Last month, the only hospital in the sleepy town of Belhaven in eastern North Carolina closed its doors, prompting Belhaven Mayor Adam O'Neal to step out of party lines and call for an expansion of Medicaid in North Carolina. And then he took a lot more steps.
The Republican mayor and self-proclaimed conservative spent the last two weeks walking the 237 miles from eastern North Carolina to Washington, D.C., to raise awareness of the need to save his and other rural hospitals around the nation.
O'Neal did it with the support of the North Carolina chapter of the NAACP. O'Neal, Belhaven residents and NAACP members met on the front steps of a U.S. Senate building on Monday. They demanded the reopening of the hospital and hoped to draw attention to what they call a rural health care crisis.
The protesters fear that the 20,000 residents of Beaufort and Hyde counties will have to travel as far as 75 miles for emergency department facilities. O'Neal asserts that people will die as a result of the hospital's closure and that one woman, 48-year-old Portia Gibbs, was the first victim of Vidant Health's "shameless and immoral" decision to close the hospital.
Barry Gibbs, husband of Portia Gibbs, joined O'Neal at the rally in D.C. He says his wife died as a result of delayed care, waiting for a helicopter to airlift her to Norfolk, Va., because the hospital in Belhaven had closed. There aren't any doctor practices or hospitals in Hyde County.
In general, rural hospitals are more financially distressed, have lower profit margins than their urban counterparts and are disproportionately affected by states' decisions to opt out of Medicaid expansion, according to Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center.
The Vidant Pungo Hospital is one of dozens that have closed since last January. Holmes says that 14 of the 16 rural hospitals that have closed in the last 18 months are in Southern states that chose to not expand Medicaid.
Vidant Health is the largest health care provider in an area historically referred to as the "Black Belt." Since the company announced last September that the hospital would close, town officials, residents and the NAACP have been actively fighting to keep the hospital's lights on.
The North Carolina chapter of the NAACP filed a complaint against Vidant Health in January, alleging discrimination against residents who are "very poor minorities" and need access to emergency department services due to a high burden of chronic diseases.
In April, the town of Belhaven, the NAACP and Vidant Health signed an agreement brokered by the U.S. Department of Justice to transfer ownership of the hospital from Vidant Health to a community-based board, and the complaint was dropped.
But what had been hailed as a promising and historic agreement between these parties fell through, and on June 24 the NAACP refiled the complaint. Instead of a transfer of ownership, the hospital doors were padlocked and bolted.
More than a loss of health care
The closure of the Vidant Pungo Hospital has caused a wave of anxiety among Belhaven residents, both for the loss of health care and for the loss of jobs and people. They say the closure of a community's sole hospital can risk putting the local economy in a downward cycle from which it's very difficult to recover.
Roads leading into this town that once had a thriving shrimping and lumber industry are conspicuously lined with signs reading "Save our Hospital."
Belhaven's local businesses, property values and tax base depend on attracting retirees who not only seek warm weather and beaches, but also access to health care, the mayor says.
"They have ripped our economic heart out of our community," O'Neal said in a recent interview. "How many people go retire somewhere where it doesn't even have a hospital?"
Roger Robertson, president of Vidant Community Hospitals, said that the decision to close the hospital was influenced by a number of reasons, including the hospital's location in a flood zone, the deteriorating building and the state's decision to opt out of Medicaid expansion as allowed for under the Affordable Care Act.
"We had to factor in a lot of different things; Medicaid expansion is one factor out of many," he says. "It does influence people's access to that form of payment."
As of now, 21 states have not expanded Medicaid under the Affordable Care Act, including most southern states. In North Carolina, an estimated 318,710 poor and uninsured adults would be eligible for Medicaid if the state expands it.
O'Neal and the North Carolina chapter of the NAACP are determined to see the hospital in Belhaven up and running again.
"We're not going anywhere until people quit dying from lack of emergency room services," O'Neal says.
Hyun Namkoong is a reporter for North Carolina Health News. This story is part of a reporting partnership between NPR and Kaiser Health News.
