Connect with us

The Conversation

One way Trump could help revive rural America’s economies

Published

on

theconversation.com – Tim O’Brien, Senior Manager of Applied Research, Growth Lab, Harvard Kennedy School – 2025-01-13 07:36:00

With close to 10,000 residents, Cody is one of Wyoming’s bigger communities. It relies on seasonal tourism revenue to support its economy.
Don and Melinda Crawford/UCG/Universal Images Group via Getty Images

Tim O’Brien, Harvard Kennedy School and Tim Freeman, Harvard Kennedy School

Picture yourself living the American Dream. You likely have more opportunity than your parents did. Through hard work, smart choices and perhaps some good luck along the way, you have financial stability and a great deal of freedom to choose your next steps in life.

Chances are also good that you live in or near a vibrant community with a robust local economy.

We tend to focus on the individual aspects of the American Dream, but we also value our communities – our downtowns, little leagues, good schools, safe public spaces and local traditions. Individuals and families tend to seek out the places that provide these things along with nearby jobs. And when communities begin to lose these quality-of-life assets, residents notice. Younger people tend to migrate away.

But why do places that were once vibrant sometimes lose this quality?

This is a question that we have reckoned with as economists who study constraints to better economic growth, most recently with the state of Wyoming. We’ve found that there is an often overlooked factor shared across many different places, and understanding it is critical to helping such communities recover.

Why communities enter cycles of decline

Whether a community thrives or falls into an economic tailspin depends greatly on its ability to generate “tradable income.”

Tradable income is jargon for money generated from stuff that a local economy sells beyond its borders. This could be the crops people grow, the products that factories manufacture, the services that businesses sell, or the minerals that are pulled from the ground. This income is then circulated within the local economy in the form of demand for other jobs, such as cashiers, barbers and handymen. Tradable income is essential to import all the goods and services that are not produced locally.

Without tradable income, the rest of the local economy will struggle to survive. You can think of tradable income like the oxygen that circulates through the body of the local economy.

Rural economies nearly uniformly have fewer and less diversified sources of tradable income than urban economies. They may rely on the same main source of tradable income that was the reason the community was settled in the first place.

A giant truck loaded with coal is viewed at the Eagle Butte Coal Mine in 2017 in Gillette, Wyo.
Coal mines have fueled the local economy in Gillette, Wyo., for decades, but that’s changing as coal use and coal jobs decline.
Matt McClain/The Washington Post via Getty Images

These economies are much more vulnerable to existential economic and environmental shocks and downward spirals of community decay than urban economies, which have built up more diversified tradable income sources over time.

Regional economies that were built on extracting and selling a natural resource, for example, can face booms and busts based on resource prices or government policies. The sudden closure of a mine can, within years, begin to wipe a community off the map. This is even though most jobs in the community were not directly supplied by the mine. The deeper and often overlooked problem is that the tradable income was tied to the mine.

This process is nothing new. It is the reason why the West has many ghost towns, and why many once-strong manufacturing towns transformed into the Rust Belt. In small communities, a regional school or even a Walmart can have the same effect if it closes, since these can be the sole sources of outside money.

Construction workers work on a home in a new subdivision. One is on a ladder leaning against the outside of the house and the walls are unfinished.
During boom years, Gillette’s subdivisions expanded with homes like these, built in 2006. The population tripled from 2005 to 2010, but it’s hovered around 30,000 since then.
Robert Nickelsberg/Getty Images

The loss of any critical source of tradable income, if not replaced, deprives the local economy of the oxygen that it needs to survive. Without new sources of tradable income, downtown stores close because businesses lack demand, joblessness rises, local tax revenue collapses and people leave.

Federal funding has a design flaw

State and federal policy has never been particularly effective at enabling local economic transitions from old sources of tradable income to new ones, or even softening the blow.

Today, it is not hard to see how climate change – as well as efforts to fight it by shutting down fossil fuel extraction and power plants – can bring new and painful shocks to local economies, just as automation and globalization have done.

