A new monthly survey of business leaders in nine Midwest and Plains states suggests faltering confidence in the region’s economy. After climbing every month since bottoming out in April, the overall index of the Creighton University Mid-America Business Conditions survey fell to 69.0 in November from October’s 70.2. Any score above 50 on the survey’s indexes suggests growth, while a score below 50 suggests recession. Meanwhile, the survey’s confidence index looking ahead six months plummeted 20 points to 50.0 this month from October’s 70.4. The monthly survey covers Arkansas, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma and South Dakota.