Kaiser Health News
Therapists Learn How To Help Farmers Cope With Stress Before It’s Too Late
Tony Leys
Tue, 25 Jun 2024 09:00:00 +0000
If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing “988,” or the Crisis Text Line by texting “HOME” to 741741.
GRINNELL, Iowa — The farmers' co-op here is a center of hope every spring. It's where farmers buy seed and fertilizer for the summer's crops, and where they seek tips to maximize their harvest of corn and soybeans.
But on a recent morning, a dozen mental health professionals gathered at the Key Cooperative Agronomy Center to discuss why so many farmers quietly struggle with untreated anxiety and depression.
Studies have concluded that suicide is unusually common among farmers. Researchers believe it's not just because many farmers have other risk factors, such as rural addresses and access to guns.
The tragic trend has caught the attention of the U.S. Department of Agriculture, which sponsors training sessions like the one in Grinnell to help health care professionals learn how to talk to farmers about the pressures they face in wringing a living out of the land.
“A lot of them are born to it. They don't have any choice,” family therapist David Brown explained to the session's participants. He noted many farms have been passed down for generations. Current owners feel that if they fail, they would be letting down their grandparents, parents, children, and grandchildren.
Brown, who works for Iowa State University Extension and Outreach, led the training in Grinnell. He said farmers' fate hinges on factors out of their control. Will the weather be favorable? Will world events cause prices to soar or crash? Will political conflicts spark changes in federal agricultural support programs? Will a farmer suffer an injury or illness that makes them unable to perform critical chores?
Brown said surveys show many farmers are reluctant to seek mental health care, partly because they think therapists or doctors couldn't understand their lives.
Tina Recker, a mental health therapist in northeastern Iowa, attended the training session. She has lived on farms, and she has seen how the profession can become a person's entire identity. “It's just farm, farm, farm, farm,” she told the group. “If something goes wrong with it, that's your whole world.”
It's difficult to estimate how much of farmers' increased risk of suicide is due to their profession.
Part of the reason for the elevated rate could be that many farmers are middle-aged or older men, who tend to be more at risk in general. “But it's broader than that for sure,” said Edwin Lewis, a USDA administrator who helps oversee efforts to address the situation.
The Grinnell training session was part of a federal program called the Farm and Ranch Stress Assistance Network. Lewis said the program, which also funds counseling hotlines and support groups, spends $10 million a year.
Jason Haglund sees the issue from multiple angles. He's a mental health advocate who farms part-time near the central Iowa town of Boone. He and his brother-in-law raise corn and soybeans on the 500-acre farm where Haglund grew up. His family has farmed in the area since the 1880s. His parents hung on despite going into bankruptcy during the 1980s farm crisis, and he embraces his role as caretaker of their legacy.
Haglund is trained as an alcohol and drug addiction counselor, and he co-hosts an Iowa podcast about the need to improve mental health care.
He said it can be stressful to run any kind of family business. But farmers have a particularly strong emotional tie to their heritage, which keeps many in the profession.
“Let's be honest: Farming at all these days isn't necessarily a good financial decision,” he said.
Farmers traditionally have valued self-sufficiency, he said. They try to solve their own problems, whether it's a busted tractor or a debilitating bout of anxiety.
“With the older generation, it's still, ‘Suck it up and get over it,'” Haglund said. Many younger people seem more willing to talk about mental health, he said. But in rural areas, many lack access to mental health care.
Farmers' suicide risk is also heightened by many of them owning guns, which provide an immediate means to act on deadly impulses, Haglund said.
Guns are an accepted part of rural life, in which they are seen as a useful tool to control pests, he said. “You can't go into a rural community and say, ‘We're going to take your guns away,'” he said. But a trusted therapist or friend might suggest that a depressed person temporarily hand over their guns to someone else who can safely store them.
Haglund said health care professionals shouldn't be the only ones learning how to address mental stresses. He encourages the public to look into “mental health first aid,” a national effort to spread knowledge about symptoms of struggle and how they can be countered.
