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.  

The post Trump Underperforms Slightly with Rural N.H. Voters  appeared first on The Daily Yonder.

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!”

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.

Over 50% of Montezuma County’s hospital births in 2022 were covered by Medicaid.

Southwest Health System is a 501(c)(3) nonprofit corporation and is managed by Community Hospital Consulting, which is owned by Community Hospital Corporation, based in Plano, Texas. CHC assumed management in 2018 when the hospital nearly went bankrupt. The CHC website describes SW Health System as a “turnaround story.”

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.

The post Activists Win a Battle for Women’s Reproductive Healthcare in a Rural Colorado Town appeared first on The Daily Yonder.

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.

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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.

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The post It Is, Once Again, an Election Year. appeared first on The Daily Yonder.

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?

Additionally, we’re an entrepreneurial bunch, and this list only covers the stories we published, not the podcast we launched in partnership with the Rural Assembly (go subscribe to Rural Remix!) or our new foray into TikTok.

It’s been quite a year.

15. Demographic Shifts in Rural America

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.

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The post The Year in Review — Our Top Stories of 2023 appeared first on The Daily Yonder.

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This story was produced through a collaboration between the Daily Yonder, which covers rural America, and Climate Central, a nonadvocacy science and news group.

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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.

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.

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.

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.

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.

“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.”

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The National Suicide Prevention Lifeline can be reached by dialing 988 and the Crisis Text Line can be reached by texting HOME to 741741.

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Rural America added more than 200,000 jobs over the past year but is still below pre-pandemic employment levels, according to a Daily Yonder analysis.

The failure to reach full recovery three and a half years after the start of the pandemic is related to larger trends, including an aging population, lack of childcare, and lower levels of formal education, according to an economist.

Rural employment grew to 20.4 million in September 2023, the latest month for which county-level jobs data is available from the Bureau of Labor Statistics. That’s an increase of one percent from last year. But rural America still has 64,000 fewer jobs this year than it did the same time in 2019, before the pandemic.

Meanwhile, metropolitan counties have gained back more jobs than they lost during the pandemic.

“Rural areas took a hit,” said Elizabeth Davis, Ph.D., professor of economics at the University of Minnesota.

Rural counties haven’t fully recovered from the 2008 financial crisis, much less the drop in employment brought on by the pandemic, Davis said.

Every month, the BLS releases data on the number of employed and unemployed people for every county for the preceding 14 months. To take a look at longer employment trends, I compared each month between January of 2020 and September of 2023 to the same month in 2019. The result gives a percentage change in employment from the last full year of pre-pandemic employment. Comparing the same months each year removes seasonal variations that affect employment.

Take this graph, for example. The start date is January of 2020, which I compared to the employment numbers of January of 2019. February of 2020 then shows the change since February of 2019, and so on. By September of 2023, employment in urban areas grew by 2%, while rural areas decreased by 0.31%, compared to pre-pandemic employment.

Urban Counties Recovered Faster than Rural Ones, but the Gap Is Closing

At the start of the pandemic in early 2020, rural counties initially didn't suffer as much job loss as urban counties. Employment dropped 13% in April 2020 compared to 2019, while urban counties had a 15% decrease for the same period.

(We’re using the Office of Management and Budget (OMB) guidelines to categorize counties as either metropolitan or nonmetropolitan. The OMB metropolitan definition is based on the size of a city in the county and/or the commuting patterns of county residents. Counties not categorized as metropolitan are nonmetropolitan. We are using this nonmetropolitan category as a proxy for rural.)

By May, employment nationwide began to recover. Rural counties were actually ahead of urban ones in employment recovery for the first year of the pandemic. (See the red line [rural/nonmetropolitan] in the graph below, which is above the blue line [urban/metropolitan] until about June 2021.) After that, urban gains eclipsed rural gains in employment. The graph below shows how that gap widened noticeably in January 2022.

This graph shows a gap in recovery rates of rural and urban counties. Where the red line is below zero, rural areas were doing better than urban ones. When the red line is above zero, urban areas are doing better. During the second year of the pandemic, urban job recovery outpaced rural recovery by larger margins.

