Iowa's physician shortage

 

Zach Kucharski of the Gazette introduces the panel

Iowa is last in the nation in obstetricians per capita, which is felt most acutely in rural areas where fewer hospitals are offering obstetrics or even pediatric services. Iowa is also third-lowest in the US in retention of physicians. Those are only two data points in an overall shortage of physicians in the Hawkeye State, which was the subject of the latest Gazette Business Breakfast earlier this week. 

Two days later, Iowa earned the infamous distinction of being the first state in the U.S. to shrink its civil rights ordinance by removing gender identity from protection. The action was justified by the legislature's earlier attempts at punishing transgendered people being struck down by the courts as running afoul of this ordinance. Without the pesky civil rights ordinance, our government is free to take whatever potshots at transgendered people that it feels like taking. What an expression of our state's official hostility to difference!

At first glance, these are two different topics. Is it possible, though, that they are connected?

Unity Point Medical District, where your humble blogger gets his doctorin'
(Google Earth screenshot)

At the Gazette event, panelists Dr. Fadi Yacoub (Linn County Medical Society), Dr. Timothy Quinn (Mercy Medical Center), and Dr. Dustin Arnold (Unity Point Health) were interviewed by the Gazette's Zach Kucharski. They referenced two main strategies for improving Iowa's physician retention: improving the doctors' bottom lines, and incentives for Iowa students to do their medical education in Iowa.

Despite Iowa's reputation for low cost of living, Quinn noted physician salaries are not keeping up with increasing levels of medical school debt, and insurance payments relative to cost of living are are comparatively low. Arnold suggested the state should see positive effects of "tort reform," which means the legislature has capped damages for medical malpractice suits. Current legislation (HSB 191) before the Iowa legislature would offer student loan repayment programs for rural doctors, and commission a study of the effects of cutting medical school from four years to three (cf. Murphy and Barton 2025). On the other hand, would-be budget cutters in Washington are looking at Medicaid, which is "essential to medical care in Iowa" (Quinn's phrase) due to the directed payment program.

The legislature is also hoping to improve retention by keeping Iowa residents in the state, creating preferences in medical school admissions. (The University of Iowa, though, is 78 percent Iowan, already near the 80 percent target for schools.) The thought is that people who are close to family and already appreciate the wonders of Iowa will want to stay here. "We don't have pro sports, we don't have concerts, but" Iowa is a state you love, said Yacoub, noting he was "preaching to the choir here." Arnold of Unity Point added Cedar Rapids is a great place to live, "once you're here you want to stay." This may or may not be true, given the state's (not the city's) regressive political culture, but even if we retain 90 percent of Iowa-based doctors the gap between working age doctors and our aging population will continue to increase.

When we take on faith that Iowa is so great you could confuse it with heaven ("Field of Dreams" reference), it precludes serious discussion of our future. When we take on faith that the most important considerations are low taxes, we miss the thousand things that make for quality of life (some of which are paid for with taxes). I'm an urbanist, not a physician, and tend to see things through an urbanist lens. As such I'm probably missing important dimensions of this specific problem. But we want more physicians to move here, so we need to think about how to make it an attractive place, which means attractive for everybody.

Iowa's physician shortage exists in a national context. Quinn noted at the start medical schools nationwide have not kept up with demand, so the whole country must rely on immigration to make up the gap. (Yacoub, who came to the United States in 1989, is one example.) Later he noted the shortage of doctors extends to nurses and support staff as well. 

But it also exists amidst a sociopolitical context in our state that is becoming increasingly hostile to difference. As Richard Florida noted two decades ago, it is openness, not turning inward, that welcomes a variety of people with varieties of talents. Iowa, except for a few larger counties, is shedding population like no one's business. We have managed to combine the worst of northern weather and southern politics: Our policies and public statements are openly hostile to poor people, immigrants, the transgendered, and city dwellers, just for starters. What message does that send to anyone else who might be or feel a little different? 