A 2023 review of studies on farmer suicides in multiple countries, including the U.S., cited cultural and economic stresses.
“Farmers who died by suicide, particularly men, were described as hard-working, strong, private people who took great pride in being the stoic breadwinners of their families. They were often remembered as members of a unique and fading culture who were poorly understood by outsiders,” wrote the authors, from the University of Alberta in Canada.
Rebecca Purc-Stephenson, a psychology professor who helped write the paper, said health professionals face two challenges: persuading farmers to seek help for mental stress, then encouraging them to keep coming back for therapy.
Back at the training in Iowa, instructors urged mental health professionals to have flexible schedules, and to be understanding when farmers postpone appointments at the last minute.
Maybe one of their animals is sick and needs attention. Maybe a machine broke and needs to be fixed immediately. Maybe the weather is perfect for planting or harvesting.
“Time is money,” said Brown, the therapist leading the training.
The session's lessons included what to ask and not ask when meeting farmers. A big no-no is inquiring right away about how much land they are working. “If you ask them how many acres they're farming, that's like asking to see their bank account,” warned Rich Gassman, director of Iowa's Center for Agricultural Safety and Health, who assisted with the lesson.
It would be better to start by asking what they enjoy about farming, the instructors said.
Many farmers also need to talk through emotional issues surrounding when, how, or even if the next generation will take over the family operation.
Tim Christensen, a farm management specialist for Iowa State University Extension and Outreach, said some standard advice on how to deal with stress could backfire with farmers.
For example, he said, a health care professional should never advise a farmer to relax by taking a couple of weeks off. Most of them can't get away from their responsibilities for that long, he said.
“There's a common saying on the farm: No good vacation goes unpunished.”
Warning Signs of Mental Struggle
The American Foundation for Suicide Prevention lists these signs that a person might be considering suicide:
- The person talks about killing themselves, feeling hopeless, having no reason to live, being a burden to others, feeling trapped, or having unbearable pain.
- The person increases their use of alcohol or drugs, sleeps too much or too little, displays fatigue or aggression, withdraws from activities and family and friends, visits or calls people to say goodbye, gives away possessions, or searches online for a way to end their life.
- People considering suicide often seem depressed, anxious, irritable, angry, ashamed, or uninterested in activities. In some cases, they may appear to feel sudden relief or improvement in their mood.
- People in crisis can reach the national 988 Suicide & Crisis Lifeline by calling or texting “988.”
——————————
By: Tony Leys
Title: Therapists Learn How To Help Farmers Cope With Stress Before It's Too Late
Sourced From: kffhealthnews.org/news/article/farmer-mental-health-suicide-therapists-iowa-usda/
Published Date: Tue, 25 Jun 2024 09:00:00 +0000
Kaiser Health News
KFF Health News’ ‘What the Health?’: SCOTUS Ruling Strips Power From Federal Health Agencies
Fri, 28 Jun 2024 19:00:00 +0000
The Host
Julie Rovner
KFF Health News
Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.
In what will certainly be remembered as a landmark decision, the Supreme Court's conservative majority this week overruled a 40-year-old legal precedent that required judges in most cases to yield to the expertise of federal agencies. It is unclear how the elimination of what's known as the “Chevron deference” will affect the day-to-day business of the federal government, but the decision is already sending shockwaves through the policymaking community. Administrative experts say it will dramatically change the way key health agencies, such as the FDA and the Centers for Medicare & Medicaid Services, do business.
The Supreme Court also this week decided not to decide a case out of Idaho that centered on whether a federal health law that requires hospitals to provide emergency care overrides the state's near-total ban on abortion.
This week's panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins schools of public health and nursing and Politico Magazine, Victoria Knight of Axios, and Alice Miranda Ollstein of Politico.
Panelists
Joanne Kenen
Johns Hopkins University and Politico
Victoria Knight
Axios
Alice Miranda Ollstein
Politico
Among the takeaways from this week's episode:
- In 1984, the Supreme Court ruled broadly that courts should defer to the decision-making of federal agencies when an ambiguous law is challenged. On Friday, the Supreme Court ruled that the courts, not federal agencies, should have the final say. The ruling will make it more difficult to implement federal laws — and draws attention to the fact that Congress, frequently and pointedly, leaves federal agencies much of the job of turning written laws into reality.