As of September of 2023 (the most recent data available), urban employment recovery was 2.5 percentage points higher than rural recovery.

Only 43% of rural counties have returned to pre-pandemic or better employment numbers, while about two-thirds of urban counties have. If we break that analysis into different sizes of urban/metropolitan counties, we find that the suburbs of major and medium-sized metro areas did the best. Small metros (under 250,000 residents) were the worst-performing metropolitan counties. And rural/nonmetropolitan places were the least likely to have fully recovered.

Rural counties made up 95 of the top 100 counties with the most employment loss. Six percent (122) of rural counties have 10% fewer jobs now than they did in 2019, compared to only 0.7% of urban counties.

But the good news is that the rural/urban gap has been narrowing over the past few months. Five out of the nine months in 2023 saw a decrease in the disparity between rural and urban counties. The gap was 3 points in January, compared to 2.5 points in September of this year.

Possible Factors: Lack of Childcare, Lower Levels of Formal Education, Older Populations

Davis, the University of Minnesota of economist, said it can be hard to generalize about rural employment because rural areas are so different from each other. But there are a few demographic factors she said might be at play in employment recovery.

“We hear a lot of employers concerned about the lack of childcare because they can’t find workers,” Davis said. “They hear from their workers and their families that they can’t find childcare so they can’t work, or can’t work full time.”

Davis said it’s challenging to sustain childcare centers in rural areas because the market is smaller. There may not be enough families with young children who can afford to pay for childcare to sustain such businesses. Lower wages and higher costs of transportation in rural areas can also affect household decisions about childcare.

A greater share of the rural population is also moving into retirement, which reduces the number of employed people.

“The aging of the workforce is happening faster in rural areas than urban areas,” Davis said.

The median age of the rural population is 43, compared to 36 for the urban population, according to the Census.

Not only are employers having trouble finding employees of working age who can afford childcare, but lower levels of formal education in rural America can also shrink the pool of potentially employable people.

Although education levels are on the rise in small towns and rural places, they still haven’t caught up with urban levels. Twenty-one percent of rural residents over the age of 25 have a bachelor’s degree, up from 15% in 2000. The share of the urban population with a bachelor’s degree increased from 26% to 36% during the same time period, which widened the gap between rural and urban education levels.

The post Rural Jobs Grew a Percentage Point in September, but the Longer-Term Trend Is Still a Problem appeared first on The Daily Yonder.

Broadband access continues to be a hot topic for Daily Yonder readers, as state broadband offices work to get access to the first chunk of the $42.5 billion that will be doled out over the next 5+ years as part of the Infrastructure Act’s Broadband Equity Access and Deployment (BEAD) program.

Rural advocates have high hopes for the BEAD program.  While it primarily focuses on providing infrastructure to places that are “unserved” (no providers that offer speeds of at least 25 Mbps download / 3 Mbps upload) and “underserved” (no providers that offer speeds of at least 100 Mbps download / 20 Mbps upload), there is also a requirement for states to describe how their plan to award funds will address broadband affordability.

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Dig Deeper

• How is your state progressing with its BEAD proposal? See the federal government’s BEAD Proposal Dashboard.
• Read your state’s proposal via the National Telecommunications and Information Administration public notice postings.

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Both are important topics for rural residents.  The most recent data we have show dramatic rural – urban gaps in both broadband access (simple availability) and adoption (percent of households signing up for broadband).  It’s widely recognized that affordability plays a large role in why households remain offline. But because there is no federally collected data on broadband price that includes both rural and urban areas, very few studies have been able to quantify the price differences across these geographies.

Thankfully, BroadbandNow (an independent broadband availability website) went through the painstaking process of gathering pricing data from over 4,000 terrestrial broadband providers in late 2020 and compiled them into a Zipcode-level database that is publicly available.  Their pricing data is for the lowest-priced terrestrial (wired or fixed wireless) residential standalone internet package for 25 / 3 service and contains entries for over 26,000 Zip codes in the continental U.S.

