Trump Wins Michigan with Slightly Greater Support in Rural Areas and Suburbs
Donald Trump won the Michigan primary with widespread support across the state, with slightly higher margins in rural areas and the suburbs of metropolitan areas, according to a Daily Yonder analysis.
The results were a soft echo of former President Trump’s performance in the South Carolina primary on Saturday, in which he polled strongest among suburban and rural voters.
In Michigan, Trump defeated former South Carolina Governor Nikki Haley by 3 to 1 (77% to 23%) in the state’s 50 rural (nonmetropolitan) counties. These voters represented 25% of the turnout in Tuesday’s primary.
He did nearly as well in the state’s small metropolitan areas, which include eight counties and 12% of the turnout. Cities in these small metropolitan areas are Battle Creek, Jackson, Midland, Monroe, Muskegon, Saginaw, Bay City, and Nile-Benton Harbor.
Trump also received over 70% of the two-candidate vote in the suburbs of major metropolitan areas (Detroit and Grand Rapids) and medium-sized metropolitan areas (Lansing, Flint, Kalamazoo, Ann Arbor, and South Bend, Indiana).
Voters in the Grand Rapids and Detroit metropolitan areas constituted nearly two-thirds of the turnout. Voters in small metropolitan areas were 12% of the electorate on Tuesday.
Definitions
The Daily Yonder analysis uses the 2013 Office of Management and Budget Metropolitan Statistical Areas to define rural.
We define counties that are not located within a metropolitan area as rural. Under the OMB’s 2013 system, nonmetropolitan counties don’t have a city of 50,000 or greater and don’t have close economic ties to a county that does have a city of 50,000 or greater.
Major metropolitan suburbs are the outlying counties of metros with a population of over 1 million.
Medium-sized metropolitan core counties are the central counties of metros with a population of 250,000 to under 1 million.
Medium-sized metropolitan suburbs are the outlying counties of metros with a population of 250,000 to under 1 million.
Small metropolitan areas include all counties in metros of fewer than 250,000 residents.
Hundreds of thousands of US infants every year pay the consequences of prenatal exposure to drugs, a growing crisis particularly in rural America
For Good or Bad, Norman Lear Helped Erase Rural America from TV
Editor’s Note: A version of this story first appeared in The Good, the Bad, and the Elegy, a newsletter from the Daily Yonder focused on the best, and worst, in rural media, entertainment, and culture. Every other Thursday, it features reviews, retrospectives, recommendations, and more. You can join the mailing list at the bottom of this article to receive future editions in your inbox.
Among the Hollywood figures who were honored in memoriam last month during the 75th Emmy Awards was Norman Lear. The iconic television writer, director, and producer passed away at 101 in December. Lear leaves in his wake a bevy of iconic television shows that defined his era and shaped the future of American popular culture. His role in U.S. television history also had a complex impact on how the nation sees — and doesn’t see — rural America.
Fifty-three years ago, Lear’s breakout hit, “All in the Family,” aired on CBS. A satire set in the New York City borough of Queens, the program made topical comedy out of the post-1960s culture wars. It also touched an immediate nerve. An instant hit, the program became the nation’s most-watched television show of its era. But Lear’s legacy is more complicated for rural Americans. His 1971 rise signaled the demise of rural America on network television.
“All in the Family’s”white-hot popularity spelled almost instantaneous doom for the show that immediately preceded it, “Hee Haw.” But the country music variety show was not the only rural-themed program on borrowed time. Airing on CBS on the same night as “Hee Haw” were “Green Acres” and “The Beverly Hillbillies.” Within a year, those programs, along with “Mayberry RFD,” “The Jim Nabors Hour,” “Petticoat Junction,” “Gomer Pyle,” and the “New Andy Griffith Show,” were canceled. Termed the “rural purge,” Norman Lear marked the end of an era.
Producer and writer Norman Lear during an interview in 1991. Lear, producer of TV’s “All in the Family” and an influential liberal advocate, died Tuesday, Dec. 5, 2023, at 101. (AP Photo, File)
In the early 1970s, Lear followed “All in the Family” with hits like “Maude,” “Good Times,” “The Jeffersons,” and “Sanford and Son.” These shows were defined by their urban settings, realism, and topical humor. By contrast, the programs canceled in the “rural purge” were wholly disconnected from the sturm-and-drang of the 1960s.
Sara K. Eskridge, Ph.D., believes “escape” was exactly the point. “I think they provided a sense of soothing,” said Dr. Eskridge, a historian who authored Rube Tube: CBS and Rural Comedy in the Sixties. “They were set in contemporary times. But they were focused on friendships. You don’t see conflict.”
Unlike Lear, who found comedy in social conflict and made shows that spoke to the moment, Eskridge said the rural-themed programs “were permanently in the past even when they were contemporary. They were not culturally relevant.”
In the 1960s, CBS so dominated television ratings with its rural-themed programming that critics dubbed it, the “Country Broadcasting System.” At television’s birth in the 1940s, CBS had also conquered the medium. But it did so with highly rated and critically acclaimed shows ranging from “I Love Lucy” to “The Twilight Zone.” Dubbed the “Tiffany Network,” for combining popularity and quality, CBS faced a changed television landscape by 1960.
In 1959, the network’s hit quiz show, “The $64,000 Question,” was embroiled in a rigging scandal.
In addition to this, technology had finally given rural Americans access to television. To please their expanded audience of urban and rural viewers, networks turned to Westerns. Popular with every demographic, the networks aired as many as 41 Westerns in one season of television programming.
With quiz shows discredited and Westerns saturated, CBS launched “The Andy Griffith Show” in October 1960. Combining the Western motif of the honest lawman with a tried-and-true comedy formula, CBS struck ratings gold. This runaway hit spawned a series of rural-themed television comedies ranging from the cornpone, “Beverly Hillbillies,” to the slightly postmodern, “Green Acres.” Critics may have moaned “the pone is the lowest form of humor,” but audiences disagreed. During the Kennedy presidency, “The Beverly Hillbillies” was America’s most watched television series.
Ironically, as American cities boomed in the 1960s so did rural-themed television programming. To Dr. Eskridge, “Nostalgia works great for this. The future was in the city and when people think ‘rural’ they think of the past.”
The cast of TV’s “The Beverly Hillbillies,” are seen riding in their car in this May 19, 1967 photo. Seen are Buddy Ebsen, front left, Max Baer, front right, Donna Douglas, rear left, and Irene Ryan. (AP Photo)
Brooks Blevins, Ph.D., understands the show’s popularity a bit differently. The Noel Boyd Professor of Ozarks Studies at Missouri State University sees a timeless narrative thread in these programs. Dr. Blevins told me, “The rich fat cats are always the butt of the joke. And that has existed for as long as there has been humor.”
