The paradisiacal and the terrifying

King's Court, Hopkinsville, Kentucky

Photo Credit: Boston Public Library

In the Pennyroyal region of southwestern Kentucky, amidst the smoky ranges of dark-fired tobacco, rests the town of Hopkinsville. Initially claimed in 1796 by Bartholomew Wood as part of a grant for his service in the American Revolution, a small tract of land quietly grew, until a town was formally established in 1804. Nearly 150 years later, in the fall of 1952, Hopkinsville welcomed its newest citizen, a baby girl born to Rosa Bell Oldham and Veodis Watkins.

Gloria Jean Watkins came roaring into a segregated world that was unprepared for the robust impregnability of a young Black girl’s voice. Raised by a man who worked as a janitor for the United States postal service and a woman who worked as a maid for white families, Gloria Jean described her rural childhood as “a rich magical world of southern black culture that was sometimes paradisiacal and at other times terrifying.” Amongst a white hegemony that could offer both the benefits of literature and the punishments of discrimination, Gloria Jean, a loner with “too much spirit”, crafted one of the most enduring identities in American social critique. bell hooks.

Greetings from Kentucky

Photo Credit: Shook Photos

A hymn for the pastoral 

bell hooks, a pen name borrowed from her maternal great-grandmother and stylized in lowercase in order to decenter the author, would go on to write nearly seventy published works, spanning from poetry and children’s literature to memoirs and magazine articles. While hooks is perhaps best known for her foundational contributions to the modern conceptualizations of intersectionality, the initial focus of this reflection is a small book of poetry released in 2012.

Appalachian Elegy opens with the following sentiment:

Even as a child I knew that to be raised in the country, to come from the backwoods, left one without meaning or presence. Growing up we did not use terms like ‘hillbilly.’ Country folk lived on isolated farms away from the city; backwoods folks lived in remote areas, in the hills and hollers. To be from the backwoods was to be part of the wild. Where we lived, black folks were as much a part of the wild, living in a natural way on the earth, as white folks. All backwoods folks were poor by material standards; they know how to make do. They were not wanting to tame the wildness, in themselves or nature. Living in the Kentucky hills was where I first learned the importance of being wild.

The collection itself, a series of “intimate untitled poems”, is a meditation on the threads that bind us, for better or worse, to our places of origin. Interrogating the enduring ways that ancestry tattoos our personage long after we leave the places we once called home. hooks’ exploration informally tracks her return to her Kentucky birthplace “blending memory with the harsh realities of destruction and the erasure of Black Appalachian history." While the work does not present a singular, nor stagnant iteration of what it means to claim an identity rooted in the rural, the introduction does, notably, distance the work from the concept of terms like 'hillbilly', a rather ironic sentiment, given what followed just four years later.

Postcard from St. Clairsville, Ohio

Photo Credit: Boston Public Library

The name taker

As of the writing of this post, there are probably few Americans unfamiliar with J.D. Vance’s 2016 memoir Hillbilly Elegy, at least in name. Within weeks of its release, the book was a New York Times bestseller and went on to be dramatized in a film directed by Oscar winner Ron Howard. Not to mention, of course, that Vance is currently serving as Vice President of the United States.

At the time of its release, there wasn’t significant notice taken, at least in most circles, of the similarities between hooks and Vance’s titles. The Hillbilly Elegy Wikipedia entry makes no mention of hooks’ work, despite referencing several other Appalachian literatures. Perhaps that is suitable, titular similarities are hardly rare in the realm of publishing, and beyond their rural origins, no one has evidenced any particular connection between the two authors or that Vance has any knowledge of hooks and her writings. The similitudes were, it seemed, pure chance.

That is, until Vance announced his second memoir, set to release in June later this year. Communion: Finding My Way Back to Faith is:

A spiritual exploration of what it means to be a Christian in all the seasons of life JD Vance has experienced—as a child, a young man, a husband, a father, and a leader. Picking up in some ways where Hillbilly Elegy left off, Communion recounts how Vance's pursuit of material privileges ultimately led him into a secular wilderness. Communion reveals how Vance regained his faith and discusses his conversion to Catholicism, how his faith guides his work in public life, and how it shapes his thoughts about the future.

Given the subject matter, the title is entirely apropos. Communion is defined as “the sharing or exchanging of intimate thoughts and feelings, especially when the exchange is on a mental or spiritual level." As such, on its face, there is nothing particularly noteworthy about Vance’s selection. However, as first noted by Claire Guinan for Jezebel, what is noteworthy is that his book isn’t the first to bear that title. Who else wrote a book titled Communion? Well, bell hooks of course.

Postcard from Castalia, Ohio

Photo Credit: Sent from the Past

The agrestic aggressor

On the sliding scale between complete coincidence and full-blown conspiracy, it is unclear where this story situates itself. While I find it difficult to suggest that Vance is uniquely plagued by a desire to co-opt the titles of hooks, to suppress her works to make room for his own; that is, in many effects, exactly what is happening. If you conduct a simple Google search for ‘elegy book’ or ‘communion book’ his works appear before hers in both iterations.

In theory, there should be room for a multitude of rural voices, but critics are beginning to express concern that Vance’s parallelism is hostile in either intent or effect. Guinan writes “I’m choosing to believe that [Vance] is a huge fan, rather than the other, more likely option, which is that he is appropriating IP from a prominent black, feminist voice.” Author B.N. Russo further opined:

Not only is this plagiarism of a Black woman’s work, it’s also search engine manipulation and keyword appropriation that will result in the detraction from Black feminist thought. Now, a student searching for “Communion book” may find promotional resources for a pseudo-religious political propaganda piece, rather than resources on hooks’ critical social philosophies. In this moment of attacks on Critical Race and Feminist Theories, removal of sociology studies from state schools, historical revisionism in National Parks, schools, and museums, censorship of public service organizations and institutions, book banning, ‘DEI’ investigations, and curriculum challenges, this is de facto censorship in the digital age.