The physician shortage is making working conditions for current physicians worse. As scheduling gets tighter, there is less space in a physician's life for continuing education or even lunch. I wonder how else working in Iowa might affect a physician's desire to be here? No one mentioned COVID at all, but I remember patients stacking up at hospital emergency rooms at the same time (early 2021) Governor Kim Reynolds was declaring the pandemic over. Evidence of the negative health effects of data centers (Criddle and Stacey 2025) and corn sweeteners is accumulating, but they are the darlings of our economic plans. Meanwhile, Iowa has the fastest-growing cancer rate in the country. It can't be easy to practice medicine in an environment that consistently chooses corporate bottom lines over public health, and hostility to vulnerable minorities over building prosperous and inclusive communities.

I can't say with any precision whether Iowa's official penchant for nostalgia and resentment is exacerbating our shortage of physicians. Some early-career physicians may prefer the Politics of Yesterday, while others may be indifferent. But overall it is unlikely to lure the talent we need.

SEE ALSO: "Iowa: You're on the Menu," 9 May 2023

The gentleman-urbanist confronts cyber-threats

(swiped from sadefenza.blogspot.com)

I am surprisingly old, faithful readers, old enough in fact to remember the Cold War, when the United States and the Soviet Union possessed enough nuclear weaponry to destroy all human life multiple times (as if once wouldn't be bad enough?). My response to this ever-present danger was to ignore it, because there was seemingly nothing I could do to change it, except to sign a nuclear freeze petition, which seemed and seems rather ineffectual. According to former Assistant Secretary of Energy Thomas P. Grumbly (2021), there are still too many nukes, and I'm still ignoring them, all 13,400 of them.

(L to R) Paul Ness, Alexis Diediker, Aaron Voss, Colin Gage

I was thinking about my life under nuclear threat while attending a panel on cybersecurity that was part of the Cedar Rapids Gazette's Business Breakfast Series. The panel--Paul Ness of Foliance, Alexis Diediker of Pro Circular, Aaron Voss of True North, and Colin Gage of Farmers State Bank--discussed "Lessons Learned from a Global Tech Outage," specifically the CrowdStrike incident of July 19. Do you remember that? I'm ashamed to say I'd already forgotten it. Maybe if I'd been flying anywhere that day?

July 19 was caused by faulty software, not malefactors, though there are plenty of malefactors out there. All panel members are involved in some way or other in protecting firms and other institutions from the effects of hacking and other dangers of our cyberconnected world. (Diediker has the intriguing job of penetration tester i.e. she tests organizations' systems for both technical and human vulnerabilities.) As a non-technical gentleman-urbanist, I don't think I'm unusual in leaving cybersecurity up to our friends in information technology, except to complain about multifactor authentication and security awareness training they make us do. Math is hard, and I've got urbanism things to do. (Worth pondering: If Google, which owns Blogger, ever disappears, this blog is disappearing with it.)

One could say, correctly, that I am not paying enough attention to the threats to my own as well as my organization's security posed by cyberthreats. After all, one tech outage can ruin your whole day. The panel called for better communication between "the basement and the boardroom" (Voss's phrase) and for that matter, the rest of the organization as well. Gage referred to "a balancing act" between connectivity and security, and while the technically trained are best equipped to enact that balancing, everyone should understand the basics of how that balance is struck.

If we can under-attend to risks, we can also over-attend to them. One of the factors that has driven the suburban development pattern for the last eight decades has been the perception that urban centers are dangerous and it is wise to spare no expense to get away from them. That has increased social isolation, individual health problems, and traffic crashes (which kill many more people annually than do guns). We can build fences, buy guns and/or post signs saying we're not afraid to use them, take pictures of everyone who passes by, buy larger and larger vehicles, and never go outside--I've encountered all of these in Cedar Rapids--but at what cost to our common life and our own souls?

