Sunday, January 31, 2021

A rural czar: will Biden connect with rural America through a new position?

A recent Politico article highlights pressure on the Biden Administration to address the problems facing rural America in light of the pandemic by appointing a rural czar. According to the article, Members of Congress and various political advocates feel that it is necessary for Biden to plan a federal response to boost his popularity in conservative areas of the country and help with rural economic recovery. The rural czar would “oversee a national strategy to uplift rural communities” by working “closely with the executive branch, especially with the Department of Agriculture.” From my understanding, the rural czar would not replace the Secretary of Agriculture, but rather work with the USDA and the Biden Administration to connect with rural communities.

A rural czar in the White House would align well with Biden’s plans to re-build rural America as set out in his platform. The President has recognized the impacts the pandemic has had on small businesses in rural areas, with nearly 1 in 5 of them closing. Among other goals, Biden has pledged to create new jobs, rescue small businesses, help farmers and ranchers, expand broadband, and partner with small communities to give them full access to various federal resources. 


There is no question that the economy in rural America has been hit hard by the pandemic. Still trying to pick themselves up after the Great Recession, small businesses in rural communities are struggling with access to funding and broadband connectivity. Here is a blog that highlights five ways the President can carry out his platform and assist rural America; it also discusses some of the most pertinent issues in rural communities. 


To start rebuilding rural communities across the country, Biden nominated Tom Vilsack, former Iowa Governor and Secretary of Agriculture under President Obama, to lead the USDA. However, rural America is already fearful of the nomination, even with the Administration’s deliberate focus on investing back in their communities. According to the New York Times, farmers worry about new and potentially burdensome regulations under the Biden Administration. Additionally, some Democrats feel that Vilsack’s lobbying for the dairy industry insinuates that he will favor larger industries over small farmers, potentially obscuring the Administration’s rural connection. Even agriculture groups have labeled Vilsack “as being too cozy with ‘Big Ag,’” and have pointed to mergers of massive companies that happened during his last term, like the $66 billion Monsanto and Bayer merger, as evidence of that. 


If confirmed, Vilsack, along with Biden, will certainly have a long way to go to win over the hearts of rural Americans. In rural counties across the country, President Biden was outvoted 2 to 1 by former President Trump; even if only 14% of Americans live in rural counties, the overall lack of support for Biden in these areas is significant enough to impact the Administration’s plans to connect with rural America. Here is a blog post highlighting some of the economics behind Democrats losing rural counties in the last election. If these voting statistics are any reflection of rural attitudes toward the new Administration, in order to change them, Biden and Vilsack will need a plan that tackles important issues facing these communities, such as access to funding, health care, and broadband.


An important question thus emerges: will a rural czar be enough for the Biden Administration to connect with rural America?


I think it would be smart for the President to appoint a rural czar. It has real potential to help bridge the gap between the Administration and rural Americans through a dedicated position. Though I am certain that not all of rural America will be open and welcoming to such a position, I think that a focus on their communities and problems is necessary and justified. The federal government’s recognition that rural Americans are struggling and its commitment to help through a specific position can potentially make these communities feel more appreciated, while also helping them through trying times. I look forward to seeing if President Biden creates this position and I will continue to blog about this as new information is released.

Friday, January 29, 2021

Coronavirus in rural America (Part CXXI): New vaccine hesitancy data shows depth of rural America’s distrust

President Biden has boasted a goal to vaccinate 100 million Americans against covid-19 in his first one hundred days. This will be challenging, and rural writers I have read this week emphasize the challenge for their communities. One of my classmates wrote more expansively about this here, but key challenges that persist across experts are storage, distribution, and misinformation.

Misinformation, specifically, was of interest to me. I knew rural communities felt some of the harshest impacts of the pandemic, and as I have studied rurality, I know changing minds of folks in rural places can be easier said than done. The depth of this distrust, or ‘vaccine hesitancy’, and ways to fight it and protect rural communities drove me to dig further.

Recently, Kaiser Family Foundation has released data collected about trust in the covid-19 vaccine.
…four in ten (38%) rural residents say they will “wait and see” before getting the vaccine, and one in ten say they will only get the vaccine if they are required to do so for work or other activities.
Rural communities are less enthusiastic overall about the vaccine when compared to suburban and urban responses.
Three in ten (31%) people in rural areas say they will “definitely get” the vaccine, compared to four in ten people in urban areas (42%) and suburban areas (43%). An additional one-third of people in rural areas say they will “probably get it” while 35% say they will either “probably not get it” (15%) or “definitely not get it” (20%).
These communities are disparately impacted by coronavirus and the most distrustful of the vaccine among other American locales.

My next questions as I explored this issue were: what causes rural folks to be hesitant of the vaccine and how do public health officials best curb the spread of related distrust and misinformation?

Rural folks could be distrustful and not enticed to get the vaccine because of a deeper distrust in the virus itself. The Kaiser Family Foundation’s polling further found:
In addition, half of all rural residents say the seriousness of coronavirus is “generally exaggerated” compared to 27% of urban residents and 37% of suburban residents.
They similarly found:
…for rural residents, getting a COVID-19 vaccine is seen more as a personal choice (62%) than as part “of everyone’s responsibility to protect the health of others” (36%).
This personal choice mentality should be considered heavily in campaigns to fight vaccine hesitancy. In an article for the Kaiser Foundation, Drew Altman suggested modeling pro-vaccine arguments after similar arguments used in favor of the second amendment. In this scenario, the vaccine is shown as a way for rural residents to protect themselves and their families from outsiders.

To reach these communities and successfully encourage them to get the vaccination, the polling found the best messenger to be local doctors who are familiar to the rural residents. This is unsurprising. Though I am not originally from a rural community, I have learned that they are weary of outsiders.

As I heard in class recently (I’m paraphrasing), “…you’re from here once your grandparents are buried here.” It makes sense then, that these same tight-knit communities would distrust a vaccine being pressed on them from an outsider.

