The federal government must aggressively bolster primary care and connect more Americans with a dedicated source of care, the National Academies of Sciences, Engineering and Medicine warn in a new major report that sounds the alarm about an endangered foundation of the U.S. health system. The urgently worded report calls for a broad recognition that primary care is a “common good” akin to public education. The plan’s five objectives are:

• Pay for primary care teams to care for people, not doctors to deliver services.
• Ensure that high-quality primary care is available to every individual and family in every community.
• Train primary care teams where people live and work.
• Design information technology that serves the patient, family and interprofessional care team.
• Ensure that high-quality primary care is implemented in the United States.

The authors recommend that all Americans select a primary care provider or be assigned one, a landmark step that could reorient how care is delivered in the nation’s fragmented medical system. And the report calls on major government health plans such as Medicare and Medicaid to shift money to primary care and away from the medical specialties that have long commanded the biggest fees in the U.S. system. Currently, only about five percent of U.S. health care spending goes to primary care, versus an average of 14 percent in other wealthy nations, according to data collected by the Organization for Economic Cooperation and Development. Read more.

Public health in the rural United States is a complex and underfunded enterprise. While urban–rural disparities have been a focus for researchers and policymakers alike for decades, inequalities continue to grow. Life expectancy at birth is now 1 to 2 years greater between wealthier urban and rural counties, and is as much as 5 years, on average, between wealthy and poor counties. This recent article published in the American Journal of Public Health explores the growth in these disparities over the past 40 years and offers 5 population-based “prescriptions” for supporting rural public health in the United States.  Read More.

An article published in Medscape explores rising vaccination rates among young adults in the United States. Although vaccination rates against the human papillomavirus (HPV) remain low for young adults, the number of self-reported HPV vaccinations among women and men between the ages of 18 and 21 years has increased since 2010, according to new research findings.

Click here to read the article.

The U.S. Preventive Services Task Force released a final recommendation statement on screening for hypertension in adults. The Task Force recommends that clinicians screen all adults for hypertension. View the recommendation, the evidence on which it is based, and a summary for clinicians, here. The final recommendation statement can also be found in the April 27, 2021, online issue of JAMA.

By Liz Carey

The research found that more units are being closed in counties with majority non-white populations. The closures tend to affect small hospitals, often designated as Critical Access Hospitals, more often.
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The Pennsylvania Department of Agriculture, working with TeamPA and Econsult, has produced the second study detailing the economic impact of agriculture in Pennsylvania.  Results show that agriculture contributes $132.5B to the state’s economy and remains a top industry, ranging from farm production to processing to feeding our families.

The report can be accessed at TeamPA_Agriculture2020EISUpdate_FINAL

ural America is economically, socially, culturally, geographically, and demographically diverse. This multidimensional diversity presents complex challenges and unique opportunities related to delivering health care and improving health outcomes and health equity in rural communities.

To explore issues related to population health in rural America, the Roundtable on Population Health Improvement of the Board on Population Health and Public Health Practice of the National Academies of Sciences, Engineering, and Medicine convened a public virtual workshop, “Population Health in Rural America in 2020” on June 24–25, 2020. The workshop planning committee was composed of rural health experts representing public health, health care, and tribal health. Presentations and discussions focused on rural America in context, rural health vital signs, rural health care in action, assessment and implementation strategies for improving the health and health equity in rural populations, and rural health policy.

This Proceedings of a Workshop summarizes the presentations and discussions from the workshop.

Download the publication here.

The White House Interagency Working Group on Coal and Power Plant Communities and Economic Revitalization delivered a report  to President Biden with their initial recommendations  to catalyze economic development and create good-paying jobs in hard-hit energy communities across the country. ARC ‘s participation in this working group enabled the organization to provide a voice for Appalachia and strengthen partnerships with other federal agencies to maximize the resources available to coal-impacted communities.

The report identified an array of existing federal funding opportunities that could be accessed by energy communities to support community revitalization efforts. ARC’s POWER (Partnerships for Opportunity and Workforce and Economic Revitalization) Initiative, which targets federal resources to help communities affected by job losses in coal mining, coal power plant operations, and coal-related supply chain industries, is highlighted in the report. POWER has invested $238 million in 293 projects touching 353 coal-impacted communities since 2015.

The report also identifies 25 specific communities that are most directly impacted by changes in the energy economy—eight of those are in Appalachia, covering 84 counties. The Appalachian communities on this list are:

• Southern West Virginia non-metropolitan area
• East Kentucky non-metropolitan area
• Wheeling, West Virginia -Ohio
• Southwest Virginia non-metropolitan area
• Northern West Virginia non-metropolitan area
• Beckley, West Virginia
• Charleston, West Virginia
• Western Pennsylvania non-metropolitan area

This ranking helps identify areas that are most vulnerable to additional near-term coal mine and power plant closures.

Access the report and fact sheet to learn more. For more background on the economic impact of energy transitions, access ARC’s report An Overview of Coal and the Economy in Appalachia.