If you're 45 or older, you may have had a colonoscopy or have had a conversation with your physician about being screened for colorectal cancer. However, recent headlines began calling into question the effectiveness of colonoscopies.

Dr. Franklin Berger, director of research & outreach for the Colorectal Cancer Prevention Network at the University of South Carolina, was not happy with what he read and recently wrote a response for The Conversation which you can read here:

Colonoscopy is still the most recommended screening for colorectal cancer, despite conflicting headlines and flawed interpretations of a new study.

In this episode of the Behind the Headlines podcast, Dr. Berger discusses his article, the importance of colonoscopies, the reasoning behind the lower age threshold for the procedure as well as alternative, less invasive screening methods.

—This episode is hosted by Terry Lipshetz, senior producer at Lee Enterprises.

If you're 45 or older, you may have had a colonoscopy or have had a conversation with your physician about being screened for colorectal cancer. However, recent headlines began calling into question the effectiveness of colonoscopies.
Dr. Franklin Berger, director of research &amp; outreach for the Colorectal Cancer Prevention Network at the University of South Carolina, was not happy with what he read and recently wrote a response for The Conversation which you can read here:
<a href="https://theconversation.com/colonoscopy-is-still-recommended-for-colorectal-cancer-screening-despite-conflicting-headlines-about-a-new-high-profile-study-192374">Colonoscopy is still the most recommended screening for colorectal cancer, despite conflicting headlines and flawed interpretations of a new study.</a>
In this episode of the <a href="https://omny.fm/shows/behind-the-headlines-pod">Behind the Headlines podcast</a>, Dr. Berger discusses his article, the importance of colonoscopies, the reasoning behind the lower age threshold for the procedure as well as alternative, less invasive screening methods.
—This episode is hosted by Terry Lipshetz, senior producer at Lee Enterprises.

Behind the Headlines features interviews with reporters and editors from newspapers owned by Lee Enterprises, including its Public Service Journalism team. Lee Enterprises is a leading provider of local news and information, and a major platform for advertising, with daily newspapers, rapidly-growing digital products, marketing services, innovative technology and nearly 350 weekly and specialty publications serving 77 markets in 26 states.

Behind the Headlines features interviews with reporters and editors from newspapers owned by Lee Enterprises, including its Public Service Journalism team. Lee Enterprises is a leading provider of local news and information, and a major platform for advertising, with daily newspapers, rapidly-growing digital products, marketing services, innovative technology and nearly 350 weekly and specialty publications serving 77 markets in 26 states.<a href="https://www.stltoday.com/"></a>

Behind the Headlines

Cancer screening advice: Avoid the confusing colonoscopy headlines

Welcome to another episode of Behind the Headlines, where we feature experts and journalists discussing a variety of topics.

In this latest episode, Virginia Annable, a reporter for Lee Enterprises Public Service Journalism team based in Hickory, North Carolina, discusses her story about Johnathan Howard Hayes, a nurse in Winston-Salem, North Carolina.

Hayes stands accused of murder and attempted murder of patients in a hospital where he worked. Hayes is accused of intentionally administering a near-lethal dose of insulin to a patient in the same year he was nominated to be a nurse of distinction.

He is also accused of administering similar lethal doses of insulin to two other patients in early 2022, killing both, according to Winston-Salem police. Hayes was arrested in October 2022, on one count of attempted first-degree murder and two counts of murder.

Read the story

NC nurse accused of killing 2 patients was family man with history of medicine mismanagement

About this program

Host Terry Lipshetz is a senior producer for Lee Enterprises. Besides producing interviews for this Behind the Headlines program, he produces the daily Hot off the Wire news podcast, co-hosts Streamed & Screened movies and television program and is the producer of Across the Sky weather and climate podcast.

Lee Enterprises produces many national, regional and sports podcasts. Learn more here.

Episode transcript

Note: The following transcript was created by Headliner and may contain misspellings and other inaccuracies as it was generated automatically:

Terry Lipshetz: Welcome to another episode of behind the Headlines, where we feature experts and journalists discussing a variety of topics. I'm Terry Lipshetz, a senior producer for Lee Enterprises, and your host in this latest episode, Virginia Annable, a reporter for Lee Enterprises public service journalism team based in Hickory, North Carolina, discusses her story about Jonathan Howard Hayes, a nurse in Winston Salem, North Carolina, who is accused of killing two patients with fatal doses of insulin. Hayes was arrested in October 2022 on one count of attempted first degree murder and two counts of murder. Virginia, welcome to the program.

Virginia Annable: Thank you for having me.

Terry Lipshetz: Can you talk a little bit about the case, what exactly happened and where things stand at the moment?

Virginia Annable: Sure, yeah. This case came to public attention in October 2022, when the district, attorney of Forsyth County and the atrium, Wake Forest Baptist Hospital, came out with a press conference and announced that they had arrested Jonathan Howard Hayes. He was a nurse at Wake Forest, and he was accused of killing two patients and attempting to kill a third. Since then, there hasn't been a lot of movement in the case, but it really caught the public's attention. Just the fact that there was this nurse who lived in the community, had been a nurse for 20 years, on the surface, seemed like everything was right. And then they were accusing him, of some pretty horrific things. So it really caught the attention of the whole state with these accusations.

Terry Lipshetz: Has there been a trial date yet? What's the status?

Virginia Annable: He has only appeared in court for his first appearance. They gave him no bond. And since then, there's been a couple dates set for an appearance. And it just keeps getting pushed back. It's really gotten dragged out. I mean, it's been almost a year now and, there's been very little movement on it.