The Biden administration’s recent push to build infrastructure and jump-start strategic industries – including through the Infrastructure Investment and Jobs Act, the Inflation Reduction Act and the CHIPS and Science Act – was partly driven by a desire to provide economic opportunity to parts of America that have increasingly been left behind.

Recognizing that different places have different needs, these federal efforts tended to channel resources to communities through discretionary grants rather than formula funding. In other words, the system put the responsibility on community leaders to identify funding opportunities and compete for that funding through proposed projects meeting predefined criteria, rather than have resources divided according to population or some other formula.

A key problem, however, is that most rural places do not have the local government bandwidth and staffing to navigate this system.

Town clerks and part-time local officials are often responsible for many public jobs and do not have the time or resources to navigate what can be byzantine federal funding systems. They do not have the time to absorb the flood of webinars, newsletters and online tools that federal agencies have created to circulate opportunities, let alone to mobilize successful grant applications for complicated programs with short application windows.

Not surprisingly, federal funds have tended to flow to larger municipalities with greater resources to begin with.

Wyoming, a largely rural state, is an example. The state is receiving less per capita in federal discretionary grants than most other states, and those grants are reaching relatively few communities. Our team at the Growth Lab at Harvard Kennedy School has been working with officials and residents there to find solutions.

Many folks in Wyoming believe that qualifying criteria for grants have purposefully disadvantaged the very conservative state. There are some criteria for qualifying for programs that fuel this narrative, such as grants targeted to coal communities that match the demographics and income levels of Appalachia more than Wyoming. Similarly, the lack of Medicaid expansion in the state lessens federal funding flows.

However, the main reason is much simpler and more mundane. Small and stressed communities from Wyoming to Vermont, across the political spectrum, face the same systemic obstacles in navigating the system.

Government can do better – here’s where to start

Statewide efforts have grown, including in Wyoming, to help local leaders identify and access federal grants, most importantly by building staffing and help centers that local leaders can draw upon to help navigate the federal system. But we believe a fundamentally better system is possible.

Rather than federal entities creating highly specific grant programs, inviting communities to apply and compete, and selecting winners centrally, they could flip the script when it comes to rural communities in regions that are facing shocks to tradable income.

Federal entities could instead work in concert with each other and with local leaders, starting with the place-specific needs of regional economies, and develop custom projects accordingly. Instead of shopping around centrally designed programs, federal agencies could do more to empower and support locally determined transformation efforts.

This was the spirit of the Recompete Pilot Program of the U.S. Economic Development Administration, which awarded six large grants last year among many, many locally driven proposals from economically distressed areas. A similar shift in approach was a key takeaway of the federal government’s Interagency Working Group on Coal and Power Plant Communities and Economic Revitalization, whose recent progress report looking back at three years of work emphasizes a greater need for working with, rather than imposing on, local leaders and coalitions.

Developing new pathways for tradable income will rarely be easy or fast, but this is one better place to start.The Conversation

Tim O’Brien, Senior Manager of Applied Research, Growth Lab, Harvard Kennedy School and Tim Freeman, Research Fellow, Growth Lab, Harvard Kennedy School

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post One way Trump could help revive rural America’s economies appeared first on theconversation.com

The Conversation

Measles can ravage the immune system and brain, causing long-term damage – a virologist explains

Published

on

theconversation.com – Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology – 2025-03-31 07:16:00

Measles infections send 1 in 5 people to the hospital.
wildpixel/ iStock via Getty Images Plus

Peter Kasson, Georgia Institute of Technology

The measles outbreak that began in west Texas in late January 2025 continues to grow, with 400 confirmed cases in Texas and more than 50 in New Mexico and Oklahoma as of March 28.

Public health experts believe the numbers are much higher, however, and some worry about a bigger resurgence of the disease in the U.S. In the past two weeks, health officials have identified potential measles exposures in association with planes, trains and automobiles, including at Washington Dulles International Airport and on an Amtrak train from New York City to Washington, D.C. – as well as at health care facilities where the infected people sought medical attention.

