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Posts tagged ‘Rural Georgia’

New Kaiser Health News data adds political dimension to Covid-19 crisis

[Note: The third data column in the table about a half-dozen paragraphs down was mislabeled when this was initially posted.  It has now been corrected thanks to a good catch by alert reader Denese Whitney.  Trouble in God’s Country appreciates the help.]

Last Thursday I posted a piece suggesting that Covid-19 might constitute a perfect storm for rural Georgia — that old age and poor health status could combine with a frail healthcare delivery system to put rural areas in particular jeopardy.  Since then a couple of reports have come out that support that view and bring certain healthcare and political realities into sharp focus.

First was a report Saturday from Kaiser Health News (KHN) that documented the number of ICU beds available in virtually every U.S. county and compared those numbers with the population of people 60 and older in each of those counties.  That’s not a perfect measure of an older person’s access to critical care, of course; just because there’s not an ICU bed in your home county doesn’t mean there’s not one in the next county or a nearby city.  But it’s not a bad measure of the magnitude of the healthcare challenge taking shape.

The second was a report in today’s Washington Post.  Philip Bump, one of the nation’s top data journalists, took the KHN data and laid it over county-level data from the 2016 presidential election between Donald Trump and Hillary Clinton.

“Comparing the county-level data from Kaiser Health News to 2016 presidential election data,” Bump wrote,  “we discovered a remarkable bit of data: About 8.3 million people who voted for Trump in 2016 live in counties where there are no ICU beds or no hospitals. That amounts to about 13 percent of the total votes Trump earned in that election, or one out of every eight votes.

“Those counties are also home to about 3.8 million people who voted for Hillary Clinton, a figure which makes up only about 5 percent of her total. Most of the counties voted for Trump by wide margins; he won them by an average of 41 points. He won 10 times as many counties with no ICU beds as did Clinton.”

This afternoon I’ve pulled Kaiser’s Georgia data and combined it with data from Georgia’s 2018 gubernatorial election and today’s Georgia Department of Public Health report on the number of people in the state who have tested positive for Covid-19.  (As of mid-day today, that number was up to 600 people from 59 counties; 38 of the “positives” were from “unknown” counties.)

Overall, the situation here in Georgia is a microcosm of the national picture Bump found — and if the primary goal in this situation is to try to meet the healthcare needs of the entire state, state politics, as always, hovers not very far in the background and imposes a set of difficult strictures on the process.

In the 2018 gubernatorial election, Brian Kemp, the Republican nominee who ultimately won and is now governor, largely swept rural Georgia, carrying 130 counties.  Of those, 83 don’t have a single ICU bed (indeed, most don’t even have hospitals).  Combined, those counties have a population of 1.7 million, more than 380,000 of whom (22 percent) are over 60.  So far, only 47 of the state’s 600 confirmed Covid-19 cases hail from those counties, but it seems likely those numbers will rise as testing becomes more available in rural areas.

In contrast, the Democratic nominee, Stacey Abrams, dominated the state’s urban areas, which has a much younger population and much more robust healthcare delivery systems.  Twelve of the 29 counties she carried were indeed rural (including a half-dozen southwest Georgia counties that are now in the orbit of the Covid-19 hotspot erupting in and around Albany) and also boast no ICU beds of their own.  But the overwhelming majority of her support came from urban and suburban areas that are home to large healthcare systems with a good number of ICU beds.

This table illustrates the contrast.

Kemp Abrams ICU Bed Table

The 130 counties Kemp carried are home to right at 52 percent of the state’s 60-plus population but have fewer than a third of the state’s ICU beds.

To use Philip Bump’s Washington Post framework, more than a half-million Georgians who voted for Kemp — about 25 percent of his total — reside in counties without a single ICU bed.  That’s true of only about 10 percent of Abrams’s voters.

Again, rural Georgians who fall victim to Covid-19 may well be able to get access to an ICU bed in Metro Atlanta or another major city if they need it, but the current pandemic does seem to put a sharp new focus on a problem that has bedeviled the state’s Republicans since they took power at the turn of the century — how to provide healthcare to rural areas that constitute their political base.

For a decade now, the state’s GOP leaders have steadfastly refused to take advantage of billions of dollars in Medicaid Expansion funds and presided over a steady stream of rural hospital failures.

I’ll try to do more with this over the next couple of days.  For now, here’s a complete list of Georgia counties with all the data discussed in this post.