After the panel, a fellow at my table who'd found out I teach political science asked if there wasn't a danger that the Federal Reserve Board has a plan to use digital currency to enable the government to control our lives? Maybe there is. I can't prove there isn't. But as an entrepreneur, he is in far more danger of a financial catastrophe from a health problem or a cyberattack than he is of the government controlling his life. To deny the government a role in economic stabilization or health care access is to play a far riskier game.

There's a psychology to risk assessment that I only dimly understand. Allowing for phenomena like discounting future impacts, or greater concern for potential losses than potential gains--two common human traits that bedevil urbanist initiatives--it's not easy to predict why some people find some risks terrifying while ignoring or discounting others. I know I've become less self-protective over time, and more concerned about human connection, and I don't even understand why that is.

Maybe the first challenge is to understand the nature of risks. For one thing, as long as we're alive we can't avoid them. We can try to achieve an informed understanding of them, and to give them the attention they deserve, and not overlook the tradeoffs involved in over-focusing on certain risks at the expense of others. (Risk reduction always involves tradeoffs. My Uncle Dwight used to tell a joke about a fellow who quit smoking and replaced the habit with chewing toothpicks, until the guy died of Dutch elm disease.) We can understand the ethics of self-protectively pushing risks onto others. Mostly we can keep in mind the goal of living the best life, which as Aristotle reminds us, is life lived in common.

Talking downtown retail

 

Two years ago, at another one of the Gazette's invaluable Business Breakfasts, Andy Schumacher noted that when his restaurant Cobble Hill opened in 2013, he noticed that downtown office workers went home at 5 and that only sometimes would another crowd come downtown to replace them in the evening. He thought that more housing, at a variety of price points, might help to generate the round-the-clock buzz of a 24-hour downtown.

I thought about Andy's comment this morning, when we gathered to hear another panel talk downtowns in the Geonetric Building cafe. While today's speakers were focused on the retail sector, on this post-Euclidean blog, retail establishments are one element of a diverse neighborhood ecosystem. Context matters. "We're all in this together," as Red Green used to say. 

Today's panel (L to R): 
Tasha Lard (Iowa City South District SSMID), Teresa Jensen (Cedar Rapids Bank & Trust), Deanna Trumbull (Iowa River Landing), Mark Seckman (Marion Economic Development Corporation), Betsy Potter (Iowa City Downtown District)

Moderator Zach Kucharski, executive editor of the Cedar Rapids Gazette, began by asking panelists what was working. There was a variety of good news to report: downtown Iowa City has filled all available retail space; Uptown Marion has a "coolness" that's attracting retail stores and restaurants; Iowa River Landing in Coralville is enjoying "great" traffic and sales; the city government in Cedar Rapids is working with downtown businesses to increase customer traffic; and the new South District in Iowa City is promoting and creating opportunities. Both Tasha Lard from the South District and Mark Seckman from Marion celebrated their working relationships with their cities' governments.

The retailers' concerns included needing space to grow (downtown Iowa City), persistently high interest rates, finding workers, the ongoing competition from online retailers, and in some cases shop owners' unhelpful closing hours. When Zach Kucharski asked about the importance of amenities, parking came up high on the list of customer concerns. The "place making" model of Iowa River Landing does anticipate visitors will park once and walk around the area, and downtown Iowa City has an unusual situation adjacent to the University of Iowa campus. Still, everyone had something to say about parking.

Kucharski's question about amenities had offered parking, events, and housing as examples. There were a number of successful events mentioned, Marion celebrated their new public library building and renovated central park, and Teresa Jensen brought a list of suggestions for downtown Cedar Rapids: redoing the 2nd Avenue bridge, occasionally closing 3rd Street, widening variety of live music, coworking spaces, food trucks, and more murals. Nobody talked about housing.