Jonathan Hayes is accused of killing two patients with lethal doses of insulin

Terry Lipshetz: You talk a little bit about the two patients that died and also the one that survived, but what was the cause of death and what is he essentially being accused of here?

Virginia Annable: The hospital gave a really thorough timeline and a lot of information into the police, and that was all detailed in the search warrant application. So we have a really good look at what happened and what the hospital is saying. Their investigation found the first accusation was Pamela Jean Little. In December of 2021, she had an overdose of insulin and had a hypoglycemic event, which is when their blood sugar drops very, very low and it can cause a coma or death. Little was lucky enough to survive, but the accusation is that Jonathan Hayes overdosed her with potentially 100 units of insulin. When the typical, largest amount you would get is twelve. Then the second patient is Gwenda Zelda Crawford. And on January 5, at least, the doctors say that she had an overdose of about 100 units of insulin. She went into a coma. They took her to the ICU. Ah. But she unfortunately passed away a few days later. And then there was a third patient, Vicky Lynn Lingerfeld. And on January 22, she also had a hypoglycemic event where her blood sugar just dropped out. They did the blood test. They believe it was again over 100 units of insulin. And she went to the ICU, but she also passed away a few days later. The documents and all the hospital investigation found that Hayes was the only nurse present at all three events.

Terry Lipshetz: In your reporting, it mentions that Hayes administered seven times more insulin than others at the hospital. Can you talk a little bit about that finding?

Virginia Annable: So it sounds like after these three events, the hospital started looking into it and realized there was something wrong. And, then they kind of found the link to Hayes. And once they saw that, they did investigation into his medication usage and the amount of insulin he was using. And it's really interesting, the number that they found was he was the top administrator of insulin in the entire hospital. It's a very big hospital of any employee for a three month period. And he was also administering seven times the average of the whole hospital staff. So for how much insulin? Everyone the average of what everyone was administering, he was typically administering, like, seven times that. So there's a pretty big indication that there are some issues with medication administration. There is also some it's a little bit more tricky to explain, but the way that he was supposed to be verifying, medication administration, he was oftentimes saying it was given by other instead of putting a specific name down when administering medication. The hospital says that of the 130 times that given by other was used during medication administration, he did it 88 times. And that's for the entire hospital.

What is the dual verification process for certain medications?

Terry Lipshetz: Yeah, I wanted to follow up on that a little bit, because in your story, you talked a little bit about a dual verification process. So the idea being that with certain medications or maybe all medications, when a nurse is about to administer it, somebody else is there. Can you talk a little bit about that and what the expectation is under normal circumstances?

Virginia Annable: Yeah. So with hospitals, certain medications they call high alert. Medications that are maybe like an opiate or something like insulin that's more regulated. Nurses or doctors, et cetera, are required to have two people present and two people verify that this dose is acceptable and this is how much we're giving to the patient. There is a small way to get around that. And that's the given by other designation, which is typically reserved for, like, if there's an emergency or someone gave the patient the medication while they were getting an X ray or just something a little bit out of the ordinary where it might be harder to get that dual verification. But then medication was needed. But it seems very rarely used.

Terry Lipshetz: So under a normal circumstance, if a patient's in a hospital room and there's nothing else crazy going on, the expectation would be there'd be a dual verification and not just given by just one person.

Virginia Annable: Not just one person and given by other. Like, there's two medical personnel who kind of sign off on it.

What is a risk management team at hospital?

Terry Lipshetz: You mentioned a little bit, too, about the risk management team at the hospital. What exactly is that, and what's the function?

Virginia Annable: The risk management team, they kind of look into when the, hospital staff or anyone kind of says, there's a problem here. So in this case, they saw a pattern of these hypoglycemic episodes, and the risk management team steps in and does an evaluation, and they actually have a whole form that they fill out for each event and what happens, and they go as far to interview employees, and they check all of the records related to it. And they were, like, a full system check of what nurses were accessing, what information related to the incident. it's pretty interesting, just the amount of detail that they looked into. And the risk management team was able to meet with the police and turn over all of that information. And so the police can investigate from there and kind of verify everything they found.

Terry Lipshetz: Once this risk management team discovered there were some issues here with this case in particular, what did they do?

Virginia Annable: It sounds like as soon as they realized there was an issue, hayes was let go. And that was in late March of 2022. So a couple of months after the second death in January, they assessed the situation, and then the hospital let Hayes go. And then probably two I think it was three days after Hayes was let go, they met with the Winston Salem Police Department to let them know about these concerns. And the police department opened the investigation from there.

Terry Lipshetz: There was a sidebar that goes with the story as well. Now, you didn't write this. It's written by, Kate Farrish, but I know you've got some insight into this as well. And it gets into insulin. So it mentions that there is a former nurse, from West Virginia that's currently serving life in prison for killing seven elderly veterans. there is a registered nurse accused of killing two patients, at a Pennsylvania nursing home. There's another nurse that's been charged with killing patients. The common link here is insulin. What is it about insulin that has become such a common thread in some of these cases where a medical provider is being accused or convicted in a murder?

Virginia Annable: Yeah, that was something that kind of stood out to us and made us want to look into it. And that's why we had Kate Ferriss do a great story on that. And one of the things that we found just talking to some experts was that insulin, while it is a high alert medication, often still doesn't have that barrier to access as maybe an opioid or some other medication that's more highly regulated or has more street value, which is someone can't necessarily walk out of, the hospital and sell insulin for a lot of money like they could with other drugs. So that means a lot of times it looks like the insulin is easier for nurses to access. They can get more of it in some instances, like the medication carts were left unlocked or easy to get to, even if someone wasn't supposed to have access to that medication. So it's really just, the barrier to access is a lot lower with insulin.

