Reports of anti-vaccine preachers spur weekly newspaper to use its 'bully pulpit' and forswear 'neutrality in times of moral crisis'

Many Kentucky newspapers are making extra efforts to increase vaccination against the coronavirus, by fighting misinformation with the facts, and Kentucky Health News plans to continue highlighting them. Chris Evans, the editor and publisher of the only paper in Crittenden County, pop. 9,000, on the Ohio River in Western Kentucky, reported on what he and his wife Allison have done:

"The Crittenden Press has published a first-person article from a local M.D. encouraging vaccines; an article about a nurse practitioner whose husband was hospitalized and unvaccinated and she changed her tune on the vaccine in a hurry; and we have had a couple of recent op-ed pieces, too. Allison wrote a very well-received column a couple of weeks ago comparing it to smallpox and polio." (See below.)

The Press spotlighted the Covid-19 deaths of a local couple.

"Last week, we began a front-page feature where businesses and/or agencies, including local government, are encouraged to tell us how many of their folks are vaccinated. Then we publish what they tell us. City council went first. We have had good response to that so far. Today I attended the funeral of a husband and wife, both unvaccinated, who died last week. The wife previously worked for us for several years."

Evans concludes, "If Covid hasn’t hit your doorstep yet, it’s coming, and we have heard about pastors preaching against the vaccine from the pulpit. I told Allison today, they may have a big audience, but ours is bigger. You probably know that I am a church-going conservative, but it’s time to use my bully pulpit. I have been somewhat reluctant until now to stick my nose squarely into the middle of this, but I think it is time. I am reminded of the phrase in Dante’s Furnace that 'The darkest places of hell are reserved for those who maintain their neutrality in times of moral crisis.'"

Here is the column by Allison Evans, headlined "Polio to Covid."

   Hopefully one day our grandchildren will have to Google-search 'Covid-19' to find a definition.
   If they do, this virus will have come to pass.
   Obviously that’s everyone’s daily prayer, that it will disappear from our society like polio, a disease I’ve tried to learn more about lately – more specifically the country’s reaction to the polio vaccine.
   Unlike the Covid-19 vaccine, apparently there was a greater public acceptance of and willingness to receive the polio inoculation.
   Some of today’s Marion residents were in elementary school back in 1955 when the polio vaccine was distributed. Talked to one recently who remembers walking as a group from school to the second-floor health office on East Carlisle Street. After climbing the stairs, students were given the vaccine, which was contained in a chewable sugar cube.

Allison Mick-Evans

   I’ve been wondering whether there was apprehension about the polio vaccine. Was the country divided about its validity, its efficacy? Were people reluctant to have their children vaccinated, were they on the phone talking about their neighbors’ willingness or unwillingness to accept an inoculation to prevent a horrible, debilitating disease that was affecting children at alarming rates?
   Here’s what I found. Surprisingly, it took 47 years from the time polio was identified until a vaccine was distributed. Because of limited technology at the time, scientists and medical professionals started from scratch to develop the vaccine. Since the 1980s, more than 90 percent of school-age children have been vaccinated for polio.
   The quick development of three Covid-19 vaccines was the result of years and years of research in the scientific archives on SARS vaccines. Because Covid and SARS are both coronaviruses diseases, scientists has a head start on dealing with the new strain, which led to the relatively quick creation of a Covid-19 vaccine.
   When it became available in 1955, people couldn’t get the polio vaccine fast enough. One of the reasons, historians say, was that Americans had a deep respect for science. A chorus of social media opinions did not exist back then to confuse the public. A campaign of disinformation and skepticism about the Covid vaccine has clearly created pockets of deep-rooted resistance, doubt and insecurity.
   Polio attacked children. Nearly 60,000 children in 1952 were infected and more than 3,000 died. By comparison, a year’s worth of Covid-19 data show 32 million cases in the U.S. and more than 573,000 deaths. Yet serious Covid illness, so far, is rare among children.
   Years worth of efforts by door-to-door volunteers acting on behalf of the March of Dimes helped Americans feel like they were helping toward the effort to eradicate polio. These are the individuals whose lives were greatly impacted by World War II and many were involved in the war effort not too many years earlier.
   By the time the polio vaccine was available in 1955, parents understood and accepted that the risks of contracting polio were a much greater threat than the risks of the vaccine.
   Sound familiar?
   We’re beginning to understand that about Covid, too. Even though individuals vaccinated for Covid-19 can contract and, unfortunately spread the virus, the risks of serious illness requiring hospitalization are lessened. A study in Georgia released last weekend pointed out that almost 90 percent of Covid hospitalizations were among the unvaccinated. Other data are bearing that out across the country.
   A friend in Louisville who works in the medical industry shared a conversation he recently had with a doctor. Standing outside one of Louisville’s largest hospitals, he pointed to the upper floors and said there were 100 seriously ill Covid patients up there. None of them were vaccinated.
  I’m always one to avoid uncomfortable topics or create controversy. I know there are varying opinions on the Covid-19 vaccine, but I think we’re beginning to see the life-threatening or life-altering effects of not being vaccinated.
   I understand the fear of the unknown. It’s a weakness I share. Being fearful of making the wrong decision is what creates hesitancy, sometimes with serious consequences.
   But we trusted scientists in the 50s to protect our children from polio. Science worked. And now it’s time to let science protect us again.
   The rollout of a life-saving vaccine is something we might only see once or twice in our lifetime. Hopefully no more.
   Folks in the '50s who trusted the process of eradicating polio should be our guide. It’s time we do the same so our kids and grandkids won’t live with Covid-19, but instead will need to Google it.
   Allison Evans is a third-generation owner of The Crittenden Press newspaper. She can be reached at allison@the-press.com.

