Category Archives: Rural Health
Young Adult Smoking Rates Fell in 2012
A recent survey from the National Institute on Drug Abuse finds that youth smoking rates fell in 2012 among eighth, tenth and twelfth graders. This is the second year in a row that the survey found a significant annual decline in youth smoking, following several years during which progress on getting more young people to quit had stalled.
According to the Campaign for Tobacco Free Kids, strategies that led to the lower smoking levels include higher tobacco taxes, well-funded tobacco prevention and cessation programs that include mass media campaigns, strong smoke-free laws, and effective regulation of tobacco products and marketing.
Rural Residents Less Likely to Follow Colon Cancer Screening Guidelines
A new study from the University of Utah finds that people who live in rural communities are less likely to follow colorectal cancer screening recommendations than urban residents. The researchers say the geographic disparity is evident across all risk groups, including those who have a family history of the disease. The study was published in the journal Clinical Gastroenterology and Hepatology.
The researchers looked at data from the Behavior Risk Factor Surveillance System, a set of telephone surveys coordinated by the Centers for Disease Control and state health departments. Factors that impact screening, according to the researchers include distance to screening facilities, fewer rural residents are covered by health insurance for colorectal screening (the researchers note that this is likely to be improved under the Affordable Care Act) and rural residents are less likely to receive a recommendation for screening from a health care provider because there are fewer primary care providers in rural areas, and those providers are under time constraints.
A new policy brief from the George Washington University school of Public Health and Health Services in Washington, DC finds that low wage workers are especially vulnerable to financial troubles that can result from on-the-job injuries and illnesses.
The researchers calculated that in 2010 1.6 million low wage earners suffered from non-fatal injuries, and 87,857 developed non-fatal occupational health problems such as asthma and found that workers compensation insurance either does not apply or fails to cover many expenses, which can bankrupt families with no financial cushion. According to the brief, insurers cover less than one-fourth of the costs of occupational injuries and illnesses. The rest falls on workers’ families, non-workers-compensation health insurers, and taxpayer-funded programs like Medicaid. The researchers say policy makers need to improve workplace safety and strengthen the safety net for low wage workers.
Next week, young farm-workers from across the country will share their stories with officials and advocates in Washington, D.C., to discuss the challenges they face working in the fields from a very young age. The youth-led and youth-organized conference will also highlight communities that are working to empower farm-worker youth to achieve healthier lives. The topics of the conference were chosen by the participating youth as the most important issues in their lives:
- Health – Pesticide exposure, the effects of working in extreme weather conditions, safety issues in work with heavy machinery, the toll the job takes on one’s body, and drugs and alcohol as coping mechanisms
- Work in the Fields – Wages, sexual assault in the fields and health issues that result from being in the fields
- Housing – The stress of migrating during the harvest, and the problems unaccompanied youth face when migrating
- Education – Barriers that migrant farm-worker youth face in finishing school, programs in place to help many farm-worker youth reach their educational goals
The event, hosted and organized by the Association of Farmworker Opportunity Programs, will take place on April 26 to April 27. Learn more about and register for the event. Registration is now free, and anyone interested in attending can email firstname.lastname@example.org.
Happy Valentine's Day! Check out #healthpolicyvalentine on Twitter for a smile.
The American Public Health Association released a statement on the current budget proposal for fiscal year 2013, released yesterday, saying it shortchanges key federal programs that protect public health and prevent the leading causes of premature death and disability in the U.S.
"APHA recognizes today’s tough economic environment, but in the midst of fundamentally transforming our nation’s health system to emphasize disease prevention and wellness, now is not the time to underinvest in our already underfunded, overburdened public health system," said APHA executive director, Georges Benjamin.
Dr. Benjamin said that with the proposed $664 million in cuts to the Centers for Disease Control and Prevention, the agency will have seen its budget authority slashed by $1.4 billion since fiscal year 2010, a more than 20 percent reduction. In addition, the Prevention and Public Health Fund established under the Affordable Care Act is slated for additional cuts of more than $4 billion over ten years. Read more on public health laws and policies.
The National Health Service Corps has awarded $9.1 million in funding to fourth-year medical students in 30 States and the District of Columbia. The doctors chosen will serve as primary care doctors and help strengthen the health care workforce. The program, administered by the Health Resource Services Administration provides financial support to students who are committed to a career in primary care in exchange for their service in communities with limited access to care. The students will provide three years of full-time service or six years of half-time service in rural and urban areas of greatest need. Read more on rural health.