Teresa Jensen responds to a question from moderator Zach Kucharski

Which brings us back to Adam Schumacher's comment from two years ago. While a number of panelists did talk about "24/7" retail areas, and working to appeal to different crowds at different times of the day, pretty much everyone took their working environment as external, something beyond their control. As a result, with the exception of Iowa City's campus-adjacent downtown, retailers were focused on bringing in visitors from elsewhere in their cities--hence the need for parking and big one-off events. 

To be fair, the panelists mostly represented support organizations with little if any power even over types of stores or closing hours, much less their cities' land use and housing policies. Any influence they do possess is persuasive, through conversations with entrepreneurs, city officials, and citizen-shoppers. Still, they could be using those conversations to promote the type of urban context in which local businesses could be sustainably thriving. (Continuing to be fair, I was not able to ask the panelists about this; their answers could have been illuminating, and I surely owe each of them a shot at a guest appearance on Holy Mountain.)

A 24-hour downtown area that mixes retail, office, entertainment, and residential uses is the most economically, environmentally and fiscally resilient approach. Parking is a game at which you never can win, because unless we want to become a nation of big-box stores and strip malls, the appetite for more parking spaces is insatiable (cf. Grabar 2023)--like the candy the witch gave the boy in The Lion, The Witch and the Wardrobe. The core of Cedar Rapids is replete with surface parking, such that one can walk from the Geonetric Building to Coe College through parking lots. (This is actually true--I've done it.) And while Betsy Potter from Iowa City suggested "parking education" might be a way to mitigate this insatiable demand, one engages in that at one's own risk.

Downtown Cedar Rapids may have 99 problems, but insufficient parking is not one
(parking areas in red; screen shot of project by former Coe College student)

A 24-hour downtown has vibe that hasn't been killed by swaths of parking. Many of your customers are right there, pretty much all the time, so you don't have to lure them in with events or hope that enough of them are in the mood today to get in their cars and "go shopping." A store I can walk to, especially one that sells the necessities of life, is part of my neighborhood, to which I have more connection than some website. Stores we don't have to drive to are stores at which we don't have to find parking, a load off our minds as well as a load off the city streetscape.

But Cedar Rapids, Coralville, and Marion, and even much of Iowa City, are far from being this sort of town. A lot has to change, both physically and psychologically. In the meantime, retailers and those who support them have to operate in the towns we have built over the last 75 years. I understand that. Whether you're in sales or politics, you have to be responsive to public demand, which is largely shaped by how people have learned to navigate the world as it is. But some gentle nudges in the right direction would serve us all well.

The next Business Breakfast will be in Iowa City on July 9; they return to Cedar Rapids September 10.

Metro housing update

 

(L to R) Jennifer Pratt, Pat Parsley, Kim Downs, Drew Retz

My friend Eric Gutschmidt is fond of saying "You can't build a $100,000 house." That unpleasant reality underlay the lively discussion of housing issues Tuesday morning at the Gazette Business Breakfast in the Geonetric Building cafeteria. Various subjects fell into three major topic areas: supply, price, and neighborhood context.

Supply

Kim Downs, deputy city manager for the City of Marion, described slow progress on a variety of housing needs. She cited a need for multi- and single family housing at all price points, a need echoed by the other panelists. Pat Parsley, community development director for the City of Hiawatha, cited a 2020 housing study showing a particular shortage of rental housing, which has spurred development of 200 units built since then.

All three towns are actively building, with the assistance of Community Development Block Grant (CDBG) funding as well as derecho recovery funds. Jennifer Pratt, community development director for the City of Cedar Rapids, reported five multifamily units underway, and previewed a program ("Roots 2.0") that will build 76 houses in the 2008 flood zone that will sell for $175,000; she also noted "growth corridors" in the northeast quadrant (mostly single-family) and to the south near the College Community School District megacampus. Hiawatha touted their first multifamily development in ten years and first senior living facility ever, to be located in their emerging Boyson Road complex. Marion mentioned the rehabilitation of the former First United Methodist Church downtown as well as an "aging-in-place" development east of Route 13 with options for all ages.