A message to Kentucky journalists: Don't let fatigue and friction discourage you from covering the pandemic

Illustration from Medium.com

By Al Cross
Director and professor, Institute for Rural Journalism and Community Issues, University of Kentucky; publisher, Kentucky Health News

Just as some people are tiring of taking precautions against the novel coronavirus, helping it spread, I'm sure some newsrooms are tiring of covering it. And that helps it spread, too, by making it seem less of a threat, and discouraging precautions.

And I fear that some newsrooms aren't just tired of covering the pandemic, but have scaled back their coverage because of objections from people who think the pandemic is overblown or even a hoax that will fade after the election.

Let me be quick to say that I haven't seen such a trend in the newspapers I read regularly, but I tend to read high-quality newspapers, so that's not probative evidence.

What I do know is that news organizations all over the country are getting pushback. 

"No matter how carefully we report . . . for the first time, our readers are questioning the credibility of our reporting on the virus, and that's dismaying," said Les Zaitz, editor-publisher of the weekly Malheur Enterprise in eastern Oregon.

Zaitz made the comment on a panel during the Society of Professional Journalists conference this month, and I followed up with him via email.

"We consistently have people telling us they don't believe the numbers we report about total coronavirus infections, and the positive testing rate," he wrote. "They accuse us of being in league with government officials to overstate the cases. Some say this is to effect more government control over people. We cite our sources, link to those government sources, and regularly explain the data in plain terms.

He added, "We also get pushback in reporting on when government imposes restrictions (limiting restaurants, for instance). We are accused of fear-mongering and trying to panic people. Again, we clearly cite our sources."

I got similar reports from some editors and publishers of Shelbyville-based Landmark Community Newspapers, with the help of Editorial Director John Nelson, who surveyed them at my request.

Publisher Stevie Lowery

Stevie Lowery, publisher of The Lebanon Enterprise, wrote, "When we share the press releases from the governor’s office about the covid-19 pandemic on our Facebook page, we get HATE HATE HATE HATE spewed at us!!!! It’s insane!!!"

"The most intense feedback has been on social media, specifically Facebook," wrote Editor Hugh Willett of the Roane County News in East Tennessee. "We are posting the regular updates on positives cases, deaths, etc., that come from the county mayor’s office. These posts generate a large number of responses and quickly deteriorate into name calling over mask use, government overreach, etc."

"We have gotten a lot negative feedback on Facebook," wrote Editor Travis Jenkins of The News & Reporter in Chester, S.C. "Lots of folks calling it the 'plandemic' and so forth. Lots of people arguing masks don’t work, it infringes on their rights, and such as that. Anytime we post anything about mask ordinances or covid, it goes berserk."

