After the Fact

Stat: 1 in 4: More than 2 million Americans suffer from opioid use disorder, but only about 1 in 4 receive any care. Story: Opioid use has become a major public health problem in the United States, but there are many obstacles to treatment, including stigma. In this episode, members of Pew’s substance use prevention and treatment team explain how to overcome barriers to care—and how new rules from the quarantine days of the pandemic can help show the way.  We also hear from Jordan Scott, an advocate for people with substance use disorders in Pennsylvania, who shares her own long journey with addiction and the obstacles she faced.     Please note that this episode references addiction and self-harm. If you or someone you know needs help, please call or text the Suicide and Crisis Lifeline at 988 or visit 988lifeline.org and click on the chat button.

Stat: 4 million to 7 million: The United States has a shortage of 4 million to 7 million homes.  Story: For many Indigenous communities, the concept of land or home ownership can stand in opposition to their cultures—which often place more emphasis on land stewardship. But just like communities across the country, on and off the reservation, housing availability and affordability is a growing problem. In this episode, Jody Cahoon Perez, now the executive director of the Salish and Kootenai Housing Authority, shares how she became a homeowner on the Flathead Reservation in Montana. And the “After the Fact” team dissects some creative solutions that could help cities address housing disparities, like restrictive zoning and inventory near city centers.

Stat: 41%: The share of U.S. adults who have some form of health care debt.  Story: Millions of Americans are struggling with debt, from credit card bills to unexpected medical expenses. And many face a tough choice between paying off debt or covering basic needs such as rent, food, and health care. But what happens when these debts go unpaid?  In this episode, Lester Bird of The Pew Charitable Trusts explains how it’s possible for consumers with debt to end up in civil court, facing a lawsuit, or experience serious consequences such as wage garnishment. He discusses how these cases make up a large portion of court dockets. Noam Levey of KFF Health News shares how medical debt cases can worsen the economic conditions of individuals and communities. And Minnesota Attorney General Keith Ellison discusses how policymakers in his state are helping to ease the burden of medical debt on his constituents through landmark reforms. 

Stat: 1 foot: the amount the sea level rose in the Chesapeake Bay in the last century, twice as fast as the global average. Story: Climate change is driving sea-level rise and worsening coastal flooding across the globe. And in many coastal communities, the rising waters are changing local environments and the places people call home. For generations, the Nause-Waiwash people have raised families, worked, and practiced traditions like muskrat trapping in the marshlands of Maryland’s Eastern Shore. In this episode, Nause-Waiwash Chief Donna “Wolf Mother” Abbott takes us through her ancestral lands and guides us through muskrat hunting in the marsh. She discusses how her Tribe’s lands are disappearing and what she’s doing to protect her community’s histories and traditions.