Postcard from Lompoc, California

Photo Credit: Sent from the Past

An Arcadian mouthpiece 

One female. One male. One Black. One White. One queer. One straight. One passed on. One living. One lowercase in an attempt to decenter the self. One seeking the most powerful title in the world. Diametrically opposed, yet united in a desire to contribute to the cultural consciousness on rural identity. Only time will tell which narrative will devour the other, or whether, perhaps, coexistence is possible. I, for one, will be monitoring the situation with careful fascination, anticipating Vance’s third memoir title with bated breath.

Further readings

For further reading on these subjects please direct your attention to the following blog posts:

“On bell hooks: Black, female, working class and ‘semirural’” 

“J.D. Vance pulls ahead in race for Republican nomination for U.S. Senate seat in Ohio, prompting comparisons to positions he took in his book”

“Hillbilly cosplay and the privilege coverup”

The Grange: Community building in rural America

                      

Credit: Anderson Valley Grange

Some of my earliest memories are attending the yearly variety show at the Anderson Valley Grange in Mendocino County, California. During these performances the bustling Grange hall felt like the busiest gathering of the year, besides the county fair. The Grange gives fair warning that “this is a variety show NOT a talent show.” In catching up with my grandma about the Grange, which she was a member of for many years, she remembered most performances as “really bad,” noting affectionately that the emcee was “extremely corny.” She and her hippie friends were often among the acts of the night and may have been at least in the neighborhood of “really bad” also.

Regardless of the varying quality of the performances, the Grange provided a sense of community in a place where many people lived too deep in the woods to see their neighbors regularly. There was always some friend of my parents or grandparents who had apparently known me since I was a baby, and I likely would not see them again until the next variety show. Unbeknownst to me as a child at the variety show, the Grange had been playing a similar role in rural communities across America for almost 150 years.

The origins of the Grange

The Grange, formally known as National Grange of the Order of Patrons of Husbandry, began as an organization dedicated to agriculture when it was founded in 1867 by Oliver Kelley, a Minnesotan with an interest in reorganizing and educating agricultural workers. Kelley had been sent to the South after the Civil War by President Andrew Johnson to assess the agricultural conditions of the region and formed the Grange partially in reaction to this tour.

I Feed You All! Image Credit: Library of Congress 

The Civil War had marked the culmination of a rapid series of changes to farming communities. The draw of urban economies and the increasing efficiency of agricultural technology had steadily reduced the share of the US population engaged in farming, declining from 90% in 1790 to 42% in 1880. This demographic shift brought changes to the social fabric of rural communities.

Once, farmers had engaged in subsistence agriculture and frequently labored together if one member of the community needed help planting or with harvest. Now, innovations like the cast iron plow greatly reduced the need for farmers to work together in the fields. Additionally, most farmers had shifted from subsistence farming to commercial farming, rendering them competing market actors rather than a community with shared goals.

Kelley began the Grange with the increasing obsolescence of traditional farm life in mind, and his vision for a new farming community was a rather radical one. The National Grange claims that “[s]ince our founding in 1867, we have lived by our motto, “In essentials, unity; in non-essentials, liberty; in all things, charity.,” and that “[w]e have always welcomed and invited people of all races, creeds, religions and nationalities into our membership.”

The Grange did in fact embody principles of equality in many ways. The institution not only welcomed women, it required that at least four members elected to the board be women in order for a Grange to be chartered. Recognition of the labor that women provided in agricultural life was central to the Grange from its inception.

In addition to the social principles espoused by the Grange, the group was strongly motivated by Kelley’s longstanding interest in developing and proliferating farm technologies in an equitable manner. Kelley saw people engaged in agriculture being left behind. In his words, "Everything is progressing. Why not the farmers? The inventive genius of the country is continually at work improving tools, and farmers remain passive."

A particularly interesting feature of the Grange is their Masonic-inspired secrecy and ritual. Kelley had found that his membership in the Masons was a helpful foot in the door during his time in the South. He believed, quite correctly it would seem, that “[t]he secrecy would lend an interest and peculiar fascination.” Grangers ascended through a variety of ranks, known as “degrees”; wore sashes, badges, and regalia corresponding to their rank; and had secret handshakes and passwords. These features faded in modern Granges, but my grandmother still recalls a secret handshake and being given a “goddess name” when she joined in the 80s.

Expansion, goals, and advocacy

The Grange was a near-immediate and explosive success, with over 24,000 chartered local Granges and almost one million members within eight years of its founding. While Kelley had founded the Grange with central planning in mind, hoping to eventually incorporate the Grange into the U.S. Department of Agriculture, Grange chapters quickly became extremely independent, with the National Grange exerting little control over their operations. The Grange was focused on farmers, but were very lenient regarding who could become a member. Even from shortly after its founding, Granges members often included lawyers, judges, and educators.

The early National Grange strongly advocated for cooperative farming. While we commonly think of cooperative farming as groupings of producers, the Grange additionally endeavored to unify production and sale of agricultural products to extract greater profits, a practice known in economics and antitrust law as vertical integration. At the peak of the Grange collectivization attempts in 1877, about 30,000 co-ops existed. The Grange also operated the infrastructure necessary for these co-ops, facilities like mills, grain elevators, and warehouses.

Though the Grange is ostensibly non-political and discourages discussion of politics at their meetings, their concern for the agricultural class manifested in advocacy for a variety of political causes, especially in their early history. Perhaps most prominent was the effort of the Grange to combat the high rates charged by railroads, an effort that resulted in the Granger Laws and inspired modern antitrust law. A contribution that perhaps has the most lasting impact on rural communities is their campaign for rural free delivery of mail.

A critical view of the early Grange

While many accounts of the Grange dote over its inclusivity, Prof. Charles Postel provides a rather scathing perspective on the Grange in his book Equality: An American Dilemma. He notes that gender equality was a relatively palatable position in Washington D.C following the Civil War, where seven of the eight founding members of the Grange were working as members of the federal government at the time of the founding. While women did occupy prominent leadership positions in some Granges, many female members were relegated to secretarial roles.