The BroadbandNow dataset also includes the number of wired providers at different speed thresholds (25/3 and 100/3) as well as the number of fixed wireless providers.  This is all taken from the slightly outdated June 2019 FCC Form 477 dataset, but it still represents a reasonably accurate portrait of the availability situation when the pricing data was collected.  When this data is combined with a Zipcode-level measure of rurality, it allows for examination of how broadband price varies by both rurality and number of providers.

The data show that in late 2020, the average monthly cost of a 25/3 broadband connection was nearly $13 higher in rural Zip codes.  In many ways, this is expected.  After all, rural areas tend to have dramatically fewer options for connecting – and there is a good argument that this “competition gap” is driving higher prices.  But the BroadbandNow data also allows us to break out urban vs. rural prices based on the number of providers available in a Zip code.

This breakout shows us a few different things.  First, the “competition gap” is real – for both urban and rural locations.  Urban Zip codes with just a single provider are paying nearly $25 more per month (!) than those with two or more providers, and this gap is nearly $10 for rural Zips.  Second, rural and urban monthly prices are about the same in Zip codes with either 0 or 1 high-speed provider (only a few urban Zips have 0 high-speed providers).  But, in Zip codes with multiple high-speed providers, a significant rural-urban gap of more than $10 exists.  Some of this is because “2 or more providers” typically means a higher number in urban (4) than in rural (2) Zips.  Some of it is also likely because infrastructure is more costly to provide in less densely-populated areas – and rural providers may need to charge higher prices to recover that investment.

This leads us to the BEAD funding’s affordability requirements. States are generally going to be spending this money in locations without another viable high-speed option, which by itself should decrease consumer costs in those locations (i.e. help them move from $88.44 to $64.90 in the above figure). Beyond this, all BEAD funding recipients are required to “offer at least one low-cost broadband service option for eligible subscribers.” Many states are interpreting this as offering an option for $30 per month or less, so that it would be fully covered by the Affordable Connectivity Program monthly subsidy. Notably, most Zip codes with 2+ high-speed providers will not be getting BEAD funds, so we shouldn’t expect many $30 or less options to pop up in these locations.

Beyond the low-cost option, the BEAD program requires each state to develop a “middle-class affordability plan.”  Preliminary plans from Louisiana and Virginia suggest that these states will include a component for affordability when they score each grant applicant prior to distributing their funds. Louisiana, in particular, will award applicants additional points if they commit to specific rates at a variety of broadband speeds.

Others have asked for additional guidance about the middle-class affordability plans, and at least one analysis has suggested that broadband is already affordable for middle-class households.  It seems likely that this requirement will be implemented differently across states – and will be worth following as the BEAD plans progress.

(Note that you can follow your state’s progress on the BEAD proposals here.  The plans are required to obtain public comments, and direct links to these plans are here.)

Brian Whitacre, Ph.D., is professor and Neustadt Chair in the department of Agricultural Economics at Oklahoma State University and is an extension specialist for rural economic development. Read more of the research Brian has published in the Daily Yonder.

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An unlikely collaboration between a Kentucky coalfield county and Kentucky’s largest city began when a former high school English teacher, Megan Downey, walked into the Lawrence County courthouse in Louisa in August.

Inspired by a personal desire to find ways to tackle the impacts of climate change, Downey had launched a nonprofit called The Solar Collaborative last year in Virginia dedicated to helping Appalachian communities transition to renewable energy.

She had been pitching an idea to local governments across Eastern Kentucky: Seek some of the billions in federal funding up for grabs in the Solar for All competition. Through the competition, the U.S. Environmental Protection Agency plans to invest $7 billion through 60 grants to states, local governments, nonprofits and tribal governments to “increase access to affordable, resilient, and clean solar energy for millions of low-income households.” The money comes from the Inflation Reduction Act’s Greenhouse Gas Reduction Fund.

When Downey talked with Deputy Judge-Executive Vince Doty about the opportunity, he agreed “within minutes” to sign up.