Public health officials must then incorporate rural healthcare providers in the information campaigns for the impacted communities. The messenger is key. As the Kaiser Foundation also found:
…a large majority of rural Americans (86%) say they trust their own doctor or health care provider to provide reliable information about a COVID-19 vaccine. Smaller shares say they trust the FDA (68%), the CDC (66%), their local public health department (64%), Dr. Fauci (59%), or state government officials (55%).
This data is revealing. It suggests that to best motivate rural Americans to get vaccinated, messaging needs to come from within the communities themselves. 

As a new administration takes the presidency and stresses vaccinations for a large chunk of Americans, it is important to keep in mind the ongoing struggle of rural communities against COVID-19, and the complicated barrier of vaccine hesitancy.

Other writing about COVID-19 vaccines and the challenges they face in rural communities on this blog can be found here and here.

Thursday, January 28, 2021

Joe Biden’s Plan to Build Back Better in Rural America

Before President Biden came into office, he planned to build a new economy both for our rural American families and the next generation of rural Americans. This included:

Creat[ing] millions of new jobs, including new opportunities in rural America; Advanc[ing] racial economic equity in rural America; Protect[ing] and build[ing] on the Affordable Care Act to expand access to health care in rural communities; [and] Expand[ing] broadband, or wireless broadband via 5G, to every American.

Now, one week into his presidency, Liz Compton notes in her Politico article that President Biden is facing growing pressure to appoint a rural envoy within the White House to oversee a national strategy to uplift rural communities that have been experiencing food insecurity and high unemployment, and are in need of affordable, reliable housing

To help better understand the challenges facing many rural communities, and the efforts made to support them, check out this podcast by NPR. 

Democratic lawmakers, in particular, are urging President Biden that embarking on a rural strategy is an immediate course of action he needs to pursue.

Former Democratic Kentucky Gov. Steve Beshear noted:

I certainly think there has to be a big emphasis on developing rural America. It is past time that the rural areas of this country be targeted for not only economic development, but for health care, for broadband access, for all of the things that will lift this whole country up. 

Similarly, Senator Ron Wyden, an Oregon Democrat said: 

After years of attempting to make these investments, what I know is this: the organization of government often makes it difficult to facilitate real on-the-ground success. A concept like a Rural Envoy at the White House who has real power to coordinate between agencies and make sure that each agency’s work supports another agency’s work in rural America would be an improvement.

While the proposed envoy would work closely with the executive branch, the Agriculture Department is expected to be the first response to many of these problems. The department has a sprawling mission statement that touches nearly every aspect of rural America, from funding affordable housing to building rural hospitals to deploying broadband access to combating climate change. 

Therefore, President Biden’s agriculture secretary nominee, Tom Vilsack, will likely be a key figure in his plan to build back a better rural America. Mr. Vilsack previously served as Agriculture Secretary for all eight years of the Obama administration before heading up the U.S. Dairy Export Council. In addition to having broad support from big agriculture, Mr. Vilsack’s allies say his record proves he’s ready to confront the numerous problems rural Americans face. 

Check out Mr. Vilsack’s interview with the Storm Lake Times, where he discussed rural economic development as a priority area. 

It is also worth noting that President Biden has selected Katharine Ferguson to serve as Vilsack's chief of staff. Ms. Ferguson served in the Obama Administration as Chief of Staff for the White House Domestic Policy Council and as Chief of Staff for Rural Development at the USDA, thereby demonstrating that rural development issues could get special attention in the overall agriculture discussion.

Although Mr. Vilsack is yet to be confirmed, President Biden’s plan to build back better in rural America is already underway with Senator Kirsten Gillibrand and House Representative Antonio Delgado’s joint announcement of their newly introduced bill in Congress that would help to bring more federal funding and resources to rural communities across the country. The Rebuild Rural America Act is set to accomplish many goals, including setting aside $50 billion dollars in block grants for rural regions and establishing a Rural Future Corps in coordination with AmeriCorps to support childcare, health, and other services, among others. 

In her announcement, Senator Gillibrand noted

Too often rural communities can’t access the federal grants and other public resources that could help them solve these problems because they don't have the same economic development organizations. They don't have the grant writers and lobbyists that the larger communities can afford and have.
For more information on Senator Gillibrand, check out a few older posts here, here, here, and here.

By the looks of it, it would appear the President Biden's plan to build back better in rural America is blowing full steam ahead, arguably providing at the very least, some relief to rural communities that something is being done. 

Check out this earlier post focusing on President Biden’s efforts to help rural America. 

Coronavirus in rural America (Part CXX): A vaccination party in a snow storm

The New York Times reports today from Josephine County, Oregon, in the southern part of the state, where a team of  health care professionals got stuck in a snow storm while traveling between tiny Cave Junction, population 1,883, and the county seat, Grants Pass, population 34,533, some 30 miles away.  A jack-knifed truck was blocking the road, so they got out and started offering the vaccine to folks similarly stranded by the accident.  They administered all six doses they had, knowing the vaccine was likely to expire by the time they got back to Grants Pass.  Here's a quote form Michael Weber, the public health director for Josephine County.  

"We had one individual who was so happy, he took his shirt off and jumped out of the car."

Another recipient, he said, was a Josephine County Sheriff’s Office employee who had arrived too late for the clinic in Cave Junction but ended up stuck with the others on her way back to Grants Pass.

Most drivers laughed at the offer of a roadside coronavirus vaccine and politely declined, even though Mr. Weber said he had a doctor and an ambulance crew on hand to help oversee the operation. He acknowledged it was not the typical setting for a vaccination.

“It was a strange conversation,” Mr. Weber said. “Imagine yourself stranded on the side of the road in a snowstorm and having someone walk up and say: ‘Hey. Would you like a shot in the arm?’”

I can't help wonder if those who declined the vaccine did so because they plan never to get the vaccine, a phenomenon that may be more common in rural areas, as discussed here.   

By the way, it's worth clicking over to the story just to see the photos of jubilant people getting and giving the vaccine, with a gorgeous snowstorm in a forest as the backdrop.  .   

