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Sorry for the posting combo, phones take no prisoners. I pray all here may forgive me. glowing-fish posted:Totally honest question: why is healthcare harder to afford for people living in Jefferson, Ohio, than people living in a city?. Healthcare: costs money. There is no money unless you're in a city, or retiring from city life to the country. Access is it's own nontrivial issue, especially if Medicaid gets schwacked and 86s a lot of rural hospitals, but affordability is by far the larger issue. Drugs: are cool, and good, and (formerly) my friend, and when you have a lot of space to do business in and not enough police or various social services to help shore up the cracks in a person's life, well... It's always a party when the coke gets here. Addicts tend to form their own support structures after a fashion, and that can be just as hard to let go of as the drug in question. If you've never known anything else, getting high and being in the mix are just two sides of the same coin. Regardless of demography, addiction tends to fall off present literally any other option.
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Jul 6, 2017 02:22
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It's worth noting that cities also simply have more addiction resources than most rural areas do. Where I am, you can walk into any pharmacy and buy naloxone, no questions asked, which has apparently already had a noticeable positive effect, but sadly isn't as viable in a place where the nearest pharmacy is over an hour away and Republicans are in office. There are a lot of hospitals, emergency response time tends to be pretty quick, and there are plenty of counseling services, methadone clinics, aa/na groups, etc. That simply isn't true for non-urban areas a lot of the time. That's not to say opiates aren't a problem here, because they absolutely are. But like a lot of things, it kinda comes down to infrastructure.
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Jul 6, 2017 02:37
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glowing-fish posted:Totally honest question: why is healthcare harder to afford for people living in Jefferson, Ohio, than people living in a city? Totally obvious answer: because the jobs in Jefferson are worse than the jobs in Denver
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Jul 6, 2017 02:37
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Crow Jane posted:It's worth noting that cities also simply have more addiction resources than most rural areas do. Where I am, you can walk into any pharmacy and buy naloxone, no questions asked, which has apparently already had a noticeable positive effect, but sadly isn't as viable in a place where the nearest pharmacy is over an hour away and Republicans are in office. There are a lot of hospitals, emergency response time tends to be pretty quick, and there are plenty of counseling services, methadone clinics, aa/na groups, etc. That simply isn't true for non-urban areas a lot of the time. Visibility too, but that's a more long-term thing that causes people to act once they realize that their neighbor's troubles soon become their troubles too if they don't lend a hand. If your front yard is 300 acres it gets real hard to tell when your neighbor needs help. FAUXTON fucked around with this message at 02:53 on Jul 6, 2017 |
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Jul 6, 2017 02:46
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Opiates used to have the reputation of being "respectable" drugs since a doctor prescribed them. You're not getting them from a drug dealer, they were given to you by a licensed medical professional. As for the healthcare bit, consider the fact that the average temp labor wage in a rural area is around $10 an hour depending on sector and there's not many options for preventative care due to the attendance requirements of working in certain places (I'm specifically referring to automotive since that's the prevalent industry in my area). Temp agencies may or may not cover the cost of insurance policies and there's been a trend for policies to get increasingly more expensive. If your take home pay is $400 a week and half of that is going to insurance, how are you supposed to cover rent and other necessities. Median household income (yes household) is $30k in the area I live in. Granted that's above the national poverty line by about $8k. Oh yeah, that $10 an hour you get working full time doing plant labor is around $2k under the poverty like of $22k. I work with people who drive 45 minutes to work a day one way and have to pay for gas an maintenance on a beater. But that's all they can afford because best case scenario they get a %5 raise each year on an already paltry salary and generally have no options for upwards mobility.
