Wonderment Wednesday: Get Covered by January 31st, Or Else....

Happy Wonderment Wednesday!
We don't know if you heard, but the last day to sign up for health insurance is Sunday on January 31st. This means that if you are uninsured by that day, be prepared to pay a penalty to the IRS.


Now some of you may be asking, why do I need insurance? I'm glad you asked because here are

4 Facts of Being Uninsured
1. Having continuous insurance is better for you physically
In a paper written by Janice C. Probst, PhD it looked at the effect of continuous insurance coverage on physical health at age 40. What the study itself did, was look at the insurance coverage of an adult for the 10 years prior to age 40. The paper looked at whether on not the person had been continuously insured  for a decade had any effect on both physical health. The results showed that people with continuous coverage had higher physical scores than those who didn't.

2. Having continuous insurance is better for you physically
In the same paper written by Janice C. Probst, PhD it also looked at the effect of continuous insurance coverage at age 40. Similar to the results of physical health, people who had continuous insurance coverage 10 years prior had better mental health scores than those who didn't.

2. Dental insurance is important for adolescents 
In a study written by Jihong Liu, PhD, it looked at the rate of dental insurance among U.S. children. According to the study, a total of 22.1% of U.S. children's parents reported not having dental coverage in 2006. Another 26.9% reported not having routine preventive dental visits. Looking deeper into the information, the children who lacked dental insurance were less likely to have preventative care and more likely to have an unmet dental need.


4. Rural residents have similar rates of uninsured as urban areas
Because we are the South Carolina Rural Health Research Center, and no post cannot go without mentioning people living in rural areas, let us talk about insurance in rural areas. In this post by the Kaiser Family Foundation, it shows that rural residents have similar rates of insurance as their urban counterparts. However, this comes with a caveat: rural residents are more likely to have public insurance than urban residents. 



In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center.We will be taking the next few weeks off, so until next time, take care!

-Matt


References
Probst JC, Moore CG, Powell MP, Martin AB. Continuity of Health Insurance Coverage and Perceived Health at Age 40. Med Care Res Review. Med Care Res Rev. 2008 Aug;65(4):450-77. Epub 2008 May 19.

Probst JC, Moore CG, Baxley EG. Update: Health insurance and utilization of care among rural adolescents. Journal of Rural Health, Fall 2005, pp. 279-287.

Newkirk V, Damico A. The Affordable Care Act and Insurance Coverage in Rural Areas. The Henry J. Kaiser Family Foundation, n.d., retrieved from": http://kff.org/uninsured/issue-brief/the-affordable-care-act-and-insurance-coverage-in-rural-areas/

Liu J, Probst JC, Martin AB, Wang JY, Salinas CF. (2007). Disparities in dental insurance coverage and dental care among US children: the National Survey of Children's Health. Pediatrics. 2007 Feb;119 Suppl 1:S12-21.

Wonderment Wednesday - New Year's Resolutions

HAPPY NEW YEAR'S EVERYONE! Here is to spending the next month remembering to write 20156 correctly and following through on your new's years resolution. Our New Year's resolution? To stop bringing down anyone who read these Wonderment Wednesday posts, especially when it comes to highlighting research. Like this piece by Forbes which reports only 8% of people follow through on their New Year's goal.

Oh. Well, there is always next year. Even though we didn't quite follow through our New Year's resolution, here are some tips to keep yours. It also shouldn't take away from the fact how good New Year's resolutions are. They help encourage healthy activities by people, like our topic today on

4 Facts About Rural Preventive Health Services

1. Rural Residents Are Less Likely To Receive Preventive Health Services
Kevin Bennett looked at rural urban differences for people with the flu vaccine. The results found that people who lived in rural areas were less likely to receive flu vaccines than people in urban areas.However, this isn't just limited to flu vaccines.

In another study also written by Kevin Bennett, PhD  looked into whether rural or urban populations were more likely receive cancer screening services. Rural residents were less likely to receive cancer screenings than urban residents .

2. Healthcare Provider Location Matters
In the same in the same flu vaccine study, it gave us a better understanding of why rural residents have less access to healthcare. Looking closer, rural residents were much more dependent on their clinical providers for their flu vaccines.