I've written previously about Cave Junction here and here and wider Josephine County here and here.  The County's population is about 80,000.

Monday, January 25, 2021

Oceano dunes reopen to vehicles amid continued controversy

A beach in Oceano, a small unincorporated town, in San Luis Obispo County, allows visitors to drive onto it and is the subject of an ongoing debate implicating public access, conservation, air quality, and local tourism economies. Oceano Dunes State Vehicular Recreation Area is one of a few off-highway vehicle areas, and the last on a state beach, administered by the California Department of Parks and Recreation. This means people can drive on the beach in both street-legal vehicles such as Jeeps and trucks, as well as non-street-legal vehicles such as ATVs and dirt bikes. 

People bring dune buggies, trucks, and a whole manner of vehicles to race and recreate at the park, as well as holding bonfires and camping. Because it is the only beach that allows off roading in the state, it attracts visitors from all over. The park is the source of long-standing tension, which have previously been written about on the blog here and here, explaining the basics of much of the fraught issue.

In addition to being the site of popular vehicle recreation, the sand dunes and beach are also habitat for two federally protected shorebirds: the Western snowy plover and the California least tern. During the winter months these birds nest in the sand and can be hard to spot, as well as easily disturbed by people, dogs, and vehicles. The dune environment would normally provide an ideal habitat for these birds, offering both access to forage for food as well as protection from predators.

The tension between the endangered species present on the dunes and the vehicle access goes back at least 40 years, and has recently been complicated and compounded by the COVID-19 pandemic. This past spring of 2020 when the state shut down for the pandemic, the park closed to off-roaders for seven months. The birds took the opportunity to expand their nesting area, and expanded past their protected, fenced-in zone. According to Cal Matters
In response, park biologists in early June scuffed over and erased plover “scrapes”— excavations by male birds to attract females and establish nests. Park personnel also herded and moved some chicks from the new areas, and installed mylar flags to haze the birds away from the riding zones…
These actions violated the Endangered Species Act, and the Coastal Commission filed a cease and desist letter against the park in June.

Proponents of vehicle use of the dunes held a “Freedom Flag Rally” to demonstrate their support for reopening the dunes. Local business owners spoke up about the impact the pandemic closure was having on their business, and their reliance on the park and its visitors. Pictures of the rally show many American flags as well as Trump banners— showing an intersection and melding together of the politicization of the pandemic as well as the existing land use, conservation, and access issues. It seems that for many, use of the park carries additional symbolic meaning about where they stand politically. 

The park reopened to vehicle access in late October 2020 in a phased reopening plan, which postponed the reintroduction of non street-legal vehicles and overnight camping. As of this writing the start dates of the second and third phases of reopening have yet to be set.

In addition to the habitat concerns on the beach, the dust from the dunes drifts throughout the area and into the predominantly Latinx community of Oceano-- implicating environmental and health concerns that ought to be taken into account about who is most impacted by the park’s presence. A recent letter to the editor in the Santa Maria Sun from an Oceano community member calls for prioritizing safe beachfront access for the Oceano community rather than use for beach drivers. The author compares the way access to nature is treated in other parts of the county, with popular developed parks such as the Pismo Preserve, Nipomo Regional Park, and Bob Jones Bike Trail, to the way Oceano’s natural resources are treated— pointing out a clear difference and inequity. 

Oceano is an unincorporated community situated within a mixed rural and non-rural, agricultural county with a huge range of socio-economic advantage and disadvantage. The voices of people who live in this community and who are impacted by the environmental consequences ought to be listened to in planning for the future of this park. A more thorough accounting of the needs of the community would also look to historic and present day Indigenous perspectives. This thread has potentially been lost, both by those who advocate for the total reopening of the dunes, or by outside environmentalists.

The Oceano dunes are a site where differing priorities regarding conservation, the environment, pandemic safety, and how our public lands ought to be used and managed, as well as who they are for, all converge on the beach of a small unincorporated community. Resolving this clash will likely continue to be a key, and complicated, issue.

Coronavirus in rural America (Part CXIX): The complicated effect of COVID-19 on the nation's farmworkers

Amid a world pandemic in which roughly 23% of Americans have faced food insecurity, America has begun paying especially close attention to those who feed us. From the farmers who plant and manage the crops, to the grocery store employees who keep the produce section stocked, America has realized that these workers are not just important but essential for our food supply and security. However, a category of these essential workers, farmworkers, have been especially hard-hit by the pandemic.

A recent study focused on farmworkers in the Salinas Valley, known to much of the country as "The Salad Bowl of the World," found that 13% of the study's participants, all farmworkers, tested positive for COVID-19 between mid-July and November 2020. This was almost triple California's general population positivity rate, which stood at 5% during the same period. 

However, the high rate of COVID-19 among farmworkers is not just a problem in California. In Tennessee, "nearly 200 farm employees [100% of the employees] on a farm in Rhea County, Tennessee tested positive for COVID-19." In early July, Maine also reported 100 COVID-19 cases among farmworkers in that state. In Oregon, a single farm, had two separate outbreaks infecting almost 100 farmworkers in April and May 2020.

As experts have discussed, contact tracing is critical for containing the spread of COVID-19. However, farmworkers do not always have the ability to get tested. Sometimes, this is related to the fact that rural areas, where many farmworkers are located, may not have free and/or accessible testing sites, if they have one at all. Furthermore, those who do have the ability to get tested, may refuse to do so out of fear that "a positive test may mean a permanent job loss."

A positive COVID-19 test is only the beginning of a difficult process for farmworkers who may lack access to crucial resources. 

When asked why they continued to work even after testing positive for COVID-19, or after experiencing symptoms, a quarter of the Salinas' study participants responded that they were concerned about losing pay, while another 13% expressed fear for losing their job if they stopped working. An additional 4% of the farmworkers in the study noted that they continued to work because their employer told them to. The fear regarding job loss is not unfounded, given that the agriculture industry has suffered deep economic loss during the pandemic. As discussed in this previous blog entry, small agricultural towns have been forced to improvise as the markets for their products continue to change during these unprecedented times. 