“He’s the biggest advocate, I think, in the whole region for this type of project,” Downey said. “A lot of low-income communities don’t have access to that economic savings that’s associated with solar, and so it’s just one more way in which a wealth gap is continuing to increase.”

Doty brought other Eastern Kentucky counties on board for an application to the competition; judge-executives in Lawrence, Johnson, Martin, Floyd, Pike, Boyd, Greenup counties all wrote letters of support. After learning they had both submitted letters of intent to apply for the federal funding, the mountain counties teamed up with Louisville’s government to submit a unified application that could provide affordable access to solar energy for thousands of low-income homes in Kentucky from its largest cities to its rural Appalachian counties.

It’s one of two competing applications from Kentucky. The other was submitted by the Kentucky Energy and Environment Cabinet; solar advocates say it could be a significant boost  for the use of residential solar across the state.

Advocates argue more distributed solar, for example via solar panels on rooftops, could mean utility bill savings for Kentuckians and a curbing of greenhouse gas emissions connected to Kentucky’s fossil fuel-reliant electricity grid.

For Doty, seeking funding for solar was foremost about easing the financial burden of his constituents in a region that faces continued economic challenges from the decline of the coal industry. Lawrence County is one of 20 Eastern Kentucky counties served by electric utility Kentucky Power, which has the highest monthly residential utility bills in Kentucky, according to a state analysis.

“We always try to put our citizens first,” Doty said. “If there’s a chance that we can save somebody $300 a month off their electric bill, that’s worth trying for.”

Solar low-income households, ‘resilience hubs’ and job training

Both the Louisville-Eastern Kentucky and state government proposals are wide in scope, highlighting specific ideas for how to use tens of millions of dollars in federal funding. Both applications could mean integrating solar energy into thousands of homes, whether through direct ownership of rooftop solar installations or better access to existing or planned community solar projects.

The Louisville-Eastern Kentucky application is asking for $150 million to be spent over five years, proposing:

• A zero to low-cost forgivable loan program geared toward having low-income households own small solar installations or receive energy efficiency upgrades. For example, homeowners applying to the loan program who are below 80% of the area median income could have an entire loan forgiven for a six-kilowatt solar installation; half of the loan could be forgiven for property owners renting to Kentuckians below 80% of the area median income.
• Turn community centers in areas prone to natural disasters into “resilience hubs” equipped with solar power and electric battery storage for times of power outages.
• Build a workforce to deploy residential solar by creating training programs, building on already existing programs in Kentucky’s community and technical college system.

Downey said Doty had advocated in a number of meetings as the Louisville-Eastern Kentucky application was being developed that it was a “non-negotiable” that Kentuckians should own the solar installations themselves

The application anticipates, if awarded funding, at least a 20% energy bill reduction for approximately 7,300 households in Kentucky taking part in the proposal. Households that ultimately receive a six-kilowatt solar installation for free could see energy bill reductions up to 50%, according to the application.

“If you put solar on your home, you immediately have benefits economically from the savings that you garner. It also increases the value of your home,” Downey said. “So this has the potential for a really significant impact if you look at it over 25 years as far as wealth generation goes.”

The Louisville-Eastern Kentucky application estimates the results of the funding would add another approximate 44 megawatts of distributed solar power onto Kentucky’s grid. That would increase distributed solar in the state by about 70%, with 63.5 megawatts of distributed solar already in Kentucky.

The application also estimates about 1,300 “green jobs” will be created through the proposed solar investment. Steve Ricketts, the board chair of the advocacy group Kentucky Solar Energy Society, said while construction work associated with larger, utility-scale solar projects is temporary, ending once the project is completed, those workers also can work on installing solar in their own communities.

“They can be working on homes in their own town, they can be working on businesses and around town. So the two are incredibly complementary, and, frankly, have to go together to make it all work,” Ricketts said.

Sumedha Rao, the executive director of Louisville Metro Government’s Office of Sustainability, said the estimates of solar power added, households helped and renewable energy jobs created through the funding proposal are somewhat conservative and that the impact of the grant could be even more.