But Blevins also understands that once the tumult of the 1960s fully emerged, “these shows are escapism. You can’t deny that there is an escapist measure in these shows.”
To Tim Brook, a television critic, the programs relied upon the trope that “Rural America was like true America, without all the problems,” he wrote in the Bitter Southerner. But even Mayberry was not immune to the times. In 1967, “The Andy Griffith Show,” in a slight nod to contemporary events, finally featured its first African American character in a speaking part.
Ironically, it was integration that spawned the rural purge. During Jim Crow and segregation, African Americans were absent from television. In that time, Dr. Blevins claims it was “hillbillies” who played the role of the exotic “other.” Through these “non-threatening, non-conformist” characters, writers could “poke fun at American materialism in a non-leftist way.” When Norman Lear integrated television, African Americans became the “other” who held up the mirror to society; hillbillies were redundant.
Network executives were eager for a change. CBS president William Paley loathed the “Country Broadcasting Network” moniker. To fix it, in 1970, he hired 33-year-old Fred Silverman as head of network programming. Silverman also detested the rural comedies but now he had a rationale to cancel what were popular shows. The new Nielsen ratings measured viewer demographics, not just raw viewership. CBS dominated the ratings, but its rural, downscale viewers would never attract top advertising dollars.
Paley and Silverman sought to revive the “Tiffany Network” by producing prestige television that attracted a younger, educated, and urban audience. Lear’s “All in the Family” fit the bill. Within a year of its premiere, Silverman had, as one observer quipped, canceled every show “with a tree in it.”
Actress Eva Gabor, center, in the role of Lisa Douglas, and costar Eddie Albert, left background, as Oliver Wendell Douglas, are surrounded by animals on the set of their television series “Green Acres” in Hollywood, California, in December of 1966. They are working with animal handlers to film a scene for the segment “It’s Human to be Humane.” (AP Photo)
In all, Silverman canned a dozen shows in the 1971 rural purge: “Green Acres,” “Petticoat Junction,” “Beverly Hillbillies,” “The Red Skelton Show,” “Family Affair,” “Hee-Haw,” “Hogan’s Heroes,” “Jim Nabors Hour,” “Mayberry RFD,” and “The New Andy Griffith Show.” Not even “Lassie” escaped Silverman’s hatchet. In 1973, Silverman’s Saturday night lineup, “All in the Family,” “The Mary Tyler Moore Show,” “Bob Newhart,” “M*A*S*H,” and “The Carol Burnett Show,” came to be regarded as the greatest night of television in the medium’s history.
Norman Lear had blazed a trail for these programs to follow. He proved it was feasible to be “topical, funny and immensely popular.” But his success came at a cost. The “rural purge” was a tipping point for depictions of rural America in popular culture. Sure, “The Waltons,” “Lonesome Dove,” “The Dukes of Hazard,” and (now) “Yellowstone” are hit programs that center on rural life. But these are outliers. Rural America, when it is depicted at all, is too often a setting for horror movies or reality show rubes. Dr. Eskridge understands that many rural people feel ignored in popular culture. They ask, in her words, “Where am I in this melting pot?”
Christopher Ali, Ph.D., thinks the rural purge points to a deeper issue. Fred Silverman’s quest for the urban, educated middle class did not stop with network television. Today, media almost wholly ignores rural America. The Pioneers Chair in Telecommunications at Pennsylvania State University told me wide swaths of rural Americans now live in “double deserts.” They lack access to both broadband and reliable local news and media.
These “double deserts” pack a powerful social wallop. In Ali’s words, “The lack of representation of rural communities creates a terrible cycle. Rural communities are vibrant, rich, and diverse. But the lack of connectivity, news, and information are never good. It limits opportunity to learn and grow economically. It limits options. It can only be a bad thing. You end up in echo chambers without connectivity.”
Lear proved television could speak to the moment — and, at times, could help heal division. His passing reminds us that television and media ignore that legacy.
Jeffery H. Bloodworth is a professor of political history at Gannon University in Erie, Pennsylvania, and co-director of the university’s School of Public Service & Global Affairs. He is the author of the forthcoming book Heartland Liberal: The Life & Times of Speaker Carl Albert.
This article first appeared in The Good, the Bad, and the Elegy, an email newsletter from the Daily Yonder focused on the best, and worst, in rural media, entertainment, and culture. Every other Thursday, it features reviews, recommendations, retrospectives, and more. Join the mailing list today to have future editions delivered straight to your inbox.
Iowa Researcher Proposes Subsidies to Bring Cardiac Care to Rural Areas
Luring cardiologists to rural parts of Iowa may mean subsidizing their salaries, a new study has found.
Tom Gruca, a marketing professor at the University of Iowa’s Tippie College of Business, looked at data from more than 40 years of public health in his state. His study, Bringing the Doctor to the Patients: Cardiology Outreach to Rural Areas, found that paying doctors to participate in traveling practice models could help alleviate the coming cardiologist shortage in his state.
Using subsidies and an existing Visiting Consultant Clinic (VCC) model would be a better and more cost-effective way to get cardiology care to rural patients, he said.
A VCC model is a formal arrangement between a rural hospital or clinic and a specialist physician, typically from an urban area nearby. In a VCC arrangement, the specialists travel to rural areas on a regular basis to see patients in their own communities. There, they can use the rural hospital to examine them and provide basic support and non-invasive procedures, and treat them in larger hospitals for more complex procedures.
“The policy that the American Heart Association and everybody else always talks about is let’s get doctors to move to rural areas,” Gruca said in an interview with the Daily Yonder. “That might work with the primary care physician because if there’s a hospital there, there’s probably enough equipment and staff for them to do what they’re doing. This will not work for almost any specialist because they need the imaging equipment, the surgical equipment, the surgery nurses, and all that other stuff to do their jobs.”
The VCC model is used in every state, he said. Looking at the numbers the research found that the model would not only provide rural patients with access to care, but save money.
Putting a cardiologist in a rural community would mean the doctor would not have enough patients or patient visits to support their practice, Gruca said. And paying cardiologists on a per mile basis to drive to rural communities would be excessively expensive. In some cases, getting doctors to give up patient time to spend up to three hours of “windshield time” to get rural communities to participate in the VCC model was a challenge.
His research found that a state investment of about $430,000 per year would provide doctors with the necessary funding to cover “windshield time” and still provide current levels of cardiology coverage in the state.
Getting that cardiology care to rural communities is important on a number of levels, he said. First, rural residents are more likely to have cardiology issues. According to one study, between 2010 and 2015, the death rate for rural residents from coronary heart disease was significantly higher than it was for those in urban areas. And a 2017 study found that people in rural areas have a 30 percent higher risk of dying from a stroke due to their increased chronic disease, and reduced access to pre-hospital care.
Second, research shows that rural residents who have access to cardiology care are better off for it.