An audience member asked about the demand for all this new housing. Unfortunately, she drowned her own question in a sea of unrelated issues, so it never got properly answered. What is the occupancy rate of recently-constructed apartments? What is the evidence (besides the existence of regular housing surveys) that we are under-supplied? Drew Retz, vice president of Jerry's Homes, said that he knew anecdotally that some of their customers have moved from out of state to take jobs, and that their houses were occupied upon construction.

Price

Only two factors in housing inflation were considered: high interest rates and regulatory compliance costs. The Federal Reserve Board is maintaining the prime lending rate, from which all other interest rates derive, at a historically high 5.25-5.5 percent, at least for now (Lee and Heuer 2024). Rates were raised to combat inflation resulting from coronavirus pandemic disruptions to the economy, and thus represent a temporary if powerful factor in raising housing prices. Kim Downs said interest rates were driving potential homebuyers into the rental market, and inspiring homeowners to convert all or part of their houses to rent. To me that suggests these individuals are deferring their long-term purchases, rather than buying a smaller cheaper house now. When they come back into the market in the next few years, that will have an interesting effect on demand and hence on prices. 

Drew Retz cited an estimate, which no one contradicted, that 25 percent of the cost of new housing is due to government regulation, and that it thereby takes about 18 months to build anything, implying (probably accurately) that price reduction was within the power of the cities, should they choose to use it. The city people all said they were working on streamlining the approval process to make it faster and more predictable, but even Pat Parsley from "developer friendly" Hiawatha allowed they also had a duty to the public to make sure the streets, trees, and such were done for the benefit of the public. (Streets "wide enough?" If developers want to build 16 foot streets, let 'em, I say.)

Retz made another point that's worth considering; Houses are built and sold by private businesses that need/expect a return on their investment, one that exceeds the return on financial instruments that don't require strenuous physical work. If buyers expect "everything," and cities are both willing to add to the cost with regulation and to subsidize some of the cost with public funds, what winds up being the right price? We seem to have lost the market price signals that could answer that question. Why wouldn't I want a big house with a big yard on a wide tree-lined street, a street that is plowed quickly after a snowstorm, located at an insulating distance from the madding crowd, yet near enough to parks and schools, if I didn't recognize that all of these have costs that must be borne by someone if not me? That's what my parents had!

We have difficulty, in both the private and public realms, talking about who pays for social costs not borne by the buyer or seller (known in the biz as "market failures"). Spreading out as we have done for two or three generations creates financial burdens for communities as well as environmental strains and all the problems attendant to car dependency. More demand raises the price of anything--that's simple economics, but problematic if we also consider a good like housing to be a necessary human right. These are awkward and unpleasant subjects to be broached in most spaces, and they were not broached on Tuesday.

Neighborhood Context

Social subjects did sneak in when the panel discussed "neighborhoods." Jennifer Pratt said Cedar Rapids is looking for "complete neighborhoods" as described in the 2015 plan EnvisionCR and subsequent updates. The adjective "healthy" was also used with respect to this, leading an audience member to ask what was meant by a healthy neighborhood. Pat Parsley defined it as a diversity of housing options, mixing uses within a walkable area (a radius of about one mile); such nodes are being built in his town of Hiawatha. Jennifer Pratt added that the cities also need to be mindful of what the market is looking for, which might include single use subdivisions.

Dorothy DeSouza Guedes of the Oak Hill Jackson Neighborhood Association, which has seen a great deal of development since the 2008 flood wiped out a huge swath of it, asked if current residents could be engaged earlier in the development process. Consultation with the neighborhood is required by law, but large developers in particular have the reputation of doing the minimum so late that it's ineffective. Yet residents have reputations, too. They surely have an essential voice in development of their own neighborhood, but too often they have exercised or tried to exercise veto power over beneficial development. 

