Children are the future - it’s a common refrain. However, in isolated, rural communities across America, there are people traveling many miles from their home to deliver babies. Since 2010, nearly 150 rural hospitals have shut down - a victim of the financial stresses facing U.S. health care. One survey finds that about 40 percent of rural hospitals lose money offering obstetric care, since it costs $18,000 on average to have a baby. So, when small hospitals look at cost-cutting measures, delivery and obstetrics units are often casualties. Just under 10 percent of rural hospitals have shut down their delivery services. For this Us & Them episode, host Trey Kay hears from families facing that change, and how it’s affecting prospects for their rural cities and towns. 

West Virginia often ends up at the bottom of national health reports — the rates of obesity and diabetes, conditions that can lead to cardiac and kidney disease. The region’s legacy of active, manual mining work has given way to a more sedentary lifestyle that relies on processed food to feed families quickly and cheaply. More than a decade ago, Huntington, WV made headlines as the “fattest city in the nation.” That spotlight led to some changes with doctors and dieticians focusing more on health and nutrition. On the new episode of Us & Them, host Trey Kay looks at continuing efforts around the Mountain State to teach new dietary habits and train the next generation a healthy approach to cooking and eating. In some counties without close access to full-service grocery stores, new farmer’s markets have sprung up and health clinics offer produce boxes with fresh fruits and vegetables. 

Homelessness has been on the rise since 2016 and the pandemic only exacerbated an acute shortage of resources to help people living on the streets. Now, many communities are struggling to provide support as some homeless people turn away from emergency shelters and remain in outdoor encampments. In Charleston, West Virginia, the city’s opioid response program also now focuses on homelessness. Outdoor encampments have been a focus at the state legislature as debate continues over how best to help people living on the street. At the same time, some people say they’re more afraid of people living on the street than in the past. Providing sustained care for homeless people continues to elude and divide even well-meaning and determined communities.

America’s prison system incarcerates millions of people, but at least 95% of all state prisoners are released after they serve their sentence. Some struggle to navigate that transition successfully. On this Us & Them episode, host Trey Kay hears about the challenges of reentry. How do we want men and women coming back after prison? How do victim advocates feel about programs designed to help formerly incarcerated people succeed on the outside? Some suggest an important starting point is to recognize that many of the men and women serving time are victims themselves. Recognizing that trauma may be a powerful step to help people make a new life after they serve their time.

Nothing divides Americans like politics. At the same time, young people are showing up to vote. Turnout in America among 18 to 29 year olds shot up in the 2020 election to 55% — a level of participation not seen since the 1970s Recent voting trends also show the number of young people engaging in conservative politics is on the rise. In 2020, four in ten young people — from 18 to 29 — voted for former President Donald Trump and Trump won that youth vote in seven states. In this Us & Them episode, host Trey Kay talks with author Kyle Spencer who’s studied that trend and says it’s not an accident. She’s researched the decades-long conservative organizing strategy to engage and mobilize young people. The money connected to values and beliefs can play an enormous and often invisible role in our democratic society. But while money can fund power, it doesn’t necessarily create a singular conservative or progressive vision.

America is staring down the barrel of its long term housing issues. Now, there are added complications and divisions created over the last few years. On this episode of Us & Them, host Trey Kay looks at the outcome of the country’s housing shortage. While rent increases have slowed, nationally, costs are still well above where they were pre-COVID. If you’re trying to buy a house, mortgage rate hikes make it prohibitively expensive for many. These days, emergency pandemic relief programs are mostly gone and temporary moratoriums on foreclosures have expired. Plus, American wages haven’t kept up with inflation. Add the two together…and you get a set of housing hurdles many people simply cannot afford. 

International adoption helped many Americans build families, but a dark side victimized poor people in developing countries. The practice began in the 1950s to help Korean War orphans and more than 70 years later hundreds of thousands of children born in other countries are part of a complex cultural legacy. By the early 2000s, corruption scandals scaled back or shut down programs in some of the most popular countries for adoption - South Korea, Romania, Russia, and Guatemala. On this Us & Them episode, host Trey Kay talks with Laurie Stern and her 24-year-old son about their adoption journey. Their podcast called “Defining Diego” chronicles Diego’s growing understanding of his Guatemalan legacy and family.  Changing social and geopolitical attitudes have made for a dramatic drop in the number of international adoptions - from more than 20,000 in 2004 to just about 3,000 in 2019. We’ll hear about that shift and how one young man finds his new name and his future, by looking back.

It’s been a year in America with lots of big political news and some very disturbing events. Supreme Court decisions are reshaping the nation’s policies as violence and shootings continue to take lives. Us & Them host Trey Kay has been traveling around asking people “How’s America doing?” and “Why do you think that?” Trey spent Election Day in a swing district in Pennsylvania talking with voters about the state of America. Some worry financial strains have made things worse while others say they see good things to come. There’s concern that politics has become just another sporting event, where all that matters is the winner. But politics can also help shape the policies that lead to the American dream, so how do we come together and collectively do the right thing for the future?

In West Virginia there are nearly 50 specialized court programs designed to help teens and adults kick their drug addictions. Drug courts divert people away from incarceration into a rigorous, court-monitored treatment program. They are intense experiences, some more than a year long. Participants are drug tested regularly and require monitoring devices. Graduation rates across the country show success rates from 29% to more than 60%. There are many supporters within the justice system, but critics say drug courts only work with the easiest first-time offenders and don’t take violent offenders or sex offenders. Some drug courts require a guilty plea before someone can participate, which can limit a person’s options if they don’t make it through the program. In this Us & Them episode, host Trey Kay talks with people about this court-designed approach to sobriety that began nearly 50 years ago when the first drug court opened its doors.

Imagining the future is at the core of this episode of Us & Them. Earlier this fall, we held a day-long workshop to hear ideas and talk about what can make the future a reality. The Civic Imagination Project based at the University of Southern California works with cities across the country to get residents thinking about new directions and possibilities for their communities. We invited people from the Upper Kanawha Valley with a range of backgrounds and experiences to discuss their hard-hit economy and consider fresh approaches and alternatives. Considering the future can offer people some control about what’s ahead and as the conversation develops, there can be inspiration for more citizens to get involved. In this episode, we learn that many things are possible if we can just imagine them.