“What we can say is that the difference between having VCC outreach and not having VCC outreach means anywhere between 700,000 and a million rural residents having better access,” he said. “And studies show that Medicaid patients who see a specialist at least once a year are way more likely to stay out of the hospital and way more likely to live for another year.”
Even more important, he said, is that rural America is facing a pending shortage of cardiologists. Currently, the state has fewer than 200 cardiologists, Gruca said, almost all of them in urban areas. Nationally, the number of cardiologists is expected to decline by as much as 10% due to retirement and aging workloads. While fellowship programs graduate about 1,500 new cardiologists a year, he said, about 2,000 leave the practice annually.
“I thought, what’s going to happen when the number of cardiologists goes down?” he said. “When this shortage actually hits… If we lose 10% of our current cardiologists… there are a lot of cities (in Iowa) that will get no outreach at all.”
Similar programs have worked in Australia, he said. The same kind of subsidies could be successful in encouraging specialist physicians to work in rural areas as well.
Even though the program was expensive, he said, it will still save states money over the alternative.
“We looked at what it would take to hire people and put them into rural areas and the cost was many, many times (the annual subsidies) simply because they would have very little to do,” he said. “If we pay them some amount to do this outreach and we build a mathematical model to figure out how much would we have to pay them per mile or per minute… it’s actually really many, many, many times the $400,000 for the subsidy that we calculated.”
With Limited Resources, One Small Town Plans for Climate Change
One of the most iconic landmarks in downtown Grants Pass, Oregon, is a 100-year-old sign that arcs over the main street with the phrase “It’s the Climate” scrawled across it.
To an outsider, it’s an odd slogan in this rural region, where comments about the climate – or rather, climate change – can be met with apprehension. But for locals, it’s a nod to an era when the “climate” only referred to Grants Pass’ warm, dry summers and mild winters when snow coats the surrounding mountains but rarely touches down in the city streets.
The “It’s the Climate” sign was first hung on July 20, 1920, to promote the temperate weather of Grants Pass. (Photo by Claire Carlson / The Daily Yonder)
Now, the slogan takes on a different meaning.
In May 2023, the Grants Pass City Council passed a one-of-a-kind sustainability plan that, if implemented, would transition publicly owned buildings and vehicles to renewable energy, diversifying their power sources in case of natural disaster.
While passing the sustainability plan in this largely Republican county was an enormous feat on its own, actually paying for the energy projects proves to be Grants Pass’s biggest challenge yet.
“There are grants out there, but I don’t think we’re the only community out there looking for grants to help pay for some of these things,” said JC Rowley, finance director for the city of Grants Pass. Some project examples outlined in their sustainability plan include installing electric vehicle charging stations downtown and solar panels at two city-owned landfills, and converting park streetlights to LED.
Rural communities face bigger hurdles when accessing grant funding because they don’t have the staff or budget that cities often do to produce competitive grant applications. This can slow down the implementation of projects like the ones laid out in the Grants Pass sustainability plan.
And time is not something Grants Pass – or any other community – has to spare.
The exterior of City Hall in Grants Pass on November 28, 2023. (Photo by Claire Carlson / The Daily Yonder)
Global climate models show the planet’s average annual temperature increasing by about 6.3° Fahrenheit by 2100 if “business-as-usual” practices continue. These practices mean no substantive climate change mitigation policy, continued population growth, and unabated greenhouse gas emissions throughout the 21st century – practices driven by the most resource-consumptive countries, namely, the United States.
In southwest Oregon, this temperature increase means hotter summers and less snow in the winters, affecting the region’s water resources, according to a U.S. Forest Service analysis. This could mean longer and more severe wildfire seasons.
In Roseburg, Oregon, about 70 miles north of Grants Pass, a 6.3°F increase would mean the city’s yearly average of 36 days of below-freezing temperatures would decrease to few or none, according to the analysis. Grants Pass would suffer a similar fate, drastically changing the climate it’s so famous for.
Grants Pass has a population of 39,000 and is the hub of one of the smallest metropolitan statistical areas in the U.S. The metro contains just one county, Josephine, which has a population of under 90,000, nearly half of whom live outside urbanized areas. Over half of the county’s land is owned by the Bureau of Land Management or National Forest, and it contains a section of the federal Rogue River Scenic Waterway.
“In the event of a natural disaster, we are far more likely to get isolated,” said Allegra Starr, an Americorps employee who was the driving force behind the Grants Pass sustainability plan. “I’ve heard stories of communities that were less isolated than us running out of fuel [during power outages].”
Building resilience in the face of disaster is a main priority of the plan, which recommends 14 projects related to green energy, waste disposal, transportation, and tree plantings in city limits. All of the projects focus on improvements to city-owned buildings, vehicles, and operations.
In partnership with Starr and the Grants Pass public works department, a volunteer task force of community members spent one year researching and writing the sustainability plan. In spring 2023, it was approved by the Grants Pass City Council.
Now, the public works department is in the grants-seeking stage, and they stand to benefit from the influx of climate cash currently coming from the federal government.
Money for Sustainability, If You Can Get It
In 2022, the Biden administration passed the single largest bill on clean energy and climate action in U.S. history: the Inflation Reduction Act, which funnels $145 billion to renewable energy and climate action programs. The Bipartisan Infrastructure Law, passed in 2021, allocates $57.9 billion to clean energy and power projects.
“It’s almost like drinking through a fire hose with the grant opportunities, which is a curse and a blessing,” said Vanessa Ogier, Grants Pass city council member. Ogier joined the council in 2021 with environmental and social issues as her top priority and was one of the sustainability plan’s biggest proponents.
But competing against larger communities for the grants funded through these federal laws is a struggle for smaller communities like Grants Pass.
Grants Pass city council member Vanessa Ogier at City Hall on November 28, 2023. (Photo by Claire Carlson / The Daily Yonder)
“I really don’t want to look a gift horse in the mouth, but when a small community only has one grant writer and they have to focus on water systems, fire, dispatch, fleet services, and they’re torn in all these different ways, it can be difficult to wrangle and organize all these opportunities and filter if they’re applicable, if we would even qualify,” Ogier said.
Having a designated grant-writing team, which is common in larger cities, would be a huge help in Grants Pass, Ogier said.
A 2023 study by Headwaters Economics found that lower-capacity communities – ones with fewer staff and limited funding – were unable to compete against higher-capacity, typically urban communities with resources devoted to writing competitive grant applications.
“[There are] rural communities that don’t have community development, that don’t have economic development, that don’t have grant writers, that may only have one or two paid staff,” said Karen Chase, senior manager for community strategy at Energy Trust, an Oregon-based nonprofit that helps people transition their homes and businesses to renewable energy. Chase was a member of the volunteer task force that put together the Grants Pass sustainability plan.