In a study written by Jessica Bellinger, PhD, it looked at the role family history when it came to cervical cancer screening. However, what they came to determine was younger populations were more likely to receive cervical cancer screenings. The author suggested that younger populations were more likely to receive cervical cancer screenings because younger women see provider more often. They study suggested that more targeted programs for older women should be implemented, but do these programs work?

3. Targeted Programs For Preventative Health Services Work
Remember the cancer screening study written by Kevin Bennett, PhD?  It found that African American women were more likely to receive preventative health services regardless of rurality. This suggest that this is proof that targeted programs encouraging African American women to receive preventative services work!

4. There Is Still Racial Differences In Preventative Health Services Access.
Unfortunately, there still is racial differences in preventative health access. In another study by Kevin Bennett, PhD, it looked at another area of preventative healthcare which is flu vaccines. It found that white rural residents were more likely to be vaccinated than urban areas than their urban counterparts, On the other hand, rural African Americans were less likely to be vaccinated than their urban counterparts.



In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center.We will be taking the next few weeks off, so until next time, take care!

-Matt




References
Bellinger JD, Brandt HM, Hardin J, Bynum S, Sharpe P, Jackson D. (2013). The role of family history of cancer on cervical cancer screening behavior in a population-based survey of women in the southeastern United States. Women Health Iss, 23(4):e197-204.

Bennett KJ, Bellinger JD, Probst JC. (2011). Receipt of cancer screening services: Surprising results from some rural minorities. J Rural Health. Epub 11 Mar 2011.

Bennett KJ, Pumkam C, Probst JC. (2011). Rural-urban differences in the location of influenza vaccine administration. Vaccine. 29(35):5970-7. Epub 2011 Jun 25.

Bennett KJ, Bellinger JD, Probst JC. (2010) Receipt of influenza and pneumonia vaccinations: the dual disparity of rural minorities. J Am Geriatr Soc. 58(10):1896-902.

Wonderment Wednesday: The South Carolina Rural Health Research Center Is Going STAR WARS

We don't know about you, but we here at the South Carolina Rural Health Research Center IS PUMPED for this Thursday. After sitting on the edge of our seats for the past year, Star Wars: The Force Awakens finally opens in theaters. We're not pumped because of all the lightsaber fights we have been recreating at the South Carolina Rural Health Research Center.

Rather, it means we can finally stop hearing everyone and their parents talk about Star Wars and how much nostalgia the trailers bring them. Before we change our profile pictures to have lightsabers, listen to the Notorious B.I.G. Star Wars mix, and fully engross ourselves in the Star Wars hype, let me pose this important question:

Will a galaxy far far away that has all this futuristic equipment include health information technology (IT)? Would it even have something called Wonderment Wednesday that talks about.......

4 Facts On Health IT
1. Health IT makes a difference
In a study that was published by Chaudry and friends, it looked at different studies that looked at the impact of health IT. In short, the study found that health IT did indeed help improve quality and efficiency of care.

2. Health IT isn't some fancy operation
Many times when people think of health IT, they think of large expensive operations requiring futuristic new machines and special suits to operate.

No,

However, that isn't always the case. In this paper written by Dr. Kevin J. Bennett, it looked at the effects of just improving the paperwork associated with health IT work. Essentially, the paperwork was customized to the needs of the academic center. The result? A 5% increase in completed charts.

3. Rural residents are less likely to have internet
Since we are the South Carolina Rural Health Research Center, we couldn't get too far without talking about rural at least once. One problem facing rural residents is the distance they need to drive, which is why the internet is important. In this study, written by Dr. Jong-Yi Wang, it found that people living in rural areas were less likely to have internet than people in urban areas. Most importantly, minorities and people with medical conditions were less likely to use the internet.

4. Rural health providers need a lot of help
This is not just a patient level problem when it comes to health information technology, it is also an organization problem. In a study published Dr. Amy Martin, it looked at the differences between rural hospitals and rural primary care providers in South Carolina on: a. telemedicine adoption, b. telemedicine training needs c. current use of technology for patient care, In all three metrics, rural hospitals were more likely to fare better than their rural primary care providers. Unfortunately, this highlights the overwhelming need in rural areas for a stronger primary care workforce.


In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center.We will be taking the next few weeks off, so until next time, take care!

-Matt

Wonderment Wednesday: HIV Awareness

Folks,
We are tired at the South Carolina Rural Health Research Center.