- That was hardly the only Supreme Court decision with major health implications this week: On Thursday, the court temporarily restored access to emergency abortions in Idaho. But as with its abortion-pill decision, it ruled on a technicality, with other, similar cases in the wings — like one challenging Texas' abortion ban.
- In separate rulings, the court struck down a major opioid settlement agreement, and it effectively allowed the federal government to petition social media companies to remove falsehoods. Plus, the court agreed to hear a case next term on transgender health care for minors.
- The first general-election debate of the 2024 presidential cycle left abortion activists frustrated with their standard-bearers — on both sides of the aisle. Opponents didn't like that former President Donald Trump doubled down on his stance that abortion should be left to the states. And abortion rights supporters felt President Joe Biden failed to forcefully rebut Trump's outlandish falsehoods about abortion — and also failed to take a strong enough position on abortion rights himself.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: The Washington Post's “Masks Are Going From Mandated to Criminalized in Some States,” by Fenit Nirappil.
Victoria Knight: The New York Times' “The Opaque Industry Secretly Inflating Prices for Prescription Drugs,” by Rebecca Robbins and Reed Abelson.
Joanne Kenen: The Washington Post's “Social Security To Drop Obsolete Jobs Used To Deny Disability Benefits,” by Lisa Rein.
Alice Miranda Ollstein: Politico's “Opioid Deaths Rose 50 Percent During the Pandemic. in These Places, They Fell,” by Ruth Reader.
Also mentioned in this week's podcast:
- Politico's “Inside the $100 Million Plan To Restore Abortion Rights in America,” by Alice Miranda Ollstein.
- JAMA Network Open's “Use of Oral and Emergency Contraceptives After the US Supreme Court's Dobbs Decision,” by Dima M. Qato, Rebecca Myerson, Andrew Shooshtari, et al.
- JAMA Health Forum's “Changes in Permanent Contraception Procedures Among Young Adults Following the Dobbs Decision,” by Jacqueline E. Ellison, Brittany L. Brown-Podgorski, and Jake R. Morgan.
- JAMA Pediatrics' “Infant Deaths After Texas' 2021 Ban on Abortion in Early Pregnancy,” by Alison Gemmill, Claire E. Margerison, Elizabeth A. Stuart, et al.
Credits
Francis Ying
Audio producer
Emmarie Huetteman
Editor
To hear all our podcasts, click here.
And subscribe to KFF Health News' “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
USE OUR CONTENT
This story can be republished for free (details).
——————————
Title: KFF Health News' ‘What the Health?': SCOTUS Ruling Strips Power From Federal Health Agencies
Sourced From: kffhealthnews.org/news/podcast/what-the-health-353-supreme-court-chevron-federal-health-agencies-june-28-2024/
Published Date: Fri, 28 Jun 2024 19:00:00 +0000
Did you miss our previous article…
https://www.biloxinewsevents.com/1st-biden-trump-debate-of-2024-what-they-got-wrong-and-right/
Kaiser Health News
1st Biden-Trump Debate of 2024: What They Got Wrong, and Right
KFF Health News and PolitiFact staffs
Fri, 28 Jun 2024 15:28:00 +0000
President Joe Biden and former President Donald Trump, the presumptive Democratic and Republican presidential nominees, shared a debate stage June 27 for the first time since 2020, in a confrontation that — because of strict debate rules — managed to avoid the near-constant interruptions that marred their previous encounters.
Biden, who spoke in a raspy voice and often struggled to articulate his arguments, said at one point that his administration “finally beat Medicare.” Trump, meanwhile, repeated numerous falsehoods, including that Democrats want doctors to be able to abort babies after birth.
Trump took credit for the Supreme Court's 2022 decision that upended Roe v. Wade and returned abortion policy to states. “This is what everybody wanted,” he said, adding “it's been a great thing.” Biden's response: “It's been a terrible thing.”
