The U.S. maternal death rate was 17 per 100,000 live births in 2018—more than double that of other developed countries according to a new report. There is an overall shortage of maternity care providers (including both obstetrician-gynecologists (OBGYNs) and midwives, but midwives in particular) relative to births, the report says. In most other countries, the number of midwives is several times greater than the number of OBGYNs and primary care “plays a central role in the health system.” Maternal deaths in the U.S. frequently occur post-birth, and the United States is the only studied country that does not guarantee access to provider visits or postpartum paid parental leave. Read more.
New Report Finds Nearly Half of All FQHC Patients Qualify for Phase One COVID-19 Vaccinations
For more than five decades, the nation’s community health centers have been a key part of broad scale immunization programs and will play an essential role in COVID-19 vaccination efforts. In a new analysis, researchers from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative estimate that nearly half of all patients served by FQHCs qualify for phase one COVID-19 immunizations, following health care workers, residents of long-term care facilities and other essential workers, under priority guidelines established by the CDC. Health centers are uniquely positioned to reach deeply impoverished, disproportionately minority populations that face elevated health risks for COVID-19. Because of their deep roots in the community, health center clinicians are well positioned to address COVID-19 vaccine hesitancy concerns in historically underserved populations that may not trust the medical establishment, the researchers said. Targeting the highest-risk people and communities for COVID-19 vaccines and ensuring that they are effectively reached is a national public health priority, making FQHCs absolutely essential to a successful vaccine strategy, and funding support for health centers ever more crucial. Read, Nearly Half of Community Health Center Patients – an Estimated 14.1 Million of 29.8 Million People Served – Qualify for Phase One COVID-19 Vaccinations Because They Fall within the CDC’s Highest Risk Categories. Read the press release.
Report: Rural Counties’ Being Reclassified as Urban Can Mask Their Successes
Researchers from Montana say that the well-established narrative about rural decline tells only a part of the story. Looking at the counties that went from rural to urban reveals what propelled growth among some of the rural areas.
Research by Headwaters Economics shows we’ve been measuring rural growth wrong. As rural counties add population, they can grow out of their rural category and take their economic growth with them.
“Rural America is reported as declining in part because we no longer count as Rural those counties that grew into a Metro classification. We are measuring those counties that stay Rural which, by definition, have not grown,” stated the report.
The research showed that 48% of counties that were classified as rural in 1970 grew into metropolitan counties by 2018. But the ones that remained rural had their share of success as well. For example, the average poverty rate in rural counties overall dropped 26% between 1970 and 2018.
The team from Bozeman, Montana found commonalities among counties that switched from rural to urban and among those that remained rural.
While the majority of “switcher” counties are located close to existing cities, they are also more likely to have diversified economies and be home to a university.
2020 Pennsylvania LGBTQ Health Needs Assessment Results Released
The Bradbury Sullivan LGBT Community Center has released the results of the 2020 Pennsylvania LGBTQ Health Needs Assessment. That report, as well as the 2018 statewide report and 2015/16 regional reports, can be accessed at https://livehealthypa.com/lgbt.
The survey instrument utilized was developed in conjunction with the National LGBT Cancer Network. Other localities are able to use the same instrument for free. Simply email info@cancer-network.org for a copy of the tool and for technical assistance on how to conduct a community needs assessment.
Please contact Christina Brasavage at christina@bradburysullivancenter.org with any questions about this project, including requests for additional presentations of data. Christina serves as the point of contact for LGBTQ organizations that would like to request data summaries focused on a particular region or demographic group. Healthcare organizations, government agencies, and academic institutions should contact Jen Keith at jkeith@phmc.org to request the raw data.
Accountable Health Communities (AHC) Model – Two Rural Participants’ Experiences
This Rural Health Value Rural Innovation Profile describes the successes and challenges of two AHCs serving rural populations. The CMS Innovation Center Accountable Health Communities (AHC) Model seeks to identify and address health-related social needs of Medicare, Medicaid, and dual-eligible beneficiaries.
Medical Journal Highlights HRSA Initiatives in Maternal Health
HRSA staff contributed to a recently published special supplement to the Annals of Internal Medicine journal, to focus on evidence-based approaches to reduce maternal mortality and morbidity rates in the United States. Experts at HRSA contributed to the journal articles, which address specific HRSA maternal health initiatives, the impact of opioid use during pregnancy and issues faced by rural populations. External authors include partners from the University of Chicago, Stanford University, University of North Carolina at Chapel Hill, the University of Utah and the World Health Organization.