Ben Sheroan, who edits one of Landmark's two dailies, The News-Enterprise in Elizabethtown, wrote that the paper "sees a lot of rude remarks and argumentative interaction on posts about daily covid reports and other covid-related stories."

Sheroan said the paper has sometimes changed its coverage "by simply being responsive to questions raised. For example, adding the positivity rate in a subsequent daily report, or providing data about the number of people hospitalized in a neighboring county. We have found sources to do stories about people who have lost family members or suffered illness."

Editor Miranda Cantrell on the job in Morgan County

The stories of the sick are important, to impress upon skeptical readers that covid-19 is a real disease, and a tough one. Leads can come from social media. That's what the weekly Licking Valley Courier in West Liberty, Ky., did when a county official posted on Facebook, "For those who don’t think covid-19 is real, it is. I tested positive."

Editor Miranda Cantrell put a note at the end of her story about the official's post, asking other victims to tell their stories, because readers in her Eastern Kentucky county wonder "whether the effects are as severe as mainstream media outlets have reported."

Yes, they do, but they are more likely to trust a local news outlet than one based somewhere else, so local editors and reports have a responsibility to tell the story of the pandemic and not flinch from friction or fatigue.

"Our main obligation is to give information to the public that's authoritative, truthful and important," Stat Executive Editor Rick Berke said during another SPJ session. He said it's "urgent" to write more stories "about how bad this is and how it affects people."

Berke, who covered politics for The New York Times, recalled that covering the topic after the 2001 terrorist attacks "was really hard because everyone was so nice to each other," so he was shocked to see the pandemic "become so politicized."

Another editor in the session, Steve Riley of the Houston Chronicle, said some readers are suspicious of national newspapers. He said anytime his paper publishes a front-page story from the Times or The Washington Post, both of which President Trump has attacked, it gets "emails that seem scripted from Fox News . . . It's our job to cut through the crap and provided unfettered, straight, reliable news, no matter where it falls."

Times science correspondent Donald McNeil Jr. said, "Every organ of government has been corrupted in this pandemic . . . Our role in this pandemic has been more important in many more crises in this country because there has been such an effort to suppress the truth, and we're fighting that."

Riley advised, "Be engaged with your critics." He said he tries to "explain in a calming way the role that we have. . . . the folks will at least nod their head and appreciate the response."

Beshear lets restaurants reopen at 1/3 capacity May 22, though Ky. hasn't met benchmarks he set, following federal guidelines

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear moved up the date for Kentucky to begin the second phase of its reopening, announcing Thursday that Kentucky's restaurants can reopen May 22 at one-third capacity, and a goal of limited child care on June 15.

He said restaurants will be allowed unlimited outdoor seating as long as they keep tables six feet apart, the standard social-distance guideline.

"I know this isn't the capacity that our restaurants probably want, but the studies that we look at show that we've got to be really careful about this step," Beshear said at his daily briefing. "This allows it to be open for Memorial Day weekend, but please be careful. . . . This is the best compromise between public health and making sure we can restart this part of the economy."

Beshear has been under pressure from Kentucky restaurants, especially in Louisville, because Indiana has allowed its restaurants to reopen. He noted that Indiana and Tennessee have reopened restaurants, but said his conversations with Ohio Gov. Mike DeWine "were a big part of it." Ohio will open its restaurants before Kentucky does, and that would likely have brought the same sort of complaints from Northern Kentucky that have been heard in Louisville.

"We had planned it for a little bit later, but I think this is partial harm reduction," Beshear said. He also cited "the belief that those that we have worked with sincerely want to do this right and only want to re-open if they can do it right. Many will find that they won't be ready for that date. Don't rush."

He added that it's important for restaurants to meet their industry-specific guidance, which will be forthcoming, and the 10 state requirements for opening, including such things as thorough, repeated cleaning; mask-wearing; taking on-site temperature checks of employees; making sure there is adequate hand cleaning access; and having a testing plan for employees with elevated temperatures.

"These aren't easy," Beshear said, adding later, "If we're gonna do this, we're gonna do it safe."

Beshear also announced that movie theaters and fitness centers will be able to reopen June 1, campgrounds will be able to reopen June 11, and some child care with reduced capacity and potentially low-touch, outdoor youth sports on June 15. But he said that wasn't guaranteed.