Additionally, the Grange was somewhat wavering in its support for suffrage. The National Grange came out in support of suffrage in 1885, but the next year reverted to support for state rights to set suffrage policy. Granges did provide an audience for suffragettes, and the National Grange finally backed the suffrage amendment in 1915.

The Grange did not explicitly discriminate against African-Americans; it was nevertheless clear to many that they were not welcome. Kelley was a lifelong Democrat, and many Granges made quite obvious overtures to white Southern farmers. Prof. Jenny Bourne of Carleton College notes in her book In Essentials, Unity: An Economic History of the Grange Movement that the National Master of the Grange in 1873 said that admitting “colored” members was a question best left to local interests. Unsurprisingly, many communities in the South answered this question with exclusion. Black farmers responded by creating the Colored Farmers’ National Alliance near the end of the 1880s.

Many positive accounts of the Grange’s early history acknowledge and discuss the exclusion of African Americans, but the relationship of the Grange to Native Americans is often left unexplored. Prof. Postel notes that Kelley was largely disinterested in the Civil War because his “deep antipathy towards the Indians of Minnesota” motivated him to cooperate with Republicans, despite being a lifelong Democrat. While the Grange performed a variety of charitable work for Native Americans from the 1940s onwards, it must be acknowledged that the interests of white farmers were often in direct opposition to those of Native Americans during the early history of the Grange.

As aptly put by Prof. Bourne, “the history of the Patrons of Husbandry exposes the classic tension between the desires for achieving overall economic success and for dictating how the spoils are split.”

The fall, rise, and second fall of the Grange

While declining profits from farming rendered cooperative efforts very attractive, Grange efforts to collectively sell and purchase agricultural products suffered from defection by individual farmers. A lack of effective cooperation between the National Grange and local and state Granges was an additional challenge. Additionally, the cooperative methods employed by the Grange often required an upfront investment that many farmers were unable to afford as the economy became increasingly strained in the late 1800s.

Grange membership had fallen precipitously in the 1880s and 1890s, as many members found that the costs of their membership outweighed the perceived benefits. It did not help that some members apparently found the agricultural programming “dull as well as not worth the money.”

In terms of rural political advocacy, the space once occupied by the Grange had been effectively co-opted by new organizations like the Farmers Alliance, the Farm Bureau, and the Greenback Party by the late 1800s. While the Grange thus receded from national politics, it was a significant influence on these successor organizations and on modern farm interest advocacy groups, like the National Cattlemen’s Beef Association and state dairy marketing boards.

   Combined Grange and Farm Bureau Facility in Del Norte County, California

 (c) Lisa R. Pruitt 2019

While the Grange had largely withdrawn from the political stage by the early 1900s, membership had begun to rebound as Grange organizations started to offer important services to rural communities. In particular, the Grange began offering insurance and created power cooperatives in the 1930s.

While nonprofit utilities and insurance providers initiated by the Grange still serve rural communities, these enterprises are now mostly under non-Grange management and no longer exclusively serve Grange members. The fact that these services gradually stopped being linked to Grange membership and decreasing rural populations has caused a steady decline in Grange membership. Since the 1955 Grange membership has fallen from 850,000 members to 140,000.

The National Grange currently advocates on the level for relatively modest and non-partisan goals, like increased spending on agricultural research. They maintain their longstanding anti-tariff views and have generally favored immigration, but the organization seem to be tempering their language to assuage Trump voters in recent years.

The Anderson Valley Grange and the new role of Granges

The Anderson Valley Grange has a particularly Northern California themed history. This wonderful article by Lisa Morehouse, published recently by KWED, the San Francisso details the initial frictions at the Anderson Valley Grange in the 70s and 80s as the longtime residents of the area, largely loggers, apple farmers, and sheep herders, were suddenly overwhelmed by hippies hoping to use the Grange, home of the best dance floor in town.

The Anderson Valley Grange, Mendocino County, California

 (c) Lisa R. Pruitt 2022

The current head of the Anderson Valley Grange is a man known around town as Captain Rainbow who “wore a loincloth [and] lived up in the woods” when he first moved to Anderson Valley. He tells the story of how a crisis led to a reconciliation of this "old-timer" vs hippie conflict. 

In his early days in Anderson Valley, “if you were a hippie, you weren’t particularly welcome here.” He didn’t go to the local bar, nicknamed “the Bucket of Blood” for about 10 years “because it was chainsaw haircut time if you did." 

Things changed in 1985 when the old Grange hall, built in 1939, burned down. When the Grangers came together to build a new building, the hippies begged the Grangers to include a dance floor and offered to help rebuild the hall if the insurance money ran out.

Captain Rainbow recounts that even if you had a bad encounter with an old timer, “The next day, hungover, both of you would be hanging sheetrock together, and you’d find out that, hey, you’re all right.” After the hall was built, Captain Rainbow was delighted to receive an invite to join the Grange, along with the many other hippies who had been involved in the effort to rebuild the hall.

A post buried about half way down this archive of the Anderson Valley Advertiser shares a similar sentiment, noting that running out of insurance money, “was a blessing in disguise, forcing us to rely on each other, it forged new friendships and respect.”

My grandmother recalls joining after this cultural divide had somewhat mended. She joined because she wanted to find a venue for her Congolese dance teacher to offer lessons, and both were welcomed with open arms.

Today, the Anderson Valley Grange still acts as a center of community for the region. They host their annual variety show, monthly pancake breakfasts, dances, and quinceaneras. The Grange maintains ties to its agricultural roots, collaborating with Anderson Valley Brewery, using the hall for agricultural education, and hosting seed exchanges. Mendocino County Grangers also started a retirement facility that houses 170 people.

