This land is your land, this land is my land
From California to the New York island,
From the redwood forest to the Gulf Stream waters;
This land was made for you and me.

That Guthrie song, with its heartfelt words, offered conflicting images of a nation’s greatness and the great strife of its people – the never-ending tension between grander and affliction. The power of his lyrics – with verses too conveniently edited out to make the song a patriotic hymnal rather than the composer’s original intent – is a call to social consciousness. The classic 1940s folk song was written to spark a social impact edge to address the needs of overlooked citizens.  The poverty Guthrie saw as he crisscrossed America’s dustbowl states continues. The reasons may be different; however, the suffering remains.

In a recent New York Times opinion piece, Tony Pipa, a senior fellow at the Center for Sustainable Development at the Brookings Institution, who leads the Reimagining Rural Policy Initiative, working to transform U.S. policy to enable equitable and sustainable development across rural America, writes:

“Too often policymakers mistake agricultural policy for rural policy. Farming now accounts for just 7 percent of rural employment. Service jobs, retailing, manufacturing and government employment all outweigh agriculture. And while $163 million of the relief the Trump administration distributed during the peak of the trade war with China went to high-income farmers making more than $900,000 annually, small-scale and family farmers are increasingly taking off-farm jobs just to get by.”

Today, more than 46 million Americans live in rural communities.  On average, rural locales lag behind non-rural communities on every measure of prosperity, from poverty rates to employment opportunities. This land may have been “made for you and me,” yet, when it comes to access to care, rural Americans live hours away from basic medical care, emergency services, and specialist providers.  Their well-being – survival – often hangs on a limited broadband connection. The system to address their needs is usually based on urban and suburban expectations.

Rural community populations trend older than urban and suburban regions, and while age is an invitation to health risks, rural areas have 20 percent fewer primary care physicians. Rural counties often do not have a psychiatrist to deal with mental health needs, and 81 percent do not have a psychiatric nurse practitioner.

LOSE THE IMAGE OF A WHITE FARMER ON A TRACTOR

Rural America’s needs are a bi-partisan issue impacting blue and red states. Congress has prioritized the rural communities’ needs for many good reasons.  People of color – often the most vulnerable in the health system – comprise 24 percent of the rural population. This includes rural Indigenous Americans and more than half of impoverished Black Americans. That compares with 18 percent of rural whites.

While politicians look for fixes to the problem, physicians, payers, private citizens and retailers are stepping forward to help address the care in access and quality gap.

Earlier this year, Walmart and Medscape released Healthcare Professionals’ Perspectives on Healthcare in Rural America, the most extensive survey to assess barriers and solutions to care delivery from the perspectives of professionals on the front lines of health care in rural and non-rural communities. More than 10,000 primary care health care professionals (HCPs) shared opinions that quality care is the most significant concern in their day-to-day efforts for their communities, particularly for people with chronic care and mental health concerns.

FORGET TECH – THE GAP IS ABOUT QUALITY CARE

Rural healthcare professionals are already utilizing telehealth and tapping into electronic medical records to improve quality care delivery. While there is plenty of buzz about remote patient monitoring and digital health technologies as tools that will enhance access to care, the biggest concern among physicians on the frontlines of addressing patient needs is clinical training and financial assistance to keep community hospitals operating. 

Physicians cite building on what they already utilize to care for their remote patients: state-of-the-art medical equipment, 5G internet service, and expanding use of electronic health records to guide their patients on self-care strategies. While technology helps with a care connection, it can only measure and monitor the substandard status quo.

PHYSICIANS IN RURAL AMERICA SEEK UPSKILLING

“We have known the systematic problems within the current health care system for decades. The Walmart-Medscape report emphasizes how health care professionals, like their patients, are most concerned about the quality of care, and we can no longer wait for old models to work,” said John Whyte, Chief Medical Officer at WebMD and Medscape and a Medika Life contributor. “This underscores the need for innovative solutions that look beyond the walls of the doctor’s office, similar to how Walmart is innovating in the space, driven by those who live and work in communities they serve.”

Often people in rural communities want to be cared for by people they know and trust and understand their local challenges and needs where they live and work. Experts addressing rural health needs know that staying well requires additional components beyond a physician visit.  The advocates seek to tackle social determinants of health, improved clinical care, and environmental factors.

Retailers like Walmart are partnering with health plans, advocacy groups, and third-party health associations like the American Heart Association to fill these gaps. Major retail pharmacies such as Walgreens are showing commitment by investing in efforts to address health drivers such as food insecurity, maternal and infant health, diabetes and hypertension solutions to reduce health disparities.

