I Will Be Presenting my Book at Classic Elements and the Writers Association of Northern Appalachia Conference

I will be presenting my book Wuthering Depths in Johnstown: By the Numbers at the annual writers conference of the Writers Association of Northern Appalachia. It will be in Wheeling, WV on September 10-12 at Oglebay Park.

I will also be presenting my book at Classic Elements in Johnstown on July 10th at 1PM.  It's on Main St. in downtown Johnstown.  I'm looking forward to meeting you all at both events.

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Medicaid Expansion Update: What is its Impact on Uninsured Rates?

In the early days of this blog, I wrote extensively on how states were rolling out Medicaid expansion under the Affordable Care Act (aka Obamacare or ACA).  The 2012 Supreme Court decision that upheld the ACA made Medicaid expansion optional for the states.  This expansion allows states to raise the income eligibility level from 100% of the federal poverty level to 133%.

The above map shows that 12 states still refuse to expand Medicaid 11 years after the ACA was passed while 31 states have expanded and 8 states have used different methods to expand.  The map below shows where each state stood on expansion in 2012.  

The census bureau has 2018 as the most recent year where estimates of the uninsured are available.  Thus, to assess the impact of Medicaid expansion, I will compare uninsured rates at the state level between 2010 (the year the ACA was passed) and 2018.  The states will be grouped by whether they refused to expand it in 2018 (19 states), implemented expansion by 2018 (26 states), or implemented it with other methods (6 states).

	Expanded by 2018	2010		2018		Change in %
	N	M	SD	M	SD
none	19	18.6%	4.2%	12.5%	3.0%	6.1%
yes	26	14.6%	4.5%	7.6%	2.5%	7.0%
modified	6	16.0%	3.3%	8.7%	2.4%	7.4%

The table above shows the mean uninsured rates for each group of states with respect to Medicaid expansion.  There was a significant decrease in the uninsured in all three groups due to the implementation of other parts of the ACA.  The states that did not expand Medicaid had higher baseline mean or average uninsured rates at 18.6% compared to 14.6% for those that expanded traditionally and 16.0% for those who expanded using modified methods by 2018.  The uninsured rates for 2018 showed a wider gap in uninsured rates between states that did not expand (12.5%) and the other two groups (7.6% and 8.7% respectively). The standard deviation or SD's show less variability in uninsured rates in all three groups by 2018.

These numbers show that the ACA is having an impact on uninsured rates throughout the U.S.  Medicaid expansion increases this effect in states that have implemented it.  There is still a group of uninsured even in states that have implemented expansion.  A much harder number to measure is the number of uninsured individuals in then U.S.  Further steps will be needed to reach universal coverage.

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Ida, Nellie and Ida: Trailblazing Women Journalists in the Victorian Age

I thought I would take a break from the coronavirus pandemic and politics to take a look at the history of the craft we call journalism.  The late 1800s were a period of yellow journalism led by Joseph Pulitzer and William Randolph Hearst where sensational headlines were what sold newspapers.  There were trailblazing male and female journalists who worked on hard news stories that mattered to people's lives.

 

Ida B. Wells (profiled in the above video) was born into slavery in 1862.  She never forgot her background and she wrote extensively on the horrors of lynching and discrimination in post reconstruction south.  She died in 1931.  There is now the Ida B. Wells society to support investigative African American Journalism.  She also received a posthumous Pulitzer Prize in 2020.

Nellie Bly (a.k.a. Elizabeth Cochrane Seaman) was another female trailblazer who was born near Pittsburgh.  She went undercover in a mental institution to expose the abuse that women received there.  She then went on an journey to simulate Jules Verne's novel Around the World in 80 Days.  She managed to complete the journey in 72 days and had many great stories to tell.  She died in 1922 only 2 years after women got the right to vote.

The last trailblazer in this post is Ida Tarbell who wrote the seminal book (The History of Standard Oil) that brought down John D. Rockefeller's Standard Oil monopoly.  Like Nellie Bly, she was from the Western Pennsylvania.  Unlike Wells and Bly, she was born before the Civil War and lived until 1944.  The journalist and whistleblower Wendell Potter has created a news organization named after Tarbell.

I don't know if Ida, Nellie and Ida ever met.  They must have known about each other.  It  would make for an interesting play with the three of them discussing their work and comparing notes and the struggles they faced.  There were other significant male journalists at this time such as Upton Sinclair.  Did he have advantages that the other three ladies didn't?