“This is a goal, a goal, we are pushing for,” he said. “We want to have a safe plan for child care, knowing that it is such a challenge for folks. I will tell you that it will be significantly reduced capacity and it will be very monitored to make sure that it’s safe.”

The gradual reopening of businesses that will begin Monday has increased calls to reopen child-care centers, but Beshear has said that would be risky. Unemployed people who get called back to work but can't find child care will be allowed to keep getting unemployment benefits.

Beshear said bars and groups of 50 or more people may be able to open in July. Groups of 10 or fewer will be able to gather on May 25.

Beshear is accelerating his reopening of the state's economy, even though Kentucky hasn't met the benchmarks that he laid out about three weeks ago, Joe Sonka reports for the Louisville Courier Journal, weaving together several threads pursued by Kentucky Health News and the Lexington Herald-Leader in the last two weeks, and providing more research and analysis.

Bloomberg chart shows positive tests in red and pink,

and negative tests in grays. Flu-like illness is shown by
bars across bottom. Gray rectangle marks last two weeks.

"Covid-19 cases are not declining, testing capacity still lags behind the White House's recommendation and 500 new workers to conduct contact tracing are possibly weeks away from starting," Sonka notes, then digs into each of these measures in detail, adding two analyses that question whether Kentucky is jumping the gun: a Bloomberg analysis and a recent study by the Louisville Metro Department of Public Health & Wellness and the University of Louisville.

The study concludes that if Louisville was able to "practice stronger social-distancing strategies, we could safely open in early June. Therefore, taking new and more effective measures can make a manageable early-June opening more likely." It said "decreasing the current social-distancing measures without efforts in regard to testing, isolating, and contact tracing can move us to an unstable status which can be catastrophic."

Dr. Paul McKinney, director of U of L's Center for Health Hazards Preparedness and co-author of the study, told Sonka that Beshear’s reopening plan likely isn’t perfect, "but it's a very reasonable plan, I think, to do it in steps. . . . The good thing about the staged plan is that if you find we're going too fast, you put the brakes on there. Rather than saying 'We're closing everything down again,' no, 'We're just stopping where we are and not moving any further'."

Beshear said Thursday, "Our goal in having a gradual plan is to be able to pause. And that would be our first step. If we saw a spike, we would pause where we are. We would look at where we've seen them, what type of businesses that we have; we would try to be surgical on those areas."

The governor says another reason the state can start reopening is it will be able to test 2 percent of its population each month, as federal guidelines call for.

He spent a fair amount of time Thursday discussing the state's increased capacity for testing, saying it would soon be able to do 30,000 tests a week. So far the state has only confirmed tests of 81,391 people; Beshear said the actual number is higher, since some labs have not been reporting negative results.

Kentucky now has at least 72 covid-19 testing locations, listed on the kycovid19.ky.gov website. Beshear announced a new partnership with First Care Clinics, which can now provide tests at 13 locations across the state, seven days a week, at no cost.

"Folks, this is big news," Beshear said. "There’s now no excuse" to not get a test. "Now we all have the tools to do the right thing and protect one another."

Politics: Some think Beshear isn't moving fast enough. U.S. Sen. Rand Paul, an ophthalmologist by trade, told Louisville's WDRB-TV that the governor is “drunk with power” and the state is living under the “dictatorship of Beshear” when its economy needs to reopen completely.

Asked to reply, Beshear said, "There is still some partisanship and some politics going on right now; I'm just not doing it. . . . I look forward to getting to the day when we don’t have an emergency."

Prisons: Beshear's office said someone made a mistake by releasing a prison inmate before knowing the result of his coronavirus test, which turned out to be positive. Now Michael Gene Welch, who has no symptoms. is back at the Green River Correctional Complex for at least weeks -- until he can test negative for the virus twice in at least 24 hours, reports John Cheves of the Herald-Leader.

Welch's fiance, who picked him up and "spent hours in confined spaces with him Tuesday before returning home to her family — including her 84-year-old mother — wants to know how this went wrong," Cheves writes. Beshear spokeswoman Crystal Staley told him, "We are investigating the circumstances that led up to the release and will take any and all appropriate action.