The Salinas study also showed that farmworkers with a higher positivity rate were more likely to speak Indigenous languages as opposed to English or Spanish. This presents a problem as they may be unable to find necessary guidelines and/or resources regarding COVID-19, isolation, contact tracing, etc., in their native language.

Much of the nation's agricultural work occurs in the rural areas of the country. Unlike urban areas which may have a larger number of health care services, rural areas tend to have fewer healthcare services available, in the sense that a rural town might not have a medical care facility, thereby requiring access to transportation for those seeking to receive medical attention. Further, those health care centers that are available, may be less well-equipped to handle a large number of COVID-19 positive patients. Most concerning in rural areas, are the lack of physicians and available hospital beds. In addition, "many farmworkers have limited access to health care and live below the poverty line" making it even more difficult to receive medical treatment or receive COVID-19 testing. Thus, a farmworker in a rural area may have a difficult time seeking medical help following the onset of COVID-19 symptoms or testing positive for COVID-19.

As if this was not grim enough, research by UCSF shows that while California's "working-age-adults had about a 22% increased risk of dying from March on," as a result of "living during a pandemic," people in agricultural work "saw their chances of death double to 40%." That number is even higher for Latino farmworkers whose chance of death is about 60%. 

In sum, the rapid spread of COVID-19 among farmworkers cannot be solved by simply enforcing social distancing guidelines and requiring masks because the issue is much more complicated than simply the higher infection rate. A lack of resources, a lack of access to health care, and language barriers are just some of the many factors playing into COVID-19's devastating impact on farmworkers. This is yet another challenge, much like California's wildfires this year, that farmworkers have been asked to endure for the sake of our nation's food supply. However, the question remains: if farmworkers are essential to our food supply, why are we not making more of an effort to ensure their health and well-being?

Sunday, January 24, 2021

Why don't rural Americans support Democrats on health care reform?

Improving access to health care is perhaps the defining policy goal of the contemporary American left. President Biden's campaign website displays the President's plans for addressing a multitude of issues, but the President highlights three of his plans in particular: beating COVID-19, economic recovery, and health care reform. President Biden wasn't alone on the left in making greater health care access a key campaign promise, and was actually one of the few Democratic Party presidential primary candidates that didn't support universal healthcare.

Rural Americans would be one of the largest beneficiaries of the health care reform plans being put forth by progressive politicians. Rural Americans are more likely to be uninsured than their urban counterparts, and must pay higher premiums on average than their urban counterparts. Rural Americans are also less likely to be screened for cancers and other potential hazards due to the lack of available primary care physicians in their area. In addition, rural counties are more likely to have only a single insurance issuer than urban counties.

Despite these health care problems rural Americans face, they don't support progressives on health care reform. In 2017, a survey found that 54% of rural Americans favored repealing Obamacare. While most of the rural disdain for the Affordable Care Act comes from rural Republicans, the polling reveals skepticism from all rural Americans. Rural Democrats were twice as likely to support repealing Obamacare than urban Democrats, and rural Independents were 14% more likely than urban Independents to support repealing Obamacare. So rural Americans, regardless of their political identity, are more likely to oppose attempts to increase access to health care despite having more to gain from these reforms.

Why isn't health care an issue that gives Democrats some modicum of rural support? It starts with rural Americans not caring about access to health care.

When rural Americans were asked by Kaiser Permanente what the biggest problem facing their community was, only 2% of the respondents cited the cost or availability of health care. Democrats can't win rural voters over with their health care stance if rural voters don't care about health care. Democrats  need to first explain to rural voters how their health care plans will benefit them. Democratic politicians need to describe to rural Americans how their plans can create competition for insurance issuers who have monopolies over isolated rural counties. Democratic politicians should hammer how unfair it is for rural Americans to have to pay higher premiums than urbanites when rural Americans already have higher transportation costs for medical care.

If affordable access to health care is going to remain one of the Democratic Party's primary policy goals, then Democrats should look to wring as many voters as possible out of this stance. Rural voters, despite favoring the repeal of Obamacare, overwhelmingly support Medicaid. Two-thirds of rural Americans believe Medicaid is "very important" to their community, and an additional 27% of rural Americans believe Medicaid is "somewhat important" to their community. I believe rural voters can show similar levels of support for future health care reform bills, but rural Americans need to be convinced that these bills are for them.

Law and order in the Ozarks (Part CXXVII): A local branch of "Save the Children"? QAnon or the real deal

I've been intrigued--or maybe puzzled is a better word--for some time by the strange association that seems to exist between "Save the Children" and QAnon.  Here's a report on the topic from the New York Times' Kevin Roose back in September, under the headline, "How ‘Save the Children’ Is Keeping QAnon Alive."  I've always known Save the Children as an international charity aimed at helping underprivileged children around the world, and I see it is one with a good ranking.  I've therefore been puzzled at how it has come to be associated with QAnon.  Turns out, the "Save the Children" associated with Q Anon is not the charity, whose name is protected by trademark, I see.  

Roose, the Times tech journalist who made the amazing Rabbithole podcast last summer, explains that QAnon is associated with the slogan "Save the Children," but that's different from the charity:  

Adopting “Save the Children” as a mantra helped save QAnon in several other ways. It created a kind of “QAnon Lite” on-ramp — an issue QAnon believers could talk about openly without scaring off potential recruits with bizarre claims about Hillary Clinton eating babies, and one that could pass nearly unnoticed in groups devoted to parenting, natural health and other nonpolitical topics.
Typical of the new, understated QAnon style are Facebook videos in which parents sound the alarm about pedophiles brainwashing and preying on children. These videos, wrote Annie Kelly, a researcher who wrote a Times op-ed about QAnon’s appeal to women this month, make for “compelling and dramatic content” that is “easily shared in other parenting groups with little indication of their far-right origins.”

