Delegitimizing Rural Public Health Departments: How Decaying Local News Ecologies, Misinformation, and Radicalization Undermine Community Storytelling Networks

• Published date: 01 May 2023
• DOI: http://doi.org/10.1177/00027162231215655
• Author: Nikki Usher
• Date: 01 May 2023
• Subject Matter: Part II: Supply

90 ANNALS, AAPSS, 707, May 2023

DOI: 10.1177/00027162231215655

Delegitimizing

Rural Public

Health

Departments:

How Decaying

Local News

Ecologies,

Misinformation,

and

Radicalization

Undermine

Community

Storytelling

Networks

By

NIKKI USHER

1215655ANN THE ANNALS OF THE AMERICAN ACADEMYDELEGITIMIZING RURAL PUBLIC HEALTH DEPARTMENTS

research-article2023

This article considers the public communication chal-

lenges that health officials in rural America faced dur-

ing the COVID-19 pandemic. I analyze the role that

public health officials played in communicating news

and information about the pandemic in 29 rural coun-

ties in Illinois. These officials were challenged by a

diminished reporting capacity among local media out-

lets, and by a political radicalization of local Republicans,

who no longer regarded local media as trusted nodes in

local storytelling networks. I find that while public

health officials can help fill a community’s critical infor-

mation needs about risk and emergency, the public’s

take-up of this information depends on sociocultural

and political forces that shape the broader communica-

tion context.

Keywords: COVID-19; public health; local news;

communication infrastructure theory;

misinformation; Facebook

The underlying premise of critical informa-

tion needs is that people need information

both about immediate concerns that are rele-

vant to daily life and about higher-order infor-

mation that can help them meaningfully

participate in civic life (Friedland et al. 2012).

This might include anything from the latest

happenings at the local high school to informa-

tion about political candidates running for

local, state, and national office.

The conceit of critical information needs,

though, is that there is an information gap that

can be filled, if only we adjust the supply of this

information—potentially with the help of

Correspondence: nusher@sandiego.edu

Nikki Usher is an associate professor at the University

of San Diego. They are the author of three books,

Making News at The New York Times (Michigan,

2014), Interactive Journalism: Hackers, Data, and

Code (Illinois, 2016), and News for the Rich, White,

and Blue: How Place and Power Distort American

Journalism (Columbia, 2021).

DELEGITIMIZING RURAL PUBLIC HEALTH DEPARTMENTS 91

media policy interventions. For example, if people lack a local newspaper and are

not able to learn about local political issues, the simplified version of a media

policy intervention might be to find a way to philanthropically support the pro-

duction of more local journalism. On its surface, this solution sounds promising,

but this is not a panacea: fixing the supply of local, professionally provided news

is a framing of critical information needs that overlooks the complexity of citizen

demand for information and the social and political contexts in which people set-

tle on sources of information to trust.

With a rising tide of right-wing nationalism and ever-increasing distrust in news

and institutions more generally (Ziblatt and Levitsky 2019), it seems naïve to pre-

sume that even if citizens’ critical information needs are met with improved sup-

ply, they will then rationally evaluate and integrate this information into their lives

in ways that have socially beneficial outcomes. The COVID-19 pandemic high-

lighted how Americans were viewing changing public health recommendations—

and even the mortality threat of the virus—through a prism of social and political

influences. For many rural Americans, Republican misinformation was the infor-

mation about the pandemic that met their critical information needs.

Unfortunately, we know that rural Americans had worse health outcomes than

did their urban counterparts during the COVID-19 pandemic. While worse

access to health care overall is in part to blame, the Centers for Disease Control

and Prevention (CDC) points out that “sociocultural identities and political ide-

ologies” also likely play into these disparities (Saelee et al. 2022). Scholarship

suggests that misinformation and right-wing Republican beliefs about the pan-

demic are in part to blame for some of these negative health outcomes (Fridman,

Gershon, and Gneezy 2021; Travis et al. 2021). For example, rural counties had

lower vaccination rates than their urban counterparts did (58.7 percent and

74 percent, respectively), took fewer COVID-19 precautions, and were more

likely to experience fatalities from COVID-19 (Callaghan et al. 2021). But a more

textured understanding of the on-the-ground experiences of rural dwellers has

received less attention. Without a better understanding of the cultural and com-

munication context through which COVID-19 unfolded in rural America, it is

hard to provide actionable solutions to the distrust in health and science and the

contributions of platforms to the growing radicalization among those who iden-

tify as Republicans.

The orienting question is, How did people who were living in deep red rural

locales learn and make decisions about the COVID-19 pandemic though their

own local community storytelling networks, given a diminished local news eco-

system and a highly radicalized Republican national rhetoric? I specifically exam-

ine one aspect of political communication about COVID-19 in rural America—that

is, how local public health officers communicated with residents about the pan-

demic. Given the preponderance of negative health outcomes in these communi-

ties, I frame my inquiry around identifying the challenges that public health

officials faced when communicating with residents about COVID-19.

Digital misinformation is networked and placeless, but uptake of COVID-19

misinformation has been locally contingent (Usher et al. 2023). Sandra Ball-

Rokeach and her Metamorphosis research team at the University of Southern