Terry Lipshetz: And it would also seem, too, that because of the nature of diabetic patients, it's possibly a little bit easier to get around. Too right, because you have to give it at certain intervals, depending on when a patient might need it. And it's a very unique thing.

Virginia Annable: It can be left up to the provider to decide if that patient needs it as well. So, that decision can land on one person, and they can say, this person blood sugar looked like they needed insulin. So there's a little more flexibility where there isn't as much with higher level medications. But this insulin obviously can still lead to death and can, cause comas and a lot of health issues.

Terry Lipshetz: Another interesting point, too, is that for teams at hospitals, or looking at maybe misuse of medications, and the various safeguards that are in place, is not necessarily about catching someone who's maybe trying to cause harm, but maybe about catching mistakes, like medication errors more than anything. Too so is that part of the problem here, or is it just yeah.

Virginia Annable: That was something that we noticed when we saw this link of insurin and these apparently intentional deaths. We thought we would try to talk to hospitals about what they're doing that could potentially catch that. and when we looked into those regulations or steps that hospitals take, it's not about catching someone who's intentionally doing this. Many of their backstops are about mistakes, medical mistakes, which is, on one hand, you're like, okay, that's probably more common. But then we see these lengths, and you just get a little curious what could have caught these people. A lot of the hospitals weren't willing to talk about catching killers in their hospitals know, they just say they're looking for those medical mistakes. But there was an instance in West Virginia, in the VA. And a VA hospital where there were some intentional killings. There was a report afterwards kind of talking about some of the problems of what could have prevented this, what could have been done. And one of the big things that they pointed out was that when doctors and investigators kind of looked into these deaths, their thought wasn't necessarily, this was intentional. This was someone trying to kill people. Their thought was, this is a medical error, or, there's something wrong with the system, that kind of thing. So it doesn't seem like it's top of mind in these regulations to be catching someone who's intentionally killing people in hospitals.

Has there been any discussion about how insulin should be regulated?

Terry Lipshetz: Has there been any discussion, or did you find anything during your reporting where there's maybe some consideration into, looking at how insulin is regulated? Or is that not something that's widely discussed yet?

Virginia Annable: We don't see a lot of discussion about it in these ancient years where it happened, where someone's loved one was killed by insulin. Those people are advocates for there being more regulation. But regulation of insulin and of medication is so, different in each state and different hospital to hospital. There's not a lot of regularity between how it is administered and how it is regulated and how it's documented and that kind of thing, which was kind of an interesting part of Kate's story, just that there are some recommendations. There are advocacy groups that say this is how you should be documenting medication, and this is how you should be keeping it safe. But, it's really often left up to a hospital. The state or Medicaid agencies say you have to have dual verification for insulin, say, but they don't say how it has to be done, whether it has to be done electronically or your medication has to be locked up, but it could be in a cart, or it could be in a room and that kind of thing. So there's a lot of variability, from hospital to hospital.

In the Hayes case, if the accusations are true, it would meet the definition of serial killer

Terry Lipshetz: You talked a little bit in your story about the definition of serial killers, because in this case, in the Hayes case, if the accusations are true, it would meet the FBI's definition of a serial killer. Can you talk a little bit about that?

Virginia Annable: Yeah, I started looking into that. I spoke with a criminologist who said I should check that. The old definition was that it was three deaths across, a month or more. But the FBI has changed the definition now to be two intentional killings in separate instances. so there's not as much of a timeline. And so under that these deaths in the hospital do meet that definition of two or more deaths in separate instances. And including the instance with little it was over about two months that these happened.

Terry Lipshetz: What's next in the case? Where do things stand? You know, is there anything else you're looking into?

Virginia Annable: Whenever the case was announced, the DA asked hospitals to check their records and make sure know they don't see any other suspicious events or suspicious deaths if like, Hayes was working there. so I'm curious to see if anything like that does pop up. I know these investigations can take a long time, so even if a hospital did see an incident and reach out to investigators, it could take some time before we actually see if there are other linked cases. So far, there aren't any. And at least one of the hospitals I reached out to where Hayes had worked said that they immediately checked their records and tried to see how long he worked there, who he was working with, if he was ever alone administering medication. so I'm sure a lot of those hospitals did the exact same thing. It'll be interesting to see where this case goes. There's two sides to every story, so I'm not sure if this case will play out in court and we'll get to hear more or if it will end up being a plea deal. I think it will take some time. I spoke to his lawyer just to see if we could talk to Hayes or talk to him about the case. and he declined to comment. But he did say just to remember, there's two sides of the story, so we'll really see how everything plays out, hopefully, in the next couple months.

Terry Lipshetz: With Hayes, he did work at multiple hospitals, right? He hadn't been at that hospital for a very long time. He had moved around from place to place. So there is that potential then, that multiple places. Do you know exactly how many, medical, facilities he had worked at prior?

Virginia Annable: Yeah, based on his resume, which was given to police by, adrian Way Forest, he had worked at potentially like six or seven other hospitals, and all kind of in the central North Carolina area. There's a couple state hospitals there's, private hospitals. And a lot of them have kind of merged or changed over the last 20 years. So it sounds like they're, really having to dig through their records to figure out where he worked and when, and try to line that up. But, yeah, it does look like it's about seven hospitals, possibly, but it could be more or less. That was just based on a resume he gave to the hospital. He did work atrium Wake Forest for, I think, at least 15 years, but it was kind of on and off.

