural Georgia" that stated its goal was to "create and replicate high-quality experiential learning opportunities" that encourage younger people to stay by teaching them a local trade or business. Some small towns in Minnesota have had success wooing urban residents by promoting the beauty and mystique "country living" as simpler and more enjoyable. Among websites and articles that address preventing or reversing brain drain, "improve broadband" is a common suggestion.

When a town's major employer closes, changes and uncertainty abound

Noel has been in the poultry business since the 1950s.
(Photo by Kaitlyn McConnell, The Daily Yonder)

When one business dominates a town's economy, its closing can create a domino effect of change. Noel, Missouri, pop. 2,100, became one of those towns. In August, Tyson Foods "announced that it was shuttering the town's poultry processing plant, and by October, it was closed – eliminating about 1,500 jobs," reports Kaitlyn McConnell for The Daily Yonder. "It leaves a question other communities have faced: What is the next chapter in a place that so heavily relied on one employer for the town's collective income?"

Unlike nearby Ozarkian towns, Noel boasted "cultural diversity, in contrast to the rest of the region, which is still largely white," McConnell writes. "In the 2020 Census, more than 1,450 residents of Noel – nearly 70% of the town's population – identified as Asian; Black or African American; Hispanic or Latino; or Native Hawaiian and Other Pacific Islander."

McConnell writes, "I drove to Noel in late November, the first time I was in town since it became known that Tyson would shutter the plant. A handful of vehicles remained in the plant's parking lot as I drove by. Tyson's bright-red logos are gone, but discoloration remains." 

Just weeks after the plant closed, "many of the immigrants have already moved away," McConnell writes. "The Hispanic residents seem to be the ones most likely to stay. . . . Another change is at Community Baptist, which closed its doors in late November. The reasons for that are complex – there were ongoing issues tied to funding – but the proverbial straw broke the camel's back when all the ethnic congregants left."

The town's mayor, Terry Lance, told McConnell: "Losing that many jobs is going to naturally affect every other business in town, from the grocery stores to everyone. We really don't know just how much yet."

McConnell writes, "In a typical Ozarkian make-do-or-do-without attitude, Lance is looking for the silver lining. Maybe the former plant can simply be torn down, Lance says, and the town can revert to its deeper tourism roots."

The U.S. is about to set a record for the most oil and gas extraction in its history

Guardian graph, from EIA data

Despite climate goals and lots of talk about the U.S. ending its dependence on fossil fuels, "The United States is poised to extract more oil and gas than ever before in 2023, a year that is certain to be the hottest ever recorded, reports Oliver Milman of The Guardian. "The U.S.’s status as the world’s leading oil and gas behemoth has only strengthened this year, even amid warnings from Joe Biden himself over the unfolding climate crisis, with the latest federal government forecast showing a record 12.9m barrels of crude oil per day, more than double what was produced a decade ago, will be extracted in 2023."

Part of what Americans want is cheaper gas, but that has come at a cost. Milman writes, "The increased fossil fuel production, which Biden championed last year as a way to tamp down gasoline prices for U.S. drivers and to support overseas allies in the wake of Russia’s invasion of Ukraine, also risks burdening disadvantaged communities living next to polluting infrastructure and threatens to alienate younger, climate-conscious voters ahead of next year’s presidential election, an adviser to the White House has cautioned."

The transition to renewables is hard for Americans to imagine. Nate Hultman, an expert in climate policy at the University of Maryland, told Milman, "We have a dynamic that feels awkward, of how to reconcile the world we are living in, that’s heavily fossil fuel-driven, with the vision of a clean, non-emitting world. That’s the tension.”

Despite the Biden administration's "boost to renewable energy in the U.S., Biden has been handing out oil and gas drilling leases on public lands at a rate comparable to Donald Trump, with the emissions from 17 large projects permitted by his administration," Milman reports. 

Big trees are a big deal. Preservation of old-growth trees is becoming a contentious battle nationwide.