 Why? It isn't because we partook in the post-Thanksgiving marathon of themed days (Black Friday, Small Business Saturday, Still Needs a Name Sundays, Cyber Monday, and Giving Tuesday). No. It's not even because we ate too much. It's because we are so fed up with HIV Awareness Day being put on the back burner that we are tired.

That is right, lost in the hustle and bustle of these post-Thanksgiving themed days was HIV Awareness Day. HIV or Human Immunodeficiency Virus that causes Acquired Immunodeficiency Syndrome or AIDS. Click here for more information on HIV. Many of you may remember the times of HIV/AIDS was a regular news story. While HIV is not as prevalent of a news story as it used to, it still shows up in everyday pop culture.

Other places it might show up? You guessed it, rural areas.

5 Facts About HIV/AIDS In Rural Areas

1. Prevalence of HIV/AIDS is higher in urban areas

In a report written by Dr. Medha Iyer (nee Vyavaharker) that looked at 28 states, HIV/AIDS were higher in urban counties than rural counties. Going deeper into the numbers,  HIV/AIDS tended to decrease as counties became more rural. FINALLY, some good news for people living in rural areas.

Don't worry, we were just as shocked as you are. But all this good news comes with a tidbit.

2. There are less HIV/AIDS services available in rural areas

The same study looked at HIV/AIDS services available to HIV/AIDS patients. In particular, Ryan White medical providers which provide HIV services to people lacking the resources for HIV care. Of the counties analyzed, 69% of urban counties do not have Ryan White clinics, while 95% of rural counties do not have Ryan White clinics. Unfortunately, it also found a higher proportion (78%) of rural residents with HIV/AIDS did not have a Ryan White clinic supporting them compared to urban (11%) of residents.  

.

3. South Carolina HIV infected adults are not accessing HIV care.

In this study written by Dr. Bankole Olatosi it looked at current HIV positive patients in South Carolina. What it found was that up to 40% of South Carolina HIV patients were not receiving care. But why? The paper pointed to several reasons which may include fear, stigmatization, denial of care, and stage of disease.

4. HIV isn't just a physical struggle, it is a mental struggle
In a study published by Dr. Kenneth Phillips, they reviewed home visits by peer counselors in rural women. What they found gives a very detailed insight of people who are infected with HIV/AIDS. During their study they found 4 themes in HIV/AIDS patients: 1. Stigma of their HIV status 2. Depression  3. Struggling Life 4. An uncomfortable dependence on others.

5. It is important to get HIV screenings if you are sexually active
Let me take the time to underline the importance of this point. Despite all the HIV awareness out there, 130,000 new people a year are infected by HIV in the United States.  The spread of HIV can be prevented. If you are sexually active here are local testing centers, please get tested often. If you are a person currently infected with HIV or AIDS, remember there is plenty of support and help out there for you. Please get in contact with your local public health department if you need it.

In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center. See you next week, same place, same time.
-Matt

Wonderment Wednesday: Thanksgiving and Obesity

It's Wednesday!
Let's cut to the chase folks, tomorrow is Thanksgiving and we at the South Carolina Rural Health Research Center have begun wearing the only appropriate headgear for tomorrow.

Thanksgiving marks the beginning of the holidays where there is much to be excited and unexcited for. For instance, being unexcited about that one uncle who takes a certain joy out of bringing everyone down at the dinner table. To prepare you for your uncle, let us be the buzz kill to the start of your holiday season. According to research, the average weight gain during the holiday is a little more than one pound. The problem is that we don't lose that gained weight over the year, which contributes to the obesity epidemic.

While most of you reading this are likely feeling bad for yourself and mentally preparing for the weight gain. You should feel even worse for people in rural areas. Based on these

4 Facts About Rural Obesity 

1. Rural children are heavier than urban children

According to this study published by Jihong Liu et al. in 2010, when comparing rural to urban children, rural children had higher rates of obesity than urban children. What made the rural children heavier than urban children? The major takeaway from the study was rural children were taking in more unhealthy food than their urban counterparts:

• Younger rural children consumed more fat than urban children (62.7 v 56.9)
• Younger rural children consumed more sweetened beverages than urban (13.5% v 7.9%)

But is it because rural children exercise less? Not really. 

2. Rural children did not exercise less than urban children 

According to the report, there was no real difference between rural and urban children in terms of exercise. Which likely means the weight difference is caused by the diet differences. However, the report did note, to the surprise of no one, 64%-74% of children (depending on age groups) spent 2+ hours in front of a TV or computer screen.