Terry Lipshetz: Virginia, thank you so much for joining me today and talking about this topic.

Virginia Annable: No problem. Thank you so much.

Terry Lipshetz: We hope you enjoyed this latest episode of behind the Headlines. You can find us on every podcast platform, and we'd love it if you could take a moment to subscribe and leave a review. Finally, if you appreciate what we're doing with this program, we encourage you to invest in local journalism by supporting the newspaper in your community. I'm Terry Lipshetz, thanking you so much for listening to behind the Headlines from Lee Enterprise.

North Carolina nurse accused of killing patients with lethal doses of insulin

Welcome to another episode of Behind the Headlines, where we feature experts and journalists discussing a variety of topics. In this latest episode, Hayleigh Colombo, a reporter for Lee Enterprises Public Service Journalism Team, talks about her story on logo apparel for colleges and the labor that is being used to produce the clothing.

Read the story

Broken threads: College clothing made in factories rife with labor violations, poverty wages

About this program

Host Terry Lipshetz is a senior producer for Lee Enterprises. Besides producing interviews for this Behind the Headlines program, he produces the daily Hot off the Wire news podcast, co-hosts Streamed & Screened movies and television program and is the producer of Across the Sky weather and climate podcast.

Lee Enterprises produces many national, regional and sports podcasts. Learn more here.

Episode transcript

Note: The following transcript was created by Adobe Premiere and may contain misspellings and other inaccuracies as it was generated automatically:

Terry Lipshetz: Welcome to another episode of behind the Headlines, where we feature experts and journalists discussing a variety of topics. I'm Terry Lipshetz, a senior producer for Lee Enterprises and your host in this latest episode, Haley Colombo, reporter for Lee Enterprise's public service journalism team, talks about her story on logo apparel for colleges and the labor that is being used to produce the clothing. Haley, welcome to the program.

Hayleigh Colombo: Thanks so much for having me.

Terry Lipshetz: Hayleigh, can you provide just an overall synopsis of what this story is about? Because it felt like there was a lot of pieces in it.

Hayleigh Colombo: I think it's important for people to know when they go to the university bookstore on football Saturday and they're buying a new T shirt or whatever to represent their favorite team, I think we make a lot of those buying decisions and don't necessarily think about what all went into it. What all went into making that shirt that is now on, the rack at my favorite university and being sold for $30 or whatever. $25. And what all went into it is this incredibly it takes an incredibly complex global labor supply chain to make those clothes, to bring them to consumers. And the reality is that the people who had the hardest job in making that shirt were compensated leap. And often those workers are getting poverty level wages that are hard for them to subsist on in their home countries making the US equivalent of a dollar 2 /hour which is even in countries where it costs less. To live or the expenses are less. It's still not enough for them to have a good life, to have the even calories that they need to subsist on. And there's lots of abuses that take place in these apparel factories, whether it's people not having the right to form a union or, when they try to form a union being retaliative against for that, sexual harassment, wage theft. And our universities, which are some of our most well known brands and most important institutions in this country, they themselves are, profiting off of this system because they earn millions of dollars of royalties from the sale of this gear. So we wanted to kind of delve into the conditions that this year is being made under and delve into what, if anything, universities have done, are doing to ensure that the people who actually make the garments with their logos on it are being treated fairly.

Terry Lipshetz: You had an interesting anecdote early in the story about a factory worker from Honduras. Can you talk a little bit about that example that you used about the working conditions and his wages?

Hayleigh Colombo: Yeah, absolutely. So I spoke with famous demas Michael Cardona Bar, and he is a worker in a factory that makes Nike gear. so he had recently worked on a University of Arizona alumni t shirt that Nike is selling for or that the university bookstores or retailers are selling for $35. He has to make upwards of works on upwards of, like, 750 to 1000 of those shirts a day, and he makes the equivalent of $97 a week. essentially that shirt, college football fans who are buying that shirt are paying more for it than he makes in a single day. And I think it's important to understand that that wage is not adequate for him to have a middle class lifestyle. He struggles to make ends meet, even though his wife is working. He has two young kids. One of his kids is a little bit younger than one of mine. So we were talking about, you know, he said it's not enough money to maintain his, you know, brands like Nike are profiting handsomely off of the sale of this gear. brands and retailers like the markup on the shirt is about 70%. Meanwhile, workers earn 1% or less of the final cost of the shirt in workers like him. And advocates in this industry, advocates fighting for fair wages, have pointed out that brands and retailers could ensure that workers are being paid fairly. They're profiting handsomely off of it.

Terry Lipshetz: Did you get any feedback from apparel companies?

Hayleigh Colombo: They largely didn't want to talk about this issue. Nike didn't respond to multiple requests for comment, even, about specific issues that had come up in their other brands that we reached out to. Kind of sent back statements, I would say, about, oh, we care about their treatment of worker. And I don't want to say that they don't, but I think that they don't feel a lot of impetus, apparently, to change the situation. And there are a lot of people suffering under this system. Experts that I talked with, who study the global apparel industry have noted that, in order to pay workers a fair living wage for them, it would really not drastically impact the cost of a t shirt. Even if they pass 100% of the cost on to consumers. It would add, like a dollar or something like that. Obviously, you could debate whether consumers should pay the full cost of doing something like that, or brands and retailers should eat into their profit a little bit to cover that. But it wouldn't be a drastic investment that they would have to make in order to write the ship.

Terry Lipshetz: And, there's not really a lot of pressure, it seems, right now, to write that ship.