The largest trees often grow together in a 'stand.'
(Photo by Steve Ringman, The Seattle Times)

Trees don't seem controversial, but they are. "The fight over the future of the last old and mature forests in America intensified Tuesday when the Biden administration called for preservation of old-growth trees," reports  Lynda V. Mapes of The Seattle Times. "The administration, after creating an inventory of the nation's old growth, wants to amend 128 forest land-management plans to conserve and steward 25 million acres of old-growth forests and 68 million acres of mature forest across the national forest system."

"For the Pacific Northwest — home to much of the nation's remaining old forests — an effort is already underway to overhaul and update key old-growth protections in the Northwest Forest Plan of 1994, one of the world's most ambitious conservation plans," Mapes writes. "But the nationwide attention from the federal government is adding to the debate over old forests' cultural and ecological significance and their ability to suck up carbon from the atmosphere that is warming the planet."

Not everyone agrees the new initiative is needed. The American Forest Resource Council, a trade group, "panned the old-growth initiative as unnecessary and burdensome," Mapes explains. Council President Travis Joseph issued a statement, saying, "Existing federal environmental laws and forest plans provide direction on managing and protecting old growth. Yet the agency is now being directed to embark on a new, massive bureaucratic process — during a wildfire and forest health crisis — that will likely make forest management more complex, costly, and contentious."

Big trees are a big deal. "They are the most important helpers in absorbing carbon because while they are slower growing than young trees, their greater mass locks away more carbon," Mapes reports. "Recent research shows large trees dominate carbon storage in the Pacific Northwest. Old and mature natural forests also provide a haven for biodiversity and human well-being."

As part of the Northwest Forest Plan overhaul, a 21-member committee "began work last September on updates to reflect changed conditions and new science." The U.S. Forest Service has announced its intent to prepare an environmental impact statement, expected in June, on the Northwest Forest Plan amendment, with a 90-day public comment period to begin at that time. 

Overdose-prevention programs in remote Maine work to stem drug-related problems and deaths

Naloxone is part of harm-reduction strategies.
(Photo by NEXT Distro, Unsplash)

Access to drug overdose prevention and addiction treatment in rural America can be almost non-existent. In Washington County, Maine, a remote area ravaged by drug use and overdose deaths, there was little help for substance-related issues. But a non-profit with federal dollars from the Substance Abuse and Mental Health Services Administration is working to change the county's number of drug-related medical problems and deaths, reports Taylor Sisk of The Daily Yonder. "In 2022, SAMSA awarded $30 million to 25 grantees to support community-based overdose-prevention programs, syringe services programs, and other harm reduction services. . . .MaineHealth received $1.2 million for a statewide overdose- and infection-prevention initiative."

Washington County, ME
(Wikipedia map)

Because Maine is small -- California is five times its size -- fewer people may know the extent of the state's drug problems. "Maine is the most rural state in the country with one of the highest drug-overdose rates. . . . It has one of the highest rates of acute hepatitis B. And it has the highest rate of hepatitis C, largely attributed to injection drug use," Sisk writes. "Washington County is the nation's easternmost county – the last stop on the line. It has a Walmart in Calais, the county's largest town, pop. 3,032. But if you live in Machias, the second largest town, pop. 2,062, it's an hour's drive. You're more likely to rely on the Family Dollar for your essentials. There's no bus service and one taxi company. . . . It has the highest poverty rate in the state."

In 2022, MaineHealth "launched Project DHARMA – Distribution of Harm Reduction Access in Rural Maine Areas – a collaboration with community-based organizations, including syringe services programs. Washington County became a beneficiary," Sisk reports. Harm reduction care "embraces a set of evidence-based strategies for reducing the negative consequences of drug use to keep people alive and as healthy as possible until such time as they should be ready to seek treatment."

Kinna Thakarar is an infectious disease and addiction medicine physician for MaineHealth and Project DHARMA's lead researcher. She told Sisk, "The services Project DHARMA is funding are evidence-based. Among the supplies and services syringe services programs typically provide in addition to clean syringes are saline, Band-Aids, condoms, information, and referrals. . . . They provide naloxone, a medication that quickly reverses the effects of an opioid overdose, and offer fentanyl test strips, an increasingly urgent need."

