The good thing about rural America is that people make their own way. It's a place where small business thrives. Then again, the bad part about rural America is that more people work for small businesses, which, in this country, means that fewer people have health insurance. National Public Radio's Howard Berkes reports, "Half of all jobs in rural places are tied to small businesses, a rate 13 percent higher than in cities and suburbs. And people who work for small businesses are twice as likely to be uninsured, according to Jon Bailey of the Center for Rural Affairs in Lyons, Neb....Also common in rural areas are farmers and ranchers, who disproportionately depend on individual insurance plans."
"Health insurance is killing rural America," farmer Linus Solberg (above) told Berkes. "Because people just can't keep up and pay their bills. And that shouldn't be in America. "We can put people on the moon," he said. "We can go up and fix this Hubble satellite that we have up there. And we can't have health care for all these people. It's ridiculous."
As the nation begins a long debate about the future of health care, little has been written (or spoken) about the special needs of rural communities. Berkes sheds some light on why the health care discussion needs to have a special place for rural Americans.
When the economy gets tough, the tough make meth. Or so it seems. The Lexington (Ky.) Herald-Leader's Bill Estep reports that the number of meth labs in Kentucky has jumped over the last 18 months, as meth "cookers" have found ways to circumvent laws meant to limit production. Kentucky, like may other states, passed a law in 2005 aimed at limiting access to an ingredient needed to make the addictive drug. (Have you tried to buy a cold medicine recently?) As states have placed monthly limits on how many cold or allergy pills an individual can purchase, meth producers have recruited small armies of buyers to buy drugs containing pseudoephedrine, which is used to produce methamphetamine. "It's like anything else — give them two or three years, and they'll find ways around it," one agent told Estep.
The U.S. placed limits on the exports of pseudoephedrine to Mexico, where meth "superlabs" were built. This has slowed production south of the border, but, in turn, that has increased production here, according to Estep. Meth producers have also figured out how to produce the drug in a two-liter soda bottle.
There are still many states without restrictions on cold medicines. None of the states bordering Kentucky have limits on the sales of drugs containing pseudoephedrine. Kentucky law enforcement officials say a national law is needed. Meanwhile, the number of meth labs discovered in Kentucky fell from 604 in 2004 to 302 in 207, but then increased to 405 in 2008.
Just last year, farmers were rejoicing in high commodity prices. This year, the Denver Post's Miles Moffeit reports, "increasing numbers of farmers are considering taking their lives." The Iowa-based Sowing Seeds of Hope provides help lines for farmers in seven Midwestern states and reports that there has been a 20 percent increase in calls this year compared to the same period in 2008. The Seeds of Hope hotline received 9,000 calls through May in 2008; this year, about 11,000 have called.
"The increase in calls really started with the change in dairy prices, as they fell last fall," said Mike Rosmann, a clinical psychologist and farmer who heads Sowing the Seeds of Hope. "We're starting to see the stress mount. It's a nationwide problem." In Colorado, Moffeit reports, "the collapse of the state's largest agricultural lender, New Frontier Bank of Greeley, has further exposed personal plights. Farmers on the edge of bankruptcy have tearfully pleaded for help from government leaders in recent public meetings." The greatest increase in calls to the Seeds of Hope hotline have come from dairy and hog farms. Calls from those farm operators have jumped 40 percent from 2008
Congress has considered a Farm and Ranch Stress Assistance Network, but hasn't passed the bill. The National Farmers Union is lobbying federal officials to activate a national hotline network, according to the Post.
Living in a rural community is no protection against the spread of an infectious disease, according to researchers at Kansas State University. In fact, closer ties among rural residents may help to spread a contagion more efficiently and more widely, according to computer models developed by the KSU engineers.
Urban residents are less likely to interact with sick neighbors and are therefore less likely to either contract or to spread the disease. In rural communities, the researchers found in a survey they conducted, the number of people who would be willing to visit others during a major disease epidemic is double that of urban areas. In cities, people may have more informal contact with many people, but close contact with few. "In a rural setting, you're maybe more likely to watch out for all of your neighbors, and your neighbors may also be your uncles, aunts and other family members," one of the researchers said.
As a result, the researchers found that epidemics will spread further and faster in rural communities. Add to that a decreased access to hospital and doctors and rural areas are "especially vulnerable during an epidemic." The K-State researchers suggested that vaccines be given first to those rural residents who have the most contact with the largest number of people. Those living in small towns know exactly who those very important people are.
Health and Human Services Secretary Kathleen Sebelius recently released a report detailing health care challenges in rural America. Hard Times in the Heartland was developed by HH staff.