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Jul 6, 2017 02:50
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Vargatron posted:Opiates used to have the reputation of being "respectable" drugs since a doctor prescribed them. No offence but: what the gently caress? My parents explicitly told me that, while they would prefer I not do any drugs at all, for obvious reasons, some are okay and won't kill you, but don't ever loving touch heroin or opiates and avoid cocaine if you can. Were opiates respectable at some point somewhere? That seems so alien to me. Even when I was given them for surgery, my main focus was to be off them ASAP and just loving deal with the short-term pain because it's probably better than withdrawal. I knew I'd get them for the surgery, and I was more concerned about the potential for addiction than I was about something going wrong during the surgery and seriously harming or killing me -- that was my number one fear leading up to the surgery, to the point where I couldn't sleep some nights. I knew the odds of something going wrong were low, but the odds of addiction were apparently very high. Maybe part of the reason I can't understand the opiate epidemic fully is because I can't appreciate a mindset so different from my own.
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Jul 6, 2017 04:29
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call to action posted:Totally obvious answer: because the jobs in Jefferson are worse than the jobs in Denver And yet, the uninsured rate in Ashtabula County, Ohio is 8.9%. The uninsured rate in Denver City/County is 12.1% The uninsured rate in Ohio is 7.6% The uninsured rate in Colorado is 9.2% https://www.census.gov/quickfacts/fact/map/US/HEA775215#viewtop (I hope that URL works, the census quickfacts page has some new tools that, while helpful, are also difficult to navigate) I mean, those numbers don't reflect exactly the numbers for Jefferson City, but from the data we have, the idea that health care access in Jefferson, Ohio is markedly worse compared to the nation as a whole is not supported. (It is possible that the insurance numbers for Ashtabula County include Medicaid, or another subsidized program for health care for the poor, but I don't have data to know if that is true) glowing-fish fucked around with this message at 04:38 on Jul 6, 2017 |
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Jul 6, 2017 04:34
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Crow Jane posted:It's worth noting that cities also simply have more addiction resources than most rural areas do. Where I am, you can walk into any pharmacy and buy naloxone, no questions asked, which has apparently already had a noticeable positive effect, but sadly isn't as viable in a place where the nearest pharmacy is over an hour away and Republicans are in office. There are a lot of hospitals, emergency response time tends to be pretty quick, and there are plenty of counseling services, methadone clinics, aa/na groups, etc. That simply isn't true for non-urban areas a lot of the time. The point I've been trying to make is that there are places where the nearest pharmacy is an hour away. For people in a town without a pharmacy, not having access to naloxone, or other pharmaceuticals, is a problem. That is why I brought up the entire issue of very small, rural places. Jefferson, Ohio, is not a city that is an hour away from a pharmacy. According to Google Maps, there are two pharmacies inside of the town. You have two different pharmacies right there on Chestnut St. There are 10 pharmacies 15-20 minutes from town. I would be surprised if there is anywhere in Ohio where someone could be more than an hour from a pharmacy.
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Jul 6, 2017 04:46
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Willie Tomg posted:
One night in May of 1998, I walked from Poultney to Rutland. I thought it would take longer than it would, so it was only like 1 AM when I walked into town. It was also cold...cold enough to frost (which, as someone who had grown up in Oregon, seemed a freakish occurence, frost in May). Still carrying all my luggage from school, I found a Denny's and sat down, I don't think for the full night, but for a few hours. I warmed up and walked around Rutland some more. The next day I got on a Greyhound bus and slept pretty much until I woke up in Madison, Wisconsin two days later. Also, I remember when I was in Vermont, people asking me questions about what Portland, Oregon was like. Was it about the size of Rutland? One person asked.
