Roughly 20 percent of Americans live in rural areas, including more than 13 million children, according to the last U.S. census. And, according to research and reporting by the Pittsburg Morning Sun and its parent company, GateHouse Media, those people have been steadily losing access to hospitals for years.

In Oklahoma, Georgia, South Carolina, and Mississippi, at least 52 percent of all rural hospitals spent more money than they made between 2011 to 2017. In Kansas, it's 64 percent, and five hospitals there shut down completely in that time. Since 2010, 106 rural hospitals have closed across the country. (Another 700 are "on shaky ground," and about 200 are "on the verge of collapse," according to Gatehouse.) Of those 106 that closed, 77 were in deep red states where local politicians refused the Obama administration's Medicaid expansion that came about as a result of the Affordable Care Act.

In short, the federal government provided funds to expand coverage for Medicaid, a program that helps pay for health care for low income patients. But the expansion was optional, and 14 Republican-controlled states rejected to take the money. The only state that bucked this trend was Utah, where rural hospitals were among the most profitable in the country thanks to a policy of shifting funds and resources from urban hospitals. Only 14 percent of rural hospitals operated at a loss and none shut down over the same time period.

he number of rural hospitals has been shriveling for some time now: more than 200 rural hospitals closed between 1990 and 2000, according to a report from the Office of Health and Human Services. Since rural areas have been losing hospitals for decades already, every additional closure is more devastating. And even the hospitals that remain open are struggling to stay fully staffed. According to the Health Resources and Services Administration, rural parts of the U.S. need an additional 4,022 doctors to completely close their coverage gaps.

Joshua Harris, one of the most influential voices on sex and relationships for a generation of evangelical Christians, announced this past week that he and his wife are separating after 20 years of marriage.

Harris' book, I Kissed Dating Goodbye, was published in 1997 when he was in his early 20s. It became a manual for young evangelicals looking for love.

In recent years, Harris has apologized for some of the ideas he promoted and publicly wrestled with them in a documentary. In an interview with NPR last year, Harris talked about going through that process with his wife, Shannon.

"I think it's made us realize how there's heartache and there's pain no matter which pathway you choose in life," Harris said. "There's no path that you can choose that can protect you from that."