Measles infections can be extremely serious. So far in 2025, 14% of the people who got measles had to be hospitalized. Last year, that number was 40%. Measles can damage the lungs and immune system, and also inflict permanent brain damage. Three in 1,000 people who get the disease die. But because measles vaccination programs in the U.S. over the past 60 years have been highly successful, few Americans under 50 have experienced measles directly, making it easy to think of the infection as a mere childhood rash with fever.

As a biologist who studies how viruses infect and kill cells and tissues, I believe it is important for people to understand how dangerous a measles infection can be.

Underappreciated acute effects

Measles is one of the most contagious diseases on the planet. One person who has it will infect nine out of 10 people nearby if those people are unvaccinated. A two-dose regimen of the vaccine, however, is 97% effective at preventing measles.

When the measles virus infects a person, it binds to specific proteins on the surface of cells. It then inserts its genome and replicates, destroying the cells in the process. This first happens in the upper respiratory tract and the lungs, where the virus can damage the person’s ability to breathe well. In both places, the virus also infects immune cells that carry it to the lymph nodes, and from there, throughout the body.

YouTube video
Measles can wipe out immune cells’ ability to recognize pathogens.

What generally lands people with measles in the hospital is the disease’s effects on the lungs. As the virus destroys lung cells, patients can develop viral pneumonia, which is characterized by severe coughing and difficulty breathing. Measles pneumonia afflicts about 1 in 20 children who get measles and is the most common cause of death from measles in young children.

The virus can directly invade the nervous system and also damage it by causing inflammation. Measles can cause acute brain damage in two different ways: a direct infection of the brain that occurs in roughly 1 in 1,000 people, or inflammation of the brain two to 30 days after infection that occurs with the same frequency. Children who survive these events can have permanent brain damage and impairments such as blindness and hearing loss.

Yearslong consequences of infection

An especially alarming but still poorly understood effect of measles infection is that it can reduce the immune system’s ability to recognize pathogens it has previously encountered. Researchers had long suspected that children who get the measles vaccine also tend to have better immunity to other diseases, but they were not sure why. A study published in 2019 found that having a measles infection destroyed between 11% and 75% of their antibodies, leaving them vulnerable to many of the infections to which they previously had immunity. This effect, called immune amnesia, lasts until people are reinfected or revaccinated against each disease their immune system forgot.

Occasionally, the virus can lie undetected in the brain of a person who recovered from measles and reactivate typically seven to 10 years later. This condition, called subacute sclerosing panencephalitis, is a progressive dementia that is almost always fatal. It occurs in about 1 in 25,000 people who get measles but is about five times more common in babies infected with measles before age 1.

Researchers long thought that such infections were caused by a special strain of measles, but more recent research suggests that the measles virus can acquire mutations that enable it to infect the brain during the course of the original infection.

There is still much to learn about the measles virus. For example, researchers are exploring antibody therapies to treat severe measles. However, even if such treatments work, the best way to prevent the serious effects of measles is to avoid infection by getting vaccinated.The Conversation

Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Measles can ravage the immune system and brain, causing long-term damage – a virologist explains appeared first on theconversation.com

Continue Reading

The Conversation

Supreme Court considers whether states may prevent people covered by Medicaid from choosing Planned Parenthood as their health care provider

Published

on

theconversation.com – Naomi Cahn, Professor of Law, University of Virginia – 2025-04-02 17:04:00

Planned Parenthood clinics, like this one in Los Angeles, are located across the United States.
Patrick T. Fallon/AFP via Getty Images

Naomi Cahn, University of Virginia and Sonia Suter, George Washington University

Having the freedom to choose your own health care provider is something many Americans take for granted. But the Supreme Court is weighing whether people who rely on Medicaid for their health insurance have that right, and if they do – is it enforceable by law?

That’s the key question at the heart of a case, Medina v. Planned Parenthood South Atlantic, that began during President Donald Trump’s first term in office.

“There’s a right, and the right is the right to choose your doctor,” said Justice Elena Kagan on April 2, 2025, during oral arguments on the case. John J. Bursch, the Alliance Defending Freedom lawyer who is representing South Carolina Director of Health and Human Services Eunice Medina, countered that none of the words in the underlying statute had what he called a “rights-creating pedigree.”