I heard it helps improve grip strength!

3. Rural adults had higher rates of obesity than urban adults

According to Tushar Trivedi et al,, this isn't just a rural children problem, because it effects rural adults as well. Rural adults had a higher rate of obesity than urban residents (35.6% v 30.4%). Similar to young children, rural adults were less likely to eat healthy food and drink more sweetened drinks. So it is just a diet problem right? Nope.

4. Rural adults reported less physical activity than their urban adults

 Unlike rural children, rural adults reported doing less physical activity than their urban counterparts. While the paper did not go into why rural adults would likely report less physical activity than urban adults a search of current research finds:

1. Not enough physical gyms/locations to exercise

2. Not enough sidewalks

3. Extreme conditions making it too cold/hot to exercise

And this too.

While all this information about rural obesity may put a cramp on you while you shove that cranberry covered stuffing down tomorrow. Look on the bright side! You've gained some excellent conversation starters at the dinner table tomorrow. 

As for preventing that 1 pound weight gain? We suggest smaller proportion sizes and finishing it off with a vigorous night of Black Friday shopping. 

In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center. See you next week, same place, same time. Make sure to have a safe Thanksgiving!
-Matt

Wonderment Wednesday: IT'S NATIONAL RURAL HEALTH DAY.....tomorrow!

Happy Wednesday folks!
We don't know if you know, but tomorrow is National Rural Health Day! At the South Carolina Rural Health Research Center we are so excited for tomorrow we can hardly contain ourselves.

We understand National Rural Health Day is a fairly new industry holiday day of celebration, which is why you should click on this link to get great ideas on how to celebrate National Rural Health Day. While it isn't a federal holiday just yet, keep holding your breathes, because we're in the process of lobbying for it to become a federal holiday. Like any good holiday, we here at the South Carolina Rural Health Research Center believe we give you a gift....as in a gift of rural health knowledge on

5 New Things About Rural That We Have Learned About In This Past Year Illustrated With GIFs To Celebrate National Rural Health Day

1. Free Clinics Are Much Rarer In Rural Counties 

Free clinics are incredibly helpful for populations that are disadvantaged and lack health insurance. Rural populations typically lack health insurance, which leads to poor health outcomes. For this reason, free clinics are quite an asset for disadvantaged populations. The problem is, as this link shows, only 22% of free clinics are located in rural areas. Obviously, this does not bode well for America's rural population.

2. 30 Day Readmission Rates Are Higher Among Dual Eligibles. But There Is A Silver Lining For Rural Dual Eligibles. 

If you are an elderly person living in with Medicare and Medicaid as your insurance, then you are a dual eligible. It also means that the odds are in your favor. According to this link, you are less likely to have a 30 day readmission than Medicare only rural residents. All this means that while rural residents are less healthy, a dual eligible resident is less likely to go back to the hospital if they do end up going.

3. Rural Medicare Residents were less likely to receive post-discharge inpatient rehabilitation care after stroke because they live too far

One of the things that is constantly highlighted by the South Carolina Rural Health Research Center is the lack of healthcare access for rural residents. This is due in large part to the amount of driving that a rural resident needs to do to reach a healthcare facility. According to this link, rural medicare residents were less likely to receive post-discharge rehabilitation care after a stroke because they lived too far. When they did receive care, rural residents drove an average of 18.6 miles versus 8-12.6 of an urban resident. 

4. Not All Deprived Rural Counties Are

In a study looking at looking at health outcomes among children, it was found that while many rural counties were sicker than other counties. It suggested that not all rural counties were sick. According to  this link some counties are actually better off than urban counties when looking at health outcomes. 

5. But When A Rural County Is Deprived, It Is Much Worse Off

This good news come with a tidbit. When looking further into the same evidence that produced the previous point, this policy brief revealed a major detail. When comparing a deprived urban county with similar characteristics to a deprived rural county with similar characteristics, the rural county was impacted worse than the urban county.

As you can see, most of the news from rural health is bad news. This only marks the need for more help in rural areas. Only you can make a difference for people in rural by writing to your legislature for policy change.

In the meantime, remember to give a nice tap on that subscribe button to the very bottom or top left hand side of this page to read more about the South Carolina Rural Health Research Center. See you next week, same place, same time.
-Matt