Hayleigh Colombo: There's been kind of waxing and waning pressure over the last several decades. There was in the early 2000s, when after US. Manufacturing of clothing declined, and more and more clothing started being manufactured overseas in these low wage countries, there was a big outcry about how apparel was being made. I don't know if people remember, like, Kathy Lee Gifford got into a lot of hot water back in the day for her clothing brand. And there have been various disasters have happened. Horrible disasters have happened over the years. In 2013, a Bangladesh building collapsed, it's kind of known as the Rana Plaza disaster. And more than 1000 people died, largely garment workers. And it's the worst disaster that the industry has ever known. So when situations like that happen, yes, there's a large outcry, but by and large, obviously there's really not. Consumers are kind of going about their day, consumers are cash strapped as well. I'm in the same way, I'm not trying to pay as much as possible to buy a t shirt. You try to get the best thing you can for the least amount of money to fit in your budget. And I've talked with folks who have said it really shouldn't be on consumers, it should be on the brands and retailers, as well as the large institutional buyers like universities, or like professional sports teams who put that pressure on the brands and retailers to change their practices.

Terry Lipshetz: The fact that this story is about universities is interesting because obviously division, one level universities are big money makers with football programs and basketball programs, and it's not professional sports, but there's a lot of money in it, like professional sports, and you get crowds of 60,000, 70,000, 80,000 or more going to football games. So it's a huge industry. But at the same time, many of these large schools are also research universities. They study things like labor practices. And it's kind of an interesting situation. So what kind of responsibility do universities bear here?

Hayleigh Colombo: It's so interesting. And one of the reasons why we focused on university gear when this problem exists across all apparel, every time you buy a shirt that insert retailer of your choice, the same issues are at play. The difference with the university apparel is that they are public facing, publicly funded, most of the time, obviously, there's private universities, but publicly funded by taxpayers, institutions of higher learning, where, like you're saying, some of the same institutions that have apparel that's being produced under unfair conditions, those same institutions have professors, there who are studying this issue. Experts have said that, universities do play a big role in trying to correct this. And to their credit, to the extent that anyone has tried to improve this, universities have. And so I talked to university officials too, who are kind of begrudging the fact that people are asking us to do more, but we're really the only folks who are doing anything right. What else can we do? What we discovered is the investment of time. The people who are really engaged in this, it's really not uniform across universities. There's a core group of universities who are really engaged in this work and really seem to care about it, and are trying to, use the leverage that they have. But there's a lot of universities, I would venture to say most based on our research, who don't appear to be engaged in this and are large, but themselves could play a role. Could be another voice asking brand of choice to ensure that workers are paid fairly.

Terry Lipshetz: Do sponsorships complicate the issue? Because you have like Nike and Adidas and all these brands will be the official shoe sponsor of such and such college football team or the basketball team or whatever. Are these relationships complicating the issue as well?

Hayleigh Colombo: Absolutely they are, because Nike, these other companies, depending on the school, they're paying a million dollars, multiple million dollars every year, in the form of these deals. And that really, I mean they're important business partners of the university. So it's tricky because it's this symbiotic relationship. What's worth more to the university, the deal being in good standing with Nike or appeasing, some students who know activists regarding sweatshop apparel.

Terry Lipshetz: Right. You had the interview with the worker from Honduras. You referenced the building collapse in Bangladesh. I know your story references a case in Bangkok, Thailand. Also, you have these factories in so many different countries. Is this complicating the situation as well? Because it's not like everybody is working in the same country and they're all making apparel in one place. So how is that complicating the situation?

Hayleigh Colombo: It's incredibly complicated. Honestly, researching this subject, my mind was truly blown about how complex the global supply chain is. I mean thousands of factories are involved. Schools have hundreds of licensees, who each have their own set of factories that they use. So it's really hard to track because it is very hard to know. I spent a lot of time trying to kind of track a specific shirt and find out which factory that shirt was made in. It is so hard to know. It's almost impossible to know. I was going through these importing logs, trying to find these shipments that would give any sort of clue about, okay, this factory had an order that came to the US with Adidas or Nike as the customer and what was in that order? And it'll just say like men's knit tops or something. And it's like, it's very hard to track. Or obviously any shirt that you're buying, it'll say, or piece of apparel that you're buying on the physical tag, it will know made in Honduras, made in Thailand, made in Bangladesh. But it doesn't give any more details, than there's, you know, hundreds, if not more factories in all these countries. So it's just really hard for folks to monitor. It's really hard for universities. I mean universities are not in the business of monitoring factories in Thailand. They're just not. So it's hard to know. And what makes it even more complicated is that brands themselves don't really own their own factories. That's not really a thing. They're all subcontractors. So it's like, okay, these are the hundreds of facilities. That where Nike gear is made. But it's not like these people are employees of Nike or employees of Adidas or Under Armour or whoever. So it makes it really hard to track, and it also makes it really hard for anyone to really, truly accept accountability for what happens in these places. Because the university can say, like, well, this was the brand that we worked with. And the brand can say, well, this is the Subcontractor that we use. and sometimes those subcontractors are their subcontracting out to other factories. So in the case of the Rana Plaza disaster, for instance, some brands were surprised that their gear was being made there. There was like, tags in the rubble and just some horrifying images where you would see this gear, this shirt was made there. And the brands themselves didn't even know because that was a, Subcontractor. Subcontractor was sewing the sleeves or something. And there's just tremendous, with an industry that fragmented, there's tremendous pressure on the factories themselves to have labor costs as low as possible.

