When a rural hospital closes, according to a new study of California’s healthcare system, the chance of dying in a time-sensitive situation like a heart attack or stroke increases by nearly 6 percent.

On average over the past 15 years, 10 rural hospitals have closed each year in the United States. Half of the rural hospitals that remain expect to lose more money this year.

These are some of the numbers behind the crisis of providing healthcare to people living and working away from major cities — but the faces of those people matter too. They include Jessica Sheridan, a new mother in Iowa Falls who had planned to give birth at the hospital five minutes away until its labor and delivery unit closed two months before her due date; Kristina Protasiewicz, president of a Michigan hospital’s nurses’ union who works alongside other healthcare workers at the short-staffed hospital as an operating room nurse; and Jim Servais, an 81-year-old farmer in Wisconsin who had to rely on the healthcare provided by his wife’s job to get his knees replaced. And the news organizations that know those people — and those stats, and the crisis — best are the local reporters trying to bring attention to it.

“I have a lot of family in rural Minnesota and was watching them deal with this. I said: Somebody needs to tell this story,” said Jennifer Hemmingsen, a longtime Iowa journalist now working at The Seattle Times. “That story wasn’t going to be told by the local newsrooms who didn’t have the resources” unless someone stepped up.

She pitched the story to Lyle Muller, then executive director and editor of the nonprofit outlet IowaWatch, earlier this year. Muller had seen his own daughter in Minnesota have to drive in winter weather to South Dakota for prenatal healthcare. Around the same time, the Institute for Nonprofit News put out feelers to its members to see what reporting projects they needed support in tackling. And a few months later, on September 30, local journalists from 12 newsrooms in seven states jointly published collaborative reporting on the crisis of rural healthcare and how it can be confronted.

This project got me thinking of my own rural health care story. Nine years ago, I found out that I was 1) pregnant with twins and 2) couldn't deliver them at our local hospital (b/c twins are high risk and the local hospital didn't have OB/GYNs – only family practice docs). https://t.co/PRTRaQk4Ox

— Sara Konrad Baranowski (@skonradb) September 30, 2019

“If the Iowa Falls newspaper writes about its hospital for two years, it’s an Iowa Falls problem that Iowa Falls has to solve,” said Muller, who has since retired but is still helping out with the project. “But when multiple newspapers in Iowa write about this issue, all of a sudden it starts becoming an Iowan issue that Iowans have to solve. And if news organizations in seven states write about it, now it’s a Midwest problem that the Midwest has to solve. And by the time you’re talking about a major region of the nation like that, it becomes a national problem to be solved.”

INN was game if its members were. Now in the third year of the Amplify News Project, the ten-year-old organization wants to help nonprofits’ journalism pack more of a punch and knows collaboration is one way to make that happen. (The project is supported by the McCormick, Joyce, and MacArthur Foundations, among others.) INN is pursuing a goal of having 20,000 journalists in nonprofit newsrooms by 2030 to offset the loss of newspaper layoffs between 2005 and 2017, INN chief network officer Jonathan Kealing said.

“We view collaboration as a way to help our newsrooms increase the heft and power of their journalism,” he said. “INN’s not here to do the journalism. We’re here to enable our members to do great work.” This collaboration, named Seeking a Cure, was the prototype.

“At INN, we have no interest in persuading people to do projects they don’t want to do. We went looking for people who had expressed an interest in rural hospital closings,” said Sharon McGowan, INN’s collaborations leader for Amplify. “I had looked at the data with Jennifer and Lyle and identified states with potential hospital closures. We saw states where despite years of awareness of the problem, rural hospitals were continuing to close or cut services. That’s where we started.”

From @BridgeMichigan: "The debate comes as a quarter of Michigan’s rural hospitals – 18 of 70 – are at “high risk” of closing."" https://t.co/WZ0AVlIVgf

— Jim Malewitz (@Jmalewitz) September 30, 2019

With $10,000 funding from the Solutions Journalism Network to reimburse partners’ reporting expenses, IowaWatch led the technical development and brought on board several of its established collaborators, Iowa Public Radio, The Gazette in Cedar Rapids, the Iowa Falls Times Citizen and N’West Iowa Review. Soon, McGowan and the partners had corralled INN members KCUR in Kansas City, Bridge Magazine in Detroit, Wisconsin Watch, WFYI’s health news unit in Indianapolis, The Conversation, as well as Minnesota Public Radio and Wisconsin Public Radio. INN provided a bit under $6,000 in support: $3,500 in stipends to help pay the lead reporter and editor from each newsroom as well as support for Hemmingsen as project manager.

Originally, 16 partners had committed, but for various reasons — mainly staffing shortages and just straight-up time constraints — three dropped out. (One more is still working on its reporting.) But many had already been tracking this issue in their communities and weren’t sure what else this project could add. “What we said to them was that may be true, but if you take all the reporting you’ve done — we don’t want to redo that — but we want to fold it in with what’s going on in the different parts of the Midwest, and you’ll see a different picture emerge,” Muller said.

Plus, local newsrooms these days are slim affairs; having a few collaborators in your back pocket could multiply the people you have to ask questions, toss ideas off of, or just compare spreadsheets with. “If you’re doing something on your own, you can move faster, but I don’t think you get the benefits from collaboration vis-à-vis peer reporting and editing to make the stories stronger,” INN’s Kealing said.

In addition to their reporting, the partners helped Hemmingsen sort through radio-speak, offered up an in-house designer when the need arose, and communicated what would be most useful for the newbie collaborators. Meetings were held via Zoom every other week to touch base throughout the summer. “The partners deserve so much praise and congratulations. It was a real leap of faith to hitch your wagon to 11 other patrons that you didn’t know very well,” Hemmingsen said.

A lot of really great stories here and also one that I did! This is a huge issue that doesn't get the mainstream coverage it probably deserves, especially with so much of the presidential campaign focused on healthcare. https://t.co/YLQicdPDvQ

— Sebastián Martínez Valdivia (@sebastiansings) September 30, 2019

The journalism was published just one week ago, so it’s still early to see the full impact. (The Gazette in Cedar Rapids organized a healthcare track as part of its Iowa Ideas conference last week.) But in the midst of an election season where the focus is on Iowa — and Wisconsin, and Michigan, and any other state with swing voters and diners — maybe it’s past time to listen to what local newsrooms have to say.

Next up: climate change in the Great Lakes. INN just held its first kickoff meeting for that new collaboration.