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Pennsylvania has Become the First State in the U.S. to Curb the Governor's Emergency Powers

In the 2021 primary election in Pennsylvania there were 2 constitutional amendments on the ballot to limit the Governors emergency powers in times of a pandemic or natural disaster.  The first amendment empowers the state legislature to terminate or extend a disaster declaration with a simple majority without input by the governor. The second amendment places a 21 day limit on a disaster declaration with legislature approval needed for an extension.  A fuller explanation of these amendments can be seen here.

These amendments have been approved with 53% of the vote apiece.  In Cambria County, the first amendment received 62.7% of the vote and the second received 63.3%.  These amendments could have major ramifications for how the state handles future crises such as natural or epidemiological disasters.

For example, in the not so distant future, natural disasters related to climate change could befall this and other states.  A legislature with a majority of climate change deniers can block the governor from taking action beyond 21 days.  There is no way of knowing how many lives Gov. Wolf's disaster declaration saved but it did save lives.  

The graph above shows the daily death counts in Pennsylvania since the pandemic began.  Restrictions were made in March the death counts rose until May and then leveled decreased as personal protective equipment and ventilators became more available.  The restrictions were eased in June and deaths did not rise.  The deaths began to rise after the November election due to mask-less rallies held by the Trump campaign in the state.  Due to this restrictions were then tightened during the Christmas holidays and the deaths decreased in the state (though higher than it was before the election).  Roughly 21% of the state's eligible voters voted in the primary.

The voters who went to the polls and voted yes on these ballot questions (10.8% of the electorate in Pennsylvania) are rebuking Gov. Wolf for listening to scientists such as Rachel Levine.  Levine now works for the Biden Administration as the first transgender department head.  The right has distributed images like the one above to demonize the governor and Dr, Levine.  One has to wonder how much transphobia played a role in this primary.

Our county, Cambria County, still ranks 9th in the state in case mortality and 5th in deaths/100,000 while it voted 63% for both measures.

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Darwin and Corona Virus Vaccine

In addition to my teaching and tracking the corona virus numbers for Cambria County I have been reading the book that is currently tied for first place on my best nonfiction book poll: On the Origin of Species by Means of Natural Selection by Charles Darwin.  For me it is not as dry a read as Moby Dick.  It talks about how species of plants, animals and microorganisms change over time.  

The modifications that appear in organisms appear at random.  Most of these changes are detrimental.  Once in a while a modification to a member of a species gives it an advantage in survival over its rivals.  These traits will be selected for in the population in breeding.  

Viruses and bacteria, with simpler DNA sequences than multicellular organisms can mutate more easily and be modified faster.  I wonder how many who still don't believe in Darwin's theory also believe that the Corona Virus was created by a sinister scientist in Wuhan China.  How many of these are also hesitant to be vaccinated?  As the vaccine has become more available, the 7day average for new full vaccinations has been coming down from 891.1 per day on April 18 to 332.3 per day today.

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COVID-19 Cases Have Risen in Cambria County but Deaths Have Not Due to Vaccinations (so far)

The second installment of We Are All In This Together: Pandemic-Johnstown 1918 has come out and can be seen above.  Recently there has been a rise in cases as spring has sprung.  Since the terrible months of December and January, the 7 day average for new cases fell from 214.29 on Dec 11 to 14.29 on March 20.  Since then, the 7 day average has risen to a high of 58.43 on April 19 to 49.29 today as can be seen in the graph below.  This rise has occurred after the vaccine rollout began on Jan 8.

Since the cases have risen, the deaths in the county have remained fairly stable as can be seen in the above graph.  The 7 day average for deaths reached a high of 8.14 deaths per day on Dec 17 (6 days after the spike in cases).  Since March 16, the average has not risen above 1 death per day.  

The graph above shows the trend in the 7 day average for new cases (black line), testing (red dotted line) and full vaccinations (orange line).  The lines for testing and vaccinations are on a logarithmic scale.  The number of full vaccinations per day has fallen from a high of 855.4 on April 14 to 399.9 today.  On April 13 all Pennsylvanian's over age 16 became eligible to receive the vaccine.  To date 40,920 of 31.43% in Cambria County have been fully vaccinated.

This graph from the state department of health shows that the majority of cases are between the ages of 20 and 59 throughout the state.  This information is not available at the county level.

This final graph shows that the vast majority of deaths in PA have been between ages 60 and 99.  The early phases of the vaccine rollout have focused on groups most vulnerable such as the elderly.  The vaccinations seem to be curtailing the number of deaths even though there has been a rise in cases.  The younger age groups still need to be vaccinated to stop the spread of the virus.  

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