Dental care and medical care have long been provided separately in America. New research and evolving models of care are challenging that traditional gap.
Chronic diseases are responsible for billions of dollars in health care costs and millions of deaths each year. Dental office screenings for diabetes, as well as other common conditions such as high cholesterol and hypertension could save the nation’s health care system as much as $102.6 million annually, researchers from the American Dental Association’s Health Policy Resources Center concluded in a study published in the American Journal of Public Health.
In this new tip sheet, Mary Otto explains some of the screenings and interventions that may be coming to a dentist’s chair near you, as well as some of the question around providing such care.
All family caregivers face struggle to provide appropriate care to their loved ones, while balancing work, other family obligations and managing stress. Latino caregivers must also overcome other barriers, including language, cultural expectations within the Hispanic community, to jobs that may not provide necessary flexibility.
According to the National Hispanic Council on Aging, one-third of Hispanic households report having at least one family caregiver (36 percent). They estimate there are at least 8.1 million Hispanic family caregivers in the U.S. Almost three-quarters (74 percent) of these caregivers are female, with an average age of 42. They provide more intensive, higher-burden caregiving, help with more activities of daily living, and more frequently live with their loved one than do their non-Hispanic, White counterparts. Yet, half (50 percent) of the caregivers rate their experiences as less stressful than do white caregivers.
Chronic diseases like diabetes affect twice as many Hispanics as non-Hispanics, especially Hispanic elders. However studies show minority caregivers tend to use substantially fewer formal support services than their non-Hispanic white counterparts. Focus groups conducted with racially and ethnically diverse caregivers found that “familism, a primary value of Latino cultures, is often cited as a motivating factor for providing care, including the expectation that extended family will assist with the care of older relatives.” Continue reading
Sometimes it’s difficult to get a handle on major health determinants in your community, and it’s even harder to make them come alive in a story. Straightforward statistics can be dry or intimidating, while percentages and frequencies might fail to resonate.
So how can you give your readers, viewers or listeners a little extra background information without boring them to sleep? Interactive atlases are an effective way to do this – they can provide stories with both images and some enriched perspective. November is National Diabetes Awareness Month, and mapping tools like the CDC Diabetes Atlas provide a visual representation of diabetes in the U.S. The Diabetes Atlas helps to illustrate both diabetes and its many determinants using four indicators:
- Diagnosed diabetes
- Diagnosed diabetes incidence
- Leisure-time physical inactivity
People with diabetes in the lowest income neighborhoods of California were 10 times more likely to lose lower extremities to amputation than people with diabetes in the highest income neighborhoods, according to a new paper published in Health Affairs.
Many news outlets covered the story, but none that I read provided much context beyond repeating what the Health Affairs paper had to say, which is a shame because there’s a lot to report. Most ignored the disturbing racial disparity in amputation rates. (HealthDay News did note the study’s finding that less than 6 percent of diabetics in California are black, but they account for about 13 percent of amputations.)
The study authors mapped hot spots of diabetic amputation in Los Angeles and across California, where rates varied from less than one to more than 10 amputations per 1,000 people age 45 and older with diabetes in 2009. Continue reading
The U.S. Preventive Services Task Force just released a recommendation that pregnant women be screened for gestational diabetes, even if they have not been previously diagnosed with type 1 or 2 diabetes.
The task force often finds itself in the news when determining what works and doesn’t work in screenings and preventive care.
Previously, it told healthy women not to bother with calcium and vitamin D pills, said many women could wait on mammograms until age 50 and recently clarified who might benefit from regular lung cancer screening tests. The task force’s work lies in translating medical evidence into clinical practice, which can be a difficult and contentious task. Its recommendations are often nuanced and misunderstood.
How does the group come to these determinations and how can you report on the science and not just the heat a recommendation generates? What is evidence-based medicine and how does the USPSTF use it to make recommendations on health care services?
In a Jan. 28 webcast, USPSTF chair Dr. Virginia Moyer and co-vice chair Dr. Michael LeFevre will explain how the task force works in an effort to deepen our reporting of upcoming task force recommendations. A Q&A with the doctors, moderated by AHCJ medical studies topic leader Brenda Goodman, will follow. Continue reading
It’s easy to blame disadvantaged people for engaging in behaviors that put them at risk for developing diabetes.
Rhiannon Meyers, a reporter at The (Corpus Christi, Texas) Caller-Times, says that “Over and over again, I heard doctors blame our region’s high rates of diabetes and related complications on noncompliant patients unwilling to make the necessary changes to get healthy,” while she was reporting “Cost of Diabetes.”
But Meyers delved deeper and found there were environmental and social forces that contribute to higher rates of unhealthy behavior and illness. In the latest “Shared Wisdom,” she explains: Continue reading
Journalists can do better educating the public about health reform and our system of health care, according to Noam Levey, a national health care reporter with the Los Angeles Times/Tribune Washington Bureau.
In the Journal of the American Medical Association, Levey offers some specific suggestions for improving public understanding of health policy, including presenting information in question-and-answer pieces, presenting issues in a less political context and relying on trusted sources rather than politicians. Continue reading
Recent updates to AHCJ’s oral health core curriculum pages include explanations of home care and prevention of gum disease, including some information about what kind of toothbrush your readers, viewers and listeners should be using.
There also are new links to resources on oral health and diabetes and a new report about how many children covered by Medicaid are getting dental care in each state.
In the coming days, watch for a tip sheet about the associations between periodontal disease and diabetes. Together, the diseases affect millions.
Using community health workers to work with frequent emergency room visitors is showing some success in reducing ER use.
The latest installment of “Cost of Diabetes,” a yearlong series by Rhiannon Meyers of the Corpus Christi (Texas) Caller-Times, looks at what Rhode Island is doing to help prevent and manage diabetes.
A “Communities of Care” program pairs peer navigators, who are community health workers, with Medicaid patients who are seen in an emergency room four or more times in a year. The peer navigators “try to figure out why [the patients] keep going to the emergency room and help them access resources they need, from housing to transportation to doctors’ appointments. The peer navigators also continuously check in with patients to make sure they are seeing the doctor as needed and taking their prescriptions to avoid unnecessary hospitalizations.”
Officials at UnitedHealthcare, which contracts with Rhode Island Medicaid, say they’ve seen a 30 percent decrease in ER use and have possibly saved up to $600,000, according to preliminary results. And those results are prompting people to look at the program as a model, said Dr. Rene Rulin, medical director of Rhode Island Medicaid at UnitedHealthcare.
(Hat tip to Keldy Ortiz.)
Using technology in health care to interact with people certainly opens up new avenues of communication and yields more data than ever. The intriguing question of whether and to what degree such interactions actually influence health behavior and improve health remains to be answered. Panelists in a Health Journalism 2013 session on the topic shared their highly varied experiences in applying technologies and social media tools to address specific concerns.
To reduce hospital readmissions by ensuring that patients know what to do when they go home,. Brian Jack, M.D., chair of family medicine at Boston University School of Medicine Boston, created an interactive tool for patients as part an initiative called Project RED or Project Re-Engineered Discharge. Virtual patient advocates interact with patients at their bedside on a touch screen, reviewing discharge information to prepare patients, then confirming their understanding by asking questions. Patients express near unanimous satisfaction with the tool, finding it easy to use even for those who have never used a computer.
Project RED also introduced a checklist for hospitals to use with elements known to reduce readmissions, such as identifying correct medications and a plan for taking them, as well as an after-hospital care plan and color-coded calendar that patients and families love. Continue reading