County # !CU Beds # Covid-19 Cases Confirmed by DPH 3/22/20 Brian Kemp’s % of 2018 General Election Vote Stacey Abrams’s % of the 2018 General Election Vote Population Aged 60+ Percent Population Aged 60+
Appling 3 0 79.7% 19.9% 4208 22.8%
Atkinson 0 0 74.4% 25.2% 1451 17.5%
Bacon 4 0 86.7% 12.7% 2329 20.6%
Baker 0 0 58.2% 41.4% 919 28.3%
Baldwin 12 2 49.5% 49.8% 9287 20.4%
Banks 0 0 89.8% 9.4% 4207 22.9%
Barrow 6 1 73.6% 25.2% 12454 16.6%
Bartow 21 57 76.1% 22.8% 18389 17.9%
Ben Hill 5 0 63.9% 35.6% 3982 23.1%
Berrien 0 0 85.0% 14.4% 4266 22.4%
Bibb 117 1 38.4% 61.0% 31993 20.8%
Bleckley 0 0 78.6% 20.5% 2860 22.4%
Brantley 0 0 91.3% 8.1% 3792 20.6%
Brooks 0 0 61.5% 38.1% 4099 26.2%
Bryan 0 0 70.1% 28.8% 4985 14.3%
Bulloch 24 0 62.8% 36.3% 11463 15.5%
Burke 0 0 50.6% 48.9% 4540 20.0%
Butts 0 1 71.7% 27.7% 4813 20.4%
Calhoun 0 0 42.7% 57.1% 1362 20.9%
Camden 5 0 65.3% 33.6% 8503 16.3%
Candler 6 0 72.4% 27.2% 2476 22.7%
Carroll 18 14 69.8% 29.1% 20423 17.8%
Catoosa 0 0 79.5% 19.3% 14752 22.4%
Charlton 0 1 75.1% 24.4% 2473 19.1%
Chatham 78 4 40.0% 58.9% 56014 19.6%
Chattahoochee 0 0 54.5% 44.7% 645 5.8%
Chattooga 0 1 79.9% 19.4% 5705 22.9%
Cherokee 15 18 72.1% 26.3% 42210 17.9%
Clarke 104 9 28.6% 70.3% 17345 14.0%
Clay 0 0 45.3% 54.0% 937 31.0%
Clayton 34 13 11.8% 87.8% 36959 13.5%
Clinch 0 0 76.1% 23.6% 1466 21.6%
Cobb 119 61 44.6% 54.0% 120689 16.3%
Coffee 10 0 70.7% 28.8% 7860 18.3%
Colquitt 10 0 75.9% 23.5% 8918 19.4%
Columbia 0 3 66.5% 32.5% 26092 18.2%
Cook 0 0 70.9% 28.7% 3527 20.5%
Coweta 19 8 69.7% 29.1% 25269 18.3%
Crawford 0 0 72.9% 26.4% 2798 22.6%
Crisp 16 0 63.0% 36.6% 5331 23.2%
Dade 0 0 82.5% 16.2% 4079 25.1%
Dawson 0 1 85.9% 13.1% 6208 26.5%
Decatur 10 0 60.2% 39.4% 5831 21.6%
DeKalb 168 45 15.7% 83.4% 121505 16.5%
Dodge 6 0 73.9% 25.7% 4726 22.4%
Dooly 0 0 52.7% 47.0% 3522 25.1%
Dougherty 50 48 29.8% 69.8% 18997 20.8%
Douglas 8 4 39.4% 59.8% 22028 15.7%
Early 0 2 55.2% 44.5% 2739 26.3%
Echols 0 0 88.2% 11.0% 681 17.0%
Effingham 0 2 76.9% 22.0% 9061 15.9%
Elbert 4 0 70.0% 29.5% 5092 26.4%
Emanuel 8 0 70.0% 29.5% 4782 21.3%
Evans 0 0 69.4% 30.2% 2260 21.0%
Fannin 5 0 83.0% 16.1% 8800 35.9%
Fayette 37 9 56.0% 42.7% 25277 22.9%
Floyd 65 9 71.1% 27.8% 20941 21.7%
Forsyth 24 4 70.6% 28.0% 33215 15.7%
Franklin 8 0 86.5% 12.7% 5691 25.5%
Fulton 538 108 26.8% 72.2% 159840 15.8%
Gilmer 0 0 83.7% 15.3% 9166 31.0%
Glascock 0 0 91.4% 8.2% 713 23.6%
Glynn 24 3 63.6% 35.6% 20679 24.8%
Gordon 8 4 81.9% 17.1% 10941 19.4%
Grady 4 0 67.3% 32.3% 5593 22.3%
Greene 0 0 65.1% 34.4% 6034 36.1%
Gwinnett 82 27 42.3% 56.5% 122430 13.8%
Habersham 4 0 83.5% 15.6% 10665 24.3%
Hall 85 9 73.4% 25.5% 36793 19.1%
Hancock 0 0 24.7% 75.0% 2435 28.1%
Haralson 0 0 87.7% 11.5% 6357 22.1%
Harris 0 0 74.0% 25.2% 7948 23.9%
Hart 0 0 76.6% 22.6% 7015 27.5%
Heard 0 1 83.2% 16.1% 2692 23.2%
Henry 40 7 42.0% 57.3% 34127 15.7%
Houston 36 1 57.9% 41.1% 25522 17.0%
Irwin 0 0 75.8% 23.9% 2170 23.4%
Jackson 0 0 81.6% 17.4% 12724 19.9%
Jasper 0 0 74.5% 24.9% 3116 22.7%
Jeff Davis 4 0 82.6% 16.9% 3219 21.5%
Jefferson 0 0 47.0% 52.6% 3828 24.0%
Jenkins 0 0 64.7% 35.0% 2049 22.9%
Johnson 0 0 72.5% 27.2% 2334 23.8%
Jones 0 0 67.8% 31.6% 6333 22.2%
Lamar 0 3 69.4% 29.9% 3955 21.6%
Lanier 0 0 71.3% 28.4% 1972 19.0%
Laurens 16 2 65.9% 33.6% 10610 22.4%
Lee 0 16 74.7% 24.8% 4964 17.0%
Liberty 0 0 36.2% 63.1% 7447 12.0%
Lincoln 0 1 69.4% 29.9% 2318 29.8%
Long 0 0 64.7% 34.4% 2398 13.4%
Lowndes 48 8 57.7% 41.6% 17921 15.7%
Lumpkin 0 1 79.2% 19.3% 7478 23.7%
Macon 0 0 36.9% 62.9% 2925 21.4%
Madison 0 0 78.5% 20.7% 6721 23.5%
Marion 0 0 63.9% 35.3% 2190 25.6%
McDuffie 0 0 60.5% 39.0% 4855 22.6%
McIntosh 0 0 59.5% 40.0% 4475 31.8%
Meriwether 0 0 58.9% 40.4% 5261 24.9%
Miller 0 1 77.9% 21.6% 1561 26.5%
Mitchell 0 0 56.2% 43.5% 4919 21.8%
Monroe 0 1 71.9% 27.2% 6594 24.6%
Montgomery 0 0 76.1% 23.3% 1891 21.1%
Morgan 0 0 71.2% 28.0% 4678 26.0%
Murray 0 0 85.8% 13.4% 7520 19.1%
Muscogee 61 2 38.6% 60.7% 34483 17.4%
Newton 10 4 45.1% 54.3% 18455 17.6%
Oconee 0 1 69.8% 29.0% 7602 21.1%
Oglethorpe 0 0 70.5% 28.4% 3441 23.5%
Paulding 8 4 66.6% 32.5% 21365 14.0%
Peach 0 3 52.2% 47.3% 5201 19.2%
Pickens 6 2 84.8% 14.2% 8464 27.9%
Pierce 0 0 88.9% 10.7% 4228 22.1%
Pike 0 0 85.7% 13.6% 3658 20.4%
Polk 0 4 79.1% 20.1% 8705 21.0%
Pulaski 6 0 69.8% 29.8% 2806 24.6%
Putnam 0 0 71.9% 27.5% 6275 29.3%
Quitman 0 0 55.5% 43.6% 913 42.7%
Rabun 0 0 80.0% 18.8% 5564 34.0%
Randolph 0 1 45.1% 54.4% 2258 31.3%
Richmond 264 10 31.5% 67.7% 38152 18.9%
Rockdale 16 2 32.0% 67.4% 17124 19.4%
Schley 0 0 81.0% 18.3% 1100 21.3%
Screven 0 0 60.4% 39.4% 3450 24.6%
Seminole 0 0 66.7% 32.8% 2541 29.7%
Spalding 22 2 61.2% 37.9% 14777 23.0%
Stephens 6 0 80.7% 18.6% 6327 24.7%
Stewart 0 0 41.8% 58.0% 1209 20.7%
Sumter 10 2 48.8% 50.7% 6539 21.3%
Talbot 0 0 39.5% 59.8% 2045 31.8%
Taliaferro 0 0 38.1% 61.6% 511 27.7%
Tattnall 0 0 76.3% 23.1% 4769 18.8%
Taylor 0 0 62.9% 36.5% 2020 24.4%
Telfair 0 0 66.8% 32.8% 3802 23.3%
Terrell 0 2 45.7% 53.9% 2148 23.9%
Thomas 35 0 61.2% 38.3% 10319 23.0%
Tift 20 2 69.7% 29.7% 8091 20.0%
Toombs 8 0 74.8% 24.8% 5815 21.4%
Towns 0 0 81.7% 17.4% 4566 40.9%
Treutlen 0 0 68.9% 30.8% 1666 24.7%
Troup 20 4 60.9% 38.4% 13380 19.3%
Turner 0 1 63.0% 36.6% 2004 24.9%
Twiggs 0 1 52.7% 46.8% 2395 28.8%
Union 5 0 83.4% 15.6% 8856 39.8%
Upson 28 0 66.8% 32.6% 6294 24.0%
Walker 0 0 81.0% 17.9% 16583 24.2%
Walton 7 0 76.9% 22.4% 17821 20.1%
Ware 22 0 71.7% 27.8% 7974 22.3%
Warren 0 0 46.6% 53.1% 1586 29.3%
Washington 0 0 50.6% 49.1% 4483 21.9%
Wayne 12 0 80.2% 19.1% 6149 20.6%
Webster 0 0 59.9% 40.0% 671 25.5%
Wheeler 0 0 71.1% 28.7% 1550 19.5%
White 0 0 84.5% 14.4% 7553 26.5%
Whitfield 34 2 72.3% 26.8% 18625 17.9%
Wilcox 0 0 73.3% 26.5% 1960 22.0%
Wilkes 0 0 59.0% 40.4% 2863 28.9%
Wilkinson 0 0 55.6% 44.0% 2285 25.0%
Worth 0 2 75.4% 24.1% 5131 24.7%
Totals 2508 562     1,863,154 18.3%