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Jul 6, 2017 04:55
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If we're talking an overdose situation, though, any distance is going to be potentially fatal, especially if we're comparing it to being able to literally run to the end of the block to get what you need. Whether we're talking a fifteen minute drive or an hour one, that's critical time being wasted, to say nothing of the possible addition of impaired driving into the mix
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Jul 6, 2017 04:55
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the thing about people who live an hour from a pharmacy is that there are very few of them. if there were more people, someone would build a pharmacy. so they dont really matter as much as the larger group of rural americans who live near small towns
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Jul 6, 2017 04:59
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kangarural
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Jul 6, 2017 05:05
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Crow Jane posted:If we're talking an overdose situation, though, any distance is going to be potentially fatal, especially if we're comparing it to being able to literally run to the end of the block to get what you need. Whether we're talking a fifteen minute drive or an hour one, that's critical time being wasted, to say nothing of the possible addition of impaired driving into the mix I mean, I know there is a lot of rural area outside of Jefferson, and there are places in the county where someone can be a dangerous distance from a pharmacy, but I feel that with much in this thread, people are moving the goalposts to fit the narrative. Not being able to visit every town in the United States, I am trying to fit together what facts I can from objective sources. The narrative is that this town doesn't have access to health care. The facts don't fit that. There might be a lot of reasons why people have opiate problems, including legal/social barriers to seeking help, I don't know what the laws are in Ohio about Naloxone. But the city has two pharmacies. If it was legally and culturally feasible, there is access to life saving drugs. I mean, is your point that people in Portland, Oregon don't overdose because there is literally a pharmacy on every corner and that everyone in Portland is only a two minute run from a syringe of naloxone? I mean, if that was true, I would probably have at least one friend still alive.
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Jul 6, 2017 05:06
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boner confessor posted:the thing about people who live an hour from a pharmacy is that there are very few of them. if there were more people, someone would build a pharmacy. so they dont really matter as much as the larger group of rural americans who live near small towns Right, but then what are the specific challenges faced by rural people? Because there were a lot of times and places when being rural meant that people didn't have access to basic services, because those basic services were too far away. But for most of rural America right now, that is not the case. There aren't a lot of rural people who "go into town" once every three months to buy new shoes and see a movie, and going into town is an entire day long trip down a gravel road. I mean, for most of human and US history, that was more or less the case, but the amount of people who that is true of now is less than 1% of the US population. Since, that is a small group of people, what is the major issue facing rural people? What separates living in Jefferson, Ohio, from living in Ashtabula, Ohio, from living in Cleveland, Ohio. The subtext to a lot of people's comments is that this is something I should automatically understand, but I honestly don't. I mean, obviously for a young person, living in Jefferson is going to be a lot more boring than living in Cleveland, but I consider both places to be within the mainstream of American culture: people there both have access to most of American culture and economy.
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Jul 6, 2017 05:13
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i dont care about your weird bad analyses as you work through the concept of relative experiences guy, i'm just saying that by definition the kind of rurality you like to herald as true rurality is an extremely small number of people representative of very little
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Jul 6, 2017 05:15
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boner confessor posted:i dont care about your weird bad analyses as you work through the concept of relative experiences guy, i'm just saying that by definition the kind of rurality you like to herald as true rurality is an extremely small number of people representative of very little Yeah this is basically the beginning and end of it :/ glowing-fish posted:I mean, I know there is a lot of rural area outside of Jefferson, and there are places in the county where someone can be a dangerous distance from a pharmacy, but I feel that with much in this thread, people are moving the goalposts to fit the narrative. Not being able to visit every town in the United States, I am trying to fit together what facts I can from objective sources. because nobody has any loving money and insurance and drivable pharmacies or clinics or whatever don't matter when you can't pay your deductible. they have opiate problems because life is a loving joke
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Jul 6, 2017 05:37
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glowing-fish posted:I mean, I know there is a lot of rural area outside of Jefferson, and there are places in the county where someone can be a dangerous distance from a pharmacy, but I feel that with much in this thread, people are moving the goalposts to fit the narrative. Not being able to visit every town in the United States, I am trying to fit together what facts I can from objective sources. Good lord, I'm not saying no one in Portland overdoses. And I stated that opiate abuse is a problem in my (non-Portland) city as well. I'm saying most cities have more infrastructure in place to deal with addiction than small towns or rural areas do, whether we're talking emergency services or na meetings. Access to Naloxone is great, but it takes a hell of a lot more than that to actually treat addiction, and those resources simply aren't present in a lot of places.
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Jul 6, 2017 05:38
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Willie Tomg posted:Sorry for the posting combo, phones take no prisoners. I pray all here may forgive me. The fact that you had to explain this to him is why I don't like him.