Cheves also reports about the coronavirus outbreak at the Federal Medical Center in Lexington where local officials have said the "prison administrators have been unresponsive to questions" from both the mayor's office and the local health department and inmates tell him they are "sitting ducks."

In other covid-19 news Thursday:

• Beshear announced 208 new coronavirus cases in the state, for an adjusted total of 6,128. Counties with five or more new cases include: Jefferson, 45; Warren, 41; Fayette, 22; Daviess, 12; Kenton and Logan, nine each; Scott, eight; and Allen, six. Click here for the summary. 
• He said 356 Kentuckians are hospitalized with the disease, 199 of them in intensive care, and 2,177 have recovered. 
• Eleven more deaths were reported, raising the state's toll to 294. All were from from adjoining counties from Bowling Green to Louisville. Five were from tiny Edmonson County: two women, 80 and 97, and three men, 92, 89 and 86; a 73-year-old man from Warren County; two men in Butler County, 94 and 62; a Grayson County woman, 87; a Hardin County man, 66; and a Jefferson County man, 78.
• Beshear said eight of the deaths were in long-term-care facilities, which have lost 165 residents and two employees to covid-19. In all, 863 residents and 353 staff have tested positive for the virus, in 78 facilities. Click here for a list. 
• As of Wednesday, five facilities had 10 or more resident deaths from covid-19: Rosedale Green in Kenton County, with 20 deaths, and 63 residents and 22 staff with positive tests; Ridgewood Terrace Nursing Home in Hopkins County, with 19 deaths and 61 residents and 21 staff testing positive; Mills Health and Rehab in Graves County, 16 deaths and 65 residents and 31 positive staff; Treyton Oak Towers in Louisville, 15 deaths, 35 positive residents and 15 positive staff; and Jackson Manor in Annville, with 10 deaths, 40 positive residents and 20 positive staff. WKYT-TV reports there are now 12 deaths at Jackson Manor, owned by Signature HealthCare, the state's largest nursing-home operator. It also has Summit Manor in Columbia, which has had nine resident deaths and the only two staff deaths in the state, and 65 positive residents and 17 positive staff.
• Beshear said the Federal Emergency Management Agency will deliver a 14-day supply of personal protective gear to all certified nursing homes.
• He said the many deaths of people in long-term care may have made people think "this isn't something people of all ages can get," so he read the ages of younger people on the list of news cases: "39, 27, 36, 35, 26, 28, 38, 36, 26, 33, 32, 41, 34, 27, 25, 44, 3, 51, 39, 25, 41, 28, 25, 27, 39, 24, 29, 22, 35, 14, 15, 3, 34, 19, 28, 25, 16. So let’s make sure that we remember . . . that it’s still out there and it’s still dangerous, and misinformation can be deadly."
• Beshear announced that Kentucky will get $10.3 million for testing by 25 health centers funded by the Health Resources and Services Administration. Click here for a list. 
• He cautioned against covid-19 scammers, saying he has heard Kentuckians are getting calls threatening to disconnect utilities without immediate payment. He noted that he had issued a order prohibiting disconnections for non-payment and fees for late payments. If you suspect a scam, call the Consumer Protection Hotline at 888-432-9257 or fill out a complaint on ag.ky.gov/scams. 
• Dr. John Barton, a leading authority on high-risk obstetrics at Baptist Health in Lexington, told John Clay of the Herald-Leader that there is still much to learn about the effects of covid-19 and pregnancy, and his best advice is to use common sense. 
• UPS is giving $100,000 to the University of Louisville to fund promising research into blocking the coronavirus from infecting human cells. Mike Stunson of the Herald-Leader wrote about this research, which involves an aptamer, a synthetic DNA and originally developed as a cancer treatment, on April 22.
• Kentucky Health News has republished a column by Becky Barnes, editor of The Cynthiana Democrat, "I will wear a mask . . . for you." Barnes has worked at the paper for 44 years and in early March, when Harrison County had Kentucky's first case of covid-19, she published a special edition about it, giving information that dispelled rumors.
• The Cooperative Extension Service is providing guidelines to farmers to help them safely welcome immigrants with H-2A work visas back to their farms in the midst of the pandemic. "Producers know that if even one person in their operation contracts the virus, it could shutter their entire enterprise for at least two weeks," Katie Pratt reports for the University of Kentucky, noting that about 780 Kentucky producers hired more than 8,300 H 2-A workers in 2019. “The packets included covid-19 information and guidance, best health practices and producer guidelines, all translated into Spanish,” Beau Neal, agriculture and natural resources extension agent from Daviess County, told Pratt. “I also included some guidelines for the employers to maintain a healthy workplace environment for all H-2A employees. Doing this helps those employees and their coworkers stay safe and healthy, and to be on the same page as the producer in developing a plan moving forward to adhere to proper health guidelines in their work environment."

