A modest proposal: Leaving

Torn down building in Shiloh Mountain area, Arkansas
© Lisa R. Pruitt, 2011

The Washington Post's 2017 article "Disabled and Disdained" tells the story of the McGlothlins, residents of Grundy, Virginia, who have fallen on hard times. The patriarch of the family is in jail after struggling with addiction. One of his sons shared the same fate. Sheila, the matriarch, lives on $500 a month in disability payments. Tyler, her 19-year-old son, lives in the household with his wife Morgan. Neither works. Tyler panhandles to supplement his mother's income. The article wants the readers (or at least that it is my impression) to feel sympathy for Tyler. Tyler did things right. He graduated high school, stayed clean, avoided unwanted pregnancies, got financial aid, enrolled in community college, and bought a car. Then, he lost his license as the result of a car accident, and as a result was unable to keep going to school. The article also describes a man named David Hess. Hess is an almost absurd character. He crossed paths with the McGlothlins when Tyler's father was out on the streets panhandling. Hess offered McGlothlin a job, but the McGlothlin patriarch refused on account of his work injuries. Outraged, Hess proceeded to chastise him (both in person and online) for his idleness. And yet, by the end of the article, I found myself sympathizing with Hess more than I did with Tyler.

Being 19 years old

In 2018, I was 19 years old, just like Tyler. I had been in the country for a couple of years by then. I rented the living room floor of a relative's apartment for $350 a month. I say floor because I slept on the floor. I did not have to, but doing so was more comfortable than sleeping on the couch, and so that's what I did. In those days, I worked full time as a shift leader at Carl's Jr. (although, due to my coworkers' chronic absenteeism, I often worked overtime), and I was simultaneously enrolled full time at Sacramento City College. I took the bus to both, spending several hours a day on it. I met a lot of curious characters on those buses (e.g. a man, who by my best guess was from Panama, who had made it routine to tell me he was going to kill me). I thought life was pretty good. One of my classes that semester was English Composition II. The class was taught by a professor whose name I have unfortunately long forgotten. The professor was a South African woman, advanced in years, and clearly well read. She taught us how to make proper use of the English language. She taught us about how we were not supposed to say "terrorist," since "freedom fighter" was the correct term. When asked whether Osama Bin Laden was a terrorist or a freedom fighter, she said he was a terrorist. English is a complicated language. The overarching assignment for the semester was an essay on a book titled Nickel and Dimed by Barbara Ehrenreich.

Shepard's job of choice in Scratch Beginnings
© Aim 2 Please Moving

Ehrenreich and Shepard

Nickel and Dimed follows journalist Barbara Ehrenreich as she goes undercover working a variety of minimum-wage jobs. In the book, Ehrenreich describes her experience in those jobs as difficult, injury-inducing, and soul-crushing. The wages she earned were not enough to cover her basic needs, and Ehrenreich, despite her best efforts, ate into the modest amount of savings she set aside for the experiment. The book's conclusion is grim: the American working poor are trapped, with very little-to-no hope of escaping despite their best efforts.

I was not convinced. My task that semester was to write a four- or five-page essay on the book. On account of a flare up of chronic contrarianism, I set out to find a book which was the antithesis to Nickel and Dimed, one which I could wield as a club against it in my essay writing process. I did not have to look for very long. Scratch Beginnings, by Adam Shepard (who, according to his LinkedIn page, is the co-founder of a brand named "Practice Empathy"), is a direct response to Ehrenreich. Shepard, a 23-year-old recent college graduate, started from scratch in Charleston, SC (a city he was unfamiliar with) with nothing but $25 in his pocket. He deliberately avoided using his degree, his connections, or any advantage not available to the general public. Ten months later, he had bought a truck, saved over $5,000, and by his account made friends and even gotten physically stronger. I echoed Shepard's criticisms of Ehrenreich in my essay and got a B. Curiously, I was not docked for the blatant contrarianism or lack of effort, but for using male pronouns a bit too much (such as when saying "if he did so..." instead of "if she did so..."). I explained to the professor that I only wrote that way because my own inner voice was male, and that was being reflected in my writing, but such an explanation was not sufficient. My core criticism of Ehrenreich, then and now, is that her experiment was unrealistic. Sixty-year-old women do not spawn into the world with nothing. In sixty years, a person accumulates skills, connections, and at least the opportunity to save. Her starting point was not a true starting point. Almost every story is a tragedy when the only thing you write is the final chapter. 

Who keeps Tyler home?

Tyler is the opposite of a 60-year-old woman. His story has really just begun; at 19, he has just entered the "agency" part of the human experience. And yet, throughout the article, I couldn't avoid the feeling like I was reading the last chapter of a story, not the first. What exactly could be the reason for that? My main suspect is the town of Grundy itself. Grundy has a population of 875 residents, distributed among 300 households and a bit under 200 families. Of these households, only about one-fifth have children at home. In the last decade, Grundy lost almost 15% of its population. With such conditions, it is not entirely unexpected that there is a lack of good jobs there. Explaining why there are no good jobs is harder. It certainly is at least partially caused by a variety of policy choices made by people far away from the McGlothlins (deindustrialization, climate policy, trade, and many more). Maybe it's just bad luck.

But a lack of good jobs cannot be the end of the inquiry. Tyler's life was more or less on rails before a few events derailed it. He lost his job at McDonald's after missing a shift due to a snowstorm, and he lost his ability to go to school after losing his license as the result of a car accident. Perhaps I am being a bit too cynical, but I doubt that a simple snowstorm and a "car accident" is all that happened. To be clear, I am not accusing Tyler of anything. However, these descriptions do not match at all with my lived experience. What kind of employer fires an employee over missing work once because of a snowstorm? I have worked a variety of jobs in food and retail, and I cannot remember even a single instance of someone being fired due to one episode of (justified) absenteeism. In all the jobs that I have had, when a person missed work due to other commitments, forgetfulness, or just being too busy doing drugs, nothing happened. At worst, they got a write-up. Businesses generally don't like to get rid of  good (or even mediocre) employees for minor absences or tardiness. Training new employees is a cost that most businesses would rather not bear too frequently. Similarly, it seems unusually harsh to take away a person's license over an accident in which they had little fault. Virginia is perhaps harsher than California in this regard, but this is still suspect. Here we come to two policies that could help a person such as Tyler, but which I am unconvinced would do the trick: (1) more stringent laws against wrongful termination, and (2) more lenient penalties for traffic infractions that result in accidents.

But even the lack of any jobs and a driver's license cannot be the end of the inquiry either. If the idea is that rural areas have a high density of acquaintanceship, was there truly not a single person in Tyler or his family's entire social network who could get him closer to a bus, or to school, or a place with jobs? Is Grundy really so far from everything? A quick search reveals that the closest metro area to Grundy is Kingsport, TN (population ~55,000), about a 2-hour-drive. This is a significant (but not insurmountable) distance, and it may explain the lack of opportunities. There are seemingly no public transportation options that would cover that trip either. Here we arrive at yet another policy that could help Tyler's situation: more extensive public transportation options. Admittedly, I have not seen a "commuter" route that stretches as far as the one Tyler would need, so its feasibility is debatable.