Since stopping child exploitation is an issue that has broad and bipartisan sympathy, QAnon’s anti-trafficking rebranding has also allowed politicians to appeal to QAnon supporters without explicitly mentioning the theory. And seeding misinformation about child sex trafficking on platforms like Instagram and TikTok has allowed QAnon to tap into a younger and less explicitly pro-Trump demographic.
Roose quotes Marc-André Argentino, a doctoral student at Concordia University who studies QAnon:

It’s bringing down the average age of a QAnon follower.  In 2019, this was mainly a boomer movement. Now we’re seeing millennials and Gen Z getting on board.

And that brings me to a story I saw in my hometown newspaper last fall.  The headline is "Jasper school literacy event touts 'Early Steps' program," and it reports on the "first annual Parables in the Park held on Sept. 29 at Bradley Park in Jasper.  It is described as a "drive thru literacy event" that served 80 individuals from 60 families and included 8 vendors providing resources, and 20 event volunteers.  "The story chosen for this year's Parables in the Park was 'Harold and the Purple Crayon' by Crockett Johnson."  So far, it sounds innocent enough, but then it mentions that the one of the items distributed was "hand soap from Save the Children's first Gift in Kind donation to the community."  I looked up "gift in kind" on the Save the Children charity website and found no results.  Also, there is a caption that reads "Save the Children Program Coordinator Kelsey Engle and Jasper Elementary student Henry Martin distribute resources to families driving through the Parables in the Park event." 

All of this has me wondering:  Is the "Save the Children" reference one that locals in my home community have taken on, probably because they are QAnon followers?  or did the well established and reputable charity actually provide swag (soap!) to this event in Jasper?  I'm guessing it's the former, which is pretty depressing because it means even more people will be hoodwinked by the dodgy conspiracy theory's association with an otherwise reputable community event.

In addition, I'm thinking the Save the Children charity must be going nuts at having its trademarked name appropriated by a conspiracy theory--especially since QAnon is anonymous and there's no one the charity can easily sue for trademark infringement--or defamation.  

Saturday, January 23, 2021

Biden's Executive Order on Racial Equity recognizes rural disadvantage

President Biden signed an "Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government" on January 20, 2021, his first day in office, and I was intrigued to see that it concerned a lot more than race.  Indeed, it includes "persons who live in rural areas" as well as "persons otherwise adversely affected by persistent poverty or inequality."  "Persistent poverty" is a federal government term of art for counties that have experienced high poverty (20% or more) for the last four decennial censuses, and the vast majority of those counties are nonmetro.  Thus, that last category seems also to be a nod toward rural disadvantage.  

Here's the full text of the definition section, with the salient portion highlighted.  
Sec. 2. Definitions. For purposes of this order: (a) The term “equity” means the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.

It'll be interesting to see how this is actualized.  Right now, as an executive order, this appears mostly symbolic.  

Nevertheless, it reminds me that of Guinier and Torres' suggestion in The Miner's Canary that rural whites are "political Blacks" for purposes of the Texas 10% plan.  Personally, I think it's good to try to build coalitions among disadvantaged populations.  

Friday, January 22, 2021

Coronavirus in rural America (Part CXVIII): The difficulties of vaccine rollout

It’s a common sentiment amongst many news articles I’ve read this week that getting rural Americans vaccinated is much harder than getting those individuals in suburban or urban areas vaccinated. Bennett Doughty and Pamela Stewart Fahs explored this difficult issue in their piece, Why Getting Covid-19 Vaccines to Rural Americans Is Harder Than It Looks, and How to Lift the Barriers. Among the key obstacles in vaccinating rural Americans are storage, distribution, and misinformation.

The first issue has to do with storage. The first two authorized vaccines – one made by Pfizer and BioNTech and the other by Moderna – are mRNA vaccines that require storage in very cold temperatures. The Pfizer vaccine must be stored at minus 94 degrees Fahrenheit and Moderna’s at minus 4 Fahrenheit. Once thawed and prepared, the Pfizer vaccine must be used within five days and Moderna’s within 30 days

Unfortunately, small hospitals, which are more prevalent in rural areas, are less likely to have expensive freezers that can accommodate storing these vaccines. An article by Thomas C Ricketts, III and Paige E Heaphy puts forth a number of figures demonstrating the numbers and distributions of hospitals in rural America. I found the most telling statistic to be the following: 

Nonmetropolitan hospitals are smaller: 72% have fewer than 100 beds, and 42% have fewer than 50 beds. Twenty percent of all hospital beds are in rural hospitals. The median number of staffed beds for nonmetropolitan hospitals is 59 compared with 156 for urban hospitals, while the average number of beds per hospital is 82 and 245, respectively. Rural hospital inpatient days account for 20% of all hospital inpatient days in the United States. Medicare and Medicaid are important sources of payment for hospital patients.

Having always lived in a city or suburbia, I found it to be astounding that hospitals with fewer than 50 beds even existed. Moreover, with the influx of coronavirus patients, I can easily see how rural hospitals with these small numbers of beds would be overwhelmed with the number of patients they need to treat. 

On another note, this got me thinking: the time limit to use the vaccines, within 5 and 30 days respectively, proves to be a larger issue because rural populations are much smaller compared to their urban or suburban counterparts. I decided to do some research and came across the following Census data, where Census Bureau Director John H. Thompson noted, “Rural areas cover 97 percent of the nation’s land area but contain 19.3 percent of the population (about 60 million people).” As a result, rural areas may not have enough individuals to vaccinate within the time limit set by the FDA, thus leading to wastage of unused vaccine doses. 

This is a great 3-minute listen provided by NPR that discusses the significant challenges faced by rural hospitals to rollout mass vaccinations. 

The second issue has to do with big batches. The vaccine doses are currently being shipped in special containers with dry ice, and for now, vaccines are being delivered only in large batches. While urban areas will be able to quickly distribute these large batch doses, finding enough patients to vaccinate quickly in rural areas may be more difficult. As a result, the vaccine distribution efforts will favor hubs that cater to more populated areas to avoid wasting any vaccine or leaving patients unable to get their second dose. 

