Children are the future - it’s a common refrain. However, in isolated, rural communities across America, there are people traveling many miles from their home to deliver babies. Since 2010, nearly 150 rural hospitals have shut down - a victim of the financial stresses facing U.S. health care. One survey finds that about 40 percent of rural hospitals lose money offering obstetric care, since it costs $18,000 on average to have a baby. So, when small hospitals look at cost-cutting measures, delivery and obstetrics units are often casualties. Just under 10 percent of rural hospitals have shut down their delivery services. For this Us & Them episode, host Trey Kay hears from families facing that change, and how it’s affecting prospects for their rural cities and towns.

Diminishing OB Care In Rural America

We tell stories from the fault lines that separate Americans. Peabody Award-winning public radio producer Trey Kay listens to people on both sides of the divide.

Society & Culture

Personal Journals

History

Philosophy

Places & Travel

There’s a foster care crisis in America. Nationally, more than 390,000 children are in foster care, in West Virginia that’s just over 6,000 children who need a safe place to call home. Last year, more than half of all states saw their number of licensed homes drop, some as high as 60 percent. That challenge comes because new foster parents don’t stay in the system for long. On this episode of Us & Them, host Trey Kay hears about the shortage of licensed foster homes. Foster care is most often needed because of parental substance use, mental health challenges, poverty and neglect. While official foster care cases are tracked and overseen by state agencies and non-profit organizations, there are many informal kinds of so-called kinship care that are not official or included in state data. Some experts say the number of those kinship cases drives the stakes of the challenge much higher.

Us & Them: Our Foster Care Crisis

More than 4.5 million Americans cannot vote because of a felony conviction but only about a quarter are currently in prison. On the newest episode of Us & Them, host Trey Kay talks with people who support expanded voting rights for felons, and those who say people who’ve committed crimes should forfeit their rights until they serve their entire sentence, including any probation or parole. Felon disenfranchisement laws differ significantly from state to state and even legal experts say it can be difficult for someone to know their rights. In a few states a person can vote from prison, while in others, voting rights are restored upon release or completion of parole or probation. Despite recent trends to expand voting rights, some states are moving in the opposite direction. In Florida, voters passed an amendment to restore voting rights to most people with felonies, but lawmakers passed a new law requiring that people pay all of their court fees first. And in Virginia only the governor can restore the right to vote for someone convicted of a felony.

Us & Them: Locked Out Of Voting?

Our country’s divides often reveal themselves in our choices and habits, including how and where we get our information. As the economics of the media landscape have imploded, the economics of the industry have forced changes. In the past two decades, online sites have taken over much of the income stream from classified ads and general advertising. That has led newspapers and broadcasters to slash thousands of jobs. Many local news outlets have gone out of business and there are now more than 200 counties across the country with no source of local news. One of those is McDowell County in West Virginia.  Last year, publisher Missy Nester was forced to shut down the Welch Daily News  after a valiant effort to keep the paper running. Join host Trey Kay and reporter Todd Melby on this episode of Us & Them to see what happens when local news organizations stop telling the stories of a community.

Us & Them: Another Small Town Paper Down

There's a nationwide rift among farmers over the use of dicamba, a popular herbicide. A 2024  federal court ruling  has halted dicamba's use, but the Environmental Protection Agency has given the green light for farmers to use existing supplies this year. In this episode of Us & Them, we revisit a story from our archives that delves into the intense battle unfolding in farm country. Originally designed to help soybean farmers combat 'pigweed,' dicamba has proven controversial because it drifts from where it’s sprayed,  causing harm to  desirable plants. The legal fallout has reached a point where farmers and gardeners hesitate to speak out about crop or plant damage due to fear. On the flip side, those advocating for dicamba have taken the matter to court, challenging the authority over pesticide use rules in some  states. In a departure from the typical tight-knit atmosphere of rural farm communities, where issues are often resolved locally,  Arkansas is experiencing an un-neighborly atmosphere, with tensions escalating.

Us & Them Encore: Dicamba Woes

Our healthcare systems continue to struggle from aftereffects of the pandemic. The most recent example spotlights Medicaid - a joint federal and state program that provides health coverage for more than 90 million Americans with limited resources. After several years of continuous coverage, now everyone must reapply for eligibility. In the this episode of Us & Them, host Trey Kay reports more than a quarter of West Virginia residents rely on Medicaid for their healthcare. It pays for three-quarters of West Virginia’s nursing home residents; and nearly half of the state's school kids use Medicaid to pay for their annual checkups. However the application process is finding many ineligible because of changes in personal information and contact data that weren’t updated in the system. Join us as we look at the ‘unwinding’ of Medicaid, as millions of the nation’s most vulnerable struggle to maintain their health coverage.

Diminishing OB Care In Rural America

Download our free app to listen on your phone