 

 

 

 

Covid-19 may stir a perfect storm for rural Georgia

When I began work on this project some years back and came up with the title “Trouble in God’s Country,” I was thinking about things like the urban-rural divide in economics, education, healthcare, and politics.  It never crossed my mind that a new plague might come along that would stir up what might be a perfect storm for rural Georgia.

To be sure, Metro Atlanta and the state’s other urban areas will obviously take huge beatings in this as well, but rural communities may prove even more vulnerable, and not even in the long run.  Without even bothering to run through my usual tons of data, we can take judicial note of certain indisputable realities.

The most basic is that Georgia’s rural communities are older and less healthy.  That alone puts a Covid-19 target on their backs.  Add to that a healthcare delivery system that might charitably be described as frail and you’ve already got the makings of a heaping helping of trouble in God’s country.

But there’s more.  You can stir politics, religion, and crime into the mix.  As I’ve documented before, rural Georgia is overwhelmingly Republican and pro-Trump, and there’s already national polling by Pew Research suggesting that Republicans are taking Covid-19 less seriously than Democrats (or at least were until President Trump and FOX News began shifting tone earlier this week).

From the Pew report on its polling: “ … a vast majority of Republicans (76%) say the news media have exaggerated the risks associated with the virus – 53% greatly and 24% slightly – while far fewer (17%) say the media have gotten it about right. Democrats, on the other hand, are much more likely than Republicans to think the news media have gotten the level of risk about right (41%).”

As for religion and crime, it’s not for nothing that the region of Georgia from the gnat line south is known as both the Bible Belt and the Prison Belt.  Both churches and prisons hold the potential to serve as lethal vectors for the bug.  I started canvassing rural Georgia contacts earlier this week and one common theme in the feedback revolved around a reluctance to cancel church services; as things have worked out, it sounds like the cancellations are indeed taking place, maybe a week later than they might have.  In several communities, churches are reportedly planning to live-stream their services via Facebook and other technologies.

Prisons are a different story.  According to the Georgia Department of Corrections’ website, its 34 state prisons house 52,000 felony offenders, and it’s difficult to imagine a more active breeding ground for Covid-19.  The vast majority of those prisons are in rural Georgia, most of them in Middle and South Georgia (as the red dots on GDC’s facilities map, here, illustrate). DOC Facilities Map

Those prison populations are constantly ebbing and flowing, as newly sentenced felons begin serving their time and those who have completed their sentences are freed.  Meanwhile, thousands of rural Georgians who work at those prisons come and go to fill the three daily shifts at each of them.

As it turns out, one of those employees has already tested positive for Covid-19, as both GDC and the AJC reported yesterday, although GDC hasn’t said where the employee worked.  So far, the department hasn’t reported any inmate infections, but it’s obviously a significant concern: GDC’s home page currently features a “COVID-19 UPDATES” banner and a “Covid19 Response” statement detailing the department’s response to the bug.  Among other things, all visitation has been suspended and prisoner movement is being limited to “required medical transfers.”