Smoking bans in public places, such as offices and restaurants, result in less smoking at home as well, according to a new study in the journal Tobacco Control. The study was conducted in four European countries and found that after smoke-free legislation was enacted, the percentage of smokers who banned smoking at home rose by 25 percent in Ireland, 17 percent in France, 38 percent in Germany and 28 percent in the Netherlands, according to the study.
According to the study, home smoking bans were more likely to be adopted when the smoker planned to quit the habit, when there was a birth of a child, and when the smoker was someone who had expressed support for a smoking ban in bars. Read up on tobacco policy and prevention news.
The New York Times and other news sources are reporting that Methotrexate, a critical medicine to treat childhood leukemia is in such short supply that hospitals across the country may run out of the drug within the next two weeks. That would leave hundreds to thousands of children at risk of dying. A key source of the shortage is that Ben Venue Laboratories was one of the nation’s largest suppliers of the drug but the company voluntarily suspended operations at its plant in Bedford, Ohio, in November because of manufacturing and quality concerns. Methotrexate is also used to treat rheumatoid arthritis. Read more on cancer.
A new blog post from the Network for Public Health Law presents the dual public health challenges of seniors driving past the time they should be and the hardships posed when seniors need to get around without their cars. The concern is significant. Studies show that seniors are involved in more fatal car accidents than any other driving age group, and many of the accidents are the results of age-related impairments such as declines in vision and cognition abilities, and increased use of medications.
Because state laws vary, the Network offers legislative proposals for states to consider—as well as the pros and cons for each—such as physician reporting on a senior’s eligibility to drive and restricting driving based solely on age.
The Network’s post offers a link to a helpful AARP article with suggestions for transportation alternatives for seniors who may not be able to drive a car of their own. Here are some others from Peter Notarstefano, director of home and community-based services at Leading Age, formerly the American Association of Homes and Services for the Aging.
- Most states have a dial-in service, usually through the area's Agency on Aging or Department of Social Services; most states also have a dial-in service to connect senior Medicaid recipients with a ride to a Medicaid appointment. There may be limitations on times and days.
- Social Service Block grants and Older Americans Act funding through the local area Agency on Aging will provide transportation to grocery shopping and medical appointments for seniors for free or at a low cost.
- Local municipalities at times have transportation programs for older adults. Check here to find out a source of transportation for seniors in your area.
>>Read the post from the Network for Public Health Law.
Weigh In: Does your community have an effective system to help seniors get around without driving their own cars?
A new study in the Annals of Family Medicine finds that patients without insurance are more likely to be discharged from the hospital sooner than patients with insurance, regardless of the underlying medical condition. Read more on access to health care.
The U.S. Department of Agriculture (USDA) has announced funding for telephone utilities to build, expand and improve broadband in rural service territories across 15 states. “[The] funding will provide residents of these rural communities with high speed internet connections to improve healthcare and educational opportunities and connect to global markets," said Agriculture Secretary Tom Vilsack. Read up on rural health.
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) is encouraging major retail employers to take precautions to prevent worker injuries during Black Friday and other major sales events during the holiday season.
In 2008, a worker was trampled to death while a mob of shoppers rushed through the doors of a large store to take advantage of an after-Thanksgiving Day Black Friday sales event. Read a recent Q&A with OSHA's Assistant Secretary of Labor, David Michaels, on workplace safety.
Children in rural areas are likely to face different challenges to their health and have less access to care compared with children in urban areas, according to a new report from the Health Resources and Services Administration (HRSA). The report, based on a survey of parents, finds greater prevalence of certain physical, emotional, behavioral and developmental conditions in rural areas.
- Children living in rural areas are more likely to have public insurance, such as Medicaid or the Children’s Health Insurance Program, while urban children are more likely to be privately insured.
- The percentage of children with chronic conditions such as obesity, asthma and diabetes is highest amongst teenagers living in small rural areas.
Read more on rural health.
Researchers from the University of Iowa College of Public Health recently published a study that found that women in rural areas are at greater risk of intimate partner violence, higher rates of HPV and severity of physical abuse than women in urban areas. The researchers, who published their findings in the Journal of Women’s Health, also found that more than 25% of women in rural and isolated areas were more than 40 miles from the closest abuse assistance services, compared with less than 1 percent of urban women.