Food Bank Sign at the Anderson Valley Grange (c) Lisa Pruitt (2022)

While still lively, the Anderson Valley Grange faces the same issues as Granges nationwide. In Captain Rainbow’s words, “We need some fresh blood.” The Grange is active, but the membership is aging. “When my generation came in and became part of the Grange, the old-timers, they needed us. And [], I’m a geezer now!”

While Grange membership has been on a long downward trend, there has been some incremental growth in the last few years. The Anderson Valley Grange, like many in California, has an increasingly Latino membership. It is also making overtures to Native Americans in the area.

Conclusions

The Grange is an institution with an extremely rich and complicated history that this post has barely scratched the surface of. While its political relevance has faded, local granges still remain as a hub of community in many rural areas. Living in the city, it is easy to forget how crucial simple infrastructure like a large hall with a stage is to cultivating community. As rural communities struggle and decline, we should be mindful of the role that organizations like the Grange play in supporting them.

Senators call for investigation into the state of rural child care—and how Trump administration policies are undermining it

Head Start offices in Toledo, WA.
Photo by Joe Mabel, distributed under a CC BY-SA 4.0 license.

On January 26, six senators led by Elizabeth Warren and Raphael Warnock announced an investigation into how the Trump administration's childcare policies affect rural families. The letter, addressed to Todd Lindsey, Acting Under Secretary for Rural Development at the U.S. Department of Agriculture, and Alex Adams, Assistant Secretary for the Administration for Children and Families, requests "information regarding ACF and USDA's current capacity to support child care, particularly in rural communities." The senators highlight the national childcare crisis, emphasizing the high costs and lack of access many families face. 

Child Care Funding in Rural Areas

This letter follows a January 6, 2026, Trump administration attempt to freeze federal funding for child care and family assistance in five states. The administration said it was taking this action due to allegations of fraud in the use of federal funding. Courts restored the funding within three days, allowing child care centers to continue receiving federal funds. The freeze temporarily affected the Child Care Development Fund Block Grant (CCDFBG), a federal funding stream that helps make child care more affordable. It also affected Temporary Assistance for Needy Families (TANF), which provides block grants to states. It has been historically known as cash assistance to families, but it also provides direct childcare assistance, as well as state-wide funding. States can choose to transfer up to 30% of their TANF funds to their CCDFBG funds and funnel them towards childcare subsidies and Head Start programs.

The Senators' statement also follows H.R. 1 (the "One Big Beautiful Bill"), which you can read more about here. The bill expanded the Child Tax Credit and increased the amount that employees can set aside pre-tax for childcare. These changes mostly benefit middle- and upper-income families. On February 3, 2026, the House passed a new spending package, and President Trump signed it. That bill increased the Child Care Development Block Grant and Head Start by $85 million each. 

Head Start provides critical resources to children up to age 5. Its programs include providing breakfast and lunch, mental health care, and school readiness. Almost half of all Head Start slots are in rural districts. In a survey of 10 states, Head Start programs comprised about one-third of childcare centers in rural communities. This program supports children and families. Expanding Head Start has drawn bipartisan support, and  78% of rural Americans support it. 

The Rural Childcare Gap 

The senators cited a September 2025 poll by the First Five Years Fund, which found that rural families experience child care challenges across the board. 

Overall, 4 out of 5 [r]ural Americans say the ability of working parents to find and afford quality child care is either in a “state of crisis” or “a major problem,” including 81% of Rural Parents and 80% of Rural Nonparents.

Further, one in five rural parents report having trouble finding or keeping a job because of the cost or access to child care.  

Data collected by the Buffett Early Childhood Institute at the University of Nebraska further illustrates the gap. 31.5 percent of rural children who may need childcare do not have access to a childcare facility within 10 miles of their home. This data assumes that parents drive, but aproximately six percent of rural households do not have a car. Lack of access to transportation can make finding childcare even more difficult in rural areas, especially when transporting multiple children. 

Kickapoo Community Childcare Center in Lincoln County, OK. Photo by Rebecca South, distributed under a CC-BY 4.0 license. 

Effect on Families

The lack of access and high costs of childcare drive parents out of the workforce. A 2021 Bipartisan Policy Center survey found that 86 percent of parents in rural areas who do not work cited child care responsibilities as a reason they stay home. Child care centers face significant economic difficulties, driven by high turnover rates and low wages. Closures have led to parents, often mothers, leaving the workforce at higher rates than ever over the last two years. 

These funds also provide child care to parents pursuing higher education. Congress did not reauthorize the Child Care Access Means Parents in Schools, pausing the program. Programs at rural colleges make child care affordable for student parents and provide other support to help them pursue higher education. 

One administrator at the University of Wisconsin-Whitewater said she expects that this will make it more difficult for student-parents to graduate. Cutting this program means student-parents will either need to work while pursuing their degree or leave their program to stay home with their child. 

The Future of Rural Child Care

Recent federal legislation surrounding rural children and families has proven to be a mixed bag. While bolstering Head Start programs might expand child care resources in rural areas, other funding cuts could undermine those gains. This administration has shown its willingness to use child care funding as a political football. ACF and the USDA, which work together on child care in rural communities, have had their funding withheld, field offices closed, and major workforce reductions. 

The senators concluded their letter with six questions about the future of rural child care, with a response requested by February 16, 2026. As of today, neither ACF nor USDA has responded. Their response—if and when it comes—will inform the debate around the future of childcare funding in rural communities through the remainder of the Trump Administration. 

The disappearing place

British Columbia's Picturesque Highways, 1942

Photo Credit: Blizzy 63 Flickr 

Name: Helen Claire Frost

Identifying Characteristics: Caucasian female. Blue eyes and brown-blonde hair. About 5 feet 5 inches. 125 pounds. 

Occupations: Table busser, berry picker, painter, laborer. 

Status: Missing for 55 years, 4 months, and 7 days. 