Rural people, immigrants, and subsidies

Venezuelan immigrants in Ecuador.

Assuming, for the sake of argument, that there isn't a single job available in Grundy; and, assuming also, that Grundy is simply so remote that it is literally impossible to commute by any means (whether public or private) to any other place where a job might be found, that raises the final question: why not move? How could things be worse anywhere else? I have looked for a satisfying answer to why people in economically depressed areas resist moving, and I have not found one.

As an immigrant, I find the resistance to moving genuinely difficult to understand. If life is so bad where you are and economic prospects are better elsewhere, why stay? I understand loving a place. Most immigrants from my country to the United States that I have met have expressed that they would like to go back some day. Many have expressed that, even if not possible during their lives, they would like to at least be buried back at home (it almost never happens, but it is a really nice sentiment). However, even with attachment considered, isn't leaving and returning with more resources a more productive approach? From my perspective, the McGlothlins' situation resembles something close to the natural, baseline state of things. What historically propels families out of such circumstances is a willingness to take risk, usually when things cannot get any worse. Usually, one member, often male, ventures somewhere harder and less comfortable, lives cheaply, saves aggressively, and slowly creates a foothold for others to follow. It is usually not pretty, but it's also a practice not unique to international migrants.

What I cannot relate to, in terms of my own lived experience, is the $500 in disability payments. Sheila's disability payment is also a policy choice. So is every other federal and state subsidy or program that flows into a place like Grundy. I want to be careful with my words, lest the spirit of David Hess fully take over me. I am not arguing that the government should abandon people in hard circumstances in order to force a sink-or-swim outcome. If the government did, a lot of people would undoubtedly just sink. I am asking whether support sometimes functions as an anchor. Tyler is not facing a choice between certain misery (staying) and possible misery (leaving). He is facing a choice between possible misery (leaving) and a small, predictable share of $500 (staying). There is a Spanish refrain which roughly translates to: "A bird in your hands is worth more than 100 in the sky."

Conclusion

Which brings me to a question that has loitered in my mind for the entire time I spent writing this post: at what point does subsidizing rural and remote areas just become subsidizing misery? Maybe the "death" of places like Grundy (or in less scary terms, their transformation) would benefit everyone, especially the people who live there. And maybe, what is slowing that transformation down is the accumulated weight of everyone's personal share of $500. I did not mean for this post to sound so negative. I do not think the McGlothlins are contemptible people. But perhaps there is something to the contempt that the David Hesses of the world display.

The dual edge of isolation: escaping to and surviving in rural Alaska

Looking at the shore off a cruise ship,
Alaska. Photo credit: Anna Tong (2012)

When I was 12 years old, I went on an Alaskan Cruise. Our cruise stopped in Juneau, Ketchikan, Skagway, Sitka, and Haines. While in Ketchikan, a tour guide showed us around town and talked about what it is like to live in Alaska. My cousins and I asked the tour guide what they like to do for fun in Alaska. He replied that many locals enjoy nature, go fishing, and hunt.

When we asked about movie theaters and TV shows, he mentioned that the town didn’t have a theater, and many locals lacked televisions or internet access. As teenagers, we contemplated at the thought of being so disconnected. While I could not imagine myself living in Alaska, this is the reality for some.

It made me wonder, who would live in Alaska? The Census Reporter estimates that Alaska’s current population is just above 740,000 with a predominantly white population (57%), and Native Alaskans (13%) representing the next highest percentage. While the population seems to be increasing, the working-age population is declining.

Tourists visiting Nugget Falls in Juneau, Alaska. Photo Credit: Anna Tong (2012)

Alaska has long captured the American imagination as the ultimate frontier for a fresh start. The state actively incentivizes newcomers through the Permanent Fund Dividend, which pays residents simply for living there for a calendar year. Beyond financial perks, the profound remoteness of the state offers a unique social refuge. People fleeing restrictive pasts (such as having a criminal record) often migrate to the state specifically because of its remote nature and anti-establishment culture.

For some, this seclusion provides a necessary second chance. J.T. Perkins III tells a reporter for The Marshall Project about how he recommends for someone with a criminal record to flee to Alaska to avoid restrictive public registries and social stigma. J.T. also describes the community created within insolation fosters an environment where neighbors judge each other by current actions rather than past mistakes. However, this "leave me alone" culture has a devastatingly dark side for vulnerable populations.

While property crime in the state has dropped to its lowest levels since 1985, violent crime remains staggeringly high. The Alaska Beacon discusses how Alaska’s rates of violent offenses have outpaced the national average since 1993, driven heavily by very high rates of rape and aggravated assault. In fact, the rate of reported rape in Alaska has consistently hovered between three and four times the national average for the last decade according to the Alaska Beacon. The Alaska Justice Information Center also reported in 2021 on the FBI's Uniform Crime Report comparing Alaska's rates to rates nationwide. It is no surprise that the crime rates in Alaska are so bad considering the lack of law enforcement (read more about that in an earlier blog post here).

This social crisis is compounded by a severe lack of public infrastructure, another direct consequence of rural isolation. NPR investigated the conditions of rural schools in Alaska. Because shipping heavy equipment and housing skilled workers is astronomically expensive, basic maintenance of schools are frequently abandoned by the Alaskan government. As a result, rural Alaska Native communities are left with schools that are literally collapsing into the permafrost, filled with black mold and structural hazards. 

This structural neglect extends to basic household utilities, with more than 200 rural Alaskan communities currently facing inadequate access to water. Residents without piped water are forced to survive on less than six liters a day, severely impacting public health.

Conclusion
Ultimately, the isolation of rural Alaska acts as a double-edged sword. It functions as a hiding place for social outsiders or people with a criminal record who are seeking to relocate, while simultaneously trapping its marginalized residents in a cycle of violent crime and infrastructural decay. 

Reflecting back on that cruise I was on in 2012, it’s wild to think that my biggest concern was just a lack of internet or a local movie theater. I was completely blind to the harsh realities of what extreme isolation means for the people living there.

Gabbs, Nevada is a real place

During Thanksgiving Break 2024, I traveled with my partner at the time to visit her family in Gabbs, Nevada. Leading up to the trip, I told my friends and family where I was going by saying the name of the town, waiting for a second, then dramatically saying "population: 58." This usually got a bit of a puzzled reaction, but I felt it effectively conveyed my bewilderment. It seemed like an impossible place to me, far more remote and isolated than anywhere I had been.

A faded sign outside of Gabbs with a list of obsolete churches and social clubs, November 2024 

It turns out the population is greater than 58, with the most recent numbers I could find putting the population at 237. I'm not sure if the discrepancy was because of my ignorance or some miscommunication. Regardless, the town was certainly isolated. It was about seventy miles away from the nearest gas station and grocery store, deep in the magnificent beige of the Great Basin Desert. 