Given that Kentucky has historically relied on fossil fuels, she said, a transition to renewables can be a “scary proposition” for some Kentuckians. But she believes the Solar for All grant competition has a lot of upside with helping the state transition economically.

“We really feel like this is something that can have a massive impact for years to come,” Rao said.

Solar installations for rebuilt homes, ‘solarize’ campaigns and community solar

The Solar for All application submitted by state officials leads with its own idea of how residential solar can be deployed across the state, particularly in areas hit by devastating floods and tornadoes in recent years.

Requesting $100 million from the Solar for All competition, one of the state’s proposals is to put residential solar and an electricity battery storage system on 850 “disaster recovery” homes that could result in 70% utility bill savings for each home — or up to $1,000 in annual bill savings per home — over the course of 20 years.

For Kenya Stump, the executive director of the state’s Office of Energy Policy, eliminating most of the energy bills is just one way to help people recovering from natural disasters who may have lost every material thing they own.

“If they can live in a home from here on out that is more resilient, that also has the burden of that kind of cost is no longer there — shouldn’t we kind of strive for that?” Stump said.

• The application also proposes to help increase solar access for low-income Kentuckians, support housing nonprofits in creating energy-efficient housing, develop residential solar in cities and boost the state’s solar deployment workforce in several ways: Create subsidies and carve-outs to help Kentuckians participating in the Low-Income Home Energy Assistance Program, or LIHEAP, take part in existing and planned “community solar” projects to cut residential utility bills by about 20%.
• Add solar power and electricity battery storage onto about 1,500 homes that already have energy efficiency upgrades, such as households that have participated in Weatherization Assistance Program.
• Develop “Solarize” campaigns to promote residential solar in Kentucky cities including Paducah, Owensboro, Henderson, Bowling Green, Lexington and Ashland.
• Create 1,500 “work-ready” scholarships and provide funding to community and technical colleges funding to create solar deployment training programs.

Stump said in many instances low-income Kentuckians live in homes that are old and energy inefficient, leading to higher energy usage and subsequently higher utility bills. She said by enrolling LIHEAP recipients in community solar programs — such as ones offered by East Kentucky Power Cooperative and Louisville Gas and Electric and Kentucky Utilities (LG&E and KU) — they can get a direct credit on their bill and get more value from the utilized renewable energy.

“The energy regardless of the source will just still leak out” of poorly insulated, inefficient homes, Stump said. “We also hope that this will incentivize the growth of more municipal and utility community solar offerings that would be eligible to have LIHEAP carve-outs as well.”

Some stakeholders involved in the Louisville-Eastern Kentucky application, while supportive of community solar projects in general, were skeptical of using Solar for All funds on such projects out of concerns that some community solar models, specifically LG&E and KU’s “Solar Share” program, subsidize an asset of an investor-owned utility with taxpayer funds.

Stump said while stakeholders may wish some existing community solar projects were designed differently, it’s what is currently offered by Kentucky utilities and “can provide some benefit” to low-income Kentuckians that haven’t been able to take advantage.

The two Kentucky applications submitted to Solar for All do align on ways to boost the workforce needed to install residential solar on homes, though Stump added that developing a renewable energy workforce needs to be paced with the deployment of solar.

“That’s our greatest challenge is to make sure we get the timing right so that it aligns with the deployment of projects. We don’t want to give someone hope, and then there not be any work,” Stump said.

For Stump, the Solar for All competition is just one federal program and incentive among many that will ultimately “shift and transform our energy landscape.”

No guarantee both applications will be awarded

Lane Boldman, the executive director of the environmental advocacy group Kentucky Conservation Coalition, believes both applications are “really solid” but points out the federal government is only giving out 60 grants. Competition for the grants is stiff: More than 30 states have submitted notices that they’re applying along with a number of local governments and nonprofits across the country.

Lawrence County and Louisville decided to collaborate, in part, to increase the chances that their Solar for All application would get awarded. The stakeholders with Lawrence County and Louisville also tried unsuccessfully to unify their application with the state’s proposal.

Boldman said a big question became if a single grant application could ask for enough funding to cover all of the “great ideas” being proposed for the competition.