PRIVATE CITIZENS SEEK TO TRANSFORM RURAL COMMUNITIES

“Challenges to rural Americans cause suffering, which drives despair and feeds discord. Dialogue that elevates awareness of people’s difficulties is an important step in providing a remedy, and communication is the first step in providing viable solutions,” said Peter Finn, who founded, with his wife Sara Finn, a Foundation to address the pressing needs within his Upper New York State community of Hunter. Finn taps communication and creativity to make a difference and transform rural communities.

“I have been a long-time resident of Hunter, one of the far too many rural communities struggling in Upstate New York. The town was economically depressed and quickly deteriorating, but rather than abandon Hunter and shut our eyes to what was happening. We chose to get involved by raising awareness and mobilizing others to create the Catskill Mountain Foundation,” he adds. 

The Foundation calls upon the arts – music, creativity and dance – to draw people into the community all year round. Today, Hunter’s streets are lined with inns, restaurants, antique shops, and art galleries. Visitors come to enjoy the fall foliage, hike, and ski. The example of Hunter, New York, and other living laboratories proves how volunteering spirit, creativity and caring about rural community needs can shift the tide of events.

Others are contributing their talents to give voice to the diverse challenges rural Americans face.  “Living in the heartland has become increasingly difficult for Americans, and with this unprecedented narrative podcast documentary, we will present noted policy, community, and industry leaders working to change this reality,” reflects Matthew Zachary, co-founder and executive producer of the award-winning podcast network of OffScrip Health. 

Zachary, who is no stranger to tackling life-threatening issues, is looking to create the first audio documentary on the struggles of rural Americans, tapping into the network of companies, rural community leaders and government leaders who want to share how they are shifting from rehashing old issues to rolling-up their sleeves to solve problems.

CONFRONTING STIGMA – MENTAL HEALTH IN RURAL AMERICA

People with mental health needs face stigma.  That remains among the biggest hurdles to seeking care – the thought of “What will people think?” For people in rural communities, anticipating the negative reactions of family and community is an added emotional challenge that keeps people from seeking the care needed. Like any illness with progressive influence, failure to treat mental illness has life-threatening possibilities. Suicide rates increase as population density decreases. According to the Centers for Disease Control, suicide rates among people living in rural areas are as much as 68 percent higher than in large urban areas.

Jeff Winton is the Founder and Chairman of Rural Minds, a nonprofit organization working to end the suffering, silence and stigma surrounding mental illness in rural America. He is a part of the multigenerational farm Wall Street Dairy, LLC — a working dairy farm in Chautauqua County, New York – and founder of a major communications firm that addresses health issues.

In his opinion piece appearing on the National Alliance on Mental Illness (NAMI) website, Winton writes:

“Increasing awareness that mental illness is a health condition — just like cancer, heart disease, or diabetes — is one way to help overcome the stigma in rural communities. In addition, talking openly with others about lived experiences with mental health challenges helps to normalize the conversation and diffuse the stigma surrounding mental illness. The simple act of sharing stories can be an important first step for people to seek help for their own mental health challenges and encourage others to admit that they are struggling.”

The physical and mental health challenges to rural Americans cause suffering, which drives despair and feeds discord. Dialogue that elevates awareness of people’s difficulties is essential in providing a remedy, and awareness is a crucial step toward viable solutions.

OVERCOMING DESPAIR, DISEASE AND DEATH

Apathy and poverty double team are the domino of rural health killers. Walmart and Walgreen, and other major retailers are engaged.  Individuals with passion are leaning into the challenge and inviting others to join in their efforts.  Health organizations such as the American Heart Association, American Telemedicine Association, Blue Cross Blue Shield, National Rural Health Association, and many others have joined the effort to raise quality and ensure access to care.

Rural America is vast, with a remarkably diverse population and needs. The biggest problem isn’t decision-makers’ willingness to dedicate money or their readiness to align blue and red forces in bipartisan action to the challenge. The government often seeks big solutions to significant challenges.  However, the image we have long held onto of rural America – the proud and industrious farmer in a ballcap sitting on a tractor – is as outdated as the stoic, proud tiller of the land.  These citizens need our help urgently.  How do we resolve these problems? We start by recognizing that a one-sized solution does not fit all.

Woody Guthrie, while some verses of your ballad were conveniently edited out, we know your question:

As they stood there hungry, I stood there asking,
Is this land made for you and me?

Yes, it is!  Woody, we still remember.

The post Rural America – A Generational Struggle for Health Equality appeared first on Medika Life.

Together, they have earned an extra $10.7 billion over last year’s profits during (and largely because of) the pandemic — a stunning 56% increase. Despite this surge, we ranked Amazon and Walmart among the least generous of the 13 large retail and grocery companies studied in our report. The two companies could have quadrupled the extra COVID-19 compensation they gave to their workers through their last quarter and still earned more profit than last year.