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Jul 6, 2017 06:23
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Wow, a thread unreadable even by dnd standards
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Jul 6, 2017 06:30
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Edgar Allen Ho posted:Wow, a thread unreadable even by dnd standards Great content
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Jul 6, 2017 06:31
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Crow Jane posted:Good lord, I'm not saying no one in Portland overdoses. And I stated that opiate abuse is a problem in my (non-Portland) city as well. I'm saying most cities have more infrastructure in place to deal with addiction than small towns or rural areas do, whether we're talking emergency services or na meetings. Access to Naloxone is great, but it takes a hell of a lot more than that to actually treat addiction, and those resources simply aren't present in a lot of places. Many of these people are close enough to service to see a doctor, get a disability claim, fill a prescription for opiates, and apply for food stamps and social security. The number of people inconveniently outside that level of civilization is vanishingly small. It is weird to refer to them as "rural" when they are effectively just on the fringes of the urban. Especially when you figure in the people who can turn to a reliable black market source of opiates.
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Jul 6, 2017 06:32
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glowing-fish posted:The point I've been trying to make is that there are places where the nearest pharmacy is an hour away. For people in a town without a pharmacy, not having access to naloxone, or other pharmaceuticals, is a problem. I grew up an hour drive from a town with a pharmacy, let alone an emergency room. My mom likes to joke about how rural we were in that we were "3 hours from the nearest Wal-Mart!" or big box store. To be honest I think you're huffing your own farts a bit here. The same rural problems (access to healthcare, poverty, poor education, lack of local jobs, etc) exist whether you're on the Great Plains or in Appalachia. glowing fish has a habit of trying to contrast western / great plains US with Appalachia, where Appalachia isn't *truly* rural that's some dumb poo poo. yeah, obviously, the rural character and demographics will vary a ton depending on where you're from. I know nothing about what it's like to be a southern black farmer, or an Appalachian snake-handling coal-miner or whatever. The only existence I can really comment on is Plains cattle ranchers and tangentially Native Americans on that same land. there isn't one singular Rural American identity and it's kind of insulting to treat it as monolithic
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Jul 6, 2017 07:05
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glowing-fish posted:And yet, the uninsured rate in Ashtabula County, Ohio is 8.9%. I was curious about this and that map doesn't go down into county levels. https://www.census.gov/library/publications/2017/demo/p30-01.html has a county map.  Using health insurance as a proxy for access to health care, it varies wildly across rural areas (e.g. little access in Montana, high access in Iowa, middlish in Kansas). You can also really, really see Obamacare kicking in between the 2014 and 2015 maps (look at Kentucky vs neighboring counties in Tennessee)
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Jul 6, 2017 07:51
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A few fun facts about rural mid ohio: 1) There are more right/christian radios than any other type of station. They include such sermons as: If you believe in creation > Climate change can not exists > vote R. Over and over and over again. The same areas that have air quality warnings. 2) There is, I believe, only one non-major health provider in the state now, down a dozen or so from a decade ago. This moves jobs away from the rural areas and the axe of medicaid will be its final blow. 3) Very very racist.