I was perhaps too unbothered by the isolation, as I neglected to fill up my car at the gas station at our last stop at the Walmart in Fernley, Nevada. As Interstate 80 changed to US 50 which changed to NV 361, the setting sun cast a lovely red glow on the desert, before turning into a pitch darkness that properly spooked me. I love a good country drive in pitch darkness, but the lack of trees or any shapes for my headlights to bounce off of was causing a low-grade panic to set in. My paranoia about running out of gas certainly did not help. 

NV 361. I swear this was terrifying at night. November, 2024

We did arrive safely, not quite sure if we were going to spend that night with our hosts or at a local motel that one Yelp review referred to as "Norman Bates scary." We thankfully did not have to find out what that meant, and spent the night on the couch after some stargazing and exploring our hosts' underground library. As always, I was stunned by the view of the night sky when there was no light pollution.

Our hosts were my partner's great uncle and aunt, we talked with them quite a bit about life in Gabbs. They were constantly on the road spending about half of the year driving to visit friends. They preferred to hole up in Gabbs in the more temperate seasons, leaving mainly during winter and summer. For them, the remoteness was peaceful, and there was a family tie. My partner's great aunt and grandmother grew up there.

Gabbs was founded around a magnesium mine in 1941, when demand for the mineral was high due to World War II. Though demand dropped off sharply after the end of the war, operations in the mine continued, and the town was built up with a library and a K-12 high school, where my partner's grandmother attended while growing up there through the 1950s. She mentioned seeing nuclear blasts on the horizon, likely seeing explosions from the Nevada Test Site, which operated continuously through the 1960s.  

Wide-Lens Shot of Gabbs, a view from the desert. November, 2024.  

The next day we had a two hour excursion of wandering in the desert and exploring the town. While the previously cited Nye County Civic-Plus source indicates that the town has an operational school, library, and community pool, it was clear from our exploration and conversations with my partner's family that this was no longer the case. The pool was dry and overrun and the library and school were just empty facades with decayed interiors. Apparently the town had been losing population over time and the population was now mostly retirees.  

An abandoned pool in the center of town, November, 2024. 

 Our discussions of rural disadvantage earlier this semester reminded me of wandering around Gabbs. The readings around the crises facing rural schools brought the image of the empty school back to my mind. This simply seemed to be a later stage of the problems described in those articles. I am now struck by how Gabbs is so remote that its decline is not noticed at all by the outside world. There is so little information available about this town even in our internet age. If I had not been there, it would have been impossible to see it as a real place.   

 On the drive back home I appreciated the beauty of the desert a good deal more. I am also happy to report that I did not run out of gas, though it got a bit too close for comfort at the end there.  

Rural news, late notice: the mail lag that quietly taxes rural life

American Samoa Post Office (2021) - Pago Pago, AS; Credit: Talanei News 

Without a post office in one’s community, one must resort to traveling farther and farther away in order to have access to this necessary element.

That quote was from a 2011 blog post about post offices as community lifelines. It, along with many other posts on threatened post office closures in 2011 and 2012, highlights a rural baseline: when infrastructure is limited, distance becomes a cost paid in time, fuel, and coordination. In 2026, however, the issue seems less about whether a post office exists and more about the timeliness of mail delivery. The issue of slow mail delivery in rural America is partly caused by public policy.

In 2025, the Postal Regulatory Commission (“Commission”) outlined nationwide changes by the United States Postal Service (“U.S.P.S.”) under its “Delivering for America” plan. The plan was introduced shortly after the Trump Administration called for privatizing the U.S.P.S. While it claims the plan is essential for financial stability, critics argue that the Delivering for America plan more resembles a "march to privatize the U.S. mail." Particularly relevant to rural America under this plan is a concept called Regional Transportation Optimization (“RTO”). The Commission explained:

Under RTO, mail dropped off at Post Offices and collection boxes more than 50 miles from a regional hub is collected the next day instead of the same day.

The Commission warned that rural communities would face disproportionate negative impacts. That is, some mail originating in rural areas enters the U.S.P.S. system later than mail from locations closer to processing centers. Hence, rural areas are more likely to experience the additional day and any subsequent delays. Reports from journalists like Sophie Culpepper help illustrate what that extra day looks like in practice for rural communities.

In her 2026 Neiman Lab Report, Culpepper described community newspapers facing mail delays that arrive late, go missing, or show up in batches. She interviewed publishers in Maine, Michigan, South Dakota, and Virginia, all of whom reported a significant increase in complaints about U.S.P.S. delays last summer. 

In Maine, the Midcoast Villager – which serves Knox and Waldo counties – is the primary or only local news source for roughly 80,000 residents. Publishers told Culpepper that they have little visibility into, or control over, U.S.P.S.’s delivery timelines:

When we’re fighting against something that we really have no control over, that’s terribly frustrating…because I can’t afford to lose a subscriber, let alone many.

Rural Post Office (2024) - Salvo, NC
Credit: Wikimedia Commons Contributors

For a weekly newspaper, punctuality is essential. Culpepper directly linked mail delays to rural livelihoods because local advertising relies on timely delivery. From community announcements like auctions and open houses to business inquiries like invitations to local project bids, if the newspaper is late, rural residents not only miss the news; they lose the opportunity to act while it still matters. 

Newspaper delivery is just one issue where mail speed influences rural life. A similar issue arises in the business context. In a 2026 interview with the Federal News Network, Elena Patel described the U.S.P.S. more as a rural economic platform than as a news pipeline. 

Patel, a Brookings senior fellow and co-director of the Urban-Brookings Tax Policy Center, argued that judging the U.S.P.S. mainly by profitability misses the role the postal service plays in rural economies. Patel pointed out that private carriers can impose geography-based surcharges of up to $20 per package, costs that can wipe out small margins for rural businesses trying to reach distant customers. 

Patel also highlighted the practical functions of post offices in rural areas: shipping goods for e-commerce, maintaining a reliable business address (including P.O. boxes), and accessing counter services such as certified mail. She concluded:

We need to rethink the Postal Service as a public good and fund it appropriately so that it can support rural economies.

Taken together, these stories reveal why the mail delivery system is a rural livelihood issue. Rural areas suffer twice when mail slows down: once in time and once in opportunity. Time is spent on extra trips to town, more phone calls, and contingency plans just to complete basic tasks. Opportunities are missed: auctions and bids close, notices arrive too late, payments are delayed, and small businesses lose customers as shipping slows or becomes more expensive.

This is the quiet tax of a lagging mailbox: not a sudden shutdown, but a consistent decline in timely mail delivery in rural communities. When a national service like the U.S.P.S. is treated as a profit-and-loss problem, delay becomes an acceptable efficiency trade-off.

Supreme Court decision on Planned Parenthood and Medicaid will undermine rural health

The U.S. Supreme Court today ruled (quoting the Associated Press) that 

States can block the country’s biggest abortion provider, Planned Parenthood, from receiving Medicaid money for health services such as contraception and cancer screenings.  