Terry Lipshetz: I mean, you don't want to provide excuses for businesses, but in some ways, it's also difficult for them. They can claim like, well, we hired the Subcontractor and they say, we're operating on the up and up. But if they're not doing it because they're not employees of these manufacturers, then it is tougher for them to monitor too.

Hayleigh Colombo: Right? Absolutely, it absolutely is. I think that, advocates would say, well, yeah, it is tough, but it's also brands and retailers who have chosen to organize themselves this way, to chosen to use Subcontractors that they don't track very well. All of this is a choice, and it's a choice that's being made in search of higher and higher profits.

Terry Lipshetz: So what's next? Are you going to continue looking at this story? Are there other angles that you're pursuing?

Hayleigh Colombo: I hope so. Honestly, it's been so fascinating. It's really been so fascinating. I definitely want to keep reporting on it. I think that it's fascinating to see what, if any, solutions people have come up with. So one really fascinating past solution was that there was a fair trade university logo factory. It’s called alta gracias in the Dominican Republic. And universities, for a time being, when Alta Gracia was up and running, they would have displays in the store like, okay, all these people are, earning fair wages. They were like, on average, three times the minimum wage or something like that. They had union collective bargaining rights, they were working in good conditions. And that factory unfortunately, closed after COVID. And so what other that was obviously such a creative solution that it was kind of a private sector solution. And it did appear to make a difference, or at least show that this model could work. it successfully worked for many years, but the COVID pandemic was kind of the nail in the coffin there. In the past, there was an effort to have something called a designated suppliers program where it would really clamp down on the number of factories that did produce university logo gear so that the universities could have a really strong oversight of those factories and what went on there. And that was the solution that a lot of the really involved universities were really hoping for, but that ran into some US. Antitrust issues and never came to fruition. So what's the next, private sector creative solution? Is there government is there ever going to be government intervention to solve this problem, or is this just a problem that we've accepted as a society as kind of the cost of doing business? I hope not, because in the reporting, it became very clear to me people are really suffering for something, as simple as us being like, oh, yeah, I'll pick up a new t shirt, like a new alma mater T shirt. Like, there's really like, there's people who are behind that who are not living good lives, and that doesn't have to be true.

Terry Lipshetz: Well, on that note, Haley, appreciate you coming on today to talk about this and certainly going to think a little bit differently the next time I pick up local apparel from either a, pro or college team. And it does give me something to think about.

Hayleigh Colombo: Absolutely. Thanks so much, Terry.

Terry Lipshetz: We hope you enjoyed this latest episode of behind the Headlines. You can find us on every podcast platform, and we'd love it if you could take a moment to subscribe and leave a review. Finally, if you appreciate what we're doing with this program, we encourage you to invest in local journalism by supporting the newspaper in your community. I'm Terry Lipshetz. Thanking you so much for listening to behind the Headlines from Lee Enterprise.