When the Inflation Reduction Act money started rolling in, many of the rural communities Chase works with did not have plans that laid out “shovel-ready” energy and climate resiliency projects, which is a requirement of much of the funding. Grants Pass’ sustainability plan should give them a leg-up when applying for grants that require shovel-ready projects, according to Chase.
“Most of my rural communities pretty much lost out,” she said.
This is despite the approximately $87 billion of Inflation Reduction Act money classified as rural-relevant, rural-stipulated, or rural-exclusive funding, according to an analysis from the Brookings Institute. Rural outreach is part of the Biden administration’s larger goal to put money into rural communities that historically have been left out by state and federal investments.
But this outreach isn’t perfect. Most of the federal grants available to rural communities still have match requirements, which are a set amount of money awardees must contribute to a grant-funded project.
The Brookings Institute analysis, which also looked at rural funding from the Infrastructure Investment and Jobs Act and the CHIPS and Science Act, found that “over half [of the rural-significant grants programs] require or show a preference for matching funds, and less than one-third offer flexibility or a waiver.”
Of the rural-exclusive and rural-stipulated programs, less than one-third of the total grants offer match waivers or flexibility to reduce the match requirement. This makes getting those grants a lot harder for rural communities with smaller budgets.
Help From the Outside
To address limited staffing, in 2021 the Grants Pass public works department applied to be a host site for an Americorps program run out of the University of Oregon.
The program, coined the Resource Assistance for Rural Environments (RARE) program, assigns graduate students to rural Oregon communities for 11 months to work on economic development, sustainability planning, and food systems initiatives. An Americorps member was assigned to Grants Pass to work as a sustainability planner from September 2022 to August 2023.
Without the Americorps member, Grants Pass officials say there’s no way the plan would have been written.
“She came in and learned about the city and the operations and the technical aspects of it and was able to really understand it and talk about that,” said Kyrrha Sevco, business operations supervisor for the public works department. “That’s hard to do.”
Kyrrha Sevco, business operations supervisor for the Grants Pass public works department, at City Hall on November 28, 2023. (Photo by Claire Carlson / The Daily Yonder)
Bringing outsiders in can be a tricky undertaking in a rural community, but RARE program director Titus Tomlinson said they collaborate with the host sites to make the transition for their members as smooth as possible.
“When we place a member, we place them with a trusted entity in a rural community,” Tomlinson said. “[The site supervisor] helps them meet and engage with other leaders in the community so that they’ve got some ground to stand on right out of the gate.”
Each participating community must provide a $25,000 cash match that goes toward the approximately $50,000 needed to pay, train, and mentor the Americorps member, according to the RARE website. Communities struggling to meet this cash match are eligible for financial assistance.
Grants Pass paid $18,500 for their portion of the RARE Americorps grant.
Allegra Starr, the Americorps employee, no longer works in Grants Pass since completing her 11-month term. In her stead, a committee of seven has been created to monitor and report to the city council on the progress of the plan’s implementation.
Much of this implementation work will fall on the director of the public works department, Jason Canady, and the business operations supervisor, Kyrrha Sevco.
Director of public works Jason Canady at City Hall on November 28, 2023. (Photo by Claire Carlson / The Daily Yonder)
“There has to be that departmental person who’s really carrying that lift and that load,” said Rowley, the Grants Pass finance director. “It’s the Kyrrhas and Jasons of the world who are leading the charge for their own department like public works.”
Now, Canady and Sevco are laying the groundwork for multiple solar projects. Eventually, they hope to bring to life what local high school student, and member of the original volunteer sustainability task force, Kayle Palmore, dreamed of in an essay titled “A Day in 2045,” which envisions bike lanes, wide sidewalks, solar panels, and electric vehicle charging stations on every street corner.
“A smile spreads across your face as you think of how much you love this beautiful city,” Palmore writes.
Trump Underperforms Slightly with Rural N.H. Voters
Rural voters were slightly less likely than urban voters to support former President Donald Trump in the New Hampshire primary Tuesday, a Daily Yonder analysis shows.
The difference between Trump’s rural and urban support was slim but indicates that in New Hampshire, the rural Republican electorate did not skew disproportionately toward the former president compared to urban voters.
Trump won the statewide contest by 11 points (54%-43%) over Nikki Haley, former U.N. ambassador and South Carolina governor.
The former president won both rural (nonmetropolitan) and metropolitan counties, but the margin in rural areas was slightly smaller. Trump earned 53.4% of the vote in rural counties, versus 55.9% in the state’s three urban counties – a spread of 2.5 points.
Haley won 44.7% of the vote in rural counties, versus 42.7% of the vote in urban counties.
Although Trump’s margin of victory was slightly smaller in rural New Hampshire overall, his largest margin of victory came in rural Coos County, the northernmost county in the state.
Trump secured 65% of the vote in Coos, beating Haley by a 28-point margin. Support for Trump among voters in rural Sullivan County, in the southwest, rivaled that of Coos County. Sixty-four percent of Sullivan County voters also cast their ballot for Trump.
Haley performed the best in rural Grafton County, which borders Coos County to the south and is home to Dartmouth College. Fifty-two percent of Grafton County voters supported Haley over Trump on Tuesday night. Grafton was the only county out of New Hampshire’s 10 counties where Haley beat Trump.
Methodology
The Daily Yonder’s analysis of the rural vote is based on the 2013 Office of Management and Budget Metropolitan Statistical Areas definitions. Counties in metropolitan areas are classified as urban, and counties not in a metropolitan area (nonmetropolitan) are classified as rural.
Activists Win a Battle for Women’s Reproductive Healthcare in a Rural Colorado Town
On June 8, 2023, Lindsay Yeager of Cortez, Colorado, woke up to a barrage of text messages, asking if she had heard about the local birth center closing. Yeager immediately sprang into action. By that evening, protesters gathered across the street from the city’s hospital with placards and a purpose: keeping the birthing center open.
The strategy worked, at least for the time being. About 10 days later, on the eve of another planned protest, Southwest Health System, which operates Southwest Memorial Hospital in Cortez, announced in a press release that the birthing center would remain open “following stakeholder input over the past two weeks.”
Yeager posted in a Facebook group that evening: “Congratulations Montezuma County! We will not be protesting tonight…Our fight is not over. We’ll be taking a breath to regroup but the battle for stable, community-focused care in Montezuma County continues!”
Community members protesting the forthcoming closure of SW Health System’s birth center in June 2023. (Photo courtesy of Lindsay Yeager)
Judging by national trends, Yeager is likely correct that the battle will continue. Across the U.S., under half of rural hospitals like Southwest Memorial provide maternal-care services, and the number is falling, as the Daily Yonder has reported. The cost of maternal services is the primary cause of closures, according to the Center for Healthcare Quality and Payment Reform.