In the fall of 1970, Helen Claire Frost slipped her arms into the sleeves of a navy nylon parka, wiped cold coffee from the corners of her mouth, and set out for a short walk from the Prince George apartment she shared with her sister Sandy. Authorities know she made it as far as the Husky gas station. They know she was four days shy of her eighteenth birthday. They know she had recently given birth to a daughter, Sandra Jeanette.

What they don’t know, is what happened next.

Theories flourished. Runaway. Suicide. Accident. Homicide. Answers, however, proved less abundant. In 2009, Sandy Frost disclosed that her father had told her, “I really hope I know what happened before I die.” Dennis Roy Frost died on July 20, 2014. Helen remains missing.

Highway of Tears Corridor

Photo Credit: OpenStreetMapContributors

The highway of tears

Chronologically, Helen is the first recorded disappearance along what Florence Naziel coined as “The Highway of Tears” in 1998. Described as a warm and eccentric Elvis-loving character with bleached blonde hair and a fondness for leopard print, the term came to the Wet’suwet’en mother and grandmother during a vigil walk in memory of the disappeared.

Specifically, it refers to a 720-kilometer-long span of Yellowhead Highway 16 that connects the towns of Prince George and Prince Rupert in British Columbia, Canada. Since 1970, this tract of land has been the site of eighteen documented disappearances, although local indigenous groups believe the number is closer to fifty. As of 2026, nearly every case remains unsolved.

Highway 16

Photo Credit: Kevin Dooley

“Another drunk Indian”

A series of explanations has been proposed to elucidate how this small stretch of pavement became a place of nightmares, how an entire country came to cultivate a years-long toleration of crime and stifled progress. Rampant poverty leads to low rates of vehicle ownership, making hitchhiking the only form of mobility for many rural British Columbians to access work, school, and medical treatment. Additionally, the region is plagued by drug abuse and domestic violence, scars of the now infamous Canadian Indian residential school system.

Royal Canadian Mounted Police (RCMP) Reserve Constable Wayne Clary, who has worked these cases for decades, believes racism has played the central role: 

“Racism? Absolutely. Along Highway 16, we have vulnerable women because of what the Canadian government did to Indigenous peoples and their history. How they tore out a generation, how they weakened a family structure [through residential schools] - that doesn’t get fixed overnight.”

In the words of Assembly of First Nations Regional Chief Terry Teegee, the stench of death in rural BC blossoms from the earliest roots of colonialism: “This goes along with 152 years of colonization. Our women are looked at as ‘another drunk Indian’."

TCH-Yellowhead 16

Ryan Craig

The finding place

There are still those who are trying to change the narrative surrounding Highway 16, from a place of loss to a place of resilience. In 2005, the RCMP founded the Project E-Pana Task Force to determine whether a serial killer, or killers, is responsible for murdering young women traveling along major highways in BC. In 2023, billboards sponsored by the families of the missing and murdered were erected along the highway to raise awareness and warn women not to hitchhike. In 2025, five cell towers were installed along the corridor to aid resource extraction efforts, which activists hope will have the unintended benefit of improving communication and safety for travelers.

Highway 16

Photo Credit: Gripso_Banana_Prune Flickr

The lost ones

More than fifty years after Helen Frost vanished into the chill night air, Chelsey Amanda Quaw’s body was discovered in a wooded area just north of Highway 16, one month after she disappeared while stepping outside for a cigarette. Her murderer has yet to be found.

To some, she will just be a name on a list. Another entry in the ‘quirk’ that is Highway 16. But she was also a beloved member of her Saik’uz First Nation community. A daughter and sister whose family will miss her dearly. Mary Teegee, a leader from the Highway of Tears Governing Body, laments that efforts to solve the case appear to be conforming to old patterns:

“Why were there not RCMP helicopters, why weren't there RCMP dogs, why wasn't there more RCMP boots on the ground?...I don't think that Pam [Heron] should have had to prove that Chelsey was not a drug addict...Imagine if this was a young white girl out of West Vancouver. Would the mother have to be [calling for] more RCMP involvement, for more of an investigation?"

Rural women face a decline in access to necessary reproductive health care

Women's rural health clinic in Bishop, California.

Credit: California Health Report

Maternal Health

The United States has the highest rates of maternal death among high-income countries, three-times higher than comparably wealthy nations. Maternal health disparities impact certain populations more severely than others. For example, the maternal death rate for black women is 49.5 deaths per 100,000 live births, compared to the US average of 22.3 deaths per 100,000. 

Rural populations face maternal death disparities too. "Noncore" areas (areas outside metropolitan and micropolitan statistical areas defined by the Census) have a maternal mortality rate of 26.8 deaths per 100,000 live births compared to 19.5 deaths per 100,000 for large central metro areas. Further, the situation for rural women is likely to get worse.

Maternal health access has been declining in recent years. In 2024, the National Rural Health Association shared that 36% of U.S. counties, a majority of which are rural, are maternity care deserts. A maternity care desert is any county without a hospital or birth center offering obstetric services. In 2022, more than half of rural counties (58.8%) had no hospital-based obstetrics unit, up from 51% in 2010.

Katy Backes Kozhimannil, a professor at the University of Minnesota School of Public Health, told The Daily Yonder that closures of obstetric units are due to "not having enough revenue to keep the units open, as well as not having enough births and specialized skills to care for obstetric patients and not having enough trained clinicians to keep the unit operating." 

Closure of rural hospitals exacerbates the maternal health crisis in these rural communities. Since 2005, 110 rural hospitals have closed, and almost 800 are currently at risk of closure due to financial distress. A previous blog post discussed the rural "slush fund" included in Trump's "Big Beautiful Bill," which included a $50 billion program to support rural health. The fund, named the Rural Health Transformation Program, is overshadowed by the fact that the bill cuts Medicaid funding by almost $1 trillion, estimated to be $137 billion in rural areas.