Tropical Storm Bertha is moving northwest, taking aim at Puerto Rico and expected to skirt the Dominican Republic's coast.
The National Hurricane Center has issued a tropical storm warning for Puerto Rico, St. Lucia, Dominica, Martinique, and the U.S. and British Virgin Islands, while the Dominican Republic has issued a tropical storm watch.
Luckily, forecasters with the Hurricane Center say upper level winds are not favorable for further strengthening, so maximum sustained winds should remain at about 50 mph.
The long-term forecast calls for Bertha to keep moving west, but at some point curve back — missing the U.S. East Coast and cruising off into the Atlantic Ocean.
"Bertha is expected to generate up to 3 inches of rain across the eastern and northern Caribbean, with isolated amounts of up to 6 inches in certain areas.
"Officials in Puerto Rico are welcoming the rainfall amid a moderate drought that has hit the island's southern region and a small portion in the northeast. More than half of the U.S. territory also is experiencing abnormally dry conditions, with the government reporting $20 million in crop losses.
"Strict rationing measures are scheduled to go into effect starting Aug. 6 if the storm doesn't generate enough rain."
Treading water in July is really fun — if you happen to be in a swimming pool.
But if you find yourself stuck in the part-time labor pool, drifting is disappointing.
On Friday, the Labor Department reported that while employers hired 209,000 workers in July, the growth rate was not strong enough to push part-timers forward.
The monthly jobs report showed payrolls grew by more than 200,000 for the sixth straight month, the longest stretch of such growth since 1997.
But the troubled part-time labor force remained roughly unchanged in July, with 7.5 million people still getting less than 40 hours of work per week, even though they are seeking full-time paychecks.
"Many Americans who would like full-time jobs are stuck in part-time positions, because businesses can hire desirable part-time workers to supplement a core of permanent, full-time employees, but at lower wages," Peter Morici, an economics professor at the University of Maryland, said in a written assessment.
With the pool of eager part-timers still so large, employers have been able to hold down wages. The Labor Department said that in July, average hourly earnings edged up by just one penny to $24.45. Over the past 12 months, hourly earnings have risen by 2 percent, just keeping pace with inflation.
The Labor Department characterized the unemployment rate in July as "little changed," with an uptick of one tenth of a point to 6.2 percent. The labor-force participation rate of 62.9 percent "has been essentially unchanged since April," the report said.
And the number of long-term unemployed, i.e., people who have been jobless for 27 weeks or more, was also "essentially unchanged at 3.2 million in July," it said.
In other words, the job market is moving along at a decent, steady pace. But the upswing is still not strong enough to change the prospects for the long-term unemployed or the involuntary part-timers, or to drive significant raises for workers.
"July's 209,000 jobs is solid, but is a decline from the strong second quarter, when 277,000 jobs were added each month on average," said Heidi Shierholz, an economist with the Economic Policy Institute. "At July's pace, it would take nearly four more years to get back to pre-recession labor market conditions."
The White House said the report confirms that the economic recovery has made huge progress, but has left behind millions of Americans.
"Short-term unemployment has fully recovered," Jason Furman, chairman of the president's Council of Economic Advisers, wrote in his assessment. However, "the long-term unemployment rate, which more than quadrupled as a result of the recession, still has the furthest to go to recover to its pre-recession average."
With so many long-term unemployed workers in the hunt for jobs, part-time workers find themselves with little bargaining power in the workplace.
Their concerns about constantly changing shifts, on-call schedules and low wages have started getting more attention this summer, at least from Democratic lawmakers.
Last month, Rep. George Miller of California, the senior Democrat on the House Committee on Education and the Workforce, and Rep. Rosa DeLauro (D-Conn.), introduced the Schedules That Work Act to reform rules for part-time workers.
For example, they want employers to guarantee workers four hours' pay any time they are called out to the job. Many workers, especially those at restaurants and retail shops, say their employers too often schedule them for only an hour or two during peak times, such as lunch hour.