Welcome to another episode of Behind the Headlines, where we feature experts and journalists discussing a variety of topics. In this latest episode, Hayleigh Colombo, a reporter for Lee Enterprises Public Service Journalism Team, talks about her story on logo apparel for colleges and the labor that is being used to produce the clothing.
Read the story
<a href="https://wire.lee.net/news/state-regional/education/college-apparel-garment-worker-conditions/article_38850d2f-c2b2-5054-8215-630c958cbce0.html"></a><a href="https://wire.lee.net/news/state-regional/education/college-apparel-garment-worker-conditions/article_38850d2f-c2b2-5054-8215-630c958cbce0.html">Broken threads: College clothing made in factories rife with labor violations, poverty wages</a>
About this program
Host Terry Lipshetz is a senior producer for Lee Enterprises. Besides producing interviews for this <a href="https://omny.fm/shows/behind-the-headlines-pod">Behind the Headlines</a> program, he produces the daily <a href="https://omny.fm/shows/hot-off-the-wire">Hot off the Wire</a> news podcast, co-hosts <a href="https://omny.fm/shows/just-to-be-nominated">Streamed &amp; Screened </a>movies and television program and is the producer of <a href="https://omny.fm/shows/across-the-sky">Across the Sky</a> weather and climate podcast.
Lee Enterprises produces many national, regional and sports podcasts. <a href="https://linktr.ee/leepodcasts">Learn more here</a>.
Episode transcript
Note: The following transcript was created by Adobe Premiere and may contain misspellings and other inaccuracies as it was generated automatically:
Terry Lipshetz: Welcome to another episode of behind the Headlines, where we feature experts and journalists discussing a variety of topics. I'm Terry Lipshetz, a senior producer for Lee Enterprises and your host in this latest episode, Haley Colombo, reporter for Lee Enterprise's public service journalism team, talks about her story on logo apparel for colleges and the labor that is being used to produce the clothing. Haley, welcome to the program.
Hayleigh Colombo: Thanks so much for having me.
Terry Lipshetz: Hayleigh, can you provide just an overall synopsis of what this story is about? Because it felt like there was a lot of pieces in it.
Hayleigh Colombo: I think it's important for people to know when they go to the university bookstore on football Saturday and they're buying a new T shirt or whatever to represent their favorite team, I think we make a lot of those buying decisions and don't necessarily think about what all went into it. What all went into making that shirt that is now on, the rack at my favorite university and being sold for $30 or whatever. $25. And what all went into it is this incredibly it takes an incredibly complex global labor supply chain to make those clothes, to bring them to consumers. And the reality is that the people who had the hardest job in making that shirt were compensated leap. And often those workers are getting poverty level wages that are hard for them to subsist on in their home countries making the US equivalent of a dollar 2 /hour which is even in countries where it costs less. To live or the expenses are less. It's still not enough for them to have a good life, to have the even calories that they need to subsist on. And there's lots of abuses that take place in these apparel factories, whether it's people not having the right to form a union or, when they try to form a union being retaliative against for that, sexual harassment, wage theft. And our universities, which are some of our most well known brands and most important institutions in this country, they themselves are, profiting off of this system because they earn millions of dollars of royalties from the sale of this gear. So we wanted to kind of delve into the conditions that this year is being made under and delve into what, if anything, universities have done, are doing to ensure that the people who actually make the garments with their logos on it are being treated fairly.
Terry Lipshetz: You had an interesting anecdote early in the story about a factory worker from Honduras. Can you talk a little bit about that example that you used about the working conditions and his wages?
Hayleigh Colombo: Yeah, absolutely. So I spoke with famous demas Michael Cardona Bar, and he is a worker in a factory that makes Nike gear. so he had recently worked on a University of Arizona alumni t shirt that Nike is selling for or that the university bookstores or retailers are selling for $35. He has to make upwards of works on upwards of, like, 750 to 1000 of those shirts a day, and he makes the equivalent of $97 a week. essentially that shirt, college football fans who are buying that shirt are paying more for it than he makes in a single day. And I think it's important to understand that that wage is not adequate for him to have a middle class lifestyle. He struggles to make ends meet, even though his wife is working. He has two young kids. One of his kids is a little bit younger than one of mine. So we were talking about, you know, he said it's not enough money to maintain his, you know, brands like Nike are profiting handsomely off of the sale of this gear. brands and retailers like the markup on the shirt is about 70%. Meanwhile, workers earn 1% or less of the final cost of the shirt in workers like him. And advocates in this industry, advocates fighting for fair wages, have pointed out that brands and retailers could ensure that workers are being paid fairly. They're profiting handsomely off of it.
Terry Lipshetz: Did you get any feedback from apparel companies?
Hayleigh Colombo: They largely didn't want to talk about this issue. Nike didn't respond to multiple requests for comment, even, about specific issues that had come up in their other brands that we reached out to. Kind of sent back statements, I would say, about, oh, we care about their treatment of worker. And I don't want to say that they don't, but I think that they don't feel a lot of impetus, apparently, to change the situation. And there are a lot of people suffering under this system. Experts that I talked with, who study the global apparel industry have noted that, in order to pay workers a fair living wage for them, it would really not drastically impact the cost of a t shirt. Even if they pass 100% of the cost on to consumers. It would add, like a dollar or something like that. Obviously, you could debate whether consumers should pay the full cost of doing something like that, or brands and retailers should eat into their profit a little bit to cover that. But it wouldn't be a drastic investment that they would have to make in order to write the ship.
Terry Lipshetz: And, there's not really a lot of pressure, it seems, right now, to write that ship.
Hayleigh Colombo: There's been kind of waxing and waning pressure over the last several decades. There was in the early 2000s, when after US. Manufacturing of clothing declined, and more and more clothing started being manufactured overseas in these low wage countries, there was a big outcry about how apparel was being made. I don't know if people remember, like, Kathy Lee Gifford got into a lot of hot water back in the day for her clothing brand. And there have been various disasters have happened. Horrible disasters have happened over the years. In 2013, a Bangladesh building collapsed, it's kind of known as the Rana Plaza disaster. And more than 1000 people died, largely garment workers. And it's the worst disaster that the industry has ever known. So when situations like that happen, yes, there's a large outcry, but by and large, obviously there's really not. Consumers are kind of going about their day, consumers are cash strapped as well. I'm in the same way, I'm not trying to pay as much as possible to buy a t shirt. You try to get the best thing you can for the least amount of money to fit in your budget. And I've talked with folks who have said it really shouldn't be on consumers, it should be on the brands and retailers, as well as the large institutional buyers like universities, or like professional sports teams who put that pressure on the brands and retailers to change their practices.
Terry Lipshetz: The fact that this story is about universities is interesting because obviously division, one level universities are big money makers with football programs and basketball programs, and it's not professional sports, but there's a lot of money in it, like professional sports, and you get crowds of 60,000, 70,000, 80,000 or more going to football games. So it's a huge industry. But at the same time, many of these large schools are also research universities. They study things like labor practices. And it's kind of an interesting situation. So what kind of responsibility do universities bear here?