Rural Health Journalism Workshop in North Carolina June 8; deadline to apply for travel stipend is May 23

The Association of Health Care Journalists is hosting a free one-day workshop on covering health on June 8 in Research Triangle Park, N.C.

The conference is free for AHCJ members, but registration is required by May 25. Members who need financial assistance should apply for one of the limited travel stipends by the May 23 deadline.

The keynote speaker will be Hannah Koch, a research and technical assistance associate for mental health at the Western Interstate Commission for Higher Education. Koch is tentatively scheduld to discuss key behavioral health issues in rural communities.

Five workshops will cover a variety of topics, including "What reporters should know about rural residents and rural health," featuring Alan Morgan, chief executive officer of the National Rural Health Association and Dr. Jeffrey Heck, president and chief executive officer of the Mountain Area Health Education Center.

Another workshop, "Will your local hospital survive?" will include George Pink, deputy director of the North Carolina Rural Health Research Program and Dana Weston, president of the University of North Carolina Rockingham Health Center.

"Addressing rural health workforce hurdles" will be a workshop with Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center and the director of the Cecil G. Sheps Center for Health Services Research, and Dr. Robert Bashford, associate dean for the Office of Rural Initiatives at the University of North Carolina School of Medicine.

The "Rural opioid crisis: Access to treatment and harm reduction" workshop will include Regina LaBelle, visiting fellow, Duke-Margolis Center for Health Policy and a former chief of staff in the White House Office of National Drug Control Policy, and Donald McDonald, executive director of the Addiction Professionals of North Carolina.

Wrapping up the day will be a workshop titled, "Can telemedicine transform health care in rural communities?" featuring Latoya Thomas, policy director for the American Telemedicine Association.

To register for the workshop, click here. To request a travel stipend click here, or send an e-mail to membership coordinator Tina England: Tina@healthjournalism.org.

Kentucky newspapers showed much more interest this year in the County Health Rankings, no matter if they were good or bad

By Elizabeth Spencer and Al Cross
Institute for Rural Journalism and Community Issues
University of Kentucky School of Journalism and Media

More Kentucky newspapers are writing about their communities' health, even when it presents an unfavorable picture, when measured by coverage of the annual County Health Rankings.

Kentucky papers reported on the rankings at a record rate in 2017, according to an analysis by researchers at the University of Kentucky's Institute for Rural Journalism and Community Issues.

The researchers examined 106 of the approximately 140 paid-circulation newspapers outside Kentucky's three major urban areas, covering 115 of the state's 120 counties. They found that 31 papers in 30 counties published 36 separate articles about the rankings in the five weeks after the rankings were released in late March. That was many more than in previous years.

Williamsburg Mayor Roddy Harrison led a one-mile walk to
promote health. (Photo: Corbin Times-Tribune, Angela Turner)

Not only did more papers report the rankings, there was no discernible difference in the likelihood of publication in healthier or unhealthier counties, unlike most previous years.

In the first few years of the rankings, residents of highly ranked Kentucky counties were much more likely to read that news in their local paper, while such stories in poorly ranked counties were scarce.

That pattern disappeared two years ago, but recurred in 2016, when relatively few Kentucky papers published stories about the rankings. This year, with a much larger sample, there was a strikingly even distribution of stories, with as many in poorly ranked counties as highly ranked ones.

That indicates that newspapers in lower-ranked counties have seen a need to inform citizens about their communities' lower health status, and to at least implicitly suggest a need for their readers to consider their health behaviors.