Stock prices for Walmart have soared 36% since the start of the pandemic. Meanwhile, worker wages had grown only 6% by the end of 2020 even after last December’s bonuses were announced by the company. Walmart has (along with Amazon) redefined the term “corporate greed”, electing to drop sick and vulnerable employees along the way, viewing them as discarded lumps of diseased flesh not worthy of their billions. Damaged goods that can no longer serve their masters, through no fault of the employee.

If you think that description is a little harsh, it isn’t. It is reflective of a political mindset in America that rewards enslaving and exploiting the poor, often at the cost of their health. It is a mindset that persists independently of the color that occupies the White House, enshrined, entrenched capitalism at its worst. You cannot argue figures away and the graph above may as well be painted in the blood of the employees and families Walmart has destroyed in the last year.

According to figures from a recent study by Human Impact Partners, the extent of the impact of Walmart’s Sick Leave policy during the pandemic is this: at least 7,618 employee cases of COVID-19 and 133 deaths from COVID-19 could have been prevented. The effects on the broader public cannot be quantified. By forcing sick employees to return to work, Walmart has knowingly exposed its customers to potential infection from the coronavirus, contributing directly to the spread of the virus in the general population. It’s motivation? Unconscionable greed.

To make matters worse, intentional obstacles to accessing the paltry two days of paid sick leave make it even more difficult for sick Walmart staff to access the funds. Workers have reported barriers like retaliation and lack of communication around the policy in accessing even this meager amount of leave. According to a 2020 survey, 45% of Walmart associates reported they were still likely to come into work if they were sick. Employees reported fear of disciplinary action, loss of wages, and no knowledge of the 48-hour policy as reasons they would choose not to stay home while ill.

Offer your workers only TWO DAYS OF PAID SICK LEAVE and the following two scenarios unfold, pandemic or no pandemic. 

• Your employee is forced to return to work on the third day if they want to put food on the table for their families. If they’ve contracted a virus, this is the time they are at their most infectious, so Walmart is encouraging a policy that exposes the public to grave risk.
• Walmart turns off the pittance it drip-feeds its employees on day three of their illness if employers have even been able to access these funds in the first place. Staff who become seriously ill face a double whammy. Any potential savings, if they are fortunate, are quickly eroded by medical expenses, medication, and the related costs of illness, and their source of income is officially disconnected as per Walmart policy. No money, no food, no medicine. Tell me which part doesn’t upset you?

Add in the institutional obstacles to accessing these funds and staff are automatically coerced into staying at work, despite being ill. This promotes the spread of disease and places the life and health of the employee at risk.

Flawed Business or Flawed America

Take your pick, one or the other or both, the outcomes are the same. Current policies and permitted practices encourage racism, enforce poverty and deprive the poorest communities of the dignity of basic health and access to care. Ask yourself this.

Why is it that hard-working Americans are required to petition employees for BASIC HUMAN RIGHTS? BASIC HEALTH? BASIC DIGNITIES? Clearly, that little piece of paper referred to as a constitution appears to be fundamentally flawed and may require a redraft. The rights of all working Americans to the dignity of something as simple as paid sick leave, particularly at the time of a pandemic should be enshrined in law, vigorously enforced by legislation, and actively policed for transgressors. Fail to do this, to recognize basic human rights, and the subsequent costs of a failed system skyrocket. Particularly for healthcare.

Walmart isn’t just killing its staff and exposing the public to danger with its despicable profit-based policies, it’s contributing to the downfall of the American Healthcare system. Vote with your feet to register your outrage and do the right thing. Shop elsewhere until this greedy corporate entity decides to recognize its employees as human beings. 

Both Democrats and Republicans need to focus more on resolving basic inadequacies like these that affect large swathes of Americans. You cannot build new infrastructure on rotten foundations, President Biden, and your current building is teetering on the verge of collapse. You can read the full HIP report here: Walmart’s role in the COVID-19 pandemic: How lack of paid sick time prolongs the pandemic and increases mortality

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Research Underscores Absence of Paid Sick Leave at Nation’s Largest Employer Poses a Public Health Risk

Date of Release: April 28, 2021

NATIONWIDE — A new study out today quantifies the public health impacts of Walmart’s failure to have a paid sick leave policy that met the needs of associates and their families during the COVID-19 pandemic. Human Impact Partners found that had Walmart established an adequate paid sick leave policy before the COVID-19 pandemic struck, at least 7,618 employee cases of COVID-19 and 133 deaths from COVID-19 could have been prevented. 