Business groups generally are opposed, arguing that part-time workers will get better hours and conditions when the economy improves enough to boost all jobs and wages. They say that imposing new rules on businesses would only discourage hiring.
The head of the World Health Organization told leaders of the African countries affected by the Ebola outbreak that the deadly virus is "moving faster than our efforts to control it."
"If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socio-economic disruption and a high risk of spread to other countries," Dr. Margaret Chan, WHO's director-general, told the leaders of Guinea, Sierra Leone, Liberia and Nigeria, who are meeting today in the Guinean capital, Conakry.
The outbreak has killed at least 729 people. The fatality rate is about 60 percent.
The WHO announced a $100 million response plan to combat the spread of the virus. The public was not at high risk for infection, Chan said, but added, "We must not give this virus opportunities to deliver more surprises."
As NPR's Bill Chappell reported Thursday, an isolation unit at Emory University's hospital in Atlanta will be used in the coming days to house and treat a patient infected with Ebola. The hospital didn't name the patient. But that person could be an American infected with the virus.
We'll update this post with information about the patient as it becomes available.
The aid group Samaritan's Purse said today that Dr. Kent Brantly, an American doctor working for the group, and Nancy Writebol, a missionary, who both contracted Ebola, are in serious condition and efforts are underway to evacuate them from Liberia to the U.S.
"The bottom line with Ebola is we know what to do, but it's not easy," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, told NPR's Morning Edition. "It requires meticulous contact tracing, meticulous isolation, and like a forest fire, if you leave one ember burning, it flares up again."
Here's what else you need to today know about the deadly virus:
— The head of Guinea's Ebola task force said efforts by Liberia and Sierra Leone to fight the disease may backfire. Aboubacar Sidiki Diakit says measures, including school closures, "make the problem worse." He added: "When children are not supervised, they can go anywhere."
— The African Union canceled a planned troop rotation in Somalia by forces from Sierra Leone because of fears over the outbreak. The AU troops are there to help fight al-Shabab militants.
— A cyclist from Sierra Leone was cleared to compete after being tested for Ebola at the Commonwealth Games in Glasgow, Scotland.
— The CDC is telling Americans to avoid nonessential travel to Guinea, Liberia, and Sierra Leone.
Wait a minute. Weren't we told by Simon and Garfunkel: "Slow down, you move too fast. You've got to make the morning last?"
And by some other philosopher to "stop and smell the roses?"
Now we learn from new research that walking slow can be a bad thing - or at least reveal that you might be slouching toward Alzheimer's.
Published in the medical journal, Neurology, the study shows that among older people with memory complaints those who walk more slowly are more susceptible to future dementia.
After examining hundreds of patients, Joe Verghese — a neurologist at the Albert Einstein College of Medicine in New York and senior author of the paper — realized that if an older person ambles along at a poky pace, he probably also has some cognitive abnormalities.
Measuring a patient's gait speed with a stopwatch - along with asking a few questions to get a handle on the person's cognitive abilities — can be a useful low-tech test for motoric cognitive risk syndrome (MCR), Joe says. Certain responses to an MCR test can determine if someone is in the early stages of the dementia process. Early detection and treatment may help slow or prevent dementia's advance.
Joe says that a slow walking speed is considered to be anything slower than a meter a second, or 2.2 miles per hour. The Neurology report is based on a study of thousands of adults around the world.
Not all dawdlers are destined for dementia, Joe points out. Sometimes people's gaits are slowed down by arthritis or inner ear conditions.
So, we ask Joe, will walking faster help a person ward off dementia? "Epidemiological studies suggest that people who walk regularly have a reduced risk of dementia," he says. "Whether walking faster will reduce risk of dementia needs to be proven — and would be an important next step."
(See what he did there?)
And, he adds, so far there seems to be no correlation between dementia risk and doing other things slowly - such as eating or speaking.
That's beneficial news for aficionados of the Slow Food Movement and for those of us from the American South.
The Protojournalist: Experimental storytelling for the LURVers — Listeners, Users, Readers, Viewers — of NPR. @NPRtpj