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The greatest public health problem is not heart disease. It’s not cancer. And it’s not mental health.
It’s inequality. That’s according to a Canadian health policy analyst quoted by André Picard in a notable series in the Toronto-based newspaper The Globe and Mail.
The Globe‘s Wealth Paradox series, published over two weeks in November, explores how Canada’s increasing wealth gap is reshaping society and putting future generations at a disadvantage. The Globe being a business newspaper, the series makes a business case for taking the threat seriously. It’s full of story ideas that can be transposed onto U.S. turf.
Picard’s piece, Wealth begets health: Why universal medical care only goes so far, dug into the heavy health impact of income inequality despite Canada’s longstanding provision of medical care to all: Continue reading
Dozens of news stories over the past year have reported on the disturbing data showing that Americans are dying younger than people in other wealthy countries and falling behind in many other measures of population health.
But much of the reporting I’ve seen shies away from covering a crucial part of the story: How social inequality may be the most important reason why the health status of Americans is failing to keep up with progress elsewhere.
Being born into poverty, growing up with curtailed opportunities for education and employment, living in a disadvantaged neighborhood – these social determinants of health are like the cards you’re dealt in a game of poker. It’s hard to win if the deck is stacked against you.
Researchers in sociology and public health have developed a fair amount of evidence that social status (typically measured by income or education) may be the most significant shaper of health, disability and lifespan at the population level. In the picture that is emerging, social status acts through a complicated chain of cause-and-effect. Education equips people with knowledge and skills to adopt healthy behaviors. It improves the chances of securing a job with healthy working conditions, higher wages, and being able to afford housing in a neighborhood secure from violence and pollution. The job security and higher income that tend to come with more education provide a buffer from chronic stress – a corrosive force that undermines health among lesser educated, lower income people. Research consistently shows that more education gives people a greater sense of personal control. Positive beliefs about personal control have a profound impact on how people approach life, make decisions about risky behavior, and cope with illness. Continue reading
Conan Murat, one of Alaska’s first dental health aide therapists, provides a first-person perspective on providing oral health care to his fellow Native Alaskans on the isolated Yukon-Kuskokwim delta in this month’s issue of Health Affairs.
One of the perks of belonging to the Association of Health Care Journalists is free access to online versions of a number of useful journals. Health Affairs is one of those and the November issue is dedicated to the theme of “Redesigning the Health Care Workforce.”
In one piece, “How to Close the Physician Gap,” the authors suggest that registered nurses and pharmacists could help address the disparity between the demand for primary care services and the number of physicians available to provide the care. Another looks at meeting growing health care needs through the wider use of nurse practitioners and physician assistants.
But Murat’s piece weighs in on another health care workforce issue that touches the lives of millions of Americans: the shortage of dental providers. Continue reading
In rural areas, the federal Centers for Medicare & Medicaid Services designates more than 1,300 hospitals as being “critical access hospitals.” So designated, these facilities get a bit more in reimbursements to ensure that Americans outside of cities and suburbs can get the care they need without having to travel too far. In August, a report from the Office of Inspector General of the federal Department of Health and Human Services recommended that 80 percent of these facilities be decertified.
When he learned of the report, David Wahlberg, a health/medicine reporter for the Wisconsin State Journal, interviewed administrators at critical access hospitals in Wisconsin and found that the administrators believed closing these hospitals would have a detrimental effect on care for Medicare patients. Continue reading
Medical research can often seem far removed from a local health beat. All the statistics, the jargon, the complicated graphs can make it easy to forget that behind every number there’s a real person. In fact, medical studies can be great jumping off points for local stories. The key is finding the people who are at the heart of the research.
We asked health reporter Eryn Brown to share how she recently turned a medical study from Yale University into a poignant local story for the Los Angeles Times. In bringing the research home, she shined a light on the heartbreaking ways low-income mothers have to stretch diapers when they can’t afford a steady supply.
The story is part of a recent push in research to “operationalize” poverty by documenting the concrete ways income impacts health and quality of life. These kinds of studies are starting to give us a glimpse into the hardships faced by people on the fringes of society and offer reporters some meaningful stories to tell.
Read about how Brown came across the story and how she reported it.
Image by Neon Tommy via flickr
It is likely that three patients and two volunteers contracted hepatitis B at a large free dental clinic held in 2009 in Berkeley County, W.V., according to investigators.