As law professors who teach courses about health and poverty law as well as reproductive justice, we think this case could affect access to health care for 72 million Americans, including low-income people and their children and people with disabilities.

Excluding Planned Parenthood

The case started with Julie Edwards, who is enrolled in Medicaid and lives in South Carolina. After she struggled to get contraceptive services, she was able to receive care from a Planned Parenthood South Atlantic clinic in Columbia, South Carolina.

Planned Parenthood, an array of nonprofits with roots that date back more than a century, is among the nation’s top providers of reproductive services. It operates two clinics in South Carolina, where Medicaid patients can get physical exams, cancer screenings, contraception and other services. It also provides same-day appointments and keeps long hours.

In July 2018, however, South Carolina Gov. Henry McMaster issued an executive order that barred health care providers in South Carolina that offer abortions from reimbursement through Medicaid.

That meant Planned Parenthood, a longtime target of conservatives’ ire, would no longer be reimbursed for any type of care for Medicaid patients, preventing Edwards from transferring all her gynecological care to that office as she had hoped to do.

Planned Parenthood and Edwards sued South Carolina, claiming that the state was violating the federal Medicare and Medicaid Act, which Congress passed in 1965, by not letting Edwards obtain care from the provider of her choice.

A ‘free-choice-of-provider’ requirement

Medicaid operates as a partnership between the federal government and the states. Congress passed the law that led to its creation based on its power under the Constitution’s spending clause, which allows Congress to subject federal funds to certain requirements.

Two years later, due to concerns that states were restricting which providers Medicaid recipients could choose, Congress added a “free-choice-of-provider” requirement to the program. It states that people enrolled in Medicaid “may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.”

This provision is at the core of this case. At issue is whether a civil rights statute provides a right for Medicaid beneficiaries to sue a state when their federal rights have been violated. Known as Section 1983, it was enacted in 1871.

Bursch, backed by the Trump administration, argued before the court that the absence of words like “right” in the Medicaid provision that requires states to provide a free choice of provider means that neither Edwards nor Planned Parenthood has the authority to file a lawsuit to enforce this aspect of the Medicaid statute.

Nicole A. Saharsky, Planned Parenthood’s lawyer, argued that the creation of a right shouldn’t depend on “some kind of magic words test.” Instead, she said it was clear that the Medicaid statute created “a right to choose their own doctor” because “it’s mandatory” that the state provide this option to everyone with health insurance through Medicaid.

She also emphasized that Congress wanted to protect “an intensely personal right” to be able “to choose your doctor, the person that you see when you’re at your most vulnerable, facing … some of the most significant … challenges to your life and your health.”

Restricting Medicaid funds

Through a federal law known as the Hyde Amendment, Medicaid cannot reimburse health care providers for the cost of abortions, with a few exceptions: when a patient’s life is at risk or her pregnancy is due to rape or incest. Some states do cover abortion when their laws allow it, without using any federal funds.

Therefore, Planned Parenthood only gets federal Medicaid funds for abortions in those limited circumstances.

McMaster explained that he removed “abortion clinics,” including Planned Parenthood, from the South Carolina Medicaid Program because he didn’t want state funds to indirectly subsidize abortions.

South Carolina “decided that Planned Parenthood was unqualified for many reasons, chiefly because they’re the nation’s largest abortion provider,” Bursch told the Supreme Court.

But only 3% of Planned Parenthood’s services nationwide last year were related to abortion. Its most common service is testing for sexually transmitted diseases. Across the nation, Planned Parenthood provides health care to more than 2 million patients per year, most of whom have low incomes.

Man with gray hair in a suit and red tie speaks at a podium.
South Carolina Gov. Henry McMaster speaks to a crowd during an election night party on Nov. 3, 2020, in Columbia.
Photo by Sean Rayford/Getty Images

Section 1983

Because the Medicaid statute itself does not allow an individual to sue, Edwards and Planned Parenthood are relying on Section 1983.

Lower courts have repeatedly upheld that the Medicaid statute provides Edwards with the right to obtain Medicaid-funded health care at her local Planned Parenthood clinic.