In one notable moment, Trump said he would not repeal FDA approval for medication abortion, used last year in nearly two-thirds of U.S. abortions. Some conservatives have targeted the FDA's more than 20-year-old approval of the drug mifepristone to further restrict access to abortion nationwide.
“The Supreme Court just approved the abortion pill. And I agree with their decision to have done that, and I will not block it,” Trump said. The Supreme Court ruled this month that an alliance of anti-abortion medical groups and doctors lacked standing to challenge the FDA's approval of the drug. The court's ruling, however, did not amount to an approval of the drug.
CNN hosted the debate, which had no audience, at its Atlanta headquarters. CNN anchors Jake Tapper and Dana Bash moderated. The debate format allowed CNN to mute candidates' microphones when it wasn't their turn to speak.
Our PolitiFact partners fact-checked the debate in real time as Biden and Trump clashed on the economy, immigration, and abortion, and revisited discussion of their ages. Biden, 81, has become the oldest sitting U.S. president; if Trump defeats him, he would end his second term at age 82. You can read the full coverage here and excerpts detailing specific health-related claims follow:
Biden: “We brought down the price [of] prescription drug[s], which is a major issue for many people, to $15 for an insulin shot, as opposed to $400.”
Half True. Biden touted his efforts to reduce prescription drug costs by referring to the $35 monthly insulin price cap his administration put in place as part of the 2022 Inflation Reduction Act. But he initially flubbed the number during the debate, saying it was lowered to $15. In his closing statement, Biden corrected the amount to $35.
The price of insulin for Medicare enrollees, starting in 2023, dropped to $35 a month, not $15. Drug pricing experts told PolitiFact when it rated a similar claim that most Medicare enrollees were likely not paying a monthly average of $400 before the changes, although because costs vary depending on coverage phases and dosages, some might have paid that much in a given month.
Trump: “I'm the one that got the insulin down for the seniors.”
Mostly False. When he was president, Trump instituted the Part D Senior Savings Model, a program that capped insulin costs at $35 a month for some older Americans in participating drug plans.
But because it was voluntary, only 38% of all Medicare drug plans, including Medicare Advantage plans, participated in 2022, according to KFF. Trump's plan also covered only one form of each dosage and insulin type.
Biden points to the Inflation Reduction Act's mandatory $35 monthly insulin cap as a major achievement. This cap applies to all Medicare prescription plans and expanded to all covered insulin types and dosages. Although Trump's model was a start, it did not have the sweeping reach that Biden's mandatory cap achieved.
Biden: Trump “wants to get rid of the ACA again.”
Half True. In 2016, Trump campaigned on a promise to repeal and replace the Affordable Care Act, or ACA. In the White House, Trump supported a failed effort to do just that. He repeatedly said he would dismantle the health care law in campaign stops and social media posts throughout 2023. In March, however, Trump walked back this stance, writing on his Truth Social platform that he “isn't running to terminate” the ACA but to make it “better” and “less expensive.” Trump hasn't said how he would do this. He has often promised Obamacare replacement plans without ever producing one.
Trump: “The problem [Democrats] have is they're radical, because they will take the life of a child in the eighth month, the ninth month, and even after birth.”
False. Willfully terminating a newborn's life is infanticide and illegal in every U.S. state.
Most elected Democrats who have spoken publicly about this have said they support abortion under Roe v. Wade's standard, which allowed access up to fetal viability — typically around 24 weeks of pregnancy, when the fetus can survive outside the womb. Many Democrats have also said they support abortions past this point if the treating physician deems it necessary.
Medical experts say situations resulting in fetal death in the third trimester are rare — fewer than 1% of abortions in the U.S. occur after 21 weeks — and typically involve fatal fetal anomalies or life-threatening emergencies affecting the pregnant person. For fetuses with very short life expectancies, doctors may induce labor and offer palliative care. Some families choose this option when facing diagnoses that limit their babies' survival to minutes or days after delivery.
