Friday, November 30, 2007

Medicare Cuts Have Disproprotionate Impact on Rural Communities

The current discussion regarding health care reform has a tremendous impact on rural America. One of the proposed funding cuts is to seniors’ Medicare benefits for skilled nursing facilities. At least in Kentucky, 55 percent of its nursing homes are located in rural areas, which means that rural areas may be hit particularly hard by any such Medicare cuts.

One article finds, “[S] eniors in rural America would shoulder approximately 25 percent of the total five year, $2.7 billion Medicare cuts -- yet in states with higher rural populations, rural seniors and the skilled nursing facilities that serve them would bear disproportionately greater cuts. In particular, Medicare beneficiaries in rural areas requiring skilled nursing care would suffer significant reductions in daily funding. In addition, the national long term care leaders emphasized, rural facilities would be increasingly forced to choose between the urgent staffing needs that impact quality in the near-term versus refurbishing facilities, upgrading technology, and purchasing new equipment -- which impacts future care quality.”

With less Medicare funding, it would not only hurt the quality of care for seniors, it also has an impact on rural economies which rely on nursing homes for employment. It would have a disproportionately negative impact on rural facilities, which make finding and retaining qualify staff more challenging that it already is.

Often times, nursing facilities may be the largest local employer, and those rural economies depend on such facilities for jobs and economic development. Cuts from Medicare could result in lost jobs, less hiring, and higher unemployment

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Rural Protests

Due to the isolation of many rural areas, I was wondering if protests manifest in different forms in rural areas compared to urban. Or if the focus or presentation to the community differs.

It might be necessary to separate those rural protests for the benefit of the local community compared to those rural protests that seek to generate media coverage, or reach a closer urban center. For this posting I will focus on labor and agrarian reform protests

One example I came across was the Mount Olive Pickle boycott in Mount Olive, North Carolina. The Farm Labor Organizing Committee's strategy was to convince consumers to no longer buy Mount Olive pickles as leverage so that the company increased wage and labor conditions. Protests occurred in Mount Olive, NC, a town of population of about 4,000. Additional protests occurred at local grocery stores throughout the state. The 5-year protest eventually gained success in the right-to-work state. Also notable is the claim as the first collective bargaining agreement for H2A guestworker employer in the state.

What is interesting is that one of the protests gathered union members from across the state to speak in the town itself. There was minimal media attention, and although it occurred near the "town center" not many residents came out of their houses or were present, except to attend the protest itself. The point is, these isolated protests must have a purpose of creating unity, or raising morale, rather than "getting the word out." (to some degree).

The Agrarian Reform movement in Nicaragua during the Somoza regime is of particular interest because although protesters resisted in "isolated" areas, by resisting landowners who attempted to regain "unused" land, the movement (and through political negotiations), they received media attention nationally. (And eventually internationally). Some 50,000 families were involved in the protests throughout rural Nicaragua. Maybe it was the mass, albeit isolated, movement that garnered so much attention (not to mention the violence of suppression in the rural areas).

I am not sure what the real answer is to the effects of rural protests and whether isolation decreases effectiveness, but I think it merits examination.

Rural Seat Belt Use and Rumble Strips

Given everything we have read, it is not surprising that rural areas would be resistant to seat belt laws. Nor should it be surprising that seat belts save lives. I am not sure if it is kosher to post a blog about a similar blog, but the blog from the Institute for Rural Journalism has an interesting article on a study about how seat belt laws cut deaths in rural areas. This was put out by the Center for Excellence in Rural Safety. According to the blog, rural areas (defined as those with populations under 5000) account for 57% of automobile-related fatalities. Given the strength of the data on the lives saved, it is really surprising to me that so many states still fail to have primary seat belt laws.