In a press release announcing the closure of the birthing center, SW Health named several factors that have affected rural maternal care programs, including cuts in reimbursements, difficulty recruiting specialists, declining birth volume, and an aging population. The press release said these are general problems in rural areas but did not link them expressly to the decision to close the Cortez birthing center.
In December, Southwest Health CEO Joe Theine, said finances are difficult for the maternity program. He said the costs per discharge in labor and delivery have gone up from $3,000 in 2019 to $4,500 in 2022. According to data from the Colorado Department of Public Health, 206 babies were born in a hospital in Montezuma County in 2022. SW Health runs the only hospital in Montezuma County.
Nationwide, less than half of all rural hospitals like SW Health offer maternal services, and the number is dropping, the Daily Yonder has reported. So Cortez has bucked the trend, for now. But the hospital’s long-term ability to provide services like the birthing center depends on community support, said Joe Theine, SW Health CEO.
In meeting minutes from an emergency board meeting on June 15 that was called in response to the birthing center protest, it was stated that SW Health was losing over $1 million annually.
“Birth is not profitable, that is not where healthcare institutions make money,” Yeagers said.
In addition to the Southwest Health System board, the hospital’s building and facilities are governed by the Montezuma County Hospital District board.
Yeager said losing maternal care services can have a ripple effect in a rural area. “I knew that not having the birthing center was going to have this domino effect,” she said. “It was going to affect women’s health care in all facets. It wasn’t just going to be that you wouldn’t be able to deliver a baby there.”
According to a March of Dimes 2022 maternal care deserts report, women in rural areas are at higher risk for childbirth complications and rural hospitals report higher rates of hemorrhage and blood transfusions as compared to urban hospitals. Half the women in rural areas have to travel farther than 30 miles to reach an obstetrics hospital, according to the study.
Without the birthing center, Cortez would be in that group. The next closest birthing center is in Durango, 45 miles east. Durango’s hospital, Mercy Regional Medical Center, is a Catholic affiliate hospital and does not provide tubal ligation or any medical procedures that could be associated with abortion.
The Cortez birthing center also serves southeast Utah or northwest New Mexico.
The closest big cities are Albuquerque (a four-hour drive) and Salt Lake City (a 5.5-hour drive). Denver is about seven hours and many mountain passes away by road.
A Community-Led Effort
Southwest Health’s initial announcement said the birthing center closure was temporary, while the hospital worked “to develop a plan that would allow us to resume these services.” But Yeager said once she started researching, she found no cases of a birth center closing temporarily and successfully reopening.
So she decided to help Cortez (population 9,117) come together to urge the hospital to keep the birthing center open.
The initial protest consisted of community members holding signs with slogans such as “Our Community, Our Hospital” and “Care close to home, just not for mothers and babies” across the street from the hospital.
After that, Yeager and a group of organizers started releasing the names and email addresses of board members and decision-makers for the hospital, and the community began to send a stream of messages opposing the birthing center’s closure. Residents connected via a Facebook group titled “Keep Our Birthing Center & Women’s Services Open,” sharing resources and planning protests.
The group’s first request was for the hospital to hold a public meeting to hear community concerns. SW Health responded with an emergency board meeting on June 15, 2023.
“It was so powerful because it was such a united voice from the community…there was just no way to deny what the community wanted,” Yeager said. She said the birthing center issue drew the community together and attracted support across political boundaries.
Hospital CEO Theine said in December that it’s up to the community to continue to support the hospital and all its services. The hospital’s costs are fixed, while the revenue fluctuates based on the number of people coming in the door. If the hospital provides it, and the community comes, they can provide more services, said Theine, “We exist to serve the community.”
Looking for Alternatives
The lack of maternity services in rural areas has some people looking for alternatives. Elephant Circle is a Colorado-based non-profit dedicated to “birth justice,” a term that includes everything from reproductive health advocacy to finding creative solutions for rural maternal care.
“Birth started in communities. It was upheld by community midwives from the beginning of time,” said Heather Thompson, deputy director of Elephant Circle. “And then the medical industrial complex eliminated midwifery and moved birth from the community into these for-profit institutions. (SW Health is a nonprofit. Ed.) And now we’re seeing some of the outcomes, those systems were not built for Black or Indigenous people. Those systems were not built to thrive in poor monetary resource places.”
Thompson advocates a more community-centered approach to birth through birth centers and midwives, although one issue with this is insurance. Medicaid does not reimburse Certified Professional Midwives (CPM), which is the only midwife certification where practitioners are required to have experience birthing babies in an out-of-hospital setting. CPMs are often only treating women with the means to afford a midwife, due to lack of insurance reimbursement, “which is not actually the populations that we’re worried about,” said Thompson.
Yeager said she worries about transportation issues if there isn’t a birthing option in Montezuma County.
“Over the course of a pregnancy, a woman may have 15 prenatal appointments or more,” Yeager said. “So if there’s a higher risk and if you don’t have a car or you don’t have gas, how many of those appointments are you going to miss? And how much does missing each appointment raise your risk level of complication?”
For now, the birthing center in Cortez remains open.
Yeager said the work to keep the center open is worth it.
“Every baby that’s been born there, every mom that’s received care there, every woman that’s been able to get care there since the date of that potential closure was worth fighting for,” Yeager said.
Editor’s Note: This article was originally published in Keep It Rural, an email newsletter from the Daily Yonder. Like what you see? Join the mailing list for more rural news, thoughts, and analysis in your inbox each week.
Happy 2024, Keep it Rural readers! In just under two weeks, presidential caucuses will begin in Iowa, followed up by New Hampshire, South Carolina, Nevada, and Michigan, promising a whirlwind start to this eventful year in politics.
Voter behavior in these elections will likely be determined by people’s perception of the economy, which polls show is negative despite an economy that is currently stronger than it’s been in years.
A new book finds rural voters in particular are weighed down by economic anxiety that could influence the way they vote. This disparity between economic perception and reality promises to affect the results of the 2024 presidential election.
People tend to measure the economy by looking at the price of consumer goods. New York Times reporting found that people referenced high gas, grocery, and housing prices as indicators of a poor economy. Yet, other indicators show that inflation is down, unemployment rates are low, and consumer spending is up.
So why do things still feel so bad? The current economic outlook is a marked change from one year ago when economists were predicting a recession. But for rural Americans, it could be that economic anxiety and a community’s well being are linked.
While it’s difficult to pinpoint exactly how much rural America has shrunk or grown – and of course, growth differs depending on where you look – rural scholars generally accept that many small towns are still losing population. For the people who reside in them, depopulation is a direct reflection of community health. This connection could weigh more heavily on the psyche of rural residents for whom place-based identity is stronger than for any other demographic, as scholar Kal Munis noted in a Daily Yonder interview.
Rural people feel the struggles of their communities more viscerally because “in small towns and on their outskirts, the poor live among the wealthy,” wrote Daily Yonder reporter Olivia Weeks in a review of the recently published book The Rural Voter: The Politics of Place and the Disuniting of America.