 The case rose to the Supreme Court from South Carolina.  The Associated Press explains: 

South Carolina Gov. Henry McMaster, a Republican, said Planned Parenthood should not get any taxpayer money. The budget bill backed by President Donald Trump in Congress would also cut Medicaid money for the group. That could force the closure of about 200 centers, most of them in states where abortion is legal, Planned Parenthood has said.

Several news outlets have mentioned the impact that this decision will have on rural healthcare.  NPR brings us this: 

Planned Parenthood's president and CEO, Alexis McGill Johnson, in an interview with NPR, said the decision would have widespread ramifications and would allow seventeen states to strip Planned Parenthood clinics of the ability to provide non-abortion medical services to rural and low income people.  (emphasis added)

The story further quotes Johnson:  

It's a dark time [when] a health center has to close, any time a patient is not able to get the care that they need.  That is a dark time because we can provide that care for our nation's most vulnerable. 

The rise of the "barndominium" and the "shouse"

Since the COVID-19 pandemic began in 2020, migration to rural areas has substantially increased. From 2019 to 2023, large urban areas like New Orleans and Cleveland experienced smaller population growth than average as many city dwellers moved to rural and rural adjacent places. The loosening of in-person work requirements likely played a large role in this migration to rural areas.

Theoretically, the pandemic's resolution and subsequent return to in-person work should have ended the rural migration trend, yet many Americans are still trading city life for country living. For instance, as of late 2024, young families with children were increasingly leaving big cities, opting instead for rural counties and small metropolitan areas. 

The benefits of living in the country are somewhat obvious. Cities tend to come with a higher cost of living, overwhelmed public school systems, higher rates of crime, and greater environmental pollution. This reality, combined with a rising cultural appreciation for the countryside aesthetic, has set the stage for homeowners to embrace a lesser-known phenomenon: the "barndominium."

Picture this: 14 acres in the middle of nowhere, abundant open space, and the opportunity to design your own home at a far lower cost than purchasing a traditional house. For people like the Barndominium Lady Stacey Lynn Bell, who built her dream barndominium and now helps others do the same, the appeal is irresistible. In a recent New York Times article reporting on the barndo's surge in popularity, Bell explained that: 

More people want bigger homes, more distant neighbors, land to raise chickens and grow vegetables, and an environment 'not as hustle-bustle.'

In the same piece, Brittany VanHouten shared that she and her husband expect their barndominium in Citrus County, Florida to be 4,500 square feet and include a home theater, library, craft room, and spacious detached garage, once finished. The Florida couple estimated their new home would cost under $300,000, which falls on the lower end of the average price to build a home in their area.

On top of all these advantages, barndominiums are often disaster-resilient, long-lasting, and energy-efficient. This is largely due to their slow-to-rust steel frames and customary metal roofs, which can withstand high winds and hurricanes. Pertinently, climate and disaster-resilient features are "very important" to 86% of homebuyers, according to a recent Zillow survey.

Of course, the barndominium has its disadvantages, too. As with rural living in general, taking up residence on vast open land may mean sacrificing easy access to schools, places of employment, restaurants, and shopping centers. 

A partial remedy to this problem is the shouse, an even more niche category of housing also taking over rural America. The term "shouse" is derived from a combination of "shop" and "house." While the shouse is extremely barndo-esque, it provides the additional option of allowing owners to combine their living space with their workshop. This feature virtually eliminates commute time, unless you count the time it takes to walk from one room to another.

Further, while a greater emphasis on function over form renders shouses somewhat less cosmetically appealing than their barndo counterparts, these structures share many of the same advantages, including lower costs and energy efficiency. 

If migration trends over the last few years are predictive of those to come, rural areas are likely to continue to experience an influx of new residents from bigger cities. Unfortunately, housing prices have already begun to increase in smaller towns and rural areas due to this shift. However, for those with the resources, patience, and vision, a barndominium or a shouse might allow potential homebuyers to make their rural dreams a rural reality.

Addressing the rural internet deficit by amending the federal BEAD program

Nearly 25% of rural Americans lack access to high speed broadband internet. Without internet access, geographically isolated communities are growing increasingly technologically isolated. This phenomenon -- the rural internet deficit -- harms rural American communities in a number of ways. 

To start, rural communities lacking adequate internet access, relative to their urban counterparts, are placed at a significant economic disadvantage. Studies indicate that "increased broadband access contributes to job and population growth, lower unemployment rates, and more business formation."

The rural internet deficit also has a direct negative impact on public health. On this point, the American Public Health Association has noted the following: 

[Today], it is almost impossible to consult a physician without access to telecommunications technology in the United States. The nation's health care systems . . . have shifted most ambulatory care to telehealth, primarily video visits. . . . Without [broadband internet access], patients cannot fully use telehealth in all its forms: asynchronous messaging via patient portals, remote monitoring devices such as blood pressure monitors, or synchronous video connections to consult with a physician.

Additionally, as noted by the National Center for Education Statistics, "students who do not have access to the Internet at home may be at risk for negative academic outcomes." 

So, what are the causes of the rural internet deficit?

The rural internet deficit can be primarily understood as a function of the relative spatial isolation of rural communities. As outlined by one Pew report

[h]ousing in rural areas, including low-income housing, is often spread out across greater distances than it is in urban regions. This increases the cost of building out the infrastructure needed to provide broadband access and means there are relatively few customers to subscribe to the service. As a result, [internet service providers] [or "ISPs"] do not see a favorable return on investment for deploying that infrastructure and often require federal or state subsidies to do so.

In addition to spatial isolation, lower median incomes amongst rural households decrease the likelihood that a given rural family will personally invest into broadband internet. The fact that many rural communities are home to older populations has also been cited as a factor driving the rural internet deficit. 

So, what are some possible solutions to address the rural internet crisis? 

In light of the lack of incentive that ISPs have to invest into rural internet infrastructure, it comes as no surprise that most of the proposed solutions, thus far, have centered on government funding. For instance, in 2021, the Biden Administration rolled out the Broadband, Equity, Access, and Deployment ("BEAD") program. This program sought to address the rural internet deficit by, amongst other things, providing federal subsidies to private companies that invest into rural internet infrastructure. 

However, over the course of the last four years, the BEAD program has proven unsuccessful in bridging the rural internet divide. Reports indicate that, to date, the program has not brought a single new internet connection to a rural household. 

One possible reason for BEAD's failure is that the program has failed to address the primary cause of the rural internet deficit -- geography. 

Currently, BEAD precludes companies willing to establish new rural internet connections via satellite from taking advantage of the program's subsidies. Rather, only companies willing to install fiber-optic cables qualify for BEAD subsidies. This is problematic because installing fiber-optic lines in rural communities is highly expensive and time consuming, due to geographical nature of rural areas. As noted by one report,  "[c]ost estimates for laying fiber-optic cable range from more than $12 per foot in rural areas with soft ground to $20 per foot — which is $105,600 per mile — in rocky terrain." 

So, one possible solution to the rural internet deficit would simply be to amend BEAD to allow satellite internet provides to take a advantage of the program's subsidies. By doing so, the geographic hurdles that have historically stymied the development of rural internet infrastructure would become a non-issue. Additionally, in contrast to fiber-optic internet, satellite internet connection can be established in a home within hours. 