As for positive tests around the state, those now appear to be seeping rapidly into rural Georgia.  Any early expectations that the virus might do most of its damage in urban areas and not find its way to the hinterlands is being undercut by daily reports from the Georgia Department of Public Health.   The number of positive tests went from 197 in 28 counties on Tuesday to 287 in 34 counties on Wednesday (with the home counties of a half-dozen victims “unknown”).

If, as these maps suggest, it turned up first in Metro Atlanta and North Georgia, it is now making its way below the gnat line.

And there’s some evidence that the reality on the ground in some localities is outpacing the information being reported on a daily basis by DPH.  Albany and Dougherty County have emerged as a South Georgia hot spot, and DPH today put the number of confirmed cases there at 20.  But at about the same time DPH was posting its Wednesday numbers, Phoebe Putney Memorial Hospital in Albany was holding a press conference where, according to the Albany Herald, it reported two more deaths (for a total of four), a total of 40 patients who had tested positive (and were either in the hospital or at home), and nearly 500 more area residents who were still awaiting test results.  Six Phoebe Putney employees have tested positive, the Herald reported.

And Thursday evening, the Tallahassee (Fla.) Memorial Hospital reported that an Early County, Ga., woman had died there of the virus.

_________

If rural Georgians were a little slower than their city cousins to react to the Coronavirus threat, they may now be taking it more seriously.  I canvassed a half-dozen contacts early in the week and then again yesterday and today.  All reported that the pace seemed to be picking up.  One South Georgia contact who reported earlier this week that people were mocking the “panic” and not changing their behavior indicated earlier today that was changing; more and more businesses cutting hours and more people were self-isolating.

Another contact, Jason Dunn, executive director of the Fitzgerald and Ben Hill County Development Authority, emailed me around mid-afternoon that it was “safe to say that we are seeing changes in day-to-day behavior.  Foot traffic in our office is down and the citizens that continuously support our locally owned eateries are more than likely to get their meal to-go rather than dining in.  The best that I can put it is that social distancing is tough in a tight-knit community, yet a majority of our citizens are taking precautions.”

And this from a northeast Georgia weekly newspaper editor: “Day-to-day has changed drastically. A lot of parents are getting a crash course in home-schooling and remote, electronic and digital learning. It also shows in dramatic fashion how a lack of adequate broadband can be a real disadvantage to a rural county without that kind of infrastructure!

“The question about the seriousness of the situation being slow to take hold was a good one,” he added.  “On a Tuesday, the track coach was planning on winning the state championship. On Friday he was bemoaning the fact that his team would probably not even get a shot at that achievement.”

Political common ground hard to find in Georgia. Literally.

A few days after Georgia’s 2018 elections, I did a quick analysis and wrote a piece positing that the state’s widening urban-rural divide went beyond economics and education and extended to politics.  Rural areas seemed to be going more and more Republican while urban and suburban areas were trending more Democratic.  Recently I’ve finally gotten around to taking a deeper dive into past election results and can report a couple of things.

The first thing I can report is that the Georgia Republican Party’s rural strategy is now pretty clear.  Basically, they’re trying to run off all the Democrats.

The second thing I can report is that they’re doing a damn fine job of it.

I am only about half-joking.  One 2018 factoid that I don’t think got nearly enough attention is that Governor Brian Kemp, then the Republican nominee, cracked 90 percent in two rural counties, Glascock (in east-central Georgia, gave him 91.4 percent) and Brantley (deep southeast Georgia, 91.3 percent).  That was a first, at least in modern political history.  Kemp topped 80 percent in 27 more counties.

Even Donald Trump didn’t do that well; in 2016, he piled up 80 percent vote totals in 24 counties but never got into that 90 percent stratosphere anywhere.  Altogether, Kemp won 76 counties with more than 70 percent of the vote; you have to wonder if he wasn’t disappointed with the 36 counties he won with a relatively meager 60 and 70 percent, not to mention the 18 laggard counties that couldn’t deliver more than 50-something percent.

This pattern isn’t exclusively Republican, of course.  Democratic nominee Stacey Abrams broke 80 percent in Clayton and DeKalb counties and got into the 70s in three more counties, and the fact that once reliably red suburban counties are now trending blue has been heavily reported and well documented.  Indeed, as I was finishing up this research, Jay Bookman went up at the Georgia Recorder with an excellent piece documenting the “velocity” with which heavily populated urban and suburban counties are flipping from red to blue.  It’s a good companion to this piece.

It’s worth taking a minute, though, to recognize how and why all this is a big deal.  Up until 1990, Democratic landslides were foregone conclusions and anything less than a 25-point win was a little embarrassing.  But Republicans were clawing their way to relevance and in the 28 years since then every gubernatorial election but one has been decided by 10 points or less; the only real blowout was Governor Sonny Perdue’s 19-point thrashing of Lt. Governor Mark Taylor in 2006.

But that rough statewide equilibrium has masked tectonic shifts taking place beneath the surface.   First of all, Georgia’s Democrats and Republicans have basically swapped geographic territory over the past three decades.  In 1990, the state’s popular Democratic lieutenant governor, Zell Miller, carried 141 counties and posted a relatively modest 8.3-point win over Johnny Isakson, at the time a suburban Republican state senator.  In 2018, Republican Kemp carried 130 counties in his squeaker over Democrat Abrams, the party’s first female and African-American nominee.  Here’s what the raw 1990 and 2018 maps looked like.

 

That’s only part of the story, however, and it is a bit deceptive.  The way those Democratic and Republican voting blocs are assembled has changed radically over the past three decades – and those changes bring the state’s political divide into even sharper relief.

In 1990, Miller beat Isakson 52.9%-to-44.5%, and that spread was generally reflective of what you found around the state.  Fifty-three of the state’s 159 counties were decided in that middling 55%-to-45% range.  Another 50 counties were carried with less than 60 percent of the vote.  In other words, the vast majority of the state’s counties were fairly competitive.