Neighborhood, in other words, is a slippery concept. I have no problem with people living in whatever type of neighborhood they wish, as long as they're willing to pay the social costs, and as long as there's room left for everybody else to live as well. This is maybe a more difficult discussion than we were ready for Tuesday.

The Gazette Business Breakfast series next moves to Iowa City in April for a discussion of state and local taxes.

SEE ALSO: "New Data on Housing Prices," 23 January 2024

The Future of Downtown Cedar Rapids

 

Bullish views of downtown Cedar Rapids were expressed by a public-private partnership of a panel Tuesday morning, sponsored by the Cedar Rapids Gazette. Mayor Tiffany O'Donnell, Jesse Thoeming of the Cedar Rapids Metro Economic Alliance, and two business owners applauded the vast increase in downtown housing and the flood protection that has enabled it, while hoping for more ideas to sustain downtown growth.

Construction underway on the "banjo block":
A game-changer I can get behind

Darryl High, a property developer and also chair of the Downtown Self-Supported Municipal Improvement District (SSMID), said downtown was at last "becoming an urban neighborhood." High cited much new construction as well as conversions of office space, concluding it will serve to "bring more people" which will eventually lead to service providers. Mayor O'Donnell anticipates a wider variety of housing that will lead to "people walking their dogs downtown." This vision of a 24-hour downtown has taken awhile to emerge, but is good to hear. 

Andy Schumacher, co-owner of Cobble Hill restaurant downtown as well as Caucho in New Bohemia, says he's noticed since Cobble Hill opened in February 2013 that office workers go home after work, and that a different crowd comes out to dinner in the evening, if it indeed it appears at all. A residential population might well be the key to sustaining downtown energy, particularly if a wider set of housing choices could allow for more "lower-middle-class vibe" than the pricey condos that have led development for the past few years. 

The Iowa Building (1914) is being retrofitted for housing
(Google Street View screen capture)

Schumacher's comments echo those of Jane Jacobs, who in a long, lyrical passage in The Death and Life of Great American Cities [Modern Library, (1961) 2011: 65-71] described the ballet of the good city sidewalk... in which the individual dancers and ensembles all have distinctive parts which miraculously reinforce each other and compose an orderly whole. This dance happened in the course of every day--without needing special festivals or events to get people there!

Jane Jacobs

On Hudson Street in New York's Greenwich Village sixty years ago, the ballet began with residents leaving for work, businesses opening their doors, and middle school students walking to school.

I make my own first entrance into it a little after eight when I put out the garbage can, surely a prosaic occupation, but I enjoy my part, my little clang, as the droves of junior high school students walk by the center of the stage dropping candy wrappers. (How do they eat so much candy so early in the morning?) (68)

Over the course of the day, the sidewalk sees elementary school students, commuters emerging from subways and taxis, shoppers, the lunchtime crowd, workers on break, children released from school, people stopping to shop on the way home, diners, and nighttime dog walkers. Her writing is so lovely, particularly considering her actual purpose is to make an argument, that I can hardly resist quoting the whole six pages. You should read them for yourself... along with the rest of this timeless book! 

Fair question: Will Downtown residents shop at corner stores
when there's a 67000 square foot Hy-Vee six minutes' drive away?

Schumacher noted the ease of auto-commuting in the Cedar Rapids metro area means that a mobile population isn't necessarily going to stay in the downtown area. How a "vibrant, growing downtown" (High) develops within "a very suburban town" (Schumacher) is a perplexing question--really worth thinking about as the conversation shifts, as it inevitably does, to what attractions the downtown should seek. ("What are workers looking for?" asks the mayor.) 