And the Supreme Court has long recognized that Section 1983 protects an individual’s ability to sue when their rights under a federal statute have been violated.

In 2023, for example, the court found such a right under the Medicaid Nursing Home Reform Act. The court held that Section 1983 confers the right to sue when a statute’s provisions “unambiguously confer individual federal rights.”

Consequences beyond South Carolina

The court’s decision in the Medina case on whether Medicaid patients can choose their own health care provider could have consequences far beyond South Carolina. Arkansas, Missouri and Texas have already barred Planned Parenthood from getting reimbursed by Medicaid for any kind of health care. More states could follow suit.

In addition, given Planned Parenthood’s role in providing expansive contraceptive care, disqualifying it from Medicaid could harm access to health care and increase the already-high unintended pregnancy rate in America.

The ramifications, likewise, could extend beyond the finances of Planned Parenthood.

If the court rules in South Carolina’s favor, states could also try to exclude providers based on other characteristics, such as whether their employees belong to unions or if they provide their patients with gender-affirming care, further restricting patients’ choices.

Or, as Kagan observed, states could go the opposite direction and exclude providers that don’t provide abortions and so forth. What’s really at stake, she said, is whether a patient is “entitled to see” the provider they choose regardless of what their state happens to “think about contraception or abortion or gender transition treatment.”

If the Supreme Court rules that Edwards does have a right to get health care at a Planned Parenthood clinic, the controversy would not be over. The lower courts would then have to decide whether South Carolina appropriately removed Planned Parenthood from Medicaid as an “unqualified provider.”

And if the Supreme Court rules in favor of South Carolina, then Planned Parenthood could still sue South Carolina over its decision to find them to be unqualified.The Conversation

Naomi Cahn, Professor of Law, University of Virginia and Sonia Suter, Professor of Law, George Washington University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Supreme Court considers whether states may prevent people covered by Medicaid from choosing Planned Parenthood as their health care provider appeared first on theconversation.com

Continue Reading

The Conversation

Feeling FOMO for something that’s not even fun? It’s not the event you’re missing, it’s the bonding

Published

on

theconversation.com – Jacqueline Rifkin, Assistant Professor of Marketing, Cornell University – 2025-04-02 07:48:00

They had so much fun without me.
Milko/E+ via Getty Images

Jacqueline Rifkin, Cornell University; Barbara Kahn, University of Pennsylvania, and Cindy Chan, University of Toronto

Imagine you’ve planned the trip of a lifetime for your animal-loving family: a cruise to Antarctica with the unique opportunity to view penguins, whales and other rare wildlife. Your adventure-loving kids can kayak through fjords, plunge into icy water and camp under the Antarctic sky.

But rather than being ecstatic, as you anticipated, your kids whine about skipping an after-school scout meeting at a neighbor’s house. Missing this ordinary weekly event triggers such intense FOMO – “fear of missing out” – for them that they don’t want to go on your amazing expedition.

If this kind of debacle sounds familiar to you – or at least if you find it perplexing – you’re not alone. The three of us are marketing professors and social psychologists who focus on how consumers make decisions and how this shapes well-being. We’ve been studying FOMO for over a decade and recently published our work in the Journal of Personality and Social Psychology. Over the years, we’ve learned what really drives intense feelings of FOMO – which explains why a run-of-the-mill meeting might feel more crucial than an over-the-top vacation.

FOMO’s real trigger

People use the term FOMO in many different ways. In our research, we focus on a very specific type of FOMO: the kind that occurs when people miss out on events that involve valued social connections.

With this kind of FOMO, we found that the pain of missing out is not related to missing the actual event or opportunity – although that could be there as well. The FOMO we study happens when people miss the chance to bond with friends, co-workers or teammates they care about.

So, the critical part of FOMO is missing out on interactions with people you value. FOMO about a group dinner at a restaurant isn’t really about the food and great lighting. Nor is FOMO about a concert just about the band’s performance. Instead, it’s about the lost opportunity to connect and make memories with people who are important to you.

Why is this upsetting? Imagine the scenario where all your best friends go out to dinner without you. They bond and make lasting memories with each other – and you’re not there for any of it.