Credit: Allie Kelly, Business Insider

A study by Georgetown University Center for Families and Children showed that 47% of children and 18% of adults in rural and small towns rely on Medicaid (numbers that the study predicts underestimate the true values). Also, nearly half of all births in rural hospitals are covered by Medicaid. While the rural "slush fund" may provide some funding for rural health care infrastructure, its only one-third of what rural communities expect to lose from the cuts. 

The fund will be distributed over five years, $10 billion each year starting in 2026. The amount each state will receive this year averages $20 million. Half of the fund is distributed equally across states, with only a quarter of the fund being distributed based on need, meaning that states with significantly larger rural populations may receive similar amounts of funding to states with lower rural populations. Additionally, the fund is broadly available to aupport health care systems, with initiatives not directly tied to rural health, such as Make America Healthy Again (MAHA), posted by Centers for Medicare & Medicaid Services (CMS) as an example of what may receive funding.

Abortion Access

On another reproductive healthcare front, access to abortion clinics from rural areas is limited. In California, about 40% of counties do not have an abortion clinic, and most of these counties are rural. In Inyo County, CA, most residents live over 200 miles from the nearest abortion provider. The lack of abortion care is shocking in light of California's support for abortion access. But residing in a state that recognizes the right to abortion does not mean its residents automatically enjoy easy access to abortion providers. Avery Van De Berg previously wrote on this blog about the severely limited abortion access in Missouri, despite their amendment to protect abortion rights.

Rural residents in states that have enacted post-Roe bans on abortion face even greater barriers to care. Many residents now have to travel significantly farther to find abortion providers. Sarah Melotte of The Daily Yonder analyzed abortion care data and found that after Roe was overturned, rural travel to abortion providers increased from 103 miles on average to 159 miles on average. This distance can be significantly farther in some rural areas. Travel to an abortion provider is as far as 800 miles of travel from parts of rural Texas and 492 miles of travel for the average rural Louisiana resident.

What's the Solution?

Policy-makers have proposed solutions to the reproductive health care crisis facing rural residents experience. Similar to solutions posed to prevent legal deserts, a solution for maternity care deserts includes recruiting, training, and retaining physicians who provide maternal care. To improve access to care, Telehealth policies have been proposed to bridge the gap between physicians in rural area and maternal care needs. 

Undoubtedly, many of these solutions come down to investment in rural health care. We've yet to see whether laws like the "Big Beautiful Bill" will fulfill promises of affordable and available healthcare in rural communities.

For more academic analysis of these issues read more here and here.

The extinction of mermaids

Photo Credit: UNxArtPartner Create COP25 Haenyeo 2019

Emerald sequins bathed in refracting light. Lavender velvet crushed beneath loose limbs. Shimmering turquoise dappled with the tacky remnants of a cherry ice pop. These were the qualities that sketched the lines of one of my most treasured childhood possessions: a swimsuit, inspired by the 1989 film, "The Little Mermaid." 

In a plastic pool in late 90s, Castro Valley, California, I would spend hours baking under the gaze of an overzealous sun, grieving the mythos of creatures that existed only in daydreams. However, nearly six thousand miles away, on the Island of Jeju, mermaids were very much a reality. 

Photo Credit: UNxArtPartner Create COP25 Haenyeo 2019

The sea women

Evidence of female free divers, or haenyeos (Korean:해녀), first appears in literature dating to the 17th Century. What began as a solely male-dominated field soon shifted into one of the quintessential representations of semi-matriarchal family structure in Asia. To become a haenyeo, women must join a fishing village cooperative, requiring the agreement of other members. Diving rights are often passed on from elderly haenyeo to their daughters and daughters-in-law. 

Diving barehanded, clad in simple cotton mulsojungi, without oxygen tanks or other technological adornments, these women routinely plunge their bodies into the gelid waters off the southernmost coast of the Korean peninsula. For seven hours a day, 90 days a year, haenyeo dive up to 20 meters below the surface to harvest marine resources, including abalone, other mollusks, octopi, sea urchin, seaweed, turban shells, and other shellfish for their families and the community. According to Kim Hoo-ran of The Korean Herald, the spirit of the haenyeo is communal, "The women seek equitable distribution of their harvest, giving away part of their catch to a diver who has a poor catch. Such favors are always returned by the recipient."

As Dr. Miyoung Kim of Ewha Women's University notes, the lifestyle is not without its dangers:

These divers are [also] exposed to decompression sickness because they perform breath-hold dives, and these dives can cause neurological problems, such as muscle weakness and dysthesia, as well as other symptoms, such as vertigo, dizziness, and nausea. In addition, increases in intraocular pressure while diving damage the optic nerves and lead to headaches. Among this group, 83.5% take analgesics and antihistamines during work to prevent the headaches and earaches that occur due to diving, and they often take more than the recommended doses; thus, drug overdose is a serious problem. 

Photo Credit: Blog Duam 

Translating the currents

The adversities, however, are paired with marvels. According to a new study in Cell Reports, generations of diving has literally altered the genetics of divers and their children, passing down a series of psychological adaptations allowing them to dive more safely. Dr. Melissa Lardo and her team observed that:

Haenyeo's heart rates drop[ped] about 50 percent more during simulated dives compared with other groups, which helps them hold their breath longer by limiting oxygen that the body needs and reducing the work the heart needs and reducing the work the heart needs to do...This blood pressure genetic variant can protect the haenyeo as they dive while pregnant-typically, pregnant haenyeo will dive up until the day they give birth, says Ilardo. Researchers suggest this lower blood pressure genetic variant could protect against complications like preeclampsia, a health risk for pregnant women that can be exacerbated by diving. 

Centuries of diving has not only changed the anatomy of these women's bodies; it has embedded in them, what Dr. Samantha Chisolm Hatfield calls Traditional Ecological Knowledge (TEK). 

TEK "specifically relates to the environment in a given traditional homeland of Indigenous groups and/or Usual and Accustomed areas. This may include but is not limited to: botany knowledge, medicinal application (collection and/or administration), hunting, fishing, gathering, processing of materials(s), caretaking such as burning, coppicing, thinning, astronomy, phenology, time, ecological markers, species markers, weather, and climate knowledge."