In sum, the rural internet deficit harms the overall well-being of rural communities in a number of ways. The primary cause of the lack of internet access in rural America is the geographical nature of these communities; specifically, because rural communities are so spatially isolated, there is a high cost associated with developing rural internet infrastructure. These high costs, in turn, disincentivize ISPs from investing into rural areas. One possible solution to addressing the rural internet deficit would be to amend the federal BEAD program, so that satellite internet providers may qualify for BEAD subsidies. This solution would provide for new rural internet connections, while taking the limiting geographical considerations out of the equation.

On rurality as a place to hide

Here's an excerpt from a New York Times essay on the capture of Ted Kaczynski, the homegrown terrorist known as the Unabomber, nearly three decades ago in a remote corner of Montana. The author of this piece, Maxim Loskutoff, who has written a novel based on Kaczynski's life.  Loskutoff grew up in Montana, about 80 miles from where Kaczynski was in hiding.  This is a rich essay, which I commend in its entirety.  I was particularly taken with this depiction of Kaczynski's hideout, which captures part of what I wrote in "The Rural Lawscape: Space Tames Law Tames Space," about the potential of rurality to conceal: 

The sudden media attention [to Kaczynski] hinted at the answers. I heard the words “cabin,” “remote” and “wilderness” repeated on the evening news with an increasingly romantic luster. I began to see how people on the coasts viewed my home state: as a wilderness of possibility. A refuge for ruffians, seekers, dropouts, dreamers and the occasional psychopath. Someplace you could go if things didn’t work out. T-shirts and coffee mugs bearing the slogan “The Last Best Place to Hide” popped up in local souvenir stores.

My "Rural Lawscape" chapter was published in The Expanding Spaces of Law:  A Timely Legal Geography (Stanford University Press 2014).  Another post that centers this issue of law's struggle to police remote places, as well as the high cost of doing so, is here.  

Space tames law, dog tames fugitive: Cavalcante captured after two week manhunt

On August 31, convicted killer Danilo Cavalcante escaped from the Chester County Prison, located in West Chester, PA. This past Wednesday, after 2 weeks on the run, Cavalcante was captured in South Coventry Township, nearly 20 miles away from the prison he escaped. While on the run, Cavalcante stole a van, stole a gun, and hid in the deep woods of southeastern Pennsylvania, all while avoiding a massive manhunt involving as many as 500 law enforcement officers. 

As the video of Cavalcante "crab walking" up the walls of the prison went viral, locals were terrified. Cavalcante was a known murderer who stabbed his girlfriend in front of her children. He was clearly dangerous and posed a threat to the community. This threat was amplified when Cavalcante stole a rifle from a local homeowner. 

Hundreds of law enforcement officers from a veritable alphabet soup of agencies combed the area on foot and horseback using dogs, drones, and aircraft with advanced surveillance technologies to look for signs of the fugitive. Meanwhile, Cavalcante hid in woods so thick with foliage that officers reportedly walked past him without realizing it. 

This wasn't Cavalcante's first rodeo. In 2017, he fled the Brazilian town of Figueirópolis, where he was wanted in connection with a murder. After hiding from the authorities and taking refuge among the cattle ranches of the northern savanna, he escaped to the US with a false identity. 

After numerous sightings, days of intense searching, and a near-miss where a local homeowner shot at Cavalcante, a surveillance aircraft with thermal imagining technology found a heat signature. Two tactical teams were deployed to the area. In a dramatic moment fit for the big screen, a police dog named Yoda subdued Cavalcante, holding the killer down while he attempted to grab his stolen rifle. 

Cavalcante sustained a minor bite wound and was arrested with no shots fired.  

The Cavalcante manhunt echoes a similar manhunt in upstate New York where issues of geography complicated search efforts. The New York search was covered on the blog here. 

It also illustrates Professor Lisa Pruitt's argument in her chapter "The Rural Lawscape: Space Tames Law Tames Space" that rural spatiality limits the ability of the state to impose the rule of law on the countryside. In essence, the vast expanse, low population density, and natural landscape resist the law. Space "tames" the law, which seeks to "tame" space. Professor Pruitt's theory of rural spatiality's effect on the law is covered in more detail here. 

Likewise, Ralph A. Weisheit, Ph.D., David N. Falcone, Ph.D., and L. Edward Wells, Ph.D noted in their article "Rural Crime and Rural Policing" that rural isolation negatively impacts rural law enforcement in several ways. Rural police have to patrol significantly larger areas. Sometimes, this means officers patrol alone with no witnesses and the grim knowledge that any backup is miles away. Generally, it means law enforcement will take longer to respond to emergencies and are forced to contend with the natural barriers presented by geography and wilderness. 

Simply put, rural isolation spreads the law thin. 

While Cavalcante was able to use the space inherent to rurality to his advantage, "taming" the law for a time, he was eventually caught thanks to the tireless efforts of law enforcement, the use of advanced technology, and the heroism of man's best friend. 

However, not every rural crime becomes national news. Not every rural crime draws significant resources from the state and federal governments. More often than not, rural police must go about their business without the benefit of drones and expensive surveillance aircraft. The law won this round, but space is far from being down for the count. 

Gambling with the rural foster youth

Nonmetropolitan Elko County covers a vast expanse of northeastern Nevada and is home to approximately 54,046 residents, but it only has twelve beds to service every foster child in the county.

Earlier this year, the need for those limited beds spiked in what one Nevada social services manager told NPR was the worst uptick in foster need she had seen in twenty years working for Nevada’s Division of Child and Family Services (DCFS). With the number of displaced children exceeding the number of foster beds, state officials were at a loss on where to house the children.

In response, Nevada social services used hotel casinos to house seven rural foster youth over a period of 89 days, with staff paid overtime to provide one-on-one supervision of the children.

Of course, casinos are not DCFS’s first choice for placement. DCFS’s primary goal is kinship care, where the child is placed with relatives. But when kinship care is not available, DCFS resorts to out-of-home placements, also known as "traditional foster care."

What happens when kinship care is not an option, and “traditional foster care” is overcrowded and shrinking? Where do these displaced children go?

This is a frequent dilemma and a national trend, which is putting other child welfare agencies in the same predicament as Elko County: KCRA 3 reported Sacramento County was fined by the state of California for placing foster youth in former juvenile detention facilities; the Child Welfare Monitor uncovered Colorado, Florida, Kentucky, Maryland, Massachusetts, Michigan, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, and Washington all reported similar situations where children removed from their parents were

warehoused in inappropriate settings, such as temporary shelters, hotels, offices, or state-leased houses staffed by social workers; sent far away for residential care, or being left in psychiatric hospitals and detention centers after being cleared for release.

Worth discussion in this regard is the Family First Prevention Services Act (“FFPSA”), which the National Conference of State Legislators describes as offering federal funds to support child welfare programs. As the Act’s name implies, the primary intention is to keep families intact. It thus necessarily shifts child welfare services towards prevention.

