Economic Impact of a Bad Smile Estimated at $27 Million

An article in the Journal of Public Health Dentistry describes the impact improving oral health could have on employability. Dr. Halasa-Rappel, PhD and her co-authors used the National Health and Nutritional Examination Survey to develop a Dental Problem Index (DPI) to quantify the impact of dental caries and missing anterior teeth on employment, and estimate the impact of a routine dental visit on the health of anterior teeth and the benefits of expanding dental coverage for non-elderly adults. They found that a routine dental visit has a negative impact on the DPI and improves the probability of employment and estimated that improvement in dental coverage would improve the employability of 9,972 non-elderly adults with an associated annual fiscal impact of $27 million.

ARC’s Chartbook a Data Destination for Appalachia

What percentage of homes in West Virginia are owner-occupied? What percent of households in Appalachian Pennsylvania have access to a vehicle? How many households in Appalachian Tennessee have a computer or laptop? What is the labor participation rate in Appalachian South Carolina?

These are only a few of the more than  300,000 data points offered in the The Appalachian Region: A Data Overview from the 2013–2017 American Community Survey, also known as The Chartbook, which was released this week. Drawing from the American Community Survey and comparable Census Population Estimates, The Chartbook offers statistics on demographics, income, employment, as well as education, computer access, housing, and transportation and other indicators—all presented at the regional, subregional, state, and county level with comparisons to the rest of the nation. The Chartbook also examines data change over recent years to show trends.  For instance, Appalachia’s median household income is now 83% of the U.S. rate, up from 80% between 2012-2016, and all diploma and degree  rates – including high school, associate’s degree, and bachelor’s degrees – are rising across the Region.

“These patterns suggest that the pace of economic recovery since the Great Recession has varied across the Region, but the counties that saw increases in median household income are also those with higher levels of education and labor force participation, and lower levels of unemployment,” said report coauthor Linda A. Jacobsen, Population Reference Bureau’s vice president for U.S. Programs who helped spearhead the project on behalf of ARC.

2018 Sub-County Population Estimates

Estimates of the population for sub-county geographies (municipalities) as of July 1, 2018 have been today by the U.S. Census Bureau. A look at Pennsylvania’s cities shows that Philadelphia had the highest numeric increase since 2010, adding over 58,000 persons. Erie had the highest numeric decrease, losing over 5,000 persons during the same time.

How did other cities fare? And how did Pennsylvania’s boroughs and townships hold up? Click here to read the full brief.


AAMC Releases Report on Physician Shortage

The American Association of Medical Colleges (AAMC) has released the AAMC Report on Physician Shortage,  its annual report on workforce shortages for health care across the nation. This year’s report projects a primary care physician shortage of 21,100 to 55,200 physicians by 2032. The shortfall range reflects the projected rapid growth in the supply of advance practice RNs and physician assistants and their role in care delivery, trends that might strengthen the nation’s primary care foundation and improve access to preventive care. The projection is based on an estimate by the Health Resources and Services Administration that nearly 14,472 primary care physicians are needed to remove the primary care shortage designation from all currently designated shortage areas. Causes of the shortfall include increasing demand from an aging population, expected retirements of many aging physicians, shorter work hours demanded by today’s physician workforce, and the growth in demand from striving to meet population health goals.

New Report Examines Financial Health of Pennsylvania Hospitals

The Pennsylvania Health Care Cost Containment Council (PHC4), the independent state agency that collects and analyzes comparative information on healthcare organizations, has released its latest report on hospitals. PHC4 Executive Director Joe Martin noted the report shows Pennsylvania general acute care hospitals’ uncompensated care again decreased, as it has in each of the past five years, to $750 million in fiscal year 2018 from $766 million the previous year. The decline can be tied to provisions in the Affordable Care Act that improve access to health insurance, particularly for those unable to get coverage at their place of employment.  The independent state agency’s study also showed the statewide average operating margin for hospitals decreased to 4.76% from 5.15% during the same time period.

New Brief Comparing Characteristics of Communities served by Critical Access Hospitals

The Flex Monitoring Team has published a new brief comparing the characteristics of communities served by Critical Access Hospitals (CAHs) predicted to be at high risk of financial distress to communities served by all other CAHs. Using data from 2017, the Financial Distress Index (FDI) model assigns CAHs to high, mid-high, mid-low, or low predicted risk levels for 2019 using Medicare cost reports and Neilsen-Claritas data summed to market areas.

CAHs predicted to be at high risk of financial distress were found to serve communities with significantly higher percentages of non-White individuals (Black individuals in particular), lower high school graduation rates, higher unemployment rates, and worse health status.

Opportunities to Advance Complex Care in Rural and Frontier Areas

People with complex care needs who live in rural communities face many of the same challenges experienced by individuals in urban areas, such as lack of transportation and food insecurity. However, rural communities are not just scaled-down cities. Despite facing similar challenges to patients living in urban areas, individuals with complex needs in rural areas often face additional hurdles caused by lack of infrastructure and geographic distances, making many high-touch complex care interventions difficult — if not impossible — to implement.

This brief, made possible through the Robert Wood Johnson Foundation, explores challenges associated with providing complex care in rural and frontier communities and outlines opportunities to ensure effective programs. Drawing from experts across the country, it summarizes strategies to improve complex care delivery in rural areas and provides examples of rural communities that are enhancing care delivery through workforce adaptations, technology innovations, tailored patient engagement tactics, and new payment models and funding streams.

The brief can be accessed at

Report Released on Preventive Health Service Use Among Rural Women

This study from the Maine Rural Health Research Center examined receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and vaccination for the human papillomavirus, also known as HPV) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services.  The report can be accessed at

Reports Released on Trends and Geographic Variation of Hospitals at Risk of Financial Distress

This week, the Rural Health Research Gateway released three policy briefs with the most up-to-date data on factors contributing to rural hospital closures.  The producer of these briefs, the North Carolina Rural Health Research Center, keeps track of rural hospital closures and counts 104 since January 2010.  The reports can be accessed at