Map the 1990 results based on the extent to which each party carried a county and you get paler shades of blue and red (left).  1990 Shaded MapYou even get some nearly colorless counties; Miller led in six counties with pluralities in the high 40s (Coweta County tipped his way by two votes out of nearly 12,000 cast).  Isakson’s best performance was 61.8 percent, in his home Cobb County.  Miller’s best showing was 75.1 percent in Chattahoochee County, one of seven rural counties where he topped 70 percent.

Last year was very different.  The closest gubernatorial race at least in modern history – Kemp’s 1.4 percent win over Abrams – was forged on the most divided and hyper-partisan political terrain in the state’s history.  Only 15 counties were decided with less than 55 percent of the vote, and only 19 more were won with less than 60 percent.

Put another way, in 1990, 60 percent was the ceiling in 103 of the state’s 159 counties – the most either Miller or Isakson got in any of those counties.  In 2018, 60 percent was the floor in 105 counties – the least either Kemp or Abrams got.  2018 Shade MapThe pastels that were so prevalent in 1990 were in shorter supply last year, especially the reds (right).

As one illustration of the magnitude of the rural shift, Miller’s native Towns County gave him 73.5 percent of its vote in 1990; last year, it went 81.7 percent for Kemp.

The real question in all this is, of course, so what?  How do the shifts and balkanization of the state’s political geography affect policy-making and legislating, especially as it relates to the problems of rural Georgia?  I won’t pretend to know, but my hunch is we’re headed for a reckoning.

For now, both the Georgia House of Representatives and State Senate are still safely in Republican hands, and they can be expected to advance and defend rural interests (even at the expense of urban taxpayers).

But the 2020 Census and the subsequent reapportionment will inevitably change that.  All the mischief that is likely to occur both in counting the bodies and redrawing the lines won’t be able to completely defy the gravitational pull of Metro Atlanta and Georgia’s other urban communities.  Rural Georgia will lose seats, and that will have political and policy consequences.

Exactly what they will be remains to be seen.  The one certain thing is that political common ground is, literally, getting harder and harder to find.

 

The Economic Innovation Group’s case for place-based “Heartland Visas”

John Lattieri, the president of the Economic Innovation Group (EIG), is up at The Washington Post with a provocative op-ed pushing the concept of place-based visas — an idea that would empower struggling rural communities to sponsor immigrants with certain skills to relocate to their communities.

Given the political and cultural realities of the areas of rural Georgia that would benefit most from such a program, I’m skeptical it’ll get much support here — but it’s a fine idea and one the House Rural Development Council would do well to consider.

You can read the entire op-ed at the link above, but here’s a nut graf:

The idea of “place-based” — rather than employer-based — visas has been already implemented in countries such as Canada and Australia. Recently, the Economic Innovation Group released a paper calling for a specific place-based visa program — a “heartland visa” — aimed directly at helping struggling regions break the economic and demographic declines they are experiencing. Such a program would open a new door — without reducing the slots available through other programs — for skilled workers who could meet a range of local needs, from helping grow a local robotics hub, to filling small-town physician shortages. But instead of relying on employer sponsorship, heartland visas would be tied to communities — ones that qualify based on a stagnant or shrinking local workforce, or other economic criteria. The draw could be considerable. Many demographically stagnant U.S. communities offer an enormously attractive chance for a better life for would-be immigrants.

As background, the Economic Innovation Group is a Washington-based think tank whose work I’ve cited several times, including here and here.

 

 

 

 

Rural Georgia: Doing its part to send Metro Atlanta kids to college

One recurring theme in my Trouble in God’s Country research is that Metro Atlanta is paying the lion’s share of taxes in Georgia while consuming a much smaller portion of social services, such as Medicaid and food stamp benefits.  Rural Georgia, generally speaking, doesn’t cover its costs for those services.

In at least one regard, however, rural Georgians seem to be doing their best to balance the books.  They’re spending millions of dollars on Georgia lottery tickets that help send tens of thousands of Metro Atlanta kids to college.

Of course, a fair number of rural Georgians get advanced education through lottery-funded HOPE scholarship grants – at either University System of Georgia (USG) institutions or one of the state’s technical colleges – but Metro Atlanta is clearly getting the better end of this particular deal.

I’m not sure this qualifies as real news.  It probably won’t come as a surprise to political leaders and policymakers who work in these areas.  Also, I should stipulate that the Georgia lottery and HOPE scholarship data I’ve been studying comes with a handful of significant caveats.  Available data from the University System of Georgia (USG) and the U.S. Census Bureau make it possible to paint pretty precise county-level and regional pictures of educational attainment patterns and college enrollment trends throughout the state.

The lottery and HOPE data are a little fuzzier and the resulting pictures are therefore a bit blurrier.  After studying the data for a bit, I’ve decided the best way to tell this story is to present two views – a big-picture, macro view, and then a more isolated micro snapshot.

First, the big picture, and here the caveats are especially important.  Lottery sales are reported on a county-specific basis, but that doesn’t necessarily mean that a lottery ticket sold in a particular county is purchased by a resident of that same county – or even a Georgia resident.  Inter-county or interstate sales aren’t tracked, although it’s pretty obvious that many of the Georgia counties on the Alabama border are pulling in millions of dollars from that state[i].

HOPE scholarships, meanwhile, are awarded to students in their county of residence, not their county of origin.  Odds are that the initial awards do go to students in their county of origin, but it’s also obvious that many students effectively move to their college towns and establish residence there while they’re still receiving HOPE awards.  Even a cursory review of data for college communities makes that clear.

Still, the big picture is a useful starting point.  For that I organized lottery sales and HOPE scholarship data by my five Trouble in God’s Country regions – 12 Metro Atlanta counties, 41 North Georgia counties, 43 Middle Georgia counties, 56 South Georgia counties, and seven Coastal Georgia counties.  Here’s how those numbers shake out:

Regional Lottery and Hope Analysis

The obvious takeaway from this is that Metro Atlanta and North Georgia were the only two regions that got larger shares of the HOPE scholarship grants than they ponied up for lottery tickets.  The largely rural areas of Middle, South and Coastal Georgia didn’t do nearly as well.