Walmart is the nation’s largest private employer in the United States and has a long history of resisting adequate paid sick leave for employees. Early on in the pandemic, Walmart refused a request made by shareholders to study the feasibility of a 14 day paid sick time benefit – even as reports were emerging of employees contracting the virus at work. Meanwhile, Walmart — like all private employers with more than 500 employers — was exempt from the Families First Coronavirus Response Act’s mandate to establish paid sick leave policy.  

“Without sufficient paid sick leave, Walmart workers face an impossible choice between staying home to stay healthy but risking wage loss and retaliation, or coming into work symptomatic despite the public health danger this poses to customers and communities,” said Sukhdip Purewal Boparai, Research Project Director at Human Impact Partners. “Employers and elected officials need to understand that paid sick leave is a non-negotiable policy that all Americans need, and an essential key to recovery from this pandemic. Walmart should be leading the way for employers across the country by implementing a universal paid sick leave policy that supports workers and the public to get through the current crisis safely.” 

Human Impact Partners is a national nonprofit organization based in Oakland, California which seeks to transform the field of public health to center equity and builds collective power with social justice movements. Researchers at Human Impact Partners calculated the national numbers of preventable COVID-19 cases and deaths among Walmart workers using methodology from researchers at University of Wisconsin, who estimated the number of COVID-19 cases and deaths among workers in Wisconsin using epidemiological surveillance data from the Institute for Health Metrics and Evaluation. HIP researchers then applied an estimate from the sick pay literature that attributes a 6% reduction in death and caseload of influenza-like disease to paid sick time policies, replicating a methodology that University of Wisconsin researchers used as well. This methodology is a powerful tool to quantify the benefits of paid sick time as an effective public health measure. 

Where Walmart’s Paid Sick Leave and COVID-19 Pandemic Policies Went Wrong 

Walmart currently provides 48 hours of “protected paid time off”, but workers have reported barriers like retaliation and lack of communication around the policy in accessing even this meager amount of leave. 

According to a 2020 survey, 45% of Walmart associates reported they were still likely to come into work if they were sick. Employees reported fear of disciplinary action, loss of wages, and no knowledge of the 48 hour policy as reasons they would choose not to stay home while ill. 

Walmart associates were also not informed when co-workers tested positive for the virus.  In collaboration with United for Respect, Walmart employees created a COVID-19 tracker to keep each other informed and safe. Currently, they are tracking 1,862 cases across the country.

“The failures in Walmart’s coronavirus response are not new,” said Cynthia Murray, a Walmart associate and leader with United for Respect, who has also introduced a shareholder resolution calling on the creation of a pandemic task force at Walmart to address policies like paid sick leave. “Workers have been telling Walmart management for years that we need paid sick leave so we’re not forced to come to work sick. This pandemic is not over yet, and Walmart’s paid leave policy gap is a life or death issue for workers and customers and a huge risk to the company. That’s why I’m calling on Walmart to create a pandemic task force. If workers’ voices were included in decision-making, we could have had paid sick leave already, and countless lives could have been saved at Walmart and beyond. It is time our employers and our elected leaders start listening.” 

Key Takeaways

HIP’s report underscored the scale and urgency of implementing adequate paid sick leave policies at Walmart and across the country:

• Access to paid sick time saves lives:  HIP’s original research found that if Walmart had an established paid sick leave policy in place before the pandemic, research indicates that 133 employee lives could have been saved, and 7,618 COVID-19 cases prevented. Without universal paid sick time, thirteen additional Walmart employees will be at risk of COVID-19 death between April and July 2021 — unless the company takes immediate action.
• Lack of paid sick leave exacerbates pandemics: Without paid sick leave, workers may not have the option to miss out on a paycheck. A study last year revealed that 94% of workers surveyed would comply with self-quarantine during COVID-19 when they were compensated for loss of income, whereas only 57% of employees would comply with the guidance if they weren’t compensated. 
• Paid sick time is beneficial for childrens’ health: Children whose parents have paid sick time are more likely to be current on their healthcare needs, like receiving their annual check-up and flu vaccine. Considering nearly half of Latinx employees and over a third of Black employees do not receive paid sick time, this undoubtedly perpetuates inequality and keeps Black and brown children from thriving.
• Employers benefit from paid sick time policies: Having established paid leave in place has been found to increase loyalty and morale amongst employees, and decrease turnover – all goals Walmart has alluded to, even in their recent decision to grant more employees full-time status. 
• Paid sick time is critical for racial, gender, and economic equity: Because Walmart employs more women and Black and Latinx workers than any other US corporation, the positive outcomes associated with paid sick time would be far-reaching — to families and communities across the country, with benefits for gender, economic, and racial equity.

Full report here >> Walmart’s role in the COVID-19 pandemic: How lack of paid sick time prolongs the pandemic and increases mortality

About HIP:

Human Impact Partners transforms the field of public health to center equity and builds collective power with social justice movements.

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