The article notes: 

The current vaccines’ cold storage requirements and shipping rules mean many rural hospitals can't serve as vaccination distribution hubs. That can leave rural residents – about 20% of the U.S. population in all – traveling long distances, if they’re able to travel at all.

The third issue has to do with difficult barriers to healthcare access. This is not a new problem in rural America. As Haider Warraich, Robert Califf and Sarah Cross discuss in their article, Beyond covid-19, rural areas face growing threat from chronic heart and lung diseases:

Rural hospital closures grab all the headlines and perhaps rightfully so. From 2010 until today, some 134 rural hospitals have closed, and a report released last spring, before the pandemic had hit many rural areas, showed a quarter of surviving rural hospitals in dire financial straits. Cancellation of routine medical care necessitated by the novel coronavirus, which causes covid-19, has pushed more hospitals off the cliff.

 The Rural Health Information Hub has also noted that:

Recent years, however, have presented challenges for rural hospitals. Factors such as low reimbursement rates, increased regulation, reduced patient volumes, and uncompensated care have caused many rural hospitals to struggle financially.” 

Rural areas have fewer health care providers that serve a more geographically diverse population than in urban or suburban communities. Moreover, in many of these areas, the closure of rural hospitals has forced individuals to travel farther for care. This got me thinking about more vulnerable populations such as the elderly and poor, which, I would imagine, have an even more difficult time traveling for care. Not only do these vulnerable populations lack access to public transportation to help them reach hospitals, at least in comparison to their urban or suburban counterparts, but at the same time, the “distance and geography, such as mountain roads, can mean driving to those sites takes time."

At a more local level, Hailey Branson-Potts notes in her article for the LA Times:

In the battle against COVID-19, health officials in Northern California face the daunting task of vaccinating more than 683,300 people spread across a mountainous, heavily forested region where calamity — either from illness or physical trauma — can mean hours-long drives to the nearest medical facility.

This further demonstrates the difficulty that rural areas across our nation face in regards to vaccinating a population that is much more spread out amongst various geographic areas. 

The fourth and last issue involves widespread suspicion and defiance. Aside from growing skepticism that the virus is a serious threat only in major towns, there is also a common fear amongst the rural community that the new vaccine is unsafe. Moreover, there has been a constant and continuous open rebellion against health orders.

As Hailey Branson-Potts discusses, “the pushback in rural parts of California is emblematic of the challenge in many parts of the United States, particularly outside more liberal urban centers.” 

"We’re getting very frustrated here in Northern California,” said Dr. Richard Wickenheiser, the Tehama County health officer. “We have a lot of anti-vaxxers and a lot of independent people who just feel that COVID was a hoax, that it was going to go away when the election was over. And that didn’t happen. ... The excuses just go on and on.” 
In Shasta County, some speakers at supervisors’ meetings have compared mask mandates to Nazis forcing Jewish people to wear a yellow Star of David and spouted conspiracy theories about vaccines containing tracking devices. The county health officer has been threatened repeatedly.
In Tehama County, where indoor dining is banned by the state, restaurants were still seating maskless customers in recent days. In downtown Red Bluff, signs in store windows read: “Please respect everyone’s personal space. ... Masks are welcome, but not required” and “Due to pre-existing health conditions, some of the staff are not wearing a face mask” and “MASKS OK."

The widespread suspicion and defiance exhibited by rural communities across Northern California are a telltale sign of the difficulties of vaccine rollout, not simply due to logistical issues, but rather of a more deeper belief system. 

This is a great podcast on the vaccine rollout in rural areas. 

Other posts on this topic are here, here, and here.


Thursday, January 21, 2021

5 ways Biden can help rural America thrive and bridge the rural-urban divide

Republished from The Conversation, by Ann Eisenberg, Jessica Shoemaker and Lisa Pruitt: 

It’s no secret that rural and urban people have grown apart culturally and economically in recent years. A quick glance at the media – especially social media – confirms an ideological gap has also widened.

City folks have long been detached from rural conditions. Even in the 1700s, urbanites labeled rural people as backward or different. And lately, urban views of rural people have deteriorated.

All three of us are law professors who study and advocate intervention to assist distressed rural communities. The response we often hear is, “You expect me to care about those far-off places, especially given the way the people there vote?”

Our answer is “yes.”

Rural communities provide much of the food and energy that fuel our lives. They are made up of people who, after decades of exploitative resource extraction and neglect, need strong connective infrastructure and opportunities to pursue regional prosperity. A lack of investment in broadband, schools, jobs, sustainable farms, hospitals, roads and even the U.S. Postal Service has increasingly driven rural voters to seek change from national politics. And this sharp hunger for change gave Trump’s promises to disrupt the status quo particular appeal in rural areas.

Metropolitan stakeholders often complain that the Electoral College and U.S. Senate give less populous states disproportionate power nationally. Yet that power has not steered enough resources, infrastructure investment and jobs to rural America for communities to survive and thrive.

So, how can the federal government help?

Based on our years of research into rural issues, here are five federal initiatives that would go a long way toward empowering distressed rural communities to improve their destinies, while also helping bridge the urban/rural divide.

1. Get high-speed internet to the rest of rural America

The COVID-19 era has made more acute something rural communities were already familiar with: High-speed internet is the gateway to everything. Education, work, health care, information access and even a social life depend directly on broadband.

Yet 22.3% of rural residents and 27.7% of tribal lands residents lacked access to high-speed internet as of 2018, compared with 1.5% of urban residents.

The Trump administration undermined progress on the digital divide in 2018 by reversing an Obama-era rule that categorized broadband as a public utility, like electricity. When broadband was regulated as a utility, the government could ensure fairer access even in regions that were less profitable for service providers. The reversal left rural communities more vulnerable to the whims of competitive markets.

Although President Joe Biden has signaled support for rural broadband expansion, it’s not yet clear what the Federal Communications Commission might do under his leadership. Recategorizing broadband as a public utility could help close the digital divide.

2. Help local governments avoid going broke

It’s easy to take for granted the everyday things local governments do, like trash pickup, building code enforcement and overseeing public health. So, what happens when a local government goes broke?