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Jul 6, 2017 19:36
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I went on my first large road trip this week, 1000km mostly through some very rural areas and smaller towns in BC, along with REAL MOUNTAINS. A few useless observations: -So many rotting buildings, so many nearly ghost towns where half the buildings are abandoned and the other half are for sale. -The only tiny communities that seemed to be doing ok were ones that got tourist traffic or could get travelers to stop. -Agriculture is still a legitimate career in a lot of these areas, but hard. Surprisingly high numbers of immigrants that bought failing farms and turned them around, it seemed like every other farm-stand was staffed by a collection of first or second generation Indian or sometimes Chinese families. -No building codes or building inspection results in some really dubious constructions and a lot of huge safety hazards creating insurance nightmares. Rural culture of just build what ever doesn't mix well with modern insurance regulations so people will build some huge poorly built addition to their house then be utterly denied when it's time to make a claim because nothing was done remotely to code. -Strong attitude that all their suffering is down to too many regulations holding the economy back. If only the government was more right wing and enacted more austerity some magic thing would happen and they'd get rich farming or all the mining jobs would come back or there'd be more forestry jobs. -Everything is extremely car focused and spread out to an extreme, even tiny small towns that used to have cute little main streets end up a sprawling mess where all the local budgets go towards paying upkeep on a growing amount of infrastructure serving a shrinking tax base. -Everyone knows each other and there's a strong sense of local solidarity, everyone has each other's back and feels like they're in it together regardless of their ethnic background or creed. So long as they aren't a drat drunk free loading native of course. -A huge mistrust of the government and a sense that the government doesn't listen or care about them when enacting plans on their behalf. This seems pretty legitimate as many people's issues isn't so much with the thing itself, but the total lack of consultation that leads to an infuriatingly flawed or wasteful government program that could have been done much cheaper or more effectively with local input. For instance in one area I noticed nearly every farm had a huge "NO NATIONAL PARK" sign at the gate. This is because the federal government wants to turn a huge mountainous area into a national park due to the unique climate, but they pushed the plans through and developed them without any sort of community engagement. Many farmers in the area have livestock that roam the area and have been the stewards of this land for generations. Facing uncertainty and scared of possible drastic changes to the allowed use of the land (mostly due to poor communication and rumours) it created a huge backlash against the proposed park, but a little consultation and appeasing local fears could have gained the support of the community. -There were anti-choice billboards on the highways, something I've never seen or even heard of in Canada.
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Jul 6, 2017 20:04
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Baronjutter posted:-There were anti-choice billboards on the highways, something I've never seen or even heard of in Canada. Pretty sure I've seen those driving through Manitoba and Saskatchewan..
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Jul 6, 2017 20:12
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Speaking of pro-choice, I remember driving through Kentucky last year and there was a gigantic billboard to the effect of "God Weeps for his 350,000 aborted babies this year".
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Jul 6, 2017 20:16
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I'm glad a pro-choice org bought all the ABORTION=MURDER billboards and replaced with "I'm thankful for my abortion." around these parts.
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Jul 6, 2017 20:24
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Patrick Spens posted:Pretty sure I've seen those driving through Manitoba and Saskatchewan.. Yeah I see lots of those around rural sask where I live, however they are all extremely worn and old. Poverty does seem to be a problem to an extent out here but reading this thread makes me feel like parts of rural America have it much worse.
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Jul 6, 2017 20:47
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Tiny Brontosaurus posted:Great content i cannot be the only one laughing at the perpetual meltdown that is that rap sheet FWIW, I saw a pretty sizeable anti-abortion protest in urban southern Ontario, two years ago today according to my facebook. They definitely exist all over Canada, albeit in much smaller numbers than the states. The impression I get from rural eastern Canada is that a lot of pro-lifers have basically taken abortion as a fait acoompli and just "would never get one myself", but might start shouting again if there was a real movement.
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Jul 6, 2017 21:46
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The poverty I saw in rural BC really paled in comparison to some of the worst US rural poverty, but we totally do have pockets like that in Canada, specially on the reserves. Some of these tiny settlements were depressing but people had jobs or were at least prevented from falling into abject poverty by what's left of our social safety net and healthcare system. They still had some sort of economy and functioning society.
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Jul 6, 2017 21:46
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Yeah I'm sure many reserves are worse off than American rurals.