"Another critical service this grant will fund is one advocates have fought hard to launch: drug testing using handheld spectrometers. Outreach workers will test drugs to determine their contents; the drugs will then be sent to Colby College for confirmation. Other academic partners are providing technical assistance," Sisk writes. "But gaining permission to do so wasn’t easy. It required passing legislation 'so that none of us would get arrested in doing this evidence-based public health work,' Thakarar said. The passage of L.D. 1745, signed into law this summer, allows select individuals to possess 'nominal amounts' of illicit or controlled substances for the purposes of drug testing."

As states receive more than $50 billion in opioid settlement money, companies are competing to get some of the funding

Caution is advised with settlement money.
(Photo by JP Valery, Unsplash)

Money from opioid settlements began to hit state coffers in November, and now a long line of companies and service providers want to help states spend it. Experts are urging caution, reports Aneri Pattani KFF Health News. Marketing pitches for everything from funding new psychedelic research to providing law enforcement with lassos instead of tasers have been flooding state and local officials in charge of distributing the more than $50 billion in settlement funds.

The billions in payments were intended as a punishment and warning to drug companies whose aggressive, harmful and often dishonest marketing practices "fueled an epidemic that progressed to heroin and fentanyl and has killed more than half a million Americans," Pattani explains. "The settlement money, arriving over nearly two decades, is meant to remediate the effects of that corporate behavior."

But as the dollars began to flow to states in early November, "a swarm of private, public, nonprofit, and for-profit entities began eyeing the gold rush," Pattani writes. "Some people fear that corporations, in particular — with their flashy products, robust marketing budgets, and hunger for profits — will now gobble up the windfall meant to rectify it."

JK Costello, director of behavioral health consulting for the Steadman Group, a firm that is being paid to help local governments administer the settlements in Colorado, Kansas, Oregon and Virginia, "receives multiple emails a week from businesses and nonprofits seeking guidance on how to apply for the funds," Pattani adds. "To keep up with the influx, he has developed a standard response: 'Thanks, but we can't respond to individual requests, so here's a link to your locality's website, public meeting schedule, or application portal.'"

KFF Health News "obtained email records in eight states that show health departments, sheriffs' offices, and councils overseeing settlement funds are receiving a similar deluge of messages," Pattani reports. "In the emails, marketing specialists offer phone calls, informational presentations, and meetings with their companies. Alabama Attorney General Steve Marshall recently sent a letter reminding local officials and vet organizations to reach out.

While some private sector companies will be partners, "the key, agree public health and policy experts, is to critically evaluate products or services to see if they are necessary, evidence-based, and sustainable — instead of flocking to companies with the best marketing," Pattani reports. "And, ultimately, failure to do due diligence could leave some jurisdictions holding an empty bag."

'White Christmas' is a carol all Americans can enjoy; its history has lessons about overcoming sad times

'May your days be merry and bright.'
(Photo by Chandler Cruttenden, Unsplash)

Dreaming of a White Christmas? Many people do -- even 80 years after the song's debut. With a "new kind of Christmas carol" Irving Berlin and Bing Crosby helped make Christmas a holiday all Americans could celebrate, writes Ray Rast for The Conversation, a journalistic platform for academics. In 1940, Irving Berlin, a Jewish immigrant, wrote "the quintessential American song, White Christmas, which the popular entertainer Bing Crosby eventually made famous."

But the 1940s was a "profoundly sad time for humanity. World War II – what would become the deadliest war in human history – had begun in Europe and Asia, just as Americans were starting to pick up the pieces from the Great Depression," Rast explains. "Today, it can seem like humanity is at another tipping point: political polarization, war in the Middle East and Europe, a global climate crisis. Yet, like other historians, I've long thought that the study of the past can help point the way forward. White Christmas has resonated for more than 80 years, and I think the reasons why are worth understanding."

Part of the song's lasting charm is its melodic nostalgia for what Americans hope for during the holidays. "The Christmases that Berlin and Crosby 'used to know' were those of the 1910s and 1920s, when the season expanded to include the nation's first public Christmas tree lighting ceremony and the appearance of Santa Claus at the end of Macy's Thanksgiving Day Parade."