This also led me to a study on the use of rumble strips in rural areas. Every time I am back in Wisconsin, the rumble strip is one of those incredibly useful tools that I miss in urban areas. For those who are not familiar, rumble strips are bumps placed on the pavement or grooves cut into the pavement near intersections that remind the distracted driver that they will need to stop soon. This has always seemed to me to an incredibly good idea, and a useful one in other locations, such as urban/suburban intersections where people frequently run red lights or stop signs. The study showed that rumble strips really influence behavior. Maybe this is a case where the urban can take a practical rural tool and use or adapt it to enhance urban safety.

Sunday, November 25, 2007

Elected official's transgender status could hardly be unknown in city of 12,000

I found myself looking for a rural angle in this story about a transgender politician in Riverdale, Georgia, population 12,000. Maybe there isn't one, given that Riverdale appears to be exurban or suburban Atlanta, but it seems to me that the lack of anonymity associated with rural areas (and towns/cities of this size) is still at play. Here's what happened: Michelle Bruce is in a run off to hold onto the city council seat to which she was elected in 2003. One of her opponents in the most recent election is suing, alleging that "Michael Bruce" misled voters by identifying herself as female. Michelle Bruce says she has always identified as transgender; "Everybody in my district knows me. Everyone in Riverdale knows me." It's hard to imagine otherwise, in a town that size.

Rural to Urban Migration in India

This article in today's New York Times fascinated me. The article focuses on the Pushpak train, a twenty-four hour train in India that takes people from rural areas to urban centers such as Mumbai. There, they will work in jobs other than farming and hopefully become breadwinners for their families. The passengers pay approximately $6 and board the train with dreams of making it big in the big city.

The most interesting statistic in the whole article is this one: during the next 43 years, 700 million people will leave rural villages in India and move to cities in India. That is, 31 Indians will arrive in an Indian city every minute for the next four decades. A similar "exodus" is predicted to occur in China.

Do these movements signal the end of ruralism as we know it around the world? If it does, I wonder what it means for rural people in the United States and what it means for rural identity globally.

One association I have with the rural is its static nature. I expect and rely upon rural people to retain old traditions and preserve old ways of life. I am counting on rural areas to preserve alternative, idyllic lifestyles that I can adopt in a few years, once I tire of city life. I had fully expected I would take my children and children's children on trips to rural parts of the country and to rural parts of other countries. Now I wonder how possible that will be.

Saturday, November 24, 2007

Clotheslines: icon of rural life, object of urban disdain

A recent story on NPR told of the "right to dry" movement in New Hampshire, where a bill has been introduced to give the states' residents the right to dry their clothes on clotheslines. The use of clotheslines has become a matter of dispute, for example, in communities of condominiums, where clotheslines are seen as eyesores.

A clothesline as an eyesore? My own associations with clotheslines are positive. That is partially because I link them with the rural idyll, with pleasant rural landscapes populated by industrious and frugal people. Of course, clotheslines are a good thing in that they save energy (which now matters more in these days of awareness about climate change), and that may ultimately save them -- no matter how ugly urban folks think they are.

Meth in Europe: A rural phenomenon there, too?

We've talked some in class about associations between methamphetamine manufacture and rural places. One reason for this link, we speculated, is that making meth stinks, literally, so that doing so wouldn't be feasible in a city, where nearby neighbors would (again literally) get wind of it. So, it was interesting to see this story in the NYTimes about the burgeoning meth problem in Europe. Only near the end of the story is the word rural mentioned. There the reporter characterizes Jesenik, the reputed center of meth production in the Czech Republic (and all of Europe, for that matter), as "rural" and "isolated." The reporter notes, interestingly, that Jesenik (population 12,000) is not typical of small rural places in that local residents do not have deep roots there; previously ethnically German, that population was expelled after WWII. I am unsure why the journalist notes this fact -- perhaps to suggest that the lack of attachment to place accounts for how such a terrible thing could be happening in a rural locale. Of course, if bad things -- drug use in particular -- aren't supposed to happen in rural locales due to residential and community stability, it's hard to figure out the meth problem in rural America, in communities populated by the same families who have been there for generations. Well, hard to figure out, that is, until you consider the poverty and lack of opportunity that tends to mark such communities.