A new study in the New England Journal of Medicine finds that as many as forty percent of people with asthma may not respond to inhaled steroids because of genetic differences that impact their response to the drugs. For those with a genetic predisposition to uncontrolled asthma, management of environmental risks and triggers may be even more important.
A new study in the journal Diabetes Care finds that years of life spent dealing with diabetes has increased since the 1980s for men and women who are obese. On average, obese men now have 5.6 more years of life with the disease; obese women have 2.5 more years.
A new study in the American Journal of Public Health finds that in recent years, there has been an increase in the number of young adults who report mental health disabilities, but also an increase in the number of people not seeking medical attention for mental health concerns, because of cost concerns.
The Department of Agriculture has awarded $103 million in funding for 23 projects to provide broadband services to unserved and underserved rural communities. Funding recipients include areas in Oklahoma damaged by a tornado earlier this year. "These loans and grants will bring the benefits of broadband, including new educational, business and public health and safety opportunities, to residents living in some of the most remote parts of [the U.S.],” said USDA Secretary Tom Vilsack.
A new study in the American Journal of Public Health finds that hookah, a water pipe used to smoke tobacco, is on the rise in California. Study results showed that from 2005 to 2008, hookah use among all adults increased by more than 40 percent; by 2008, hookah use in California was much higher among young adults – 24.5 percent among men, 10 percent among women – than it was among all adults – 11.2 percent among men, 2.8 percent among women.
A new study in the journal Cancer finds that that a decline in hormone therapy use, and therefore doctor visits, among women aged 50 to 64 years is linked with lower mammogram rates in that age group as well.
By implementing smoke-free rules throughout properties, owners of California multi-unit rental buildings could save up to $18 million a year statewide on the cost of cleaning apartments vacated by tenants who smoke, according to a new UCLA study.
More than 90 percent of heart attack patients who require an emergency artery-opening procedure known as angioplasty are treated within the recommended 90 minutes, compared to less than half five years before, according to a new study in the journal Circulation.
We often hear about food deserts – low-income communities that lack ready access to healthy food – and think about urban areas, which are far-removed from the farms and orchards that grow the food. But according to a new report, issues of access and cost can be just as acute for rural residents, who often are not getting the fruits and vegetables they need to be healthy.
An article from CaliforniaWatch.org discusses research that found that rural residents eat less produce than their city-dwelling counterparts, in spite of living closer to where food is grown, in nearly 40 U.S. states. The article notes that California is among the states where rural residents are falling short of the recommended fruit and vegetable intake. More than 2.8 million California residents live in rural areas, and just 22.9 percent of the adults in these areas are getting enough produce. For rural residents, stores that sell produce are often few and far between, and prices are high.
The research comes from a new report from the Essentia Institute of Rural Health, which analyzed 2009 Behavioral Risk Factor Surveillance Survey data and mapped prevalence differences by state.
Read the full story here.
For more on food deserts and potential solutions, take a look at this interview with the founder of a mobile grocery truck for Native American communities in New Mexico.
Michael Meit, M.A., M.P.H., Program Area Director, Public Health Research Department, National Opinion Research Center (NORC) at the University of Chicago, led a session at the recent National Association of County and City Health Officials annual conference on areas under-served by local public health departments, with a focus on rural communities.
NewPublicHealth spoke with Michael Meit, who also serves as the Co-Director of the NORC Walsh Center for Rural Health Analysis, on how to address public health challenges for rural communities, including infrastructure issues, budget concerns and sheer distance between residents and services.
NewPublicHealth: How complete a picture do we have on the rural public health infrastructure?
Michael Meit: I think it’s helpful to understand the historical perspective behind the development of health departments. In rural jurisdictions, they developed about 100 years later than they did in urban jurisdictions and perhaps because of that late start many communities never fully developed and many communities were left with areas of under-service.
And when we talk about that under-service, we’re talking about fewer available dollars, fewer staff, less training, less technological capacity, and typically, a smaller array of public health services that are provided. The main data source that we have to compare rural health departments to non-rural health departments is the NACCHO National Profile of Local Health Departments [a survey of the nation’s nearly 3,000 local health departments on how they operate and what services they provide]. The report shows very clearly that rural health departments as a whole have less capacity – but it’s important to remember that the NACCHO profile looks at areas that have local health departments, while there are many communities that really don’t. The profile is the good news – the positive story about public health. But many areas that don’t have local health departments probably are doing worse than those communities in the NACCHO profile.
NPH: What are some of the key challenges that rural communities face in providing public health services?