Berlin's inspiration for the song came in 1937 when he spent Christmas alone. "Berlin had connected his lonesome Christmas to the broader turmoil of the time, including the outbreak of World War II and fraught debates about America's role in the world," Rast explains. "This new song reflected his response: a dream of better times and places. It evoked a small town of yesteryear in which horse-drawn sleighs crossed freshly fallen snow. It also imagined a future in which dark days would be 'merry and bright' once again. . . .This was a new kind of Christmas carol. It did not mention the birth of Jesus, angels or wise men – and it was a song that all Americans, including Jewish immigrants, could embrace."

Bing Crosby was already an American favorite. When 'Holiday Inn' premiered in August 1942, "reviewers barely mentioned the song, but ordinary Americans couldn't get enough of it," Rast writes. "By December, it was on every radio, in every jukebox. . . . The key reason was the nation's entry into World War II. . . . White Christmas was not overtly patriotic, but it made Americans think about why they fought, sacrificed and endured separation from their loved ones. As an editorial in the Buffalo Courier-Express concluded, the song 'provided a forcible reminder that we are fighting for the right to dream and for memories to dream about.'. . . This made it a song all Americans could embrace, including those not always treated like Americans."

To read Rast's entire essay, click here.

More than $1 billion in medical debt abolished for Appalachians by RIP Medical Debt organization

A national nonprofit announced recently that it has abolished more than $1 billion in medical debt for people in the Appalachian region. RIP Medical Debt, a nonprofit "that raises funds from donors and uses them to acquire and abolish medical debt for people who are financially burdened" has a program that focuses specifically on people in Appalachia, "one of the poorest and least healthy areas of the U.S.," according to information from the organization.

The region's campaign to wipe out medical debt began in 2019 "with the generous support of two families with ties to the region – Jim and Sharen Branscome and Bill Bishop and Julie Ardery – whose donation wiped out $10 million of medical debt for 10,000 individuals in Appalachia. The Branscome's ongoing fundraising has played a major role in reaching the 1 billion dollar milestone." Read more about that donation and the funders' connection to the area here.

According to the organization, Appalachia comprises 423 counties across 13 states and spans 206,000 square miles, from southern New York to northern Mississippi. The region is home to 26.3 million residents. "While it has made progress in recent years, it still lags behind the nation in key socioeconomic indicators. Just under 1 in 7 people in Appalachia are in poverty, and approximately 2.2 million people are uninsured. With higher debt burdens than other parts of rural America, nearly 1 in 4 Appalachians have medical debt in collections."

RIP Medical Debt works nationally to relieve people of medical debt, which in turn helps individuals "enhance their economic opportunities and enable them to live healthier lives. RIP’s criteria for debt relief are those individuals who are four times or below the federal poverty level or those with medical debt that is 5% or more of their gross annual income. Medical debt relief cannot be requested . . . ."

Since RIP Medical Debt's inception in 2014, "more than $10.4 billion of medical debt has been abolished, helping more than 7 million people. Medical debt often results from unplanned, unexpected illnesses and accidents. About one-third of U.S. adults have difficulty covering unexpected health care bills."

New Mexico schools use wastewater testing to identify student drug use; the science is catching on in other places

Wasterwater testing can pinpoint drug use in schools
and communities. (N.M. Health Dept. photo via WP)

School administrators in New Mexico are using wastewater testing analysis to learn more about student drug use and to help inform their decisions on how to respond. "Using a technique that became popular nationally to spot Covid-19 outbreaks, New Mexico appears to be the first state to test wastewater at public high schools for a range of opioids and stimulants," reports Sara Randazzo of The Washington Post. "Initial data released since last week from more than three dozen high schools. . . included what school leaders and state officials called a surprise: cocaine use in nearly 82% of the campus communities."

