Kentucky is rarely considered part of the Midwest, although it can be grouped with it in some contexts. It is categorized as Southern by the Census Bureau and is usually classified as such, especially from a cultural standpoint. In addition to intra-American regional overlaps, the Upper Peninsula of Michigan has historically had strong cultural ties to Canada, partly as a result of early settlement by French Canadians. Moreover, the Yooper accent shares some traits with Canadian English, further demonstrating transnational cultural connections. Similar but less pronounced mutual Canadian-American cultural influence occurs throughout the Great Lakes region. The accents of the region are generally distinct from those of the South and of the urban areas of the American Northeast. To a lesser degree, they are also distinct from the accent of the American West. The accent characteristic of most of the Midwest is popularly considered to be that of "standard" American English or General American. This accent is typically preferred by many national radio and television producers. Linguist Thomas Bonfiglio argues that, "American English pronunciation standardized as 'network standard' or, informally, 'Midwestern' in the 20th century." He identifies radio as the chief factor. Currently, many cities in the Great Lakes region are undergoing the Northern cities vowel shift away from the standard pronunciation of vowels. The dialect of Minnesota, western Wisconsin, much of North Dakota and Michigan's Upper Peninsula is referred to as the Upper Midwestern Dialect (or "Minnesotan"), and has Scandinavian and Canadian influences. Missouri has elements of three dialects, specifically: Northern Midland, in the extreme northern part of the state, with a distinctive variation in St. Louis and the surrounding area; Southern Midland, in the majority of the state; and Southern, in the southwestern and southeastern parts of the state, with a bulge extending north in the central part, to include approximately the southern one-third. The rate of potentially preventable hospital discharges in the Midwestern United States fell from 2005 to 2011 for overall conditions, acute conditions, and chronic conditions. All cities listed have a population of 250,000 or more. The Midwest has been an important region in national elections, with highly contested elections in closely divided states often deciding the national result. In 1860–1920, both parties often selected either their president or vice president from the region. One of the two major political parties in the United States, the Republican Party, originated in the Midwest in the 1850s; Ripon, Wisconsin had the first local meeting while Jackson, Michigan had the state county meeting of the new party.