In general, poverty in a small town is more evident because it’s easier to see than in a city, where rich and poor neighborhoods are often closed off from one another. This means that “the precarity of the [rural] neighbor, town, and county are transmuted into individual anxieties, even among those with sturdy financial foundations,” Weeks wrote.
In rural America, the current negative outlook on the economy could be because people can see one another’s struggles plainly.
So what does this mean for the presidential election? According to a Pew Research Center poll, the majority of Americans express low confidence in President Biden’s ability to “make good decisions on economic policy.”
And in rural America, where support for Democrats has plummeted since 2016, another red rural election cycle seems a likely – but not foregone – conclusion. Whether Democrats decide to show up for rural America in the coming 11 months will make all the difference.
Just like that, another year of rural reporting comes to a close here at the Yonder. As is our custom, we’ve gathered the most popular stories of 2023 to share with all of you.
These are the top original stories written and published by our staff and contributors, but it’s worth noting that, just like we offer our stories to other outlets for republication free of charge, we uplift excellent rural reporting from other outlets by republishing it on our own website. This year, a story about what happens when a college town loses its college, first published in the Mile Markers newsletter from Open Campus Media, and a story about the fate of National Parks and the small towns that surround them, from Corner Post, were very popular among readers.
This list of stories is always fascinating to peruse. What resonated? What kinds of stories are folks most hungry for? It’s also interesting to reflect on whether the most popular stories were also the ones we found most important and meaningful?
Rural America, like the rest of the world, is changing. But prevailing narratives might tell you otherwise. Our reporting, backed by new data and research, often complicates these sorts of assumptions.
14. Turmoil in Tennessee
You might remember that in April, the Tennessee House of Representatives voted on the expulsion of three members accused of breaching decorum in their support of debating gun regulations after a school shooting in Nashville that left three children and three adults dead. Democrats Justin Jones of Nashville and Justin Pearson of Memphis, were expelled and then reinstated two days later in a special election. The third representative, Democrat Gloria Johnson of Knoxville, retained her seat by one vote. Jones and Pearson are Black men. Johnson is a white woman.
Whitney Kimball Coe, Tennessean and vice president of national programs at our publishing organization, the Center for Rural Strategies, wrote about being someone who doesn’t fit the stereotype of a rural voter, telling others like her “you are not alone.”
13. An Appalachian Social Media Breakout Star
It’s been a mess of a year for social media (Thoughts on the current state of Twitter, er, X?). But in some instances, rural voices rose above the noise.
12. Rural Broadband
11. Historic Cemeteries
10. Telling Rural Stories With Video
This year, Jared Ewy’s videos appeared frequently among our offerings, giving folks a chance to watch rural news rather than just read it. The piece about ranch dogs who protect livestock from wolves in Colorado captivated the most Yonder fans, but others, like the inspiring story of Carlos Valdez, or the origin of the Mullen guitar, weren’t far behind.
9. Why Are Eggs so Expensive?
According to Axios, the most popular “why are ___ so expensive?” search term in every single state in 2023 was “eggs.” Claire Carlson did what we do best by looking at the topic through a rural lens.
8. Spooky Season
Spooky content has proven to be a perennial favorite among Yonder fans, and this year we delivered. Many people wanted to read about “dark tourism” in Kentucky, and audiophiles got an extra treat: the first series of our Rural Remix podcast focused on the way horror movies have reinforced rural stereotypes.
7. Changes Afoot
6. Rural On-Screen
Rural arts and culture coverage continued strong this year. With these three pieces, about a made-for-TV movie, a rural reality show, and a stand-up comedian rising to the top. For more like this, be sure to check out our newsletter that examines pop culture through a rural lens, “The Good, the Bad, and Elegy.”
5. Flooding in East Kentucky
In the summer of 2022, floods devastated rural communities in Eastern Kentucky. We began reporting on the disaster in its immediate aftermath, but as other outlets turned away, we stuck with the story — producing a film, contributing to radio programming and photography projects, and publishing stories that detailed recovery efforts and remarkable resilience. Explore our full suite of coverage:
4. Rural Churches and Religion
In August, Sarah Melotte wrote about fracturing within the United Methodist Church. Last week, the New York Times took a page out of our book and did the same.
3. Country Music Misses the Mark
Jason Aldean’s song “Try That in a Small Town” created a lot of controversy this year. In a Yonder commentary, Skylar Baker-Jordan examines what Aldean got wrong about rural values. But, as Claire Carlson wrote later in the year, it wasn’t all bad for country music in 2023.
2. Rural Voters
As we head into an election year, rural voters are once again a source of intense speculation. Our coverage of rural voting trends and attitudes was among the most-read content on the Daily Yonder website this year. Polling conducted by our parent organization, the Center for Rural Strategies, contributed to the Yonder’s unmatched analysis.
1. The Keep It Rural Newsletter and Columns
Topping the charts for 2023 was a column by Claire Carlson about the environmental factors contributing to this year’s shortage of the popular hot sauce Sriracha. Not far behind were her pieces on misplaced “rural rage” in the New York Times, and why the Burning Man music festival, held in Nevada’s Black Rock Desert, was such a disaster this year.
These three pieces all come from the Yonder’s Keep It Rural newsletter, which hits inboxes every Tuesday and is published on our website the next day.
Happy New Year
This list doesn’t even scratch the surface on all the hard work we’ve done this year — the news keeps coming, and we roll up our sleeves. It’s rewarding stuff, and we’re grateful to our readers and contributors for making this work possible. Here’s a to a safe, healthy, and happy new year, from all of us to all of you.
Persistent Wildfire Smoke is Eroding Rural America’s Mental Health
This story was produced through a collaboration between the Daily Yonder, which covers rural America, and Climate Central, a nonadvocacy science and news group.
Will and Julie Volpert have led white water rafting trips on Southern Oregon’s Rogue and Klamath rivers for over a decade for their company Indigo Creek Outfitters, out of the small town of Talent, Oregon. The rafting season, which extends from May to September, is a perfect time to be out on the river where snowpack-fed cold water provides respite from the region’s hot summer.
Or it would be perfect if wildfire smoke weren’t a looming concern.
“We’ve been in operation here since 2011, and almost every year there’s some smoke that comes in and is noticeable on our trips,” Will Volpert said in an interview. If people have flexibility, he recommends that they schedule a trip before the third week of July when the likelihood of smoke in the air is lower.
Customers frequently cancel in late July and August because of the smoke, especially for day-trips. Federal data shows air quality tends to be more than four times worse on average in Jackson County, Oregon, during this period than earlier in the summer.
“We’ve gotten very used to saying, ‘Hey, it’s very likely going to be smoky on your trip. It might not be, but it could be.’” Volpert said. But as long as they’re not putting their participants at risk, Volpert said, they won’t cancel a rafting trip because of wildfire smoke.