In a paper published in the Journal of Marine Island Cultures, Hatfield and Dr. Sung-Hee Kong interviewed haenyeo and concluded that they have highly developed environmental acuity, a unique ability to read environments and document information on environmental changes. This is particularly vital as the collection of resources has steadily declined, and sustainability efforts are necessary to mitigate the ravages of climate change. 

Photo Credit: Bernard Gagnon

The ebbing tide 

After thousands of years, the mermaids of Jeju face extinction. According to Katie Hunt of CNN Science "The practice is dying out. Young women are no longer continuing this matrilineal tradition; the current group of haenyeo divers, with an average age of around 70 years years may represent the last generation." The recalibrated values of a modern Korea are looking increasingly incompatible with this practice, threatening to erase the women of Jeju and their stewardship of the peninsula's marine ecology. 

Without haenyeo governance, author Taeyoung Kim expresses concerns that the combination of non-traditional extraction methods and capitalism-driven development will irreparably damage rural Jeju:

“Rapid economic progress [has] led to the exploitation of working class, women, and rural areas to reinforce the progress of national economic development. This action was justified as a means for "nation building", which led to severe repercussions to the natural habitat in Jeju marine ecosystem…External capital inflow extracted profits by expropriating Jeju people's land, resources and communal assets, which is a common mechanism used by traditional colonial extractive industries.”

Photo Credit: Peter Chanovec

A coruscation of hope

However, as in all fairy tales, the hope of happy ending remains. In 2016, the haenyeo were included on the UNESCO List of Intangible Cultural Heritage and just this month, haenyeo was added to the Oxford English Dictionary, which many hope will raise awareness for this vanishing way of life. Furthermore, although the population continues to dwindle, younger generations are beginning to answer the haenyeo's siren song. Together, these factors may protect the last of the mermaids. 

Catching up on rural healthcare stories

I wrote several posts about rural healthcare this summer, mostly prompted by the consideration and passage of Trump's One Big Beautiful Bill, which was widely discussed as undermining rural health care and rural hospitals.  Since then, I've neglected the issues except to address some of them in this forthcoming law review article, which focuses on the challenge of maternal mortality for rural women.  

In this post, my plan is just to provide links to the stories I've seen about rural health care since the summer, making this something of a repository of resources to study how rural health care is faring in the Trump administration's first year and likely further degradation of services as a consequence of recent Republican policies.

First off, the Trump administration is withholding support to tsunami proof this hospital.  Katia Riddle reports from Astoria, Oregon.   One interesting aspect of this story is how local Republicans who supported Trump are flummoxed--or worse--about his administration's failure to support a rural hospital that has saved many local lives.  Here's some context:   

The Trump administration has canceled billions of dollars in federal grants across multiple agencies, and one of those grants is for a program that was designed to help local governments fortify places that are vulnerable to natural disasters.

* * *  

[The hospital in Astoria], called Columbia Memorial, was built decades ago. Now that we know more about earthquakes, it's hard to imagine a worse spot to build a hospital. Not only is the whole town in a major subduction zone, the building is just a few blocks from the water, on top of dangerously unstable ground.

And here's a key quote from a former mayor of Astoria, Willis Van Dusen, a Republican who voted for Trump but now is frustrated by the recent turn of events regarding the needed hospital work: 

Van Dusen: What is more important than a hospital in a rural community like Astoria? Now, it saved my life.

Riddle: Van Dusen points to a framed photocopy of a piece of paper - the EKG reading when he had a heart attack some years ago. At one point, he flatlined.

Van Dusen: All these are (imitating electric current), and they're hitting the paddles. And I had actually died.

Riddle: It was doctors at Columbia Memorial that brought him back. Van Dusen says he and many other people in Astoria wouldn't be here without this hospital. Making sure that it can keep providing care during an earthquake and a tsunami, he says, is the opposite of waste, fraud and abuse.

Van Dusen: And just to jerk that money away from us, I can't just say it makes - it's frustrating. It makes me livid. It makes me angry.

Riddle: Van Dusen says he's not the only one in this town who's mad.

Van Dusen: I know every single Republican that I have talked to is livid over what's happening.

This is a rare instance when I've seen a Trump voter whose mind has been changed by Trump's spending priorities--and how those priorities have played out in the voter's own community.  It shows that Trump voters can be swayed when Trump's spending priorities impact them, something rarely illustrated.  

Regarding the $50 billion "rural health fund," sometimes referred to as the rural slush fund, Sarah Jane Tribble of Kaiser Health News reported about ten days ago on how states are competing for these funds.  It hardly seems like a fair fight.   Tribble provides details on how and why substantial chunks of the funds might not even wind up in rural places:  

Nationwide, states are racing to win their share of a new $50 billion rural health fund. But helping rural hospitals, as originally envisioned, is quickly becoming a quaint idea.

Rather, states should submit applications that "rebuild and reshape" how health care is delivered in rural communities, Centers for Medicare & Medicaid Services official Abe Sutton said late last month during a daylong meeting at D.C.'s Watergate Hotel. Simply changing the way government pays hospitals has been tried and has failed, Sutton told the audience of more than 40 governors' office staffers and state health agency leaders — some from as far away as Hawaii.

"This isn't a backfill of operating budgets," said Sutton, CMS' innovation director. "We've been really clear on that."

Rural hospitals and clinics nationwide face a looming financial catastrophe, with President Trump's massive tax-and-spending law expected to slash federal Medicaid spending on health care in rural areas by $137 billion over 10 years. Congressional Republicans added the one-time, five-year Rural Health Transformation Program as a last-minute sweetener to win the support of conservative holdouts who worried about the bill's financial fallout for rural hospitals.

