rural issues

Jackie Fortier / StateImpact Oklahoma

Oklahoma may soon see more money to help fight the AIDS epidemic. Robert Redfield, director of the Centers for Disease Control and Prevention recently visited health care facilities that offer treatment in Oklahoma, one of seven states where the rural transmission of HIV is exceptionally high.

Those states, which also include Alabama, Arkansas, Kentucky, Mississippi, Missouri, and South Carolina will be targeted by President Donald Trump’s plan to halt the spread of HIV within the next ten years, along with 48 mainly urban counties, Washington, D.C., and San Juan, Puerto Rico.

The sunrise in rural central Michigan reveals a landscape of neatly divided cornfields crossed by ditches and wooded creeks. But few of the sleepy teenagers on the school bus from Maple Valley Junior-Senior High School likely noticed this scene on their hour drive to Grand Rapids.

They set out from their tiny school district of about 1,000 students, heading to the closest big city for a college recruiting fair. About 151 colleges and universities were waiting.

When the Chemours chemical plant in New Johnsonville, Tenn., needed workers to maintain its high-tech machinery, it advertised for them as far as 90 miles away in Nashville in one direction and 150 miles away in Memphis on the other.

It still couldn't fill the jobs.

Jacob McCleland / Oklahoma Public Media Exchange

Twenty-nineteen means a new governor for Oklahoma and a fresh class of state legislators — nearly 40 percent of whom have zero political experience. It’s a new year, but the state government’s slate hasn’t been wiped clean.

Here’s a roundup of some of the biggest policy issues on deck for the upcoming year and legislative session.

Energy & Environment

Rural hospitals close when they don't have enough paying patients to care for, but they're also dinged when the same patients show up over and over again. That puts outlying medical facilities in the precarious position of needing to avoid repeat customers.

Charlotte Potts is the type of patient some hospitals try to avoid. She lives in Livingston, Tenn. — a town of 4,000, tucked between rolling hills of the Cumberland Plateau.

Two students share a laptop in the atrium of the chemistry building at the University of Michigan. One, Cameron Russell, is white, a freshman from a rice-growing parish in Louisiana; the other, Elijah Taylor, is black, a senior and a native of Detroit.

They are different, yes, but there is much that unites them.

Lindsay Bunker woke up from a nightmare.

The 32-year-old lives with her sixth-month-old daughter on the Lac Courte Oreilles Indian Reservation in northern Wisconsin. She's struggled with addiction for over 10 years, mostly to heroin. Then came the nightmare: She dreamt two men were attacking her baby while she could think only about drugs.

"In my mind I was thinking, 'If I can just get one hit, if I can get one line, I can save her,'" she recalls, pausing before continuing, "I woke up and I was panicking. How can a mother think like that?"

Sen. Claire McCaskill, D-Mo., is about to head home after losing her bid for re-election, and in defeat she's blaming her own Democratic Party for abandoning moderates.

McCaskill has represented Missouri in the Senate since 2007. During her tenure, President Obama lost Missouri twice and President Trump won it handily. McCaskill was one of 10 Senate Democrats running for re-election in states Trump won; four lost.

Jackie Fortier / StateImpact Oklahoma

On Election Day, voters in three traditionally Republican-led states will decide whether or not to expand Medicaid, the government health insurance program for the poor and people with disabilities.

When he was police chief of Stanwood, Wash., population 7,000, Ty Trenary thought rural communities like his were immune from the opioid crisis.

Then, one day, a mother walked through his door and said, "Chief, you have a heroin problem in your community."

"And I remember thinking, 'Well that's not possible,' " Trenary recalls. "This is Stanwood and heroin is in big cities with homeless populations. It's not in rural America."

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