Hayleigh Colombo: It's so interesting. And one of the reasons why we focused on university gear when this problem exists across all apparel, every time you buy a shirt that insert retailer of your choice, the same issues are at play. The difference with the university apparel is that they are public facing, publicly funded, most of the time, obviously, there's private universities, but publicly funded by taxpayers, institutions of higher learning, where, like you're saying, some of the same institutions that have apparel that's being produced under unfair conditions, those same institutions have professors, there who are studying this issue. Experts have said that, universities do play a big role in trying to correct this. And to their credit, to the extent that anyone has tried to improve this, universities have. And so I talked to university officials too, who are kind of begrudging the fact that people are asking us to do more, but we're really the only folks who are doing anything right. What else can we do? What we discovered is the investment of time. The people who are really engaged in this, it's really not uniform across universities. There's a core group of universities who are really engaged in this work and really seem to care about it, and are trying to, use the leverage that they have. But there's a lot of universities, I would venture to say most based on our research, who don't appear to be engaged in this and are large, but themselves could play a role. Could be another voice asking brand of choice to ensure that workers are paid fairly.
Terry Lipshetz: Do sponsorships complicate the issue? Because you have like Nike and Adidas and all these brands will be the official shoe sponsor of such and such college football team or the basketball team or whatever. Are these relationships complicating the issue as well?
Hayleigh Colombo: Absolutely they are, because Nike, these other companies, depending on the school, they're paying a million dollars, multiple million dollars every year, in the form of these deals. And that really, I mean they're important business partners of the university. So it's tricky because it's this symbiotic relationship. What's worth more to the university, the deal being in good standing with Nike or appeasing, some students who know activists regarding sweatshop apparel.
Terry Lipshetz: Right. You had the interview with the worker from Honduras. You referenced the building collapse in Bangladesh. I know your story references a case in Bangkok, Thailand. Also, you have these factories in so many different countries. Is this complicating the situation as well? Because it's not like everybody is working in the same country and they're all making apparel in one place. So how is that complicating the situation?
Hayleigh Colombo: It's incredibly complicated. Honestly, researching this subject, my mind was truly blown about how complex the global supply chain is. I mean thousands of factories are involved. Schools have hundreds of licensees, who each have their own set of factories that they use. So it's really hard to track because it is very hard to know. I spent a lot of time trying to kind of track a specific shirt and find out which factory that shirt was made in. It is so hard to know. It's almost impossible to know. I was going through these importing logs, trying to find these shipments that would give any sort of clue about, okay, this factory had an order that came to the US with Adidas or Nike as the customer and what was in that order? And it'll just say like men's knit tops or something. And it's like, it's very hard to track. Or obviously any shirt that you're buying, it'll say, or piece of apparel that you're buying on the physical tag, it will know made in Honduras, made in Thailand, made in Bangladesh. But it doesn't give any more details, than there's, you know, hundreds, if not more factories in all these countries. So it's just really hard for folks to monitor. It's really hard for universities. I mean universities are not in the business of monitoring factories in Thailand. They're just not. So it's hard to know. And what makes it even more complicated is that brands themselves don't really own their own factories. That's not really a thing. They're all subcontractors. So it's like, okay, these are the hundreds of facilities. That where Nike gear is made. But it's not like these people are employees of Nike or employees of Adidas or Under Armour or whoever. So it makes it really hard to track, and it also makes it really hard for anyone to really, truly accept accountability for what happens in these places. Because the university can say, like, well, this was the brand that we worked with. And the brand can say, well, this is the Subcontractor that we use. and sometimes those subcontractors are their subcontracting out to other factories. So in the case of the Rana Plaza disaster, for instance, some brands were surprised that their gear was being made there. There was like, tags in the rubble and just some horrifying images where you would see this gear, this shirt was made there. And the brands themselves didn't even know because that was a, Subcontractor. Subcontractor was sewing the sleeves or something. And there's just tremendous, with an industry that fragmented, there's tremendous pressure on the factories themselves to have labor costs as low as possible.
Terry Lipshetz: I mean, you don't want to provide excuses for businesses, but in some ways, it's also difficult for them. They can claim like, well, we hired the Subcontractor and they say, we're operating on the up and up. But if they're not doing it because they're not employees of these manufacturers, then it is tougher for them to monitor too.
Hayleigh Colombo: Right? Absolutely, it absolutely is. I think that, advocates would say, well, yeah, it is tough, but it's also brands and retailers who have chosen to organize themselves this way, to chosen to use Subcontractors that they don't track very well. All of this is a choice, and it's a choice that's being made in search of higher and higher profits.
Terry Lipshetz: So what's next? Are you going to continue looking at this story? Are there other angles that you're pursuing?
Hayleigh Colombo: I hope so. Honestly, it's been so fascinating. It's really been so fascinating. I definitely want to keep reporting on it. I think that it's fascinating to see what, if any, solutions people have come up with. So one really fascinating past solution was that there was a fair trade university logo factory. It’s called alta gracias in the Dominican Republic. And universities, for a time being, when Alta Gracia was up and running, they would have displays in the store like, okay, all these people are, earning fair wages. They were like, on average, three times the minimum wage or something like that. They had union collective bargaining rights, they were working in good conditions. And that factory unfortunately, closed after COVID. And so what other that was obviously such a creative solution that it was kind of a private sector solution. And it did appear to make a difference, or at least show that this model could work. it successfully worked for many years, but the COVID pandemic was kind of the nail in the coffin there. In the past, there was an effort to have something called a designated suppliers program where it would really clamp down on the number of factories that did produce university logo gear so that the universities could have a really strong oversight of those factories and what went on there. And that was the solution that a lot of the really involved universities were really hoping for, but that ran into some US. Antitrust issues and never came to fruition. So what's the next, private sector creative solution? Is there government is there ever going to be government intervention to solve this problem, or is this just a problem that we've accepted as a society as kind of the cost of doing business? I hope not, because in the reporting, it became very clear to me people are really suffering for something, as simple as us being like, oh, yeah, I'll pick up a new t shirt, like a new alma mater T shirt. Like, there's really like, there's people who are behind that who are not living good lives, and that doesn't have to be true.
Terry Lipshetz: Well, on that note, Haley, appreciate you coming on today to talk about this and certainly going to think a little bit differently the next time I pick up local apparel from either a, pro or college team. And it does give me something to think about.
Hayleigh Colombo: Absolutely. Thanks so much, Terry.
Terry Lipshetz: We hope you enjoyed this latest episode of behind the Headlines. You can find us on every podcast platform, and we'd love it if you could take a moment to subscribe and leave a review. Finally, if you appreciate what we're doing with this program, we encourage you to invest in local journalism by supporting the newspaper in your community. I'm Terry Lipshetz. Thanking you so much for listening to behind the Headlines from Lee Enterprise.

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