Through FFPSA, states with approved funding have the option to apply funds towards “prevention services.”

One explicit goal of FFPSA is to curb the use of congregate or group homes by prioritizing family foster homes for child placement. States are generally not reimbursed under the FFPSA if they place a child in a group home for more than two weeks.

This well-intentioned goal likely will but up against rural realities: it can be particularly difficult to successfully place children with rural foster families, as noted by the American Enterprise Institute (AEI).

In general, the process for vetting a foster family is intensive, for both the government and the prospective family. The Plight of Rural Child Welfare: Meeting Standard Without Services accentuates how spatial barriers, like sheer distance from a social services office, can make it especially difficult for caseworkers to visit foster families and for foster families to engage with social services.

Rural communities often lack the support networks and resources that are necessary for child welfare, which undermines efforts to identify rural foster family placements.

In "When Mamaw Becomes Mom: Social Capital and Kinship Family Formation amid the Rural Opioid Crisis," Professor Kristina Brant posits that social capital with the local legal actors (e.g. bureaucrats, judges, and child welfare caseworkers) plays an important role when establishing foster families in rural communities. Naturally, good social capital cuts in favor of a family becoming a caregiver, while poor social capital likely prevents them from doing so.

The advantages of social capital plummet, however, when the relevant legal actors are no longer local. This is not an uncommon problem given the spatial remoteness typically associated with rural communities and the phenomena of “legal deserts,” a term coined to refer to the rural lawyer shortage. (Read more about “legal deserts” here and here).

In cases where social capital cannot be employed, a key determinant for getting approved as a rural foster family is effectively out of reach.

To compound and exacerbate the difficulties of finding a rural foster family, the social services associated with supporting families and preventing child maltreatment are few and far between in rural communities.

Some of the notable services considered necessary for adequate child welfare—that are scarce in rural communities—are substance abuse treatment, mental healthcare, and parenting classes. For the social services that are available, material distance—the literal distance that must be traveled—can make accessing and providing services expensive and time consuming.

Simply put, the lack of support and services in rural communities sweeps the legs out from under some of the broad reforms in the child welfare system, like the FFPSA, and leaves rural foster children with no place to go.

This only scratches the surface of several intersectional barriers to adequate child welfare in rural communities, a few of which have been discussed in a thread of blogs starting here, and in this law review article.

Child welfare is by no means an easy issue, and I cannot deny that state agencies and committed individuals and organizations are making efforts to improve it. I only draw attention to differences in rural infrastructure and social services that make rural foster youth especially vulnerable and frustrate the goal of family foster placements. 

California rural schools facing teacher shortages

Hailey Branson-Potts reports in the Los Angeles Times today from Modoc County, California, population 8,700, under the headline, "‘No one is coming to our rescue’: Inside rural California’s alarming teacher shortage."  Some excerpts follow: 

In small, rural districts like Modoc Joint Unified in Alturas, a cattle ranching town of 2,700, being short even a few teachers can send a school spiraling.

At Alturas Elementary School, there are six vacancies — a quarter of the teaching staff.

It has become so difficult to hire and retain educators that administrators have attended hiring fairs not just across California, but also in Montana, Nevada, New Mexico and Oregon.

They tried going to North Dakota this year, figuring they could attract small-town folks who might prefer the slightly warmer Northern California winters. They made it all the way to Denver but had to turn back — it had snowed too hard, and their connecting flight was canceled.

All of the out-of-state travel has yielded zero qualified applicants.

The teacher shortage is so dire that administrators say they have no choice but to violate a new state law that will require public school districts to soon offer free TK — an additional year of instruction that precedes kindergarten — to all 4-year-olds.

The district, which had a single TK teacher, is scrapping the grade level altogether.

To recruit teachers, school officials try to sell the perks of rural life: The slower pace. The deer that walk right along Main Street. The postcard-pretty sunrises over the Warner Mountains. Low crime and so little traffic that there is only one stoplight in the whole county.

But they don’t sugarcoat the isolation. When they interview job candidates, they note: Alturas is 100 miles from the nearest Walmart, across the state line in Klamath Falls, Ore.

Branson-Potts then links what's happening to political context:   

People in California’s rural north feel as if this famously liberal state is leaving them behind — a feeling of alienation that has long fueled the region’s conservative politics.

The population is dwindling. Wildfires are getting worse. Law enforcement agencies are woefully understaffed. Hospitals are few and far between.

The state’s move to ban the sale of new gas-powered cars by 2035 is, to many residents, laughable in a vast region with few electric vehicle chargers, where people drive farther and, often, over mountain passes. Like universal TK, it feels like an edict from lawmakers who don’t understand the challenges of rural life.

Don't miss the rest of this well-told story.  

Texas Monthly takes a deep dive into the consequences of vouchers and school choice for rural schools

Forrest Wilder reports for Texas Monthly out of Fort Davis, Texas, on the way Texas' school choice legislation is hurting rural schools.  Fort Davis is the county seat of Jeff Davis County, population 1,996, on the southwest edge of the state.  The story features a "conservative, gun-toting superintendent" named Graydon Hicks III, who says that, recently, he "has never felt farther from the state's political center of gravity."  

For years Hicks ... has been watching helplessly as a slow-motion disaster has unfolded, the result of a deeply flawed and resource-starved public school–finance system. Over the past decade, funding for his little district, which serves just 184 students from pre-K through twelfth grade, has sagged even as costs, driven by inflation and ever-increasing state mandates, have soared. The math is stark. His austere budget has hovered at around $3.1 million per year for the past six years. But the notoriously complex way the state finances schools allows him to bring in only about $2.5 million per year through property taxes.

Hicks has hacked away at all but the most essential elements of his budget. More than three quarters of Fort Davis’s costs come in the form of payroll, and the starting salary for teachers is the state minimum, just $33,660 a year. There are no signing bonuses or stipends for additional teacher certifications. Fort Davis has no art teacher. No cafeteria. No librarian. No bus routes. The track team doesn’t have a track.

But Hicks can’t cut his way out of this financial crisis. This school year, Fort Davis ISD has a projected $621,500 funding gap. To make up the difference, Hicks is tapping into savings. Doug Karr, a Lubbock school-finance consultant who reviewed the district’s finances, said Fort Davis ISD was “wore down to the nub, and the nub’s all gone. And that pretty much describes small school districts.”

“I am squeezing every nickel and dime out of every budget item,” Hicks said. “I don’t have excess of anything.” When I joked that it sounded like he was holding things together with duct tape and baling wire, he didn’t laugh. He said, “I literally have baling wire holding some fences up, holding some doors up.”