Some Republicans who have made claims similar to Trump's point to Democratic support of the Women's Health Protection Act of 2022, which would have prohibited many state government restrictions on access to abortion, citing the bill's provisions that say providers and patients have the right to perform and receive abortion services without certain limitations or requirements that would impede access. Anti-abortion advocates say the bill, which failed in the Senate by a 49-51 vote, would have created a loophole that eliminated any limits on abortions later in pregnancy.
Alina Salganicoff, director of KFF's Women's Health Policy program, said the legislation would have allowed health providers to perform abortions without obstacles such as waiting periods, medically unnecessary tests and in-person visits, or other restrictions. The bill would have allowed an abortion after viability when, according to the bill, “in the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient's life or health.”
Trump: “Social Security, he's destroying it, because millions of people are pouring into our country, and they're putting them onto Social Security. They're putting them onto Medicare, Medicaid.”
False. It's wrong to say that immigration will destroy Social Security. Social Security's fiscal challenges stem from a shortage of workers compared with beneficiaries.
Immigration is far from a fiscal fix-all for Social Security's challenges. But having more immigrants in the United States would likely increase the worker-to-beneficiary ratio, potentially for decades, thus extending the program's solvency.
Most immigrants in the U.S. without legal permission are also ineligible for Social Security. However, people who entered the U.S. without authorization and were granted humanitarian parole — temporary permission to stay in the country — for more than one year are eligible for benefits from the program.
Immigrants lacking legal residency in the U.S. are generally ineligible to enroll in federally funded health care coverage such as Medicare and Medicaid. (Some states provide Medicaid coverage under state-funded programs regardless of immigration status. Immigrants are eligible for emergency Medicaid regardless of their legal status.)
——————————By: KFF Health News and PolitiFact staffs
Title: 1st Biden-Trump Debate of 2024: What They Got Wrong, and Right
Sourced From: kffhealthnews.org/news/article/biden-trump-2024-presidential-debate-fact-check/
Published Date: Fri, 28 Jun 2024 15:28:00 +0000
Kaiser Health News
Republicans Are Downplaying Abortion, but It Keeps Coming Up
Julie Rovner, KFF Health News
Fri, 28 Jun 2024 09:00:00 +0000
For generations, the GOP campaigned on eliminating the right to an abortion in the United States. Now, torn between a base that wants more restrictions on reproductive health care and a moderate majority that does not, it seems many Republicans would rather take an off-ramp than a victory lap.
And yet, they just can't escape talking about it.
The policy high point for abortion opponents — the Supreme Court's 2022 decision to strike down Roe v. Wade — is proving a low point for public support for their cause. More American adults consider themselves “pro-choice” than at any time in the past 30 years, according to a recent survey from Gallup: 54%, compared with 41% who identify as “pro-life.”
The tide is turning even as some conservatives seek restrictions on birth control and fertility treatments. A new KFF survey of women voters found that Democrats are more likely than Republicans to say that abortion is the most important issue in their vote for president — a reversal from recent elections. One in 5 women under age 30 and 13% of those under age 50 said it is their top concern. Among independents, 81% said they believed abortion should be legal.
Democrats are counting on the issue to help turn out their votes and ensure President Joe Biden's reelection, despite persistent dissatisfaction with his leadership. Abortion could prove particularly disruptive in battleground states expected to have initiatives on the ballot to enshrine access to abortion in state constitutions, including Arizona and Nevada.
Eight in 10 Democratic women in states with possible ballot measures said they were “absolutely certain” they would vote — and also said they were more likely to back Biden compared with Democratic women in other states, KFF found.
So far, abortion rights supporters have prevailed in each of the seven states that have put ballot initiatives before voters — including in states where Republicans control the legislatures, such as Kansas, Ohio, and Kentucky. About two-thirds of women in Arizona told KFF they support the state's proposed Right to Abortion Initiative, including 68% of independents.