New Study on Factors that Influence Children’s Healthy Development
The ability of 3- to 5-year-olds to practice self-control is an important developmental milestone predictive of later success. Dr. Reem Ghandour, an epidemiologist with HRSA’s Maternal and Child Health Bureau, collaborated with researchers at the CDC to examine the risks and protective factors that influence this aspect of a child’s development.
The newly published study, Factors Associated with Self-regulation in a Nationally Representative Sample of Children Ages 3–5 Years: United States, 2016, compared the qualities of parents who identify their preschoolers as “on track” to those “not on track” with this developmental skill. Children described as “on track” more often lived in financially and socially advantaged environments and less often experienced family adversity. Only half of children not “on track” received developmental screening and only 25% of children described as “not on track” received educational, mental health, or developmental services.
Learn more about the study, or contact Dr. Reem Ghandour.
HRSA Announces Highest HIV Viral Suppression Rate in New Ryan White HIV/AIDS Program Client-Level Data Report
A new report from HRSA released this week shows that clients receiving Ryan White HIV/AIDS Program medical care were virally suppressed at a record level – 88.1 percent – in 2019.
This means people with HIV who take medication daily as prescribed and reach and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner. Led by HRSA’s HIV/AIDS Bureau, the Ryan White HIV/AIDS Program Annual Client-Level Data Report, 2019, is the sixth annual publication of national client-level data from the Ryan White HIV/AIDS Program Services Report (RSR).
The RSR is HRSA HIV/AIDS Bureau’s primary source of annual, client-level data reported by more than 2,000 funded Ryan White HIV/AIDS Program recipients and subrecipients across the United States. The publication provides an in-depth look at demographic and socioeconomic factors among program clients served, including age, race/ethnicity, transmission risk category, federal poverty level, health care coverage and housing status. The report also assesses the demographics of those receiving services and highlights the progress and disparities in HIV-related outcomes – particularly viral suppression.
Survey Shows Dentists Are Receptive to Teledentistry
Telehealth has become a path to provide safe, efficient, and accessible dental care during the COVID-19 pandemic. A survey of nearly 3,000 dentists conducted by the DentaQuest Partnership reveals that the oral health care system is ready to implement teledentistry as a viable tool to deliver preventative care, not only during the pandemic, but long-term. The results can be narrowed down by teledentistry usage type, state, financial considerations, and opportunities for growth.
Journal of Appalachian Health: Volume 2, Issue 4 Available NOW!
Commentary
Rural Community Toolbox to Help Battle Opioid Epidemic, Liz Carey
Advancing Cancer Prevention Practice Facilitation Work in Rural Primary Care During COVID-19, Dannell Boatman, Susan Eason, Mary E. Conn, Summer Miller, & Stephenie Kennedy-Rea
COVID-19 and Opioid Use in Appalachian Kentucky: Challenges and Silver Linings, Rachel Vickers-Smith, Hannah L.F. Cooper, & April M. Young
Research Articles
Improving Access to Treatment for Opioid Use Disorder in High-Need Areas: The Role of HRSA Health Centers, Michael Topmiller, Jennifer Rankin, Jessica L. McCann, Jene Grandmont, David Grolling, Mark Carrozza, Hank Hoang, Josh Bolton, & Alek Sripipatana
In Their Own Words: How Opioids Have Impacted the Lives of “Everyday” People Living in Appalachia , Patricia Nola Eugene Roberson, Gina Cortez, Laura H. Trull, & Katherine Allison Lenger
Qualitative Analysis of Maternal Barriers and Perceptions to Participation in a Federal Supplemental Nutrition Program in Rural Appalachian North Carolina , Sydeena E. Isaacs, Lenka H. Shriver, & Lauren Haldeman
Leveraging Electronic Health Records Data for Enhanced Colorectal Cancer Screening Efforts, Adam D. Baus, Lauren E. Wright, Stephenie Kennedy-Rea, Mary E. Conn, Susan Eason, Dannell Boatman, Cecil Pollard, Andrea Calkins, & Divya Gadde
Review & Special Articles
The Landscape of Connected Cancer Symptom Management in Rural America: A Narrative Review of Opportunities for Launching Connected Health Interventions , Ming-Yuan Chih, Anna McCowan, Sadie Whittaker, Melinda Krakow, David K. Ahern, Eliah Aronoff-Spencer, Bradford W. Hesse, Timothy W. Mullett, & Robin C. Vanderpool
Media Reviews & Reports
Review of: From the Front Lines of the Appalachian Addiction Crisis Healthcare Providers Discuss Opioids, Meth and Recovery , Carl G. Leukefeld
Notes from the Field
Rural Appalachia Battling the Intersection of Two Crises: COVID-19 and Substance Use Disorders, Margaret Miller, Rebekah Rollston, Kate E. Beatty, & Michael Melt