A lot of rural local governments are dealing with an invisible crisis of fiscal collapse. Regions that have lost traditional livelihoods in manufacturing, mining, timber and agriculture are stuck in a downward cycle: Jobs loss and population decline mean less tax revenue to keep local government running.

Federal institutions could help by expanding capacity-building programs, like Community Development Block Grants and Rural Economic Development Loans and Grants that let communities invest in long-term assets like main street improvements and housing.

Rural activists are also calling for a federal office of rural prosperity or economic transitions that could provide leadership on the widespread need to reverse declining rural communities’ fates.

3. Rein in big agriculture

Only 6% of rural people still live in counties with economies that are farming dependent.

Decades of policies favoring consolidation of agriculture have emptied out large swaths of rural landscapes. The top 8% of farms in America now own more than 70% of American farmland, and the rural people who remain increasingly bear the brunt of decisions made in urban agribusiness boardrooms.

Rural communities get less and less of the wealth. Those in counties with industrialized agricultural are more likely to have unsafe drinking water, lower incomes and greater economic inequality.

What many rural people want from agricultural policy is increased antitrust enforcement to break up agricultural monopolies, improved conditions for agricultural workers, conservation policies that actually protect rural health, and a food policy that addresses rural hunger, which outpaces food insecurity in urban areas.

Access to affordable land is another huge issue. Beginning farmers cite that as their biggest obstacle. Federal support for these new farmers, like that imagined in the proposed Justice for Black Farmers Act or in other property-law reforms, could help rebuild an agriculture system that is diversified, sustainable and rooted in close connections to rural communities.

Biden’s plan to bring former Secretary of Agriculture Tom Vilsack back in the same role he held in the Obama administration has cast doubt on whether Biden is really committed to change. Vilsack built a suspect record on racial equity and has spent the past four years as a marketing executive for big dairy, leading many to worry his leadership will result in “agribusiness as usual.”

4. Pursue broad racial justice in rural America

One in five rural residents are people of color, and they are two to three times more likely to be poor than rural whites. Diverse rural residents are also significantly more likely to live in impoverished areas that have been described as “rural ghettos.”

More than 98% of U.S. agricultural land is owned by white people, while over 83% of farmworkers are Hispanic.

Criminal justice and law enforcement reforms occurring in cities are less likely to reach small or remote communities, leaving rural minorities vulnerable to discrimination and vigilantism, with limited avenues for redress.

At a minimum, the federal government can enhance workplace protections for farm laborers, strengthen protections of ancestral lands and tribal sovereignty and provide leadership for improving rural access to justice.

5. Focus on the basics

People who live in distressed rural communities have important place-based connections. In many cases, the idea of “just move someplace elseis a myth.

The greatest historic progress on rural poverty followed large-scale federal intervention via Franklin Roosevelt’s New Deal and Lyndon Johnson’s War on Poverty. Although these reforms were implemented in ways that were racially unjust, they offer models for ameliorating rural poverty.

They created public jobs programs that addressed important social needs like conservation and school building repair; established relationships between universities and communities for agricultural and economic progress; provided federal funding for K-12 schools and made higher education more affordable; and expanded the social safety net to address hunger and other health needs.

A new federal antipoverty program – which urban communities also need – could go a long way to improving rural quality of life. The 2009 American Recovery and Reinvestment Act targeted many of these issues. But urban communities’ quicker and stronger recovery from the Great Recession than rural ones shows that this program neglected key rural challenges.

Some of these steps will also require Congress’s involvement. So the question is, will federal leadership take the bold steps necessary to address rural marginalization and start mending these divisions? Or will it pay lip service to those steps while continuing the patterns of neglect and exploitation that have gotten the U.S. to where it is today: facing an untenable stalemate shaped by inequality and mutual distrust.

Wednesday, January 20, 2021

Biden on unity acknowledges rural-urban divide, says we can transcend it

I'm just going to highlight one little part of Biden's inaugural speech, for obvious reasons:  

We must end this uncivil war, that pits red against blue, rural versus urban, conservative versus liberal.  We can do this if we open our souls instead of hardening our hearts.  

Those who watched or listened to the speech will have noticed that he stumbled over the word "rural" and had to repeat "rural versus urban."  Oh well, as someone pointed out on my Twitter feed, lots of folks do struggle to pronounce "rural."  I think it's something about those two r's in close proximity.  

Saturday, January 16, 2021

Coronavirus in rural America (Part CXVII): The conundrum and paradoxes of health regulations in multi-jurisdictional Lake Tahoe

Susanne Rust reports in the Los Angeles Times under the headline, "At Lake Tahoe, unfurling the statewide welcome mat is ‘awkward’ as pandemic rages."  Some geographic background is helpful to understand the story:  The California side of Lake Tahoe falls within two counties, El Dorado and Placer, that stretch westward all the way to greater Sacramento.  The state announced a few days ago that the Sacramento region, including Lake Tahoe, is no longer part of the state’s stay-at-home order.  Further complicating the array of salient regulations is that Lake Tahoe straddles the California-Nevada state line, and Nevada restrictions have generally been less stringent than those here in the Golden State.  

The story quotes several local officials regarding the conundrum they face and the paradoxes of trying to stop a virus with regulations that vary across arbitrary state and local boundaries.  

Here's an excerpt from Rust's story referring to Tamara Wallace, mayor of South Lake Tahoe, a municipality in El Dorado County:

As much as she wants to uphold the orders banning indoor dining, she’s had few tools at her disposal: El Dorado County’s sheriff and district attorney have both said they will not enforce the governor’s mandates.

Rust also quotes Cindy Gustafson, a Placer County supervisor, who lives in Tahoe City, on the "north shore."

“It’s just an influx of people going back and forth [between this part of California and Reno],” she said, also noting the arbitrariness of the governor’s regional orders, which pulls unincorporated cities, such as Placer County’s Tahoe City, into the Greater Sacramento region.