“The decision really was that it was better to keep them as two separate applications,” Boldman said. “I have to say that I think both grants are very strong and deserving, and so we just have to wait and see what the federal government decides.”

‘Massive’ federal solar investment could mean big utility savings in Kentucky coal country is an article from Energy News Network, a nonprofit news service covering the clean energy transition. If you would like to support us please make a donation.

Kansas Governor Laura Kelly dedicated this year’s fall to traveling around her state and talking with constituents and community leaders about expanding Medicaid.

In a state where 60 rural hospitals are at risk of closing, forcing the legislature to expand Medicaid would be a lifeline, she said in an interview with The Daily Yonder. Her new campaign, “Healthy Workers, Healthy Economy” aims to help residents understand what Medicaid expansion could mean for rural hospitals, rural residents, and the state’s economy.

“There’s no doubt that Medicaid expansion is not enough to rescue rural hospitals,” she said. “But without Medicaid expansion, there is no doubt that rural hospitals will close.”

In 2013, the Affordable Care Act expanded Medicaid coverage to most adults with incomes up to 138% of the Federal Poverty Level, or about $41,400 a year for a family of four. To date, nine states – Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, South Carolina, and Wyoming – have not expanded Medicaid.

North Carolina’s Governor Roy Cooper signed legislation into law that directed the state to expand Medicaid, but the implementation of that expansion has been stalled awaiting legislative action.

Kelly said since 2013, Kansas has seen eight of its rural hospitals close. The latest, Herington Hospital in Herington, Kansas, closed on October 9 after 104 years. The hospital said the decision stemmed from lengthy financial struggles and low patient volumes.

More could follow. According to a study released in July by the Center for Healthcare Quality and Payment Reform (CHQPR), more than half of Kansas’ rural hospitals, 60 out of 104 (58%), are at risk of closure. The report found that the states with the most rural hospitals at risk of closing are Kansas, Texas, Tennessee, Mississippi, Georgia, and Alabama – all of which have failed to expand Medicaid.

Study after study has shown that health outcomes for rural residents in states that did not expand Medicaid are worse than outcomes for their counterparts in states that did expand Medicaid. In 2020, a look by Kaiser Family Foundation at more than 400 studies done since 2013 found that states that did expand Medicaid saw improvements in healthcare access, financial security, and health outcomes among other things.

Kelly said Kansas only needs to look to its neighbors to see the benefits.

“We can only judge the impact of not expanding Medicaid by looking at the states around us that have,” she said. “It’s clear that Kansas has sicker populations and populations with more mental health issues.”

Brian Barta, CEO of William Newton Hospital in Winfield, Kansas, (population 11,726 in 2021), said failure to expand Medicaid impacts more than just rural residents. His hospital saw revenues decline after the pandemic. According to reports, the hospital had $41.5 million in total patient revenue in 2022, with $49.3 million in total operating expenses. Even with $3.5 million in grants and other revenue, the hospital still ended 2022 being $4.3 million in the red.

“It is estimated that Medicaid expansion will help over 150,000 Kansans and continued failure by the state legislature to support Medicaid expansion undermines the physical, emotional, and economic health for all of Kansas,” Barta said during a September press event announcing Kelly’s “Healthy Workers, Healthy Economy” campaign.

The closure of a rural hospital impacts more than just rural residents though, Kelly said. Closed rural hospitals mean communities lose much-needed jobs and tax revenue.

“When a rural hospital closes, it impacts not just the physical health of our communities, but it also impacts the economic health of our communities,” she said.

Kelly said expanding Medicaid is her number one priority for the 2024 legislative session. While some other governors have taken action through executive order, Kelly said her hands are tied. Under the previous administration, legislation was passed that required any Medicaid expansion could only be done by the legislature. So far, she’s tried five times to get that kind of legislation passed.

And while it’s not the first time she’s fought this fight, this time, she said, she’s taking it to the voters.