The district’s crisis comes at a time when the state is flush with an unprecedented $32.7 billion budget surplus. Hicks is a self-described conservative, but he thinks the far right is trying to destroy public education. For years, the state has starved public schools of funding: Texas ranks forty-second in per-pupil spending, according to Raise Your Hand Texas, a pro–public education nonprofit founded by H-E-B chairman Charles Butt. And yet Governor Greg Abbott is spending enormous political capital on promoting a school-voucher plan, which would divert taxpayer funds to private schools. Public education, Abbott has repeatedly said, will remain “fully funded,” though public-education spending is projected to be lower this year than when he took office, in 2015, and the Legislature recently passed a $321.3 billion budget with no pay raise for teachers and very little new funding for schools. Unable to get his voucher plan through the regular legislative session, Abbott is threatening to call lawmakers back to Austin until he gets his way.

* * * 

With each passing month, his rural district inches closer to financial ruin. If nothing changes by fall of next year, Fort Davis will have depleted its savings. He doesn’t know the exact day that his schools will go broke, but he can see it coming.

Wilder, by the way, does an admirable job breaking down and describing Texas' complex school funding system.  One of the challenges of that funding formula for places like Fort Davis is that local property values are going up, which leads to a diminution in funds received from the state but not necessarily any commensurate rise in local funds to support the schools.  

Near the end of the story comes this, highlighting the tension between the state's rural reaches and decision makers in Austin: 

As we were sitting outside his office in his red pickup with the engine idling, Hicks told me that he’d given up on lobbying the Legislature. He mentioned again that [Lt. Gov] Patrick and other GOP lawmakers are trying to destroy public education by using vouchers to privatize schools, and he said that most other politicians “don’t give a s— about West Texas.” But for the time being he was still fighting: writing op-eds, firing off plaintive missives, asking concerned citizens to contact their legislators.

Toward the end of our visit, I asked Hicks what’s going to happen to his schools. “I don’t know,” he said. “I’m not patient enough to spend time with assholes in Austin, and I’m not rich enough to buy any votes.” TEA has suggested that Fort Davis consolidate with another district—most likely Valentine, which is 35 miles away—but Hicks said both districts would suffer for it.

And the very end of the story gives us the news that Superintendent Hicks has announced his retirement. 

An earlier New York Times story about the school funding situation in Texas--as it relates to vouchers--was more positive about the survival of rural schools-- in part because residents will fight for them.  And in places like New Home, which is economically embedded with Lubbock, those fighting for rural schools are more numerous and will perhaps have enough political clout to influence legislators in Austin.  

On the dangers that lurk in the rural South

Margaret Renkl writes in her most recent column in the New York Times of a new monograph, Dark Waters (Aperture 2023), by photographer Kristine Potter.  Here are some excerpts from Renkl's column, which strike me as echoing the themes of my 2013 book chapter, "The Rural Lawscape:  Space Tames Law Tames Space," in which I hypothesize the relative absence of law in rural spaces, which are more challenging and costly to police--and to keep people safe--because of the nature rural spatiality.  I also wrote about that book chapter here in relation to a McClatchy Press series about the practical realities of rural law enforcement in California.  

Here are some salient excerpts from Renkl's essay on Potter's book: 

The landscapes in these photographs are not so much threatening as bereft of protection. Entering such beautiful spaces is always a risk for a woman alone — not because of anything inherently dangerous about a mist-drenched stream or a bamboo-clotted riverbank or even a rocky waterfall, but because bucolic settings aren’t always as empty as they seem. And nobody would hear you scream if danger has followed you into the woods — or if danger is already there, just waiting for you to arrive.

* * * 

In the South, our most isolated places are at once the most beautiful and the most blood-soaked, and Ms. Potter understands that women are in no way the sole victims of this violent legacy. In one photo, an older white man teaches a young Black man how to tie on a fishing hook. The younger man’s position — kneeling, head bowed, eyes cast downward, arms raised, wrists together — suggests both resignation and supplication. He could be learning to tie a hook on a fishing line. He could as easily be crouching to avoid blows. He could as easily be presenting his wrists for handcuffs.

Our deep woods are lovely, our still waters restful, but the Southern landscape has never been a safe place for a woman alone. It has never been a safe place for a Black man alone. It has never been a safe place for L.G.B.T.Q. people of any race or gender. To enter an isolated place alone has always been to take a risk, and we have known that all our lives.

Another story of law enforcement struggles to serve (and protect) rural communities

Dani Anguiano wrote in The Guardian a few days ago under the headline, "‘We’re on our own’: the rural US town where police refuse calls."  The story is about Rancho Tehama, an unincorporated community in Tehama County, California, population 65,829, about 120 miles north of Sacramento.

Failures of law enforcement in Tehama County burst into the news in 2017 after a mentally ill gunman killed five in remote Rancho Tehama, including at an elementary school.  The Los Angeles Times covered the events thoughtfully, drawing state wide attention to happenings that might otherwise have gone largely unnoticed because of the remote location.  I wrote a few blog posts in the aftermath of the killings, here and here. 

More recently, Tehama County has been in the news in relation to its inability to recruit and retain enough deputies to serve the county.  CalMatters report on the issue was the topic of a December, 2022 blog post here. 

Here's a lede from Anguiano's Guardian story last week: 

In Rancho Tehama Reserve, residents are used to getting by without everything they need. The price, or the perk, of living among the oak trees and rolling hills where cattle graze in this rural northern California community is its isolation.

People typically come to the Ranch, as residents call it, looking for space and quiet – they only got proper cellphone and internet service three years ago. The settlement is at the end of a two-lane road that meanders through the hillsides of California’s Sacramento Valley and offers glimpses of the snow-capped peaks of Mounts Lassen and Shasta. The gas station has snacks, propane and phone chargers, and the hardware store carries alfalfa pellets, kerosene and bolts, but most anything else requires at least a 30-minute drive.

Sherri Burns, the owner of the hardware store, said people here knew one another, and were often united by their love for a place viewed by outsiders as the “armpit of Tehama county”.

Burns, who is also the assistant volunteer fire chief, is quotes:  

I love it. I wouldn’t go anywhere else.  If you respect people, you get respect back. I’ve never had fear out here – and I’ve gone on calls in the middle of the night by myself.

Recently, however, the remoteness has presented a dilemma:  

[R]esidents say when they call 911, they are frequently unable to get any help.

In places like Rancho Tehama, residents say, the issue is not a lack of police, but neglect. The staffing challenges only exacerbated a longtime problem – residents say that for years, even when the sheriff’s office had more deputies, the county’s remote settlements received little attention. Though the absence of patrol deputies affected the entire 3,000 sq mile county, it hit those living in rural areas particularly hard due to their distance from major population centers and the lack of other law enforcement agencies.

One Rancho Tehama resident, Cheyenne Thornton, called the situation a "ticking timebomb," adding:

 Unless you’re bleeding or dying, you’re probably not going to get a sheriff or anyone to respond.

You feel like you don’t matter out here – you’re on your own.

Others, like Chris Foster, said they were less troubled by the lack of law enforcement protection:  

I can protect myself and my family, whether I shoot you in the ass or beat you with a stick. This is the country. People packing guns is normal to me and my nine-year-old son. Because, you know, you have to protect your wellbeing and your property. It’s like anywhere else.

