Wonderment Wednesday - 04/13/2016

A happy Wednesday to you! Since the last time we spoke, we are officially in Spring!

The birds and bees are in the air, the flowers are blooming, and there is new life in the air. Just because it's Spring, it doesn't mean rural health disparities have changed any much more. Which is why today's post is on..

3 Facts of Rural Health Disparities

1. Health disparities is not just based on rurality, but by race as well
For the most part, research has shown that there are disparities between rural America and urban America. However, when we dig deeper, it finds there are disparities among rural populations by race. In a study written by Kevin J. Bennett, PhD it looked at different rates of disease of rural black Americans compared to other racial groups. Rural black adults were found to be more at risk for obesity and diabetes.

2. Less access to care
Based on the same study, it found that rural blacks were less likely to have preventative visits for their diabetes. In addition, rural black residents were less likely to meet any CDC recommendations for physical activity.

3. Less access to care Part 2
Based on a recent finding by Amy Martin, DrPH, only backs up the results by Dr. Bennett. In her research, it looked at the location of free clinics, which serves to treat populations with lower income levels. The results showed that 22% of clinics were located in rural areas. The most astounding result from the study? 17 states had no free clinics in rural areas.

Final Thoughts
Today, we've highlighted the health disparities between rural and urban. Unfortunately, for rural populations these disparities are magnified because the lack of care. What you can do is to help give to organizations running free clinics and help write to your local congressmen or congresswomen about the need for funding in rural areas.

References


Bennett KJ, Olatosi B, Probst JC, Health Disparities: A Rural-Urban Chartbook, June 2008

Martin A, Bhavsar G, Workman L, Probst, JC, Free Clinics in the Rural Safety Net, September 2015

Wonderment Wednesday: Pregnancy Research

In one of the more interesting election cycles in recent memory, the results from the Iowa caucuses have come in. Based on multiple reports, these are the closest results that Iowa has ever head. 6 precincts decided by a coin toss! This only means that this election cycle is pregnant with possibilities. With just 9 months left, after a long and tenuous process, our nation will decide a new president.

But why all these analogies to pregnancy you ask? Obviously, it is a thinly veiled attempt to transition to our topic today:

4 Findings of Pregnancy Research

Rural pregnant women are more likely to gain weight than urban women
It is known that unhealthy prepregnancy weight and gaining weight during pregnancy has been shown to increase the risk of a poor pregnancy and birth outcomes. Therefore, Alexa Gallagher, PhD, looked into whether or not mothers in rural areas were more likely to be at an unhealthy weight at pregnancy. It found that rural women were more likely to be at an unhealthy weight than their urban counterparts. In addition, it found for rural women of normal weight, they had more trouble gaining appropriate amounts of weight during the pregnancy. However, obese and overweight rural women were less likely to have excessive weight gain during the pregnancy themselves.


Pregnant women receiving poor prenatal care are more likely to have excessive fetal growth
Nathan Hale, PhD had a study that looked into the variation for pregnancies that had excessive fetal growth. For the most part, the it found that women with gestational diabetes were more likely to have excessive fetal growth. However, when looking at closer among women with gestational diabetes, women who had inadequate prenatal care were more likely to have excessive fetal growth than women who had intermediate/adequate prenatal care.

Women delivering in rural hospitals are less likely to have delivery complications
In a study by Sarah Laditka, PhD it looked at whether the area of a hospital location had any effect on delivery complications. When looking at the data, it found that women on Medicaid who had a pregnancy in a rural hospital were actually less likely to have a delivery complication. Surprise!

However, the authors pointed out that this difference is most likely to due to women in rural areas driving to urban areas for their births.


African American women delivering in rural hospitals are more likely to have delivery complications
Unfortunately, when we look into the data deeper, we find that African American women are still at a disadvantage. African Americans women delivering in rural hospitals were more likely to have a delivery complication than their African American counterparts in urban hospitals. One of the factors that made this difference is because African American women were less likely to have access to care than their other women.

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.
-Matt



References
Catalano PM. Increasing maternal obesity and weight gain during pregnancy: the obstetric problems of plenitude. Obstetrics and Gynecology 2007; 110(4):743-744

Gallagher A, Liu J, Probst JC, Martin AB, Hall JW. Maternal obesity and gestational weight gain in rural versus urban dwelling women in South Carolina. J Rural Health. 2013 Winter;29(1):1-11

Hale N, Probst JC, Martin AB, Bennett K, Liu J, Glover S. Variation in Excessive Fetal Growth Across Levels of Prenatal Care among Women with Gestational Diabetes. Journal of Primary Care and Community Health. Accepted for publication April 19, 2011.\


Laditka SB, Laditka JN, Bennett KJ, Probst JC. Delivery complications associated with prenatal care access for Medicaid-insured mothers in rural and urban hospitals. J Rural Health. 2005 Spring; 21(2):158-66.

Wonderment Wednesday: Cold Fronts

Good Wonderment Wednesday Everyone!
Do you feel that shaking? That's us at the South Carolina Rural Health Research Center shivering over our computers in what is reported the worst cold front  of the year. Fortunately if it get's cold enough, as KARE 11 has reported, this gives us all the opportunity to play the standing jean prank.
Too bad it isn't actually cold enough in South Carolina to partake in this Minneapolis tradition. However, today's Wonderment Wednesday topic has our jeans standing up in anger over....

5 Facts About Rural Disparities 

1. There Are Disparities in Education
In a study written by Janice C. Probst, PhD looked at different health disparities in terms of education, health insurance, and access to care. One of the interesting results from the study written by Janice C. Probst, PhD was the fact that minorities in rural areas had lower education levels. Interestingly, it goes into the educational disadvantages among rural African Americans. Essentially, it found that African Americans that moved from rural to urban areas are more highly educated. This meant that the population that is left over in the rural areas are less educated than their counterparts. This is important because education has direct effects on health and income level as well. Both of which in turn effects health access.

2. Rural Minorities Are Less Likely To Have Health Insurance
In the same study by Janice C. Probst, PhD it looked at the rates of insurance among rural residents. It found that African Americans (31.9%) and Hispanics (44.9%) had higher uninsurance rates than Whites (17.8%). In a study written by Saundra Glover, PhD it went deeper into the data that looked at rural minority adults and their ability to access care. When the analysis included other resource related factors such as education, income and employment, it found that these differences were insignificant. This means that minorities in rural areas suffer from a lack of resources.However, uninsurance is just one barometer of access. 

3. Rural Minorities Also Were Less Likely To Use Health Care Services
Going back to the study by Janice C. Probst, PhD it also looked at whether there were any differences in going to see a health care professional as well. It found that Hispanics (37%) and African Americans (27%) vs 20% of Whites had not seen a health care professional in the past year. Once again, in Sandra Glover, PhD looked at the results when resources were taken into account. Dr. Glover found that the difference between African Americans and Whites was gone. However, Hispanics were still less likely to receive healthcare services.


4. Minorities Need To Drive More For Their Healthcare
In another study by Janice C. Probst, PhD it looked at the amount of distance needed to drive for care by minorities compared to whites. White and African Americans did not differ much in terms of travel distance. However, African Americans, on average, spent more