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Jul 6, 2017 22:18
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Submarine Sandpaper posted:A few fun facts about rural mid ohio: Point 2 is going to be the reason Ohio drops like 3-4 electoral votes over the next 20-30 years. My grandmother (a former GM steelworker's wife who voted for Bernie because he seemed like a "nice old man") was recently in one of the rural hospitals in the Warren area, and it looked like a scene from One Flew Over the Cuckoo's Nest. Like, the food they had is cooked by the kitchen staff from 8-10 in the morning then kept warm for the next 24 hours. Half of the lights in the hallway were burned out. Their pharmacy managed to give my Grandmother 3 different sets of the wrong pills (which she thankfully didn't take) before actually getting her the proper blood thinners. People want to talk about rural areas losing hope with the loss of factory jobs and whatever other small town America issues, but the sad truth is that the hospitals, in their current condition, are quite literally going to kill them from lack of resources about as quickly as the heroin usage and gun suicides will. Morbid as it may be, the decaying rural medical environment is a sword of damocles on the whole situation that will quite literally remove rural voters from the equation, and it will only get worse as they continue to vote for things to get worse and worse on themselves by cutting medicaid and removing any chance the hospitals get the money to ever improve. Factor in that they have to pay a premium to get any doctors to work there and are likely to have issues with the locals refusing to see any non-white doctors and...yeah, it's going to be bad. There's no workforce ready for it, and there's no money for capital either.
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Jul 7, 2017 01:02
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Main Paineframe posted:Just like people assume there's two kinds of welfare, they also assume there's two kinds of poverty. The difference between the urban poor and the rural poor is that people believe the stereotypical rural person doesn't deserve to be poor (I'm sure you can guess why). Same goes for healthcare and drug addiction - these have plagued the poor for decades, it's just now they're starting to manifest in demographics that people feel shouldn't have these problems. I think an interesting thing to keep in mind is that in a twisted and perverse way small towns actually are the libertarian utopia of (most) everyone being (mostly) equal. In a lot of small towns the richest person isn't THAT much richer than the poorest person, everyone has the same background, everyone went to the same school and had generally the same opportunities. I think that is one of the fundamental disconnected in rural and urban mindset. If someone is in a lovely situation it either is their fault and it's easy to say they made their bed and they should lay in it or it's obvious they didn't deserve it and everyone will be happy to pitch in and I think it's hard to get people into the larger mindset that the whole world isn't like that. (as it is harder to get a city person into the mindset that poor rural town logic makes any sort of sense in their situation)
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Jul 7, 2017 01:39
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Baronjutter posted:A few useless observations: People from the city are surprised that agriculture is still a "legitimate" career? What does that even mean?
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Jul 7, 2017 01:52
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I was actually surprised by how many farms are owned by immigrants in BC. In Saskatchewan it's mostly whites, generally in multi-generation family farms. Although those are dying out to bigass commercial farms that own tons of land.
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Jul 7, 2017 02:10
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A four page arguement because no one could come up with the word "exurb."
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Jul 7, 2017 02:55
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Babylon Astronaut posted:A four page arguement because no one could come up with the word "exurb." To me, a suburb is continuous with a city, like there are no fields and forests separating them. An exurb is an area that is easy to commute to from a city, but has some intervening terrain that is fields or forests. Do those definitions make sense to people?
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Jul 7, 2017 03:08
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reagan posted:People from the city are surprised that agriculture is still a "legitimate" career? What does that even mean? Probably more along the lines of small scale farming as opposed to a gigacorporate humongo-farm where you're either an overpaid suit or underpaid labor.
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Jul 7, 2017 03:08
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People also envision agriculture as a bunch of people picking plants in a field. Depending on the crop a lot of harvesting can be done with machinery which reduces the amount of manual labor required. Still there are plenty of farms that rely on migrant labor in the Southeast but agriculture is a pretty diverse field. Based on recollections from my childhood, cattle farming can be handled by relatively few workers in comparison to crops. Also it was pretty common for most high school boys to work the summer hauling hay or cleaning out chicken houses for cash. ...And when I mean clean out chicken houses I mean pick up dead chickens that didn't make it to adulthood. Back when I was a kid, most farms were owned by individual families around here but now there's a trend where the owners are getting old or dying and the farms are getting sold off. The tendency is for the farms to get bought out and ran by single entities, but agriculture is so important that there's not going to be any risk of the industry collapsing around here.
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Jul 7, 2017 03:16
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