The County Health Rankings and Roadmaps is a program at the University of Wisconsin Population Health Institute and funded by the Robert Wood Johnson Foundation. The rankings are based on health outcomes, such as statistics on disease and death; factors that affect health, such as health behaviors like smoking, as well as social and economic factors; and local policies and programs, such as clinical care and the physical environment.

The rankings compare counties within each state, not nationwide. Communities can use the comparisons to identify problems that individuals, community organizations and local leaders need to address.

Research details

The main source for the latest research was the archive of printed Kentucky newspapers at the University of Kentucky. Papers unavailable in the archive were searched online. Not all Kentucky papers could be searched, because some newspapers do not have websites. Not all the published articles may have been found, because some papers that have websites do not place news articles there, and some that do greatly limit their online publication of stories that are not locally generated.

Because the Institute for Rural Journalism focuses on rural news media, the study did not include newspapers in Kentucky's five most urban counties: Jefferson, Fayette, Kenton, Campbell and Boone.

Researchers found 36 County Health Rankings articles in 31 newspapers. In one county, two papers had a CHR story. In three counties, the newspaper published more than one story, including an editorial in The News-Enterprise of Elizabethtown.

The Corbin Times-Tribune, which covers Whitley and Knox counties and part of southern Laurel County, did a three-part series on the rankings, one of which promoted a community walk held by the Whitley County Health Department. The county ranked 107th in health outcomes and 87th in health factors. Knox County ranked 102nd and 115th, respectively.

Analysis of the coverage included whether or not the paper framed the story with a county-specific localization of the data. Of the total sample, 89 percent included some form of localization, but two of those stories were localized only by the headline. Thirty-one percent of the stories included a comment from a local authority on health factors and outcomes. Only 11 percent quoted a community member.

Newspaper staff members wrote 69 percent of the stories. One-fourth of the coverage used the Kentucky Health News story, which focused on the rise in Kentucky's premature death rate. KHN is an independent news service of the Institute for Rural Journalism, funded by the Foundation for a Healthy Kentucky.

Overall, 34 percent of the sampled papers published a story about the County Health Rankings. The publication frequency for 2016 rate was only 7.6 percent.

In 2015, the publication rate was 24.53 percent, and in 2014, it was 18.52 percent. In those years, Rural Journalism researchers examined one-third of all papers in the state, drawing a random sample from those available in the printed archive.

The research also examined whether the stories described the rankings and the county's health status in a positive or negative light. Not surprisingly, 16 had a positive framing, 16 had a negative framing, and 11 percent (four) of the stories offered a more balanced perspective. While some stories reflected celebration of an improved ranking, there are still serious health issues in every county.

Because the differences among closely ranked counties are small, maps with the rankings separate them into quartiles, or fourths. An online interactive map gives the individual rankings, and clicking on a county gives a detailed breakdown of the factors contributing to the rankings, as well as its recent trend.

Free journalism workshop will be held June 9 in Cincinnati on covering health care and health in rural America

The Association of Health Care Journalists is hosting a free workshop on covering rural health on June 9 in Cincinnati. The keynote speaker will be Julie Willems Van Dijk, director of County Health Rankings and Roadmaps, an annual measure of vital health factors revealing a snapshot of how health is influenced by where people live, learn, work and play. The registration deadline is May 26.

Five workshops will cover a variety of areas, including "Finding rural health stories: What reporters need to know," featuring Trudy Lieberman, contributing editor of Columbia Journalism Review and Laura Ungar, investigative and enterprise reporter for The Courier-Journal and USA Today. The workshop will moderated by Al Cross, director of the University of Kentucky's Institute for Rural Journalism and Community Issues, which publishes Kentucky Health News.

Another workshop, "Challenges of keeping a rural health workforce," will include Timothy L. Putnam, president and chief executive officer of Margaret Mary Health and Brent Wright, associate dean for rural health innovation at the University of Louisville School of Medicine. The workshop will be moderated by Melissa Patrick, a journalist for Kentucky Health News, which is published by the Institute for Rural Journalism and Community Issues.

Other workshops on the schedule are: "How the battle over health reform is impacting rural residents;" "The geographic divide: Reporting on disparities;" and "Covering the opioid epidemic beyond cities." To register for the event click here.