Yet, the words used by CMS Administrator Mehmet Oz and his agency's leaders to describe the new pot of cash are generating tension between legacy hospital and clinic providers and new technology-focused companies stepping in to offer new ways to deliver health care.

It's "what I would call incumbents versus insurgents in the rural space," said Kody Kinsley, a senior policy adviser at the Institute for Policy Solutions at the Johns Hopkins School of Nursing.

I further detail possible non-rural uses of the fund in my forthcoming law review article, which relies on Tribble's reporting. 

Finally, Abigail Ruhman reported for the Texas Tribune a few weeks ago on how Texas' rural hospitals are competing for a piece of that "rural slush fund."  

As Texas develops its application for a new rural health funding program, rural hospital leaders say the priority should be financial stabilization for their facilities.

The recent sweeping tax and spending plan includes a $50 billion appropriation for the Rural Health Transformation program. States will receive funding based on applications they submit in early November.

During an hours-long public hearing Monday to discuss the program, several hospital leaders raised concerns that without direct funding, the state may experience more rural hospital closures.

Erin Clevenger, CEO of Memorial Medical Center in Port Lavaca, southeast of Victoria, said her hospital is high on the list of Texas hospitals at risk of closure.

“Every day is a battle to make sure we don’t become one of those statistics,” Clevenger said.

In the last decade, Texas has lost 14 rural hospitals. Of the 156 rural hospitals currently in the state, about 70% have lost services, and more than half are at risk of closing, according to a report from the Center for Healthcare Quality and Payment Reform.

Memorial Medical Center is in the southern part of the state, but it provides critical services that benefit people across Texas – even patients in Dallas.

“When even large urban hospitals could not take on more patients, we opened a COVID care unit and accepted their transfers, even flying patients in from Houston and Dallas,” Clevenger said.

Keep an eye out for more news about whether rural hospitals are getting the benefit of the "Big Beautiful Bill" and its rural slush fund--and whether any funds they receive are sufficient to keep them open.  It'll also be interesting to see if the anticipated closure of rural hospitals will turn rural Trump supporters against him--if those closures happen during his presidency.  

Meanwhile, the reduction and reinterpretation of other federal funding streams, along with other strains,  have been threatening--and in one instance, closing--hospitals in rural California.  Read more here (Inyo County in the eastern Sierra) and here (Imperial/Riverside County).  

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. 

Building blocks: how a lack of childcare infrastructure is hurting children and their parents

In mid-March, The Daily Yonder published a piece detailing social worker and filmmaker Laura Norton-Cruz’s efforts to bring awareness to the lack of childcare infrastructure in rural Alaska. Norton-Cruz is intimately familiar with the shortage of childcare, and the problems this shortage creates for rural Alaskan families. The Daily Yonder writes:

Norton-Cruz remembers finding out that she was pregnant and feeling like she’d just been “thrown to the wolves.”  “What am I going to do about child care?” she asked. “What am I going to do about breastfeeding and pumping at work? What am I going to do about paid leave?"

Over a decade after becoming a single mother, Norton-Cruz enlisted the help of filmmaker Joshua Branstetter and created At Home/In Home: Rural Alaska Childcare in Crisis, a documentary that would provoke Alaska’s state legislature.

Norton-Cruz’s documentary focuses on Kotzebue, Alaska, a rural town of 3000 residents, primarily Alaskan Native people. More than 500 children under the age of five reside in Kotzebue, yet the town does not have a single licensed childcare facility. 

Unfortunately, Kotzebue is not unique. According to a December 2024 report from the Alaska Governor’s Task Force on Child Care, 61% of Alaskans have limited or no access to licensed childcare facilities, even though over half of young children live in households where all parents are employed and need childcare.

The documentary portrays parents who are forced to leave jobs in childcare deserts, employers who cannot find employees, public officials who track the economic damage of the childcare crisis, and residents who battle the state childcare licensing system as they try to establish a home-based childcare facility.

Childcare deserts are not just present in rural Alaska. In fact, nearly two-thirds of American rural families live in a childcare desert. Childcare deserts are defined as areas where there are more than three young children for every licensed childcare slot available. 

Additionally, rural Americans spend more money and travel farther for childcare arrangements. On average, a rural family spends 12.2 percent of their income and travels 7.5 miles for childcare while urban families spend 10.8 percent of their income and travel 3.5 miles for childcare. (Read more about rural childcare here and here).

The lack of infrastructure to support women and children is a recurrent problem in rural areas, and expands beyond a lack of childcare. A 2023 CDC report found that only 31% of rural municipalities had some type of paid maternity leave in 2021 compared to 41.2% of urban areas, and 42.3% of rural municipalities provided break time and space to pump breast milk versus 55.4% of urban municipalities.

It is well documented that rural areas are also lacking in maternal care. As of 2024, 59% of rural counties qualify as maternity care deserts. As a result, rural women have consistently higher predicted probability of maternal mortalities, with 37.9 pregnancy-related deaths per 100,000 occurring in rural areas in 2020 and 31.2 deaths per 100,000 in micropolitan areas, compared to 29.9 per 100,000 in large metropolitan areas. (Read more about rural maternal health care here and here).

Alaska is a particularly challenging place to deliver health and human services due to its vast size, sparse population, extreme climate, and the unique needs of its diverse communities, including Native populations. As such, rural Alaskan populations often face even more extreme disparities in healthcare access and outcomes.

Thankfully, Norton-Cruz’s film has prompted the Alaskan governor to set up the Alaska Child Care Task Force, which has allowed Kotzebue residents to erect a home-based non-profit early learning program. Although residents admire the program’s progress, the early learning program only serves eight of the 500 children under the age of five in Kotzebue. Clearly, there is still much work to be done. 

Norton-Cruz continues to document the Task Force’s progress. She states:

We have to keep paying attention to this issue and keep the pressure on…because that’s what leads to changes in funding and changes in policy. We need to help employers, legislators, and leaders see that this is the most important part of child development and the most abandoned policy issue of our time.