“Expanding Medicaid and ensuring that every Kansan has access to affordable, high-quality health care is the smartest, sanest way to keep our state moving forward,” Kelly said. “I encourage every Kansan to call their legislator and tell them to demand that legislative leadership give them a chance to vote for Medicaid expansion.”

She said she recognizes that her efforts may not influence legislators and that constituents may not either. But with every legislative seat up for re-election in 2024, if she can’t move legislators, she hopes her efforts will at least influence the outcome of the election, she said.

The post Expanding Medicaid to Help Rural Hospitals a Priority for Kansas Governor appeared first on The Daily Yonder.

Authors of a new study on social mobility found rural children born in poverty gain higher incomes as adults compared to low-income urban children. But on some measures of income attainment, girls born in low-income households don’t benefit from the same rural advantage as boys.

Factors like community trust, social capital, and the rate of two-parent households help explain more upward social mobility, or positive change in one’s economic status, among rural children born into poverty, according to a 2023 study.

“Rural places actually seem to be faring quite well relative to their counterparts in cities and larger towns,” said professor Dylan Connor, Ph.D., in a phone interview with the Daily Yonder. “People have kind of noticed this rural advantage, but haven’t really been able to explain it.”

Connor is an associate professor in the School of Geographical Sciences and Urban Planning at Arizona State University and one of four authors on the social mobility study. He said the research emerged out of a need to examine why social mobility in the United States is looking increasingly worse for children born into poverty.

“The U.S. has this long history of being kind of a land of opportunity,” Connor said. “But when we look at comparisons today between the U.S. and other countries, we’re now not faring as well as we used to be.”

In response to this trend, Connor and other researchers think it’s important to look at places that are still delivering opportunity and to try to determine what characteristics of those places make them favorable.

The Advantage of a Two-Parent Household

“The conventional thing that people have said is that conditions are so bad in these rural places that kids just grow up and leave,” Connor said. But he said his research demonstrated the opposite. “Rural places actually seem quite favorable compared to urban places.”

Connor and his colleagues found that rural children in poverty achieved higher incomes as adults than urban children in poverty did. One explanation is that a greater share of rural children are born into two-parent households.

“We know that, on average, kids growing up in [two-parent households] seem to do better as adults on a whole range of outcomes,” Connor said.

That finding holds true when the researchers controlled for factors like race.

The rural advantage doesn’t just apply to the people who grew up in a rural community but moved to a city as adults. The study demonstrated that both low-income children who remained in a rural community through adulthood and those who left experienced an income advantage compared to their urban-born peers.

“The source of the rural advantage is rooted more in the childhood and adolescent contexts faced by individuals rather than the labor markets in which they ultimately work,” the study states.

White and Hispanic children experience a greater rural advantage than children born in Black households. Appalachia and parts of the rural South are also exceptions to the rural advantage. These regions generally have lower rates of two-parent households, and low-income rural children there tend to not do as well as their rural counterparts in other regions, according to Connor.

Connor and his colleagues also looked at whether factors other than family structure contribute to income mobility. They looked at marriage rates, volunteering rates, poverty, employment, and the racial composition of communities, among other characteristics. But they found that no other variable has as much power over mobility as the two-parent household effect.

With Personal Income, Girls Are at a Rural Disadvantage

Females born into poverty in rural areas had an advantage in household income over their urban counterparts compared to urban females. But with personal income – which refers to the incomes of each adult member of the household, not their combined incomes – women earned significantly less than their male peers.

“What we actually see is that the rural advantage is really being driven by the personal incomes of the man in the house,” Connor said.

The authors attribute these differences to the gender roles rural women may be more likely to face compared to their urban counterparts.

Disparities in personal income between men and women are greater in rural areas than they are in urban ones.

“Rural women are more likely to get married earlier, start having children earlier, and they’re less likely to go to college,” Connor said. “You could almost think of it as a traditional rural effect. Women actually seem to benefit from growing up in a city in terms of pursuing their own careers and so on.”

The post Poor, Rural Kids Earn More than Urban, Poor Kids Later in Life. A Higher Incidence of Two-Parent Households Might be the Reason appeared first on The Daily Yonder.