On the campaign trail, Republicans are bobbing and weaving to avoid the subject, even when that means distancing themselves from — well, themselves. Former President Donald Trump, who has taken a few different stances since calling himself “pro-choice” in 1999, reportedly urged lawmakers during a recent closed-door visit to the Capitol not to shy away from the issue, but also to support exceptions to bans, including to protect the life of the pregnant person.
In pivotal Arizona, U.S. Senate Republican candidate Kari Lake, who embraced a near-complete abortion ban while running for governor two years ago, recently said “a full ban on abortion is not where the people are.” In Nevada, the GOP Senate nominee, Sam Brown, who as recently as 2022 headed up a branch of a conservative anti-abortion group, has said he will respect his state's permissive abortion law and would not vote for a nationwide ban if elected.
The Supreme Court is keeping the issue on the front burner. In a decision June 27, the court left emergency abortions legal in Idaho, a state with a strict ban, though the issue remains unsettled nationally. Justice Ketanji Brown Jackson, who joined the majority in an unusual ruling that sent the case back to the lower court and declared it had been accepted prematurely, accused her colleagues of dawdling on the issue.
“Pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires,” she wrote.
The KFF survey found broad, strong support for preserving access to abortion in cases of pregnancy-related emergencies: 86% of women voters — including 79% of Republican women — support laws protecting access in those circumstances.
In mid-June, the court rejected an effort to overturn the FDA's 24-year-old approval of the abortion pill mifepristone, but only on a technicality. With no actual ruling on the merits of the case, the justices left open the possibility that different plaintiffs could provoke a different outcome. Nevertheless, the push to redefine reproductive health care post-Roe v. Wade continues. The influential evangelical Southern Baptist Convention recently called for significant legislative restrictions on in vitro fertilization, which its members call morally incompatible with the belief that life begins at fertilization.
Abortion opposition groups are pressing Trump not to discard a main plank of the GOP's presidential platform since 1976: a federal abortion ban. Trump has recently said states should make their own decisions about whether to restrict abortion.
Democrats and Democratic-aligned groups are exploiting Republicans' discomfort with the issue. On the day Senate Democrats forced a vote on legislation that would have guaranteed a federal right to contraception, a group called Americans for Contraception floated a giant balloon shaped like an IUD near the Capitol. (Republicans blocked the bill, as expected — and no doubt Democrats will frequently remind voters of that this year.)
A week later, Senate Democrats tried to bring up a bill to guarantee access to IVF, which Republicans also voted down. No giant balloon for that one, though.
Republicans still appear bent on dodging accountability for the unpopularity of their reproductive health positions, if only by highlighting other issues they hope voters care about even more — notably, the economy. But one thing they're unlikely to accomplish is keeping the issue out of the news.
HealthBent, a regular feature of KFF Health News, offers insight into and analysis of policies and politics from KFF Health News chief Washington correspondent Julie Rovner, who has covered health care for more than 30 years.
——————————
By: Julie Rovner, KFF Health News
Title: Republicans Are Downplaying Abortion, but It Keeps Coming Up
Sourced From: kffhealthnews.org/news/article/republicans-downplay-abortion-election-issue-voter-opinion/
Published Date: Fri, 28 Jun 2024 09:00:00 +0000
Did you miss our previous article…
https://www.biloxinewsevents.com/2-million-disbursed-to-victims-and-community-groups-in-wake-of-super-bowl-mass-shooting/
-
SuperTalk FM5 days ago
Manhunt underway after Saucier detainee escapes police custody
-
Local News6 days ago
Ocean Springs Main Street Opens Applications for the 2024 Façade Grant Program
-
SuperTalk FM6 days ago
Thompson, Buttigieg emphasize importance of Medgar Evers Blvd. project in Jackson
-
Our Mississippi Home7 days ago
June Bugs Are Cool Critters
-
Local News Video5 days ago
6/23 – Trey Tonnessen's “Heat Index” Sunday Night Forecast
-
Mississippi News Video4 days ago
Cummins apologizes to families of victims
-
Mississippi Today7 days ago
On this day in 1909
-
The Conversation5 days ago
Do hormonal contraceptives increase depression risk? A neuroscientist explains how they affect your mood, for better or worse