Will Volpert stands in a building that houses equipment for his rafting company, Indigo Creek Outfitters. (Photo by Jan Pytalski/Daily Yonder)
Will Volpert poses with one of the rafts used on river trips for his company, Indigo Creek Outfitters. (Photo by Jan Pytalski/Daily Yonder)
Running a business affected by wildfire smoke has become normal for the Volperts, but it hasn’t come without its personal toll.
“I used to get very stressed out and paralyzed with the idea of losing our summer, which for us is, as the owners of this small business, our livelihood,” Volpert said.
While Volpert says he’s learned to manage that anxiety, wildfire smoke is a frequent source of stress for many people living in rural communities. The smoke harms farms and recreation-based businesses, can be psychologically triggering for wildfire survivors, frequently drives residents indoors, and recent research showed it’s associated with increases in rural suicides.
Wildfire smoke has become a pervasive form of air pollution released from intensifying fires due to the warming effects of heat-trapping pollution and a litany of other environmental changes.
Southwestern Oregon experienced unhealthy air from wildfire smoke nearly 13 days each year on average from 2013 through the end of 2022 — up from one to two days on average from 1985 through 2012, according to a report by Oregon’s Department of Environmental Quality that used data from the town of Medford, about 10 miles northwest of Talent where Indigo Creek Outfitters is based.
Smoke pollution exacerbates asthma, worsens infections and contributes to a variety of other physical maladies. Tiny smoke particles move from lungs into bloodstreams and can directly affect brain health, with research out of the University of Montana connecting smoke exposure to the development of dementia.
Its noxious effects on mental health, particularly on rural communities, tend to receive less discussion.
Hidden Dangers in Rural Valleys
Southern Oregon’s Rogue Valley is at the heart of a region synonymous with white water rafting, rock climbing, and other outdoor activities in the Klamath Mountains and Cascade Range. Vineyards and pear orchards dot the valley, and in the mid-size town of Ashland at the valley’s south end, the annual Oregon Shakespeare Festival boasts international recognition.
Wildfire smoke fills the air at an olive orchard on the North Umpqua River in Glide, Oregon, in September of 2020. (Photo by Jan Pytalski/The Daily Yonder)
All these activities hinge on good summer weather, and during the past decade, they’ve been disrupted by wildfire smoke, directly affecting wages, profits and reducing overall quality of life.
“In rural areas there’s likely more people whose livelihoods are based on the land and working outside,” said Colleen Reid, a health geographer and environmental epidemiologist at the University of Colorado in Boulder who studies the health effects of wildfire smoke.
In the valley, wildfire smoke settles more easily and often sticks around longer than it does in the surrounding mountains and plains. Atmospheric conditions often arise in valleys that keep smoke close to the ground, where its effect is the strongest. This can trigger more than physical ailments like asthma.
“We’re increasingly seeing mental health impacts,” Reid said. While early research focused on the effects of flames from wildfires, she said “there are some more recent studies where even individuals who were just affected by the smoke could have mental health impacts.”
By trapping people inside homes and forcing the cancellation of outdoor social events like youth sports, smoke can contribute to loneliness, domestic quibbling and despair.
A study published last fall in the science journal Proceedings of the National Academy of Sciences linked smoke exposure with increases in suicides among rural populations, though not among urban ones.
“In rural areas, we find that smoke days are significantly associated with increases in suicide rates,” said David Molitor, a health economist at the University of Illinois at Urbana-Champaign who led the research, which drew on 13 years of smoke and federal suicide data to track mental health effects.
Because deaths from suicide are tracked by the federal government, they can be a useful measurement reflecting mental health, which is otherwise difficult to research and track. And that federal data shows that rural Americans are about a third more likely to die from suicide than those living in cities or suburbs.
“I think what’s different with rural people is they have access to guns, and they’re much more effective at succeeding in their efforts,” said Joseph Schroeder, a disaster response veteran and former mental health extension specialist at the University of Kentucky with experience working at and running crisis hotlines for farmers and other rural residents.
Suicide ideation often arises from desperate needs for financial aid and other help, more so than poor mental health. This puts residents of rural communities that have been hollowed out following closures of timber, manufacturing and other employment-rich industries at greater risk.
“From my experience, the despair that has become suicidal ideation, or a suicidal threat, they’ve all come from conversations I’ve had with people who are calling me to get out of a situational problem — mostly financial,” Schroeder said. “It’s a poverty problem and it’s an isolation problem. And that looks differently in rural communities than it does in urban communities.”
The Almeda Fire
Come smoke or shine, Indigo Creek Outfitters – Volpert’s white water rafting company in Talent – always operates.
But on the morning of September 8, 2020, Volpert knew something was different about the wind whipping through the trees around his house outside of Phoenix, just three miles from Talent. The weather was so unusual he canceled the Upper Klamath rafting trip planned for that day.
“That is literally the only time that I can remember ever pulling the plug on one of our trips,” Volpert said. A few hours after making that decision, Talent and Phoenix were engulfed in flames.
The wildfire, known as the Almeda Fire, was the most destructive in Oregon history: About 3,000 buildings burned, most of them homes. Three people and many more animals died.
A concrete building that survived the Almeda Fire in Talent, Oregon, undergoes reconstruction on November 29, 2023. (Photo by Claire Carlson/The Daily Yonder)
A cement chimney is all that remains of a building that was burned in Talent, Oregon during the Almeda Fire. (Photo by Claire Carlson/The Daily Yonder)
Analysis of weather station data shows the Almeda Fire broke out during a bout of fire weather — when conditions are persistently dry, warm and windy. The area was in extreme drought at the time, setting up conditions conducive for an extreme wildfire once winds strengthened. It took more than a week for firefighters to extinguish the flames completely.
After surviving a wildfire that completely changed the lives of so many in the Rogue Valley, there’s an added layer of grief that comes with the smoke season.
“For me, [smoke] causes a lot of anxiety,” said Jocksana Corona. The mobile home in Talent where she lived with her husband and two children burned down during the Almeda Fire. The family relocated to a suburban neighborhood in nearby Central Point, but haven’t been able to rebuild the kinds of strong community ties they had enjoyed in Talent.
“My kids grew up in the Latino community [in Talent] where there were always kids on their bikes, people on the streets walking their dogs,” Corona said. “In our new community and our new neighborhood, we don’t have that. It’s like we don’t know anybody.”
Even though Corona and her family were able to buy a house after losing their mobile home, she said three years later they’re still not fully recovered.
“We’re listed [by the state of Oregon] as a recovered family because we purchased the house and relocated,” Corona said. “But for me, for my own mental health and for my kids’ mental health, I wouldn’t say we’re recovered. I’m still experiencing triggers from the fire.”