Don't miss the rest of Anguiano's story, where you'll also echoes of this post about rural law enforcement's struggles to effectively oversee vast physical territory with few resources.  The story also notes that some Rancho residents sued the county over the 2017 shootings, in particular the failure to seize the killer's guns pursuant to a restraining order that compelled them to do so.  

Finally, if you want to learn more about this community, the 2017 killings at Rancho Tehama are the subject of a just-released set of episodes on the podcast This is Actually Happening.  

On the rural version of imposter syndrome in the context of higher education

Nick Foureizos reported for the Daily Yonder a few days ago out of far northern California, both inland Mount Shasta (Siskiyou County) and coastal Humboldt County, home of Cal Poly Humboldt in Arcata.  Here are some key excerpts about what Cal Poly is doing to meet the needs of students coming from rural places, but starting with a vignette featuring a Cal Poly student, Miranda Connelly, who grew up in Siskiyou County: 

Just about 21% of Siskiyou County’s adults over 25 have a bachelor’s degree, significantly below California’s 35% average.

Despite two local scholarships available to cover gaps in federal and state aid, a number of her peers were convinced they couldn’t afford college, and chose to pass on even trying.

“For so many years, they had it pounded into their heads that it wasn’t feasible,” Connelly says.

“It’s not a blatant thing. It’s mostly parents just saying they can’t afford to send them to college. It’s an unwritten thing. But it adds barriers.”

Connelly, who now works as an academic mentor to first-generation students, notes that many rural students are the first in their families to go to college. They don’t always know how the system works.

The second part of the story shifts to a focus on Cal Poly Humboldt, which is experiencing a severe housing shortage, in part because of growth in the region that is taking housing that once would have been available to students off the market.  The university's provost also talks about the institution's role in the region. 

The housing challenges come at a time when the university is working to expand programs as part of its new polytechnic mission, including offering software programming courses that had just a 14% acceptance rate at other California institutions.

“We’re saying, ‘Let’s go ahead and offer these programs that people want, that they couldn’t get into elsewhere,” [Provost Jenn] Capps says.

It’s also investing in a fire resiliency center and launching a $10 million health hub for training radiology nurses and other medical professionals.

Though it can’t do everything, Capps is clear that it’s not an option for the university to sit idly on the sidelines in a remote community like this.

“The campus has to be the centerpiece in creating access,” she says.

Chinese spy balloon over Montana gives new meaning to "flyover states"

This afternoon as I was driving home from work, I heard NPR report the breaking story of a high-altitude balloon over Montana--at least that is where it was yesterday.  The U.S. Government says it is a Chinese surveillance balloon and is not disclosing where the balloon is now.  Given Montana's reputation as a "rural state" that is sparsely populated, I found interesting this coverage by Dan Lamothe and Alex Horton in the Washington Post:

The incident, first reported by NBC News, prompted a series of unusual events as the balloon was observed Wednesday over sparsely populated Montana, officials said. The state is home to numerous U.S. nuclear missile silos.

* * * 

Senior military officers, including Gen. Mark A. Milley, chairman of the Joint Chiefs of Staff, advised against [shooting down the balloon], citing concerns that falling debris could put people and property at risk, the senior official said.

The balloon’s flight path takes it over “a number of sensitive sites,” this official said.

Also of interest is this about prior Chinese surveillance of U.S. territories outside the North American continent, surveillance that spanned "several years."  

[S]imilar balloons, carrying guidance systems on board, have been detected previously over Hawaii and Guam, a U.S. territory that houses substantial American military assets.

The presence of missile silos in Montana is reminding me that many are also present in my home state, Arkansas.  This, it seems, suddenly makes sparsely populated places of interest and value--if only because strategic defense systems have been sited in them.  I assume that the sparse populations and cheap land are primary reasons for the decisions to site this sensitive--and potentially dangerous military infrastructure--in these rural places.  

The Washington Post story notes similar national security concerns in Montana's neighbor to the east, sparsely populated North Dakota: 

China’s brazen surveillance effort coincides with recent warnings from the U.S. Air Force over proposed Chinese land purchases in North Dakota about 12 miles from a military facility where drone test flights are conducted. The pending deal for a corn milling site has fueled concerns that the purchase is a cover for Chinese surveillance activities. A U.S. interagency committee decided last year it did not have jurisdiction to oppose the sale.

Air Force Assistant Secretary Andrew P. Hunter took an unambiguous view in a letter released earlier this week by North Dakota’s senators.

“The proposed project presents a significant threat to national security,” it says, “both near- and long-term risks of significant impacts to our operations in the area.” The senators called for the project to be discontinued.

Here's a somewhat humorous quote from the New York Times coverage of the surveillance balloon: 

On the ground in Montana, Jeffrey Sherlock, a retired state district court judge in Helena, agreed that the balloon was a “provocative” move. But he also expressed wonder that the Chinese would have been interested in his part of the country.

“I can’t believe they are spying on Billings, Mont.,” he said. “There’s not much there.” 

This recent post similarly speaks to the conflict between rural development and the risk of Chinese surveillance or influence.  

How remote medicine is transforming care of rural sexual-assault survivors

Arielle Zionts reports for Kaiser Health News and The Atlantic. The excerpt that follows features nurse Amanda Shelley in Eagle County, Colorado (population 55,731), and it picks up after she's received a call from the local police that a teenager has reported a sexual assault. 

Shelley... called a telehealth company to arrange an appointment with a sexual-assault nurse examiner, or SANE. The nurse examiners have extensive training in how to care for assault survivors and collect evidence for possible criminal prosecution.

About an hour later, Shelley met the patient at the Colorado Mountain Medical urgent-care clinic in the small town of Avon. She used a tablet to connect by video with a SANE about 2,000 miles away, in New Hampshire.

The remote nurse used the video technology to speak with the patient and guide Shelley through each step of a two-hour exam. One of those steps was a colposcopy, in which Shelley used a magnifying device to closely examine the vagina and cervix. The remote nurse saw, in real time, what Shelley could see, with the help of a video camera attached to the machine.

* * *

TeleSANE services are expanding across the country in rural, sparsely populated areas. Research shows that SANE programs encourage psychological healing, provide comprehensive health care, allow for professional evidence collection, and improve the chance of a successful prosecution.

... [T]here are no comprehensive national data on the number and location of health-care professionals with SANE training. But she says studies show that there’s a nationwide shortage, especially in rural areas.

Some rural hospitals struggle to create or maintain in-person SANE programs because of staffing and funding shortfalls, Pierce-Weeks says.

Training costs money and takes time. If rural hospitals train nurses, they still might not have enough to provide round-the-clock coverage. And nurses in rural areas can’t practice their skills as often as those who work in busy urban hospitals.

* * *

Avel eCare, based in Sioux Falls, South Dakota, has been providing telehealth services since 1993. It recently added teleSANE to its offerings.

Avel provides this service to 43 mostly rural and small-town hospitals across five states and is expanding to Indian Health Service hospitals in the Great Plains. Native Americans face high rates of sexual assault and might have to travel hours for care if they live in one of the region’s large, rural reservations.