For the micro view, I organized a cluster of 16 largely rural counties in interior Middle and South Georgia; I’m calling it the South Central Georgia Cluster[ii]Cherokee S. Georgia MapAll these counties are far enough away from a state line that they shouldn’t get a lot of interstate lottery dollars, and most (with a couple of exceptions) are well off the beaten path of the major interstate highways.  In other words, it’s a fair presumption that their lottery sales are largely local.

As a point of comparison, I chose Cherokee County, an exurban county on the northern edge of Metro Atlanta (that’s the green county in the northern part of the map).  In 1994, the 16-county cluster of rural counties was home to a little more than twice as many people as Cherokee County – 231,402 to 107,569, according to Census estimates for that year.  But from the git-go, the rural counties were more enthusiastic lottery players.  In 1994 (the first full year of the lottery), lottery sales in those 16 counties were 3.6 times as much as in Cherokee County.

Today, the populations are roughly equivalent: 254,149 for Cherokee County versus 271,182 for the 16 rural counties, based on 2018 Census Bureau estimates (the latest available).

But lottery sales in those 16 counties are still more than double Cherokee County’s: $151.9 million to $69.3 million.  If Cherokee County and the 16 South Central Georgia counties constituted a state of sorts, here’s what their total respective shares of the lottery sales and HOPE grants would look like over the life of the programs:

South Central Cherokee Comparison

Perhaps more interesting than the total shares of lottery sales and HOPE grants is the way the trend lines evolved over time.  From 1994 through 2011, the 16-county South Central Georgia Cluster received more in HOPE scholarships than Cherokee County.  But in 2012, both areas took major hits in HOPE funding (as did the state as a whole).  The South Central counties suffered a 43.2 percent hit in HOPE scholarship grants and still haven’t gotten back to their 2011 level; Cherokee County dropped 26.5 percent but recovered more quickly and had gotten nearly all the way back to its 2011 high by 2017.  The result has been that Cherokee County passed the 16 rural counties in HOPE grants in 2012 and has been widening the gap ever since.

South Central Cluster Cherokee Trendlines

This matches a pattern I’ve seen in other education-related data.  As I noted in my last post, up through 2010, Metro Atlanta had trailed the other 147 counties in the state in fall freshman enrollment at USG colleges.  But those lines crossed in 2011 and the gap has been widening ever since.  The same pattern shows up in a comparison of Gwinnett County and all 56 counties of interior South Georgia from late 2016.

I’ve got more work to do on all this.  I need to take a deep dive into enrollment patterns at the state’s technical colleges, and I’m expecting to get a breakout on HOPE scholarship grants by type of institution – USG, technical college, or private college – fairly soon.  I’ll try to update all this within a couple of weeks.

Even with that work still to be done – and with all the caveats stipulated above – it seems fair to suggest that a lot of poor folks in rural Georgia are sending a lot of Metro Atlanta kids to college.

__________________________________

[i] I figured this out when I was trying to get a handle on lottery sales patterns in different parts of the state.  One approach I took was to calculate lottery sales per capita – in other words, to divide total lottery sales by population.  The state average for 2018 was $437.08 per capita.  Far and away the top producer was Quitman County at more than $4,800 per capita.  One of the smallest and poorest counties in the state, Quitman County sits forlornly on a stretch of the Chattahoochee River that is known as Walter F. George Lake in Georgia and Lake Eufaula in Alabama; Quitman County’s top economic asset in this regard is no doubt the Ernest Vandiver Causeway, which spans the lake and connects it to the State of Alabama, which is one of about a half-dozen U.S. states that still doesn’t have a lottery of its own.  While Quitman County’s per capita sales dwarf those of all other counties, seven of the top 10 per capita sales counties border Alabama, and two others are just east of Quitman County.

[ii] The counties included in the South Central Georgia Cluster are: Atkinson, Bacon, Ben Hill, Bleckley, Coffee, Dodge, Irwin, Jeff Davis, Laurens, Montgomery, Pulaski, Telfair, Toombs, Treutlen, Wheeler, and Wilcox.

Kemp’s “rural strike team” should be a step in the right direction. We’ll see.

First, props where they’re deserved.  Georgia Governor Brian Kemp actually took a step in the right direction Monday when he told the AJC he’s creating a “rural strike team” to try to stimulate economic development in the state’s dying hinterlands.  He reportedly plans to unveil the details in Swainsboro on Thursday.

Only time will tell whether this is anything more than eyewash and window dressing, but there were a couple of promising hints in the AJC’s story.  One was that he’s bringing together “a half-dozen state departments and higher education agencies” to drive the effort.  That implies a more strategic approach and focus than I’ve seen so far, and one that’s long overdue.  Still, the strike force will have its work cut out for it.

The state of Georgia is quite literally in the process of tearing itself apart along rural and urban lines, and especially between Metro Atlanta and just about everything else from Macon south.  These are not slow-moving trends.  No matter how you come at it – economically, educationally, health-wise, politically – you can pretty much watch the division in real-time.

Take education as an example.  In 1970, according to Census Bureau data, there were fewer than a quarter of a million college graduates in the entire state of Georgia, and slightly more than half of them lived outside Trouble in God’s Country’s 12-county Metro Atlanta region.  Today, the state is home to nearly two million college graduates and 63 percent of them live in Metro Atlanta.

That disparity is only going to grow.  Up until 2011, the 147 counties outside Metro Atlanta sent more freshmen to University System of Georgia (USG) institutions than the 12 Metro Atlanta counties, which is probably what you’d expect.  But in 2011 Metro Atlanta overtook the rest of the state and ever since then it’s been sending significantly more freshmen to USG colleges and universities than the rest of the state combined (see graph at right).

At the state’s two flagship universities, the University of Georgia and Georgia Tech, the gulf is bigger yet.  At Georgia Tech, 75.5 percent of the Fall 2018 in-state freshmen came from Metro Atlanta; at UGA, just over 63 percent of the in-state freshmen came from Metro Atlanta.  By my count, 71 counties, all rural, didn’t send a single high school graduate to Tech in the fall of 2018; at UGA, the same was true of 22 counties.