Health and school officials plan to use testing results to "guide drug-prevention programs and pinpoint how to allocate resources for addiction services," Randazzo writes. "The tests aren't meant to assist in punitive measures, but to give a snapshot of campus drug use. . . . Fentanyl, a synthetic opioid that has led to a surge in overdoses nationwide, and its metabolite appeared at nine of the 38 New Mexico schools. None showed a heroin presence."

Europe and Australia began deploying wastewater testing to measure illicit drug use around 2010, but the method has been slow to "catch on in the U.S.," Randazzo reports. 

New Mexico may be the first to use wastewater testing in schools; however, "communities in California, Delaware, Virginia and elsewhere started broader municipal wastewater drug-testing programs this year focused on the opioid epidemic, some of it funded by the federal government," Randazzo writes. "Drug overdoses killed more than 100,000 people in the U.S. in 2022, federal data shows, more than two-thirds of those from fentanyl and other synthetic opioids."

The wastewater testing company Biobot Analytics "is working with Marin County, an affluent area north of San Francisco, where drug overdoses are now the leading cause of death for those 55 and under," Randazzo adds. "Matt Willis, Marin County's public health officer, said weekly testing over the past year helped them see in May that xylazine, a powerful horse tranquilizer that is dangerous to humans, was entering the community. . . ."

Female election officials are often targets of physical and verbal threats, but there are tools to protect them

A polling station worker in Falls Church, Va.
(Reuters photo via Brookings)

As the U.S. heads into the final months of election preparation, officials are dealing with challenges that go beyond counting votes --  physical and verbal threats, especially against women. "The threat of violence against election officials is pervasive. Women make up 80% of election workers in the United States, and they face unique, gendered harassment," report Zoe Wynn, Hannah Fried, and Norman Eisen of Brookings.

With more partisan politics, election site hostility has become more common. "Legal tools are available to make things better. The Violence Against Women Act of 1994 lays out confidentiality provisions aiming to protect the personal information of survivors of domestic violence," Brookings reports. "If codified into state law, similar provisions based on those in VAWA could help protect female election officials in advance of the expected surge of election denialism in the 2024 election."

The harassment of female election officials has been well-documented, alongside the loss of seasoned election officials who have quit or retired. "An investigation by Reuters in 2021 found that threats to election officials were typically generated by men and directed at a predominantly female workforce. Reuters found that dozens of these threatening messages used sexual or misogynistic language," Wynn, Fried and Eisen write. "The Brennan Center for Justice found that one in five election officials are 'very' or 'somewhat unlikely' to continue serving through 2024. The election officials surveyed specifically cite attacks on the system and stress as their primary reasons for leaving."

The VAWA gives states a framework to begin protections, but a "one-size-fits-all" structure is not the answer. "The VAWA provides a useful legislative starting point for a tailored, female-specific anti-harassment law. The bill's aims include reducing violence against women, securing offender accountability, and ensuring victim safety," Brookings reports. "Eleven states have passed comprehensive laws to protect election officials. . . . Threats to female election require a tailored approach that accounts for the gendered nature of the issue."

"A critical portion of the law is its confidentiality provisions. Confidentiality provisions are measures to protect the personal information of survivors of domestic violence and can provide opportunities for disciplinary action if personal information is disseminated," Wynn, Fried, and Eisen explain. "Lawmakers identified these measures as an effective means of preventing abusers from tracking their victims and causing them further harm."

Brookings reports, "Women who serve in election posts should be awarded similar protections commensurate with the nature of the threat to their safety. The functioning of our elections, and therefore our democracy, depends upon it."

Some rural Americans hope the Farm Bill can help in getting broadband services to their homes and businesses

Broadband is reaching some rural residents while others
feel 'cut off.' (Photo by Emily Haxby via Modern Farmer)

Farming families need broadband for education, connection, and to compete in global food markets. Too often, farmers feel cut off from the rest of the world with few viable options, reports Emily Baron Cadloff of Modern Farmer. "Millions of Americans live without reliable internet services. For farmers and food providers, this leaves them lagging behind competition and stuck with outdated equipment. Now, they're looking to the Farm Bill for answers."