And on a somewhat related note . . . this in today's NYTimes: "Farmyard Stills Quench a Thirst for Local Spirits." The "farmyard stills" language conjures up a familiar image that I associate with rurality. So does the entrepreneur featured here, who references six generations of moonshine makers in his family. The phenomenon is taking off in the Midwestern states and some others with significant rural populations. Nevertheless, the micro-distillery trend seems largely not to be a rural one, as California is currently the leader in small-scale distilling.

Monday, November 19, 2007

Obama's track record with the rural vote?

Given Sen. Obama's recent surge in Iowa and that state's demographics, this article struck me as a timely analysis of the Senator's strengths and weaknesses courting voters in the rural midwest.

The article suggests that Sen. Obama's claim about his 2004 Senate primary, ""we won the white vote, we won the rural vote, we won the farmer vote" isn't well supported by the election results from that race, though he did well even amoung white districts in Chicago that are historically hostile to black candidates.

If race can't account for his underperformance in downstate Illinois in 2004, perhaps something about rural communities? But then again, he is leading the pack in Iowa...

Sunday, November 18, 2007

Third World Clinic, in the United States?

We've talked a lot in class about rural access to health care. This story, from today's New York Times Magazine, paints a portrait that makes the issue a little more real. The article describes the work of traveling doctors, using tents and sterilized animal stalls to create makeshift clinics in areas like rural Virginia. 47 million people, or 15 percent of population in the United States, live without health insurance. While they may not all be serviced in clinics like those described in the article, the presence of such clinics sheds light on the pressing need for greater access to services in rural areas. Despite these doctors' best intentions, hundreds of patients can be turned away any given weekend, leaving one to wonder where it is that they turn next.

Saturday, November 17, 2007

Tourism in Rural Areas

A story I heard recently on NPR got me thinking about the self-preservation efforts of rural communities. In this broadcast, a surfer from New Zealand extolled the virtues of surfing in a remote fishing village in Guatemala. Jed Thynne, the surfer, said that to travel to El Paredon, he must take a bus, a taxi, and a boat. But, he likes it because "there is nobody here." A website about El Paredon surf camp brags about the "exotic black sand beaches" and great waves in a "tranquil fishing village."

The community members hope to attract surfers and others in order to increase their economic livelihoods. The community opened a small surfing camp, complete with "rotting bunk beds," and some of the new jobs include cooking and teaching surf lessons.

The example of El Paredon is certainly an optimistic one for many rural communities. Rural regions can bring work and money into their communities through tourism. Of course, opening a rural community to visitors may be inimical to the tranquility that characterized the rural region in the first place.

Many rural communities are finding ways to attract tourists without compromising their rural identity. In fact, this site, from UC Davis, provides a wonderful variety of resources for those interested in agritourism. Furthemore, agritourism is now part of popular culture, thanks to a recent episode of "The Office," in which Dwight Schrute explains that "agritourism is a lot more than a bed and breakfast. It consists of tourists coming to a farm, showing them around, giving them a bed, giving them breakfast."

While I fully support agritourism and other methods of economic development, I wonder what will become of communities that lack natural resources that are tourist-worthy. El Paredon is fortunate to be located near such great waves, and the fictional Schrute Farms in rural Pennsylvania is located in a lovely wooded setting. But what about other regions that no one wants to visit? How can those residents develop a sustainable livelihood?

Friday, November 16, 2007

Extreme transportation challenges in western Alaska, but is it "rural"?

A story this morning on NPR told of how gasoline prices are "frozen" in the western Alaska community of Bethel because fuel is transported in during warm weather and then doled out over the course of the winter. This is both good and bad for local residents. It is bad because it means gas prices are always high ($5 to $7/gallon) due to the high transportation costs associated with getting gasoline (and other product) to Bethel. It is good because when gas prices are creeping up (or zooming up), prices in Bethel are set, at least until the next season (or until the supply runs out and gas is flown in, the added transportation costs inflating prices even more).

