A reporter covering Coal Country asks, is it ok to intervene when sources are desperate?

There are many reasons that rural Pennsylvanians are sicker and cut off from essential health care services. Population decline, poverty, economic collapse, difficulty attracting health workers to rural areas, to name a few. There’s not one villain or problem at the root of the health gap.

My 2018 National Fellowship series focused on deeply personal stories that made people care about the issue. The series, “Sick and Struggling and Coal Country,” examines poor access to health care in Carbon County, part of Pennsylvania’s coal country. The region is one of the state’s sickest, as statistics bear out, and rising health care costs make it hard for clinics and doctors to keep their doors open. Compared to the state as a whole, there are half as many primary care doctors and dentists for every 100,000 residents, and one-fourth as many mental health providers.

Meanwhile, drug addiction and chronic health conditions plague the region. While life expectancy in Pennsylvania averages 78.5 years old, it’s a year less in Carbon County, and only 72 in Lansford, the borough at the heart of the series. In Carbon, where the population skews older, the number of heart disease deaths is nearly 20 percent higher than the state average, deaths by cancer are about 24 percent higher, and deaths by respiratory disease are more than 30 percent higher.

The first part of my series looked at how the coal region in Pennsylvania declined when the coal industry died out, and how that’s impacted health in the region for different people. The second part explored how lack of transportation prevents people from getting care. The third looked at the lack of treatment options for people struggling with addiction. And the last part examines how the doctor shortage contributes to declining health.

How I found my sources: I found Travis Litts, who’s featured in multiple parts of the series, begging for medicine on the street. From there, I met his girlfriend Alicia, who had her own story to tell. Through going to the emergency room with Alicia, I found Carol Loggins, who was frustrated with the wait at the ER. At an alcoholics anonymous meeting, I met Keith Enlund. And through attending a rally against addiction with Keith, I met Kay and Jon Steigerwalt. Going with my sources to places where they sought out help and support, whether that be an emergency room or an AA meeting, connected me with other people with important stories. I also visited senior centers throughout the region to talk to the elderly population.

How do you gain the trust of sources? I’m upfront with my sources about what it means to be in my story. Their private lives will be in the paper. Plus, I talk about why it’s important for their stories to be told. I also tell them that I will let them know what I use from their lives in my story before it’s published. I find that usually immediately gives me more access because they know they won’t be surprised. I’ve done this with long stories multiple times, and not once has a source ever asked me to remove something from a story. It’s only fair to gives people a heads up after they open up their lives to you. And I check in on them and see how they’re doing even if I’m busy with other dailies. I’ll text and ask about a doctor’s appointment, or call and see how they’ve been doing. I believe that builds trust between my sources and I.

The difficult ethics of watching people struggle in poverty: The most challenging part of my reporting was figuring out when to intervene in desperate times. In the months that I reported out the story, I intervened a few times when I felt it was the humane thing to do. But I didn’t want my sources to depend on me or expect help in return for access. Nor did I want to change the trajectory of the story through providing help. So I’d ask myself, does this action change the story in the long term? And did the source agree to talk to me before I provided help? I couldn’t have done this without the help of my editor, Christine Schiavo, and the mentor assigned to me through the University of Southern California program, Bob Ortega.

Here’s an example: When I checked in with Travis Litts in the fall, he was scrambling to figure out how to get to the pharmacy to get a refill on his medication that prevents his heroin cravings and withdrawal symptoms. I waited a few days and checked in with him via phone. I talked to my editor Christine, and Bob, who said it’s not atypical for reporters to give sources rides for their time. However, I would be inserting myself and thus changing a story about transportation by providing a ride. That Friday, I visited him to see how he was doing. He asked me if I could take him to the pharmacy. I asked him to show me his medication. He had cut his pills into pieces to make them last longer. He had been talking to me for a month or so already. Giving him a ride doesn’t solve his lack of access to affordable and convenient transportation. And I had another conversation with him explaining my role as a reporter.

Similarly, I went with Alicia to the emergency room because she had a painful toothache. She didn’t get seen by a doctor and was in a lot of pain. She asked me for a bottle of Tylenol. I already spent the day with her so my reporting was done. And buying you a bottle of Tylenol doesn’t solve her problem, which is lack of dental care.

I was tormented by these situations and questions. In the end, I provided a few rides and bought Tylenol for Alicia, which we disclosed in each of the articles. Developing some guidelines for myself helped me navigate these tricky situations.