The report indicates that nearly 50 million people in rural America face challenges accessing health care. Not only do these Americans face higher rates of poverty, they report more health problems, are more likely to be uninsured, and have less access to primary health care providers than do Americans living in urban areas. The report notes:
* Nearly one in five of the uninsured -- 8.5 million people -- live in rural areas. * Rural residents pay on average for 40 percent of their health care costs out of their own pocket, compared with the urban share of one-third. * In a multi-state survey, one in five insured farmers had medical debt.
The Hard Times report also details statistics relating to lack of access to quality providers in rural communities as well as the disparities of needs of rural patients. Diabetes, obesity, heart disease and high blood pressure are more common in rural communities.
“Americans in rural communities have seen their premiums skyrocket and are finding it difficult, if not impossible to get the care they need,” Secretary Sebelius said. “Today’s report confirms that we cannot wait to enact comprehensive health reform.”
What’s the real cost of health care for rural residents? Richard Oswald explains how labor and delivery equal debt to most young families. And the price only goes up.
Cash hog prices have dropped by between $3 and $5 per hundredweight, just this week. Hog futures have been dropping on the Chicago Mercantile Exchange. The problem is "swine" flu, and the belief worldwide that one can contract the virus by eating a pork chop. You can't contract the flu from bacon, ham, fatback, ribs or chops, of course. In fact, the CEO for the American Veterinary Medical Association tells Brownfield Network that this "particular H1N1 virus has no known origin back to swine." Nobody knows even if pigs can get the swine flu.
No matter. Several nations have closed their borders to U.S. pork and analysts "predicted a sharp decline of pork sales in grocery stores, and some consumers began steering clear of pork chops," according to the New York Times. This has thrown the pork industry into a tizzy. Stock prices for meat producers continued to plummet. (Late Thursday, the stock price for Smithfield Foods, the nation's largest pork producer, was down another 6%.)
So the pork industry has gone into fifth gear in trying to separate swine from flu. House Ag Committee communications director Demert Slayton wrote in an email that the flu strain is "more properly" called H1N1. Slayton continued, according to The Hill: “If you could please try to refrain from using ‘swine flu’ to refer to the outbreak (and please no pig graphics), this would be extremely helpful as the U.S. tries to maintain international trade and consumer confidence in our nation’s swine industry.” Meanwhile, the Centers for Disease Control and Prevention continue to call the virus the "swine flu."
Has the way we raise hogs helped create the swine flu variant that is now spreading across the globe? Mike Davis, in a column in the Guardian, writes that "corporate industrialisation of livestock production" in China and now across the world has transformed animal husbandry "into something that more closely resembles the petrochemical industry than the happy family farm depicted in school readers." He quotes a report from the Pew Research Center last year warning that industrial animal production causes a continual cycling of viruses that "increase opportunities for the generation of novel virus through mutation or recombinant events that could result in a more efficient human to human transmission."
Davis' column is based on a warning that appeared in a March 2003 article in Science magazine. Bernice Wuethrich wrote that "after years of stability, the North American swine flue virus has jumped onto an evolutionary fast track, churning out variants every year. Changes in animal husbandry, including increased vaccination, may be spurring this evolutionary surge. And researchers say that the resulting slew of dramatically different swine flue viruses could spell danger for humans, too. The evolving swine flue 'increases the likelihood that a novel virus will arise that is transmissible among humans,' says Richard Webby, a molecular virologist at St. Jude Children's Research Hospital in Memphis, Tennessee."
Pigs are good "mixing vessels" where human, bird and hog viruses can swirl and match, producing new and sometimes deadly strains. The last two flu pandemics occurred when avian and human flu viruses swapped genes in pigs.
A Houston-born doctor moves to small-town Oklahoma and gets the education of a lifetime -- in banking, health care policy, public relations, and asphalt.
In Nebraska, people in some rural areas live hundreds of miles from professional counselors, despite an ongoing effort to supply communities with trained mental health professionals, according to a story by AP reporter Timberly Ross. In fact, a shortage of mental health professionals is a particular problem in the rural West. "All rural America has a problem, but it becomes especially problematic as you move to the west," said Dennis Mohatt, who directs the mental-health research center at the Western Interstate Commission for Higher Education in Denver.
Nebraska is preparing legislation that would increase training and expand the state's network of health care delivery by phone and Internet. It will help, but still the government has declared that all but five Nebraska counties should be designated federal mental health shortage areas. The wait to get help for depression or schizophrenia can last for months.
About 31 percent of Nebraska's mental-health workers are in rural Nebraska, but that's where 43 percent of the state's residents live.