Corona said she is bothered by the smoke in the air much more after her experience with the Almeda Fire, especially around its September anniversary.
A swing set at the Gateway Project in Talent, Oregon. The project provided more than 50 transitional housing trailers for people who lost their homes in the Almeda Fire. More than three yearsafter the fire, people are still living in the trailers. (Photo by Claire Carlson/Daily Yonder)
Smoke is a constant reminder for wildfire survivors of their own harrowing experiences, and the potential for it to happen again.
“That grieving and that mourning is re-triggered by smoke season because it’s evident in the very air we breathe that their experience is not only real, but it hasn’t ended,” said Tucker Teutsch, executive director of Firebrand Resiliency Collective, a nonprofit created to support the area’s recovery from the Almeda Fire.
The nonprofit runs a peer support group that provides a safe grief space for Almeda Fire survivors to share recovery resources and talk through problems they’re having in the fire’s aftermath. The group has met weekly since the 2020 fire.
When Clean Air Is Impossible to Find
In the Methow Valley, a rural region in north-central Washington state, a coalition of community members has been supporting each other during smoke seasons since the 2013 Carlton Complex Fire, which destroyed 500 buildings.
The community coalition, called Clean Air Methow, spreads awareness about air quality safety. It also supports people struggling with the mental health toll of living with smoke.
“With this mental health and wellness piece, what we often don’t explicitly acknowledge is the threat of what the oppressive, opaque, physical heaviness of being under this white smoke for a prolonged period of time is like,” said Elizabeth Walker, director of Clean Air Methow.
“People kind of just say, ‘oh, it’s so bad, so smoky, I hate it,’” Walker said. “But when we ask people to actually give the words of their experience, they use ‘oppressive, heavy.’ They feel depressed.”
The number one clean air recommendation is for people to stay indoors, but this can contribute to feelings of social isolation when it’s smoky, according to Walker. Indoor air isn’t always cleaner than outdoor air, either. Older homes without modern windows, doors, ventilation and air conditioners can let in lots of smoke particles.
“Make sure you’re indoors, but also make sure you’re indoors with a HEPA filter or an air filtration system,” said Erin Landguth, a University of Montana at Missoula scientist who researches the health effects of wildfire smoke exposure. Because buying and maintaining such systems are expensive, a “key difference” from cities is that rural residents may be less able to afford them.
Clean Air Methow has been advocating for “cleaner air shelters” in the Methow Valley to provide public spaces with better indoor air quality for community members to visit when it’s smoky out. They’ve also provided air purifiers to people living in homes that let lots of smoke in.
Poor indoor air quality affects countless rural communities.
At Southern Oregon University in Ashland, access to clean indoor air during smoke season is hard to come by. The college’s older buildings don’t have updated indoor ventilation, causing workers and students there to be exposed to toxic smoke particles.
Willie Long stands in front of a climbing wall at a Southern Oregon University climbing gym. (Photo by Jan Pytalski/The Daily Yonder)
“I’m lucky enough that the building I work in was built in, I think 2016 or something like that, and it has a great HVAC system,” said Willie Long, assistant director at the outdoor program and climbing center at Southern Oregon University. “I generally have pretty good air quality when I get to go to work, but it’s not like that for most people who work at SOU.”
And when it’s smoky, colleges stay open. Southern Oregon University issued a policy in 2019 that states it will postpone all non-emergency strenuous activity, review filtration, and HVAC systems, and “encourage the use of N95 filtration masks or equivalent for personnel outdoors” when air quality exceeds the rate deemed by the U.S. Environmental Protection Agency as hazardous for everyone.
Trauma and Anxiety
Heidi Honegger Rogers spent 25 years working as a family nurse practitioner before shifting her focus as an academic at the University of New Mexico researching the health impacts of weather disasters and environmental change. She’s an active member with the Alliance of Nurses for Healthy Environments. “Wildfire is a really intense and often traumatizing experience,” she said.
Though not everybody gets a diagnosis, Rogers said research shows that between a quarter and 60% of those directly affected by a wildfire will experience post-traumatic stress disorder (PTSD). About one in 10 people could still be affected a decade later, she said.
“Even after a trauma has dissipated and there’s no immediate emergency, the people stay in this agitated, super-alert state, which is characterized by anxiety,” Rogers said.
Smelling wildfire smoke or seeing another community burn can be triggering for those with PTSD, according to Rogers.
Smoke has become a trigger for Jocksana Corona, the former Talent resident who lost her mobile home in the Almeda Fire. She sought counseling after the fire to deal with her anxiety, in part because she didn’t want it interfering with her own work as a drug and alcohol counselor.
“I knew my physical and emotional reactions to the smoke could interfere with my ability to help my own clients with their own struggles,” Corona said.
She went to a mental health counselor for six months who helped her process her anxiety. Corona encouraged her two children to seek counseling as well, but for her daughter, the experience wasn’t helpful. Most of the mental healthcare providers in the Rogue Valley are white and only speak English, which can be a barrier for non-white or non-English speaking patients.
“I think that when it comes to mental health counseling for Latinos, it’s definitely lacking no matter whether you’re in Central Point or Medford, which are bigger towns,” Corona said.
When Corona worked as a drug and alcohol counselor, she said she was one of just a handful of bilingual counselors in Jackson County – which includes Talent and Phoenix – and neighboring Josephine County. She had clients come from Roseburg, 100 miles away, seeking her bilingual services.
Trauma manifests itself differently in every person through experiences like sleep loss, chronic worry, and grief, Rogers said. “People can do okay for a little bit and then they can be triggered by something that goes into their brain and reminds them of this scary experience that they had.”
Stress, anxiety, and sleeplessness can manifest in declining physical health. “It degrades our immune response. We end up with more inflammation. We end up with more pain. We end up with more cardiovascular problems, high blood pressure,” Rogers said.
And for those not directly affected by wildfires, seeing infernos on the news and smelling smoke hundreds of miles away can serve as reminders that the climate is changing. Rogers said that can lead to senses of hopelessness and anger that corporations continue to pollute the atmosphere despite decades of warnings and mounting impacts.
One of the consequences of atmospheric pollution has been stark increases in the number of days each year when fire weather occurs across the U.S. and the world. Fire weather is marked by windy, hot, and dry conditions.
The region torched by the Almeda Fire sees three to six more days on average every year during the past decade when fire weather conditions are present, compared with four decades prior, analysis shows.
“We can have anxiety and fear and worry about any of those injustices that we’re seeing, or any of those losses that we’re seeing,” Rogers said.
Walker, the clean air educator with Clean Air Methow, said it can be helpful to remember that “smoke season doesn’t last forever” during smoky days.
“I think that living with wildfire smoke can become this really lovely reinforcement of mindfulness,” Walker said. “This is what it is right now, whether it’s good or bad, it’s going to change.”