These differences matter.  Not only do they fuel Metro Atlanta’s outsized economic growth, they drive widening disparities in taxes paid and social services consumed.  With just under half the state’s population, Metro Atlanta in 2016 coughed up nearly two-thirds of the state’s federal taxes while consuming, as examples, about 37 percent of the state’s Medicaid services and about 41 percent of its food stamp benefits.

You can do the math on the other side of that equation.  Oh, okay, I’ll help: the 99 counties that constitute Trouble in God’s Country’s Middle and South Georgia regions don’t even come close to covering their own Medicaid and food stamp costs, let alone anything else.  After a while these kinds of numbers get to be politically untenable.

Some years back, I presented a very early version of my Trouble in God’s Country research to a group made up primarily of legislators.  One of those was House Ways and Means Committee Chairman Mickey Channell, who has since passed away.  “What do you do about it?” he asked.  I didn’t know then and still don’t, at least not entirely.  But I’ve since given it a lot of thought and would offer the following as a running start at an answer:

  • First, the multi-agency approach suggested by Kemp is the right idea — and critical. The state of Georgia arguably has one of the strongest and most sophisticated economic development infrastructures in the nation, but my sense is that its work has been largely siloed and not well integrated with other departments and agencies of state government.  The state’s urban-rural divide and the deterioration in much of rural Georgia constitutes a truly strategic problem.  It’s not an exaggeration to call it an all-hands-on-deck crisis.  In addition to the departments of Economic Development and Community Affairs, the team will have to include high-level engagement from throughout the state’s education bureaucracies and, I’d argue, public health and human services.
  • Start with a realistic evaluation of the state’s various rural areas and recognize that some are more viable than others. Some politicians like to say they want to run government like a business.  In business, if you’re losing money year after year, sooner or later you call it quits.  Under that theory, I can take the governor to 50 or so counties where he ought to turn out the lights and call it a day.  We can’t do that, of course, but it ought to be possible to invest discretionary tax dollars and other public resources in areas that at least have a fighting chance of generating a return, in terms of new growth and economic prosperity.  In other words, resist the normal political temptation to attack the worst problems first; instead, identify the regions that still have a pulse and see if they can be saved.
  • Shore up the regional hub cities first. It’s not just Georgia’s purely rural areas that are in serious decline; a lot of the major regional cities – Macon, Columbus, Augusta, etc. – are suffering various types of distress, and they are vital to rural areas around them.  As a practical matter, it may be too late to do much good for Albany and the rural counties between it and the Alabama line; that entire region of the state is bleeding population and shrinking economically to a degree that may put it beyond near-term salvation.  Figuring out how to strengthen other major hubs in ways that will enable them to better support their rural neighbors should be pretty close to the top of the to-do list for Kemp’s strike force.
  • Challenge the rural areas to compete for the state’s attention and dollars. Hopefully, one of the initiatives that will come out of Kemp’s effort will be a process by which multi-county regions or areas of the state can apply to the state for funding and technical support.  It shouldn’t be entirely on Kemp’s strike force to show up in Enigma, Ga., and say, “We’re from state government and we’re here to help you.”  Rural areas should be required to come forward with a rational vision, demonstrate that they have the leadership capacity to drive a major effort, and put serious skin in the game.  There should be milestones in that process and a credible system for evaluating progress.
  • Bite the political bullet and implement Medicaid Expansion. I should have listed this first but figured Republicans would stop reading right then and there.  Refusing to take advantage of Medicaid Expansion was the major failure of Nathan Deal’s administration and Kemp shows little inclination to do any better.  His attempt at a “waiver” approach (an all but transparent effort to deny Barack Obama any credit for the program) apparently can’t even pass muster in Donald Trump’s Washington.  Meanwhile, rural hospitals continue to close and people continue to die, prematurely and unnecessarily.  Even if Deal, Kemp & Co. are blind to the health benefits of Medicaid Expansion, you’d think they’d see the economic benefits of pumping billions of dollars into rural Georgia.  Maybe all things Obamacare still constitute a third rail of politics for Georgia Republicans, but my hunch is that the radioactivity levels tied to Medicaid Expansion have diminished to a point that it could be a political winner for Kemp – a Nixon-to-China sort of moment.

Again, I don’t know whether Kemp’s ”rural strike force” will prove to be anything more than eyewash and window dressing, but it’s encouraging that he’s taking a stab at the problem.  Hope springs eternal.

(c) Trouble in God’s Country 2019

 

Coming to Rural Georgia from Outer Space: Broadband Internet Service

I’ve been arguing pretty much since the rural broadband craze started that we’d be nuts to plow probably at least a billion tax dollars — most of it from Metro Atlanta — into running fiber to Georgia’s most sparsely populated counties.

Give the private sector and advancing technology time, I’ve felt, and we’ll probably get a better solution long before the state could plow up all the red clay in rural Georgia and put fiber in the ground.

Satellite-based internet has been around for years, although one of the legitimate raps on its potential as a consumer solution has been speed: the satellites are so far above the Earth that it takes a while for the signal to bounce back and forth.

Well, now comes SpaceX with the launch of 60 low-orbit satellites designed to solve that problem: https://nyti.ms/2M8E4nH

Per the New York Times’s story, these new satellites will orbit the planet at a much lower altitude than the current 22,000 miles: “The Starlink satellites will orbit much lower — between 210 and 710 miles above the surface. That reduces the lagginess, or latency. SpaceX has said performance should be comparable to ground-based cable and optical fiber networks that carry most internet traffic today. Starlink would provide high-speed internet to parts of the world that currently are largely cut off from the modern digital world.”

The Times’s story indicates it’ll take nearly 2,000 of these low-orbit satellites to blanket the planet, but my hunch is SpaceX will get that done long before the State of Georgia could hardwire rural Georgia — and we won’t have to pay for it.

Trump says America is ‘FULL.’ Tell that to Rural Georgia.

(Note: I wrote this yesterday afternoon and decided to sleep on it and give it a fresh read-through this morning.  In the process, I got scooped by The New York Times, which is leading this morning’s web edition with a terrific story on this same issue at https://nyti.ms/2VyTbam.)