If they get closer to each other, where does that leave you? What happens to your social relationships and your sense of belonging? Do you become a less important friend? Less worthy of future invites? Or even kicked out of the group altogether? The anxiety of FOMO can begin to spiral.

People with what psychologists call an anxious attachment style chronically fear rejection and isolation from others. Because FOMO involves anxiety about future social belonging, it may not come as a surprise that people who are naturally more anxious about their friendships tend to get more intense FOMO. When we asked people in one of our studies to scroll social media until they encountered something social they missed, we found that the more anxiously attached a participant was, the more intense FOMO they experienced.

cheerful group laughing together around an outdoor dining table
They’ll always remember that summer cookout – and you weren’t there.
Maskot/DigitalVision via Getty Images

Not just missing Coachella

Getting FOMO for an amazing event you can’t attend makes sense. But if FOMO is less about the event itself and more about the social bonding, what happens when you miss something that’s not really fun at all?

We find that people anticipate FOMO even for unenjoyable missed events. As long as there is some form of missed social bonding, feelings of FOMO emerge. One of our studies found that people anticipated more FOMO from missing an un-fun event that their friends would be at, than a fun event without their friends.

For better or for worse, sad and stressful events can often be emotionally bonding: Going to a funeral to support a friend, cleaning up the mess after a party, or even white-knuckling through a harrowing initiation ceremony can all offer opportunities to forge stronger connections with one another. Stressful contexts like these can be fertile grounds for FOMO.

How to fend off FOMO

Popular discussions about the negative consequences of FOMO tend to focus on the FOMO people feel from compulsively scrolling on social media and seeing what they missed out on. Consequently, much of the suggested advice on how to mitigate FOMO centers on turning off phones or taking a vacation from social media.

Those recommendations may be tough for many people to execute. Plus, they address the symptoms of FOMO, not the cause.

Our finding that the core of FOMO is anxiety about missed social relationships yields a simpler strategy to combat it: Reminding yourself of the last time you connected with close friends may provide a sense of security that staves off feelings of FOMO.

In an experiment testing multiple interventions, we asked 788 study participants to look through their social media feeds until they encountered a post of a missed social event. We asked about 200 of these participants to immediately rate how much FOMO they were feeling. They averaged a 3.2 on a 1-to-7 scale.

Another group of about 200 participants also scrolled through their social media feeds until they encountered a post of a missed social event. But before indicating how much FOMO they were feeling, we asked them to think back to a prior experience socializing and bonding with their friends. Encouragingly, this reflection exercise seemed to curtail FOMO. Their average FOMO rating was 2.7 out of 7, a significant drop.

group of older women on a neighborhood walk with a leashed dog
Reminding yourself about other good times with your pals can help keep FOMO at bay.
AJ_Watt/E+ via Getty Images

With the remaining participants, we tested other strategies for mitigating FOMO – thinking about the next time they might see their friends or imagining what they’d say to a FOMO-suffering friend – but the simple reflection exercise was by far the most promising.

So, reminding yourself of the meaningful relationships you already have and reaffirming your social belonging in the moment may help combat the rush of anxiety that is characteristic of FOMO.

And missing out on social bonding experiences doesn’t have to be anxiety-provoking. In fact, in our activity-packed, hectic lives, missing some “must-attend” events may be a welcome relief – especially if you remind yourself that your social belonging is not in jeopardy. Cue a recent wave of counter-FOMO programming called JOMO, or “Joy of Missing Out.”

To quote Stuart Smalley, the fictional self-help guru of 1990s “Saturday Night Live,” reminding yourself that “I’m good enough, I’m smart enough, and doggone it, people like me!” might be just the trick to mitigate FOMO.The Conversation

Jacqueline Rifkin, Assistant Professor of Marketing, Cornell University; Barbara Kahn, Patty and Jay H. Baker Professor of Marketing, University of Pennsylvania, and Cindy Chan, Assistant Professor of Marketing, University of Toronto

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Feeling FOMO for something that’s not even fun? It’s not the event you’re missing, it’s the bonding appeared first on theconversation.com

Continue Reading

Trending