• It is possible that Cedar Rapids' core will grow through in-migration of telecommuters looking for a less expensive but still urban version of their current cities. ("Look at us! We're cheap... and kinda urban... just don't pay attention to the legislature, lol!!") Thoeming suggested doing the riverfront right could make us stand out to would-be digital nomads. 
• It is possible that the much-talked-about big regional attraction, which Mayor O'Donnell thankfully has repackaged as "an entertainment complex with a casino in it," will draw residents as well as encouraging visitors to check out other downtown establishments. (Schumacher called this "a question I don't have the answer to.") 

Market After Dark promo, from Cedar Rapids
Downtown Farmers Market Facebook page

• It is possible that Downtown will mostly draw people in for big events, like the farmers' market and outdoor movies, or "closing 2nd Street every once in awhile" (the mayor).

Do we need to provide the rest of the region with reasons to "come visit downtown" (Darryl High), or do we follow Strong Towns' dictum that...

Drive-in visitors will need places to park, of course, crowding residents and leading to the vast swaths of parking lots that already plague the core of our town. Check out my town, or your town, at the interactive map created by Katya Kisin (2022). All that parking creates space that increases the distance between destinations, so walking is less convenient and the land less productive.

Darryl High said that Downtown has been in contact with other SSMIDs like the MedQuarter and New Bohemia on having a trolley route around the area. This would be great, if frequent enough, augmenting public transportation in an important way. Overall, as Brent Toderian argues, development of core areas needs to emphasize alternatives to cars:

[I]t has to be multimodal. In fact, it has to have active transport priority: walking, biking and transit have to be emphasized. If you try to design density around cars, it's a recipe for failure. You have to make walking, biking and transit not just available, but delightful. (quoted in Roberts 2017) 

An hour's discussion is hardly enough to touch on all the facets of downtown development, but I would have like to have seen more attention to socioeconomic inclusion/equity. The restauranteur Andy Schumacher, whom I quoted above, did call for greater variety of housing types and prices within the downtown area. 

There was no discussion, however, in response to the moderators' question about connectivity, of connections to core residential neighborhoods like Wellington Heights, Oak Hill Jackson, and the Taylor Area. As of now downtown is surrounded by a gigantic doughnut of emptiness that separates it from all other parts of town. If we could close some of that, and create seamless connections to the city's most densely populated and diverse areas, it would do wonders for individual economic opportunity, and the resilience of the local economy, not to mention vibe.

8th Street SE bisects an "empty quarter" between 
Downtown and Wellington Heights
(Google Street View screen capture from May 2022)

Another issue would be how to assist locally-owned, small businesses to populate the downtown area. (See my report on a talk by Ellen Shepherd of Community Allies, or the array of evidence aggregated by Stacy Mitchell of the Institute for Local Self-Reliance.)

[Personal note: As I bicycled to get coffee before the webinar, 25 cars went by me on 3rd Avenue SE. Only seven were headed towards downtown; 17 were outbound, and one was doing the funky cross at 14th Street. This is only one 1.5 mile data point on one morning, but it is interesting and might signify broader trends?] 

The panel was moderated by Gazette columnist Michael Chevy Castranova and reporter Marissa Payne.

SEE ALSO: 

     Marissa Payne, "Cedar Rapids Looks to Re-Imagine Downtown, Shifting from Office Center to Entertainment," Cedar Rapids Gazette, 26 June 2022

     Rick Reinhard and Chris Elisara, "A Call to Rethink Dying Houses of Worship," Public Square: A CNU Journal, 7 June 2022. [By my count, only five churches remain in the Downtown Cedar Rapids area: Bethel African Methodist Episcopal, First Presbyterian, Grace Episcopal, St. John the Baptist Greek Orthodox, and Veritas; only the aging but thriving First Presbyterian has a substantial physical footprint. Getting into the MedQuarter and Wellington Heights is a different story.]

PREVIOUSLY ON HOLY MOUNTAIN:

"Cedar Rapids Mayoral Runoff 2021," 22 November 2021

"Envisioning CR I: A 24-Hour Downtown," 1 March 2015

"News from Downtowns," 23 June 2017