Investigators documented problems with infection control at the large Mission of Mercy clinic, held at a school gymnasium. But they were unable to definitively link those breaches with the five infections, or to determine exactly how the patients and volunteers were infected. They have shared their conclusions in the October issue of the Journal of the American Dental Association.
The news of the cluster of hepatitis B infections among attendees at the West Virginia clinic attracted wide attention in 2010, after health officials sent out letters notifying hundreds of clinic patients and volunteers that they might have been exposed. The highly infectious hepatitis B virus can lead to serious liver damage. Continue reading
An estimated 60 million Americans live in rural areas of the United States. How these Americans use the new insurance marketplaces could be the key to success (or failure) of the Affordable Care Act.
This is an issue our panelists will address on Thursday, Oct. 17, at 2 p.m. Eastern, when AHCJ hosts a webcast, “How will rural Americans tap into the insurance marketplaces?”
Each state is wrestling with issues related to enrollment in the health insurance marketplaces. For journalists in the 29 states that the federal government considers to be mostly rural, the issue of how many residents enroll will be particularly important to follow in the coming months.
Our panelists (Al Cross, director of the Institute for Rural Journalism and Community Issues at the University of Kentucky; Jim Doyle, who covers the business of health care for the St. Louis Post-Dispatch; and Alan Morgan, CEO of the National Rural Health Association) will address this issue among others during the one-hour webcast. Reporters will have plenty of time to ask questions of the panelists. Continue reading
Image by Michael Coghlan via flickr.
Want to know more about innovative dental care programs reaching rural areas? Curious about oral health disparities in isolated communities? Looking for rural health contacts, programs or statistics for your state?
You might want to check out a Rural Oral Health Toolkit just launched by the Rural Assistance Center, a rural health information portal established by the U.S. Department of Health and Human Services’ Rural Initiative.
The toolkit is primarily geared toward helping rural communities set up successful and sustainable oral health programs. But it might just as easily serve as a source of story ideas and background for journalists covering rural places.
On the site you can learn about initiatives such as the “Into the Mouths of Babes” program. It addresses the shortage of Medicaid dentists in rural North Carolina by training physicians to apply fluoride varnishes to the teeth of small children.
You also can find out more about mobile clinic programs that have been successfully bringing screenings, education and care to children in isolated communities from Louisiana to South Dakota. There are school-based, dental home, community outreach and workforce auxiliary models as well. Elsewhere on RAC’s site, you can locate directories for rural hospitals and federally qualified health centers and state-by-state listings for rural health care resources. Continue reading
Advocates for the poor and uninsured have worked long and hard to bring attention to the shortage of dental care for millions of Americans. On Wednesday, the American Dental Association weighed in on the problem too, announcing a nationwide campaign designed to respond to address what leaders called the nation’s “dental crisis.”
“We’ve made great progress with each generation enjoying better dental health than the one before,” ADA President Robert Faiella, D.M.D., noted. “But there is still a dangerous divide in America between those with good dental health and those without. Our mission is to close that divide. Good oral health isn’t a luxury – it’s essential.”
Yet many go without that care.
While a vast majority of middle- and upper-income Americans reported good access to dental services, nearly half of lower-income adults said they had not seen a dentist in a year or more, according to a Harris poll released by the ADA as part of the campaign’s launch. The poll also found that poor Americans are more than two times as likely to be toothless than their wealthier counterparts and that low-income adults were far more likely to seek last-resort care in emergency rooms than their better-off counterparts. Continue reading
The photo of the man sitting in a dental chair, cradling his hurting face, drew me right into the San Francisco Chronicle story.
Reported by staff writer Drew Joseph, the Jan. 31 article took a thoughtful – and painful – look at the shortage of dental care for California adults.
“Jabari Kelly showed up at San Francisco General Hospital’s dental clinic last Friday looking like he was hiding a golf ball in his left cheek. He had been in pain for three weeks.
“The 36-year-old San Francisco man had an infected wisdom tooth, and swelling had spread into his jaw and cheek. A few more days, he was told, and the infection could have advanced below his chin, possibly restricting his breathing,” Joseph wrote.
“You’ve got 32 teeth – each one can kill you,” Newton Gordon, D.D.S., of the UCSF School of Dentistry, told Joseph. Continue reading