Listening to the story caused me think that Bethel must be a sort of "wide spot in the road" place that happens nevertheless to be a regional center for many surrounding villages. While Bethel is clearly remote, however, its population of 6,262 means it doesn't even qualify as a "rural" place, as that term is defined by the U.S. Census Bureau. Nevertheless, at 340 miles from Anchorage, a commercial hub for 56 surrounding villages in the Yukon-Kuskokwim Delta, it is surely more rural than many places with smaller populations that are within an urban shadow. Material consequences of this rurality include the increased cost of transportation (and other facets of inconvenience associated with spatial isolation), along with the fact that such costs drive up prices for all sorts of goods and services.

Saturday, November 10, 2007

Sports reporting that idealizes rural America

Two recent sports stories from the New York Times struck me as interesting in relation to their angle on small town America. The first, about a high school football powerhouse in northern Kansas, appeared on the paper's front page recently. In a way, it's just another story about football madness in the "fly over states," but the reporter also provides demographic and economic context for the town of Smith Center (population 1,931), where the football team just won its 52d consecutive game. While its economy isn't diversified, and its population is shrinking, the school district is actually growing a bit (high school enrollment: 154). Some attribute this modest growth to a new ethanol plan nearby, others to a transcendental meditation center set to open next year. Perhaps my favorite part of the story is the quote from the coach: "What we do around here real well is raise kids." What he says next, though, is rather sad, and also explains, perhaps, the decline in population: “In fact, we do such a good job at it — and I’m talking about the parents and community — that they go away to school and succeed, and then pursue opportunities in the bigger cities."

The second story plays up "rurality" in the context of a story that is less centrally about a rural place than the football story. The story is about Ryan Shay, the 28-year-old elite runner who died in the Olympic marathon trials last weekend in New York City. Ryan grew up in the town of Central Lake, Michigan, population 990, and the reporter begins by focusing on his hometown's response to his death. That is just a poignant jumping off point, however, for a story that is more about the athlete as a person, his extraordinary career, and the circumstances of his death.

I think both stories illustrate, perhaps to differing degrees, nostalgia for our rural past and how rurality still attracts and sells -- even in the context of sports reporting.

Friday, November 9, 2007

Wal-Mart Wages

The American Bar Association Journal had a brief article on the fact that Wal-Mart has begun to balk about billing increases caused in part by high associate salaries at law firms. Wal-Mart is a huge employer in rural areas and is known for its low wage jobs. But for some reason this struck me as a fascinating bit of news. Will this be the Wal-Mart tipping point? Will people begin to take the threats of low wage jobs seriously if Wal-Mart hurts attorney wages?

Monday, November 5, 2007

Crime in a rural university town

The New York Times recently reported the death of Donald Farrell, a 19-yr old university student at Rowan University in rural New Jersey. The article detailing Mr. Farrell's fatal beating, allegedly tied to a robbery, describes the former security most students felt attending a university in a rural, "tranquil" town of 19,000, highlighting how the beating and death has brought a new sense of unease to the community. The details of Mr. Farrell's death are truly shocking as he seemed to be taking precautions against crime: traveling at 9pm in a group, along busy roads in a well lit area to get to a local convenience store. The reactions noted throughout the article note a theme we've spent a lot of time discussing: the perceived security and safety of rural America. It is unfortunate that such phenomenons are often noted only in the face of tragedy. I also can't help but wonder whether if this tragedy fell upon, say, a student at urban Columbia University, it would have received similar media attention.

Sunday, November 4, 2007

Chickens in NYC and Oakland ...

I got a kick out of this segment on NPR today. It is about how city folks are, increasingly, keeping chickens in urban locales -- as pets, ready suppliers of eggs, and both. Particularly rich was the quote by one resident of Park Slope, Brooklyn, who commented on his association of chickens with "god-forsaken places in upstate" New York.

So now, in contrast to the exurban phenomenon that takes the city to the country, the country is coming to the city?