It's widely known that getting broadband to "the last mile" is a challenge, but there are other dead spaces. The Stroup family farm raises beef cattle and grows soybeans and wheat near Bessemer City, NC., pop. 5,400. "The family has been consistently stymied when it comes to internet access on their farm," Cadloff writes. "The farm is a classic example of those impacted by the middle mile effect. In an urban area, if an internet service provider lays a mile of cable for broadband internet, it will be able to connect hundreds, if not thousands, of customers because the area is densely populated. In a rural area, that same mile of cable might connect a single family, so ISPs aren't financially incentivized to run cable in those regions. What ends up happening is a lot of high-volume areas, surrounded by dead zones."

Dead zones disproportionately limit rural connections from online schooling to a farmer's ability to update his tractor's technology software, but the solution has been hard to come by. Sascha Meinrath, the Palmer Chair in telecommunications at Penn State University, told Cadloff: "The Farm Bill could include a mandate that says anytime a provider reports to a federal agency that they provide service at an address, they must provide that service within 30 days or get fined $10,000 a day until they do." Cadloff adds, "In other words, force the ISPs to show verification that they are doing what they claim."

Reinstating "common carriage" is another solution. "Up until 2005, we had common carriage in the US, just like the universal service with telephones," Cadloff reports. Meinrath told her, "If you had a telecommunications infrastructure, you had to carry the traffic of your competitors." But Cadloff reports, "the government got rid of common carriage in 2005, so ISPs started focusing on only the most profitable areas."

To find out why there is still so much work left to do to connect rural America with broadband, click here.

Listening to holiday music can help runners improve their mood and speed; even non-runners benefit from music

Maybe Santa is a runner.
(Photo by Artem Maltsev, Unsplash)

Running with holiday tunes crooning in your ears can improve your mood and your stride. "It's the most wonderful time of the year for 'music doping,'" reports Mallory Arnold of Outsider. "One study had 20 male participants perform two six-minute running tests, one with and one without music. Researchers measured mean running speed, blood lactate, total distance covered, heart rate, and rate of perceived exertion. The results concluded that runners who listened to their music of choice were significantly faster and had lower blood-lactate concentrations."

No wonder Santa can get so much done in one night -- he's obviously knee-deep in snow and Dean Martin. Erin Hannon, director of the University of Nevada Las Vegas Music Lab, told Arnold, "You may not realize this, but when you listen to music, the part of your brain you're using doesn't just process sound. It's also the part that controls movement, so you're actually engaging the motor system of the body when you listen to music."

It makes sense that Santa would need to be fit.
(Photo by RawKim, Unsplash)

It's true that an individual has to enjoy holiday music for their run to improve while listening. "Those who have positive feelings around the holiday season will benefit from listening to carols while running, as the brain becomes stimulated (or aroused), hyper-focused, and releases endorphins that can not only create that 'runner's high,' but can promote short-term psychoactive effects like feelings of calm and elevated mood," Arnold explains. "Excess endorphin release has also been studied for its pain-relieving properties, which can be extremely beneficial during a run, like a natural ibuprofen."

Of course, listening to carols after the holiday may not have the same impact. Then, what's a person to do after Dec. 25? Keep listening to music -- even if you're not running or listening to holiday tunes. As Henkjan Honing points out in her report for The MIT Press Reader, a study showed "newborns possess the ability to discern a regular pulse – the beat – in music. It's a skill that might seem trivial to most of us, but that's fundamental to the creation and appreciation of music," Honing writes. "The discovery sparked a profound curiosity in me, leading to an exploration of the biological underpinnings of our innate capacity for music, commonly referred to as 'musicality.'"

Newborn babies participating in a listening experiment.
(Courtesy Eszter Rozgonyiné Lányi, MIT Reader)

"Alongside psychology and neuroscience, the realms of biology and genomics now offer effective toolkits for empirically testing theories on the origins of music in the present day," Honing reports. "Consequently, musicality research is gaining scientific respectability, coherence, and maturity. The once-speculative nature of the origins of musicality research is giving way to a more concrete and scientifically rigorous approach, making it an exciting and promising avenue" for discovery.