Lately President Trump has taken to proclaiming that the United States is “full.” He said it a few times over the last few days and has tweeted it at least a couple of times, including Sunday.

Trump Country Full

Well, not really.
Let me say here that I know full well that this notion is entirely ludicrous and will no doubt subject me to all manner of ridicule, much of it probably deserved. Truth is, I’m not really suggesting anything specific. I’m not even sure what a specific recommendation would look like.
But …
The truth is that a core problem afflicting rural America is population loss. Here in Georgia, whole regions are hollowing out. In 2017, 71 of Georgia’s 159 counties recorded more deaths than births.  All but one, Glynn County, were rural.
Georgia has 33 counties with populations of less than 10,000 people. Of those, only five posted any population gains at all over the five-year period 2013 through 2017 (the most recent for which the U.S. Census Bureau has posted estimates). And of the five that did grow, only two managed to grow more than one percent – for the entire five-year period.
The 16 counties that make up the southwestern-most corner of Georgia lost more than 9,000 people in that five-year period, or 3.4 percent of their population. Only Lee County, which has evolved as the white-flight county north of Albany and Dougherty County, posted a gain (2.6 percent) for that five-year period; the other 15 all lost population.
Dougherty County, historically the economic, cultural and political center of Southwest Georgia, is bleeding population; in the 2013-2017 span, it lost 5.5 percent of its population, or more than 1,000 people a year.
It shouldn’t need to be said that losing population is generally not a good thing. The pattern in rural Georgia is that young people leave, especially if they have a college education. Population decline naturally shrinks the consumer base, and that leads to weakened sales and property tax revenues. It’s no exaggeration to suggest that some areas of rural Georgia are now in a death spiral.
Could it be that we have two problems here that might help solve one another?
Again, I know this is nuts, for a whole host of reasons. Neither Trump nor his loyal Republican Southern governors (who preside over many of the worst rural disaster areas in the country) would even begin to entertain a strategy of deliberately importing, say, caravans of people from Mexico and Central America to dying rural communities in South Georgia. What’s more, the vast majority of those counties voted overwhelmingly for Trump, and it’s a sure bet these are the folks who favor building that wall, even if we have to pay for it.
All that said, it’s worth noting that, to some degree, people from outside the U.S. are already finding their way to struggling rural communities, even as locals move away. Probably the most dramatic example in Georgia is Stewart County, which is one of those 16 counties in deep southwest Georgia.
Over the five-year period form 2013 through 2017, according to Census Bureau data, 552 locals moved out of Stewart County, and there were 122 more deaths than births. But 479 people from outside the United States moved into Stewart County.  (Note to self: Find out what the heck’s happening in Stewart County.)
For that 16-county Southwest Georgia region, international in-migration is about the only positive trend going. For the period 2013-through-2017, literally every one of those 16 counties suffered a loss of domestic population – locals moving out. Half that group had at least some international in-migration. Altogether, the 16-county region lost 13,515 domestic residents and got back about one-tenth of that – 1,332 people – in international migrants.
As a region, Southwest Georgia is still reporting more births than deaths, but the margin is narrowing. Eleven of the 16 counties posted more deaths than births for the 2013-through-2017 period, and not one of the 16 is experiencing anything that could be considered a positive trend in its birth-to-death ratio.
As this graph shows, these trends have been a long time developing. The number of births in the region began to drop precipitously in 2007, and the number of deaths began a slower climb in 2011. If the current trends continue, these lines will cross within a few years.

SW GA Births & Deaths 1994-2017.jpg
It will, of course, take a lot more than new population growth to revitalize rural Georgia’s struggling counties and communities.  But without that new population, it’s not clear that much else will matter.

For the third time in this piece, I know what I’m suggesting here is crazy and has less than zero chance of happening, in any form or fashion. But for South Georgia and much of the rest of rural America, the only thing that might be crazier is to do nothing. For these areas, it’s way past time to start thinking outside the box.

(Notes: The data in this post was drawn primarily from two sources.  The population data came from a recent update by the USDA’s Economic Research Service of U.S. Census Bureau county-level estimates.  The data from the Births & Deaths chart immediately above was pulled from the Georgia Department of Health’s OASIS system.  The 16 counties included in the 16-county Southwest Georgia region referenced in this piece are: Baker, Calhoun, Clay, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Quitman, Randolph, Seminole, Stewart, Terrell, and Webster.)

© Trouble in God’s Country 2019

Georgia blacks make strong gains in premature death rates; rural white females losing ground

As we’ve noted in various previous posts, Georgia’s premature death rate (known formally as Years of Potential Life Lost before age 75, or YPLL 75) has been improving fairly steadily over the 20 years that the state’s Department of Public Health (DPH) has been compiling pertinent data.[1]  Between 1994 and 2013, the state’s YPLL 75 rate improved from 9,195.6 to 7,104.7, a gain of 19.4 percent.  The national median, as reported the Robert W. Johnson Foundation in its latest County Health Rankings, was 7,681, so Georgia is doing a little better than the nation as a whole.

But, as we’ve noted in past posts, Georgia’s improvement has been far from even; we’ve focused in particular on regional differences and the dramatic gap in YPLL 75 performance between Metro Atlanta and the rest of the state.  Until now, however, we haven’t looked at racial or gender comparisons, and that produces a couple of interesting headlines.  One is that the vast majority of gains in premature death rates between 1994 and 2013 have been made in the black population.  The other is that rural white females are losing ground.  Read more

Is Rural Georgia Dying? Literally?

A basic premise of Trouble in God’s Country is that rural Georgia is dying.  Truth is, I’ve meant that figuratively rather than literally – a reference to local economies gutted by globalization and other factors, failing schools and small hospitals in danger of closing, among other things.

Recently, however, I read an article that made passing reference to the growing number of rural counties across the country where deaths outnumber births.  I wondered if that might be the case in Georgia.

A quick dive back into the Georgia Department of Public Health’s (DPH) OASIS system produced some pretty startling results. Read more