“Auburn may be where the county seat is,” she said, “but we’re nothing like Auburn. We’re a rural, mountain town.”

This is an interesting distinction Gustafson is drawing because many would characterize Auburn as also a "rural, mountain town."  An earlier story about Placer County's reaction to COVID-19 also depicts Auburn as "rural," of a sort.  

Friday, January 15, 2021

Were rural folks responsible for the Capitol riots last week?

Over the past four years, rural voters have drawn enormous attention in relation to--and enormous responsibility for--the presidency of Donald Trump.  Ditto working-class whites, people like coal miners and factory workers, for example.  Now, however, in the wake of the January 6 attack on the Capitol, the media are waking up to the fact that many of the insurrectionists were neither rural nor low-income.  Indeed, the media are waking up to a fact I've been trying to draw attention to for some time:  lots of rich folks voted for Trump, and they were prominent among the folks who led the raid on the Capitol last week.  We're learning more and more about them because (1) they are starting to be arrested and (2) the dead among them are being identified. 

This story from the Los Angeles Times provides a good overview of who the rioters were.  The headline is "A broad cross section of Trump supporters stormed the Capitol, arrests show. Now what?," and Kevin Rector, Chris Megerian and Anna M. Phillips report.   Here's an excerpt:  

The reality of the Jan. 6 attack, captured in affidavits and court filings in dozens of criminal cases, is that the crowd included not just fringe radicals but also a broad cross section of President Trump’s supporters — people with office jobs, kids and mortgages, and otherwise respectable public reputations.

Among those identified and charged with crimes by law enforcement as participating in the insurrection were municipal employees, former members of the military, social media influencers, police officers and a school therapist. Also charged were a data analytics company’s chief executive and a two-time Olympic gold medalist swimmer from USC.

They came from across the country. A West Virginia state delegate livestreamed himself alongside the rioters. Houston Police Chief Art Acevedo said one of his officers — who resigned Thursday — had “penetrated” the Capitol building and was expected to face federal charges soon. Two Virginia police officers have been charged with violent entry and disorderly conduct on Capitol grounds.
Law enforcement officials are alarmed by the varied backgrounds of the pro-Trump intruders and say it can be difficult to prevent attacks and uncover dangerous motives when extremists hide behind the veneer of normality.

Among the folks that apparently surprised us as having been involved in the Capitol raid is this Dallas-area real estate agent who flew a private plane to DC for the riot.  Note that the framing by law professor Jennifer Taub, who re-tweeted the story, implies that Trump voters are homogeneous by highlighting the topic of socioeconomic class based on one very rich rioter.  That is, she appears to question the economic anxiety or economic distress of all Trump voters by noting that this Trump-inspired rioter is under no economic distress.  Law professors should be above that sort of shoddy reasoning.  

What follows are some Tweets that further illustrate the point that the rioters were not just--and perhaps not even primarily--working class whites.     

Here are two other stories about relatively affluent folks who participated in the Capitol riots, this one about a CEO from suburban Chicago and this one about a man who owns a carwash in suburban Atlanta.  Finally, here's a deep dive by Connor Sheets for Pro Publica about a rioter from Decatur, Alabama (part of the Huntsville, Alabama metro area) who appears to have been living a middle-class existence; he died of a heart attack during the events in Washington, DC.  He's one of those particularly intriguing Trump devotees who was, until relatively recently, a Democrat and voted for Obama in 2008.

In spite of what we're learning about the rioters, some are nevertheless blaming working-class white and rural voters for the riot.  Others see the riot as vindication of sorts of the working-class and rural folks who've been widely blamed for Trump's presidency.  In the Tweets immediately below, I respond to a journalist, Olivia Paschal, who is ignoring some important facts about poverty on the day after the riot. Interestingly, she grew up and now again lives in the same county as the Gravette, Arkansas man, Richard Barnett, who was widely photographed with his feet up in Nancy Pelosi's office, the one now in federal custody.  That's Benton County, Arkansas, a metropolitan county that's home of Walmart's "home office" (aka corporate headquarters).  It's one of the wealthiest counties in the state.  Gravette is an exurban part of the county, but the journalist grew up in one of the two large cities, Bentonville and Rogers, that have now effectively merged.  She went away for an Ivy League education and is now back working as a reporter for Facing South.  Generally, I am a fan of her work, but her argument that there is no "economic anxiety" in Benton County or elsewhere is an unhelpful one that will alienate many voters who are, in fact, suffering economic distress.   That said, I have read that Barnett, the Gravette ma,n is a contractor, from which one could surmise he is not economically distressed.  

Screenshot taken January 7, 2021

Here's more of that unhelpful framing, which I've not (yet) responded to, from Amy Siskind, a notable progressive who leads The New Agenda.

Screenshot taken January 15, 2021

Siskind went down this path after the Charlottesville riots, too, suggesting that event proved racism on the part of Trump supporters, to the exclusion of economic anxiety.  I wrote about the problem with that thinking here.  What's lost in that framing, obviously, is that not all folks who voted for Trump--not nearly all of them--marched in Charlottesville or on the Capitol last week.  Siskind's comment also has the very unfortunate effect of dismissing the economic pain experienced by many Americans who voted for Trump, just as journalist Paschal did in her tweets above.  

Here are some more Tweets about who the Capitol rioters were (along my responses to some of them): 

Screenshots taken January 8, 2021

Smarsh is the author of Heartland:  A Memoir of Working Hard and Being Broke in the Richest Country on Earth.  

Screenshot taken January 14, 2021

Screenshots taken January 12, 2021

Finally, here's a screenshot I've shared frequently in recent years; it's from the 2016 election exit polls broken down by income.  It shows that it is, in fact, those who might be called the "petit bourgeoisie," those who've gotten a leg up on the poor folks around them, who are most likely to oppose social safety net programs and support Trump.  The point is fleshed out in my scholarly writings and also illustrated here.  

Cross-posted to Working-Class Whites and the Law

Post script:  Here's a Washington Post story about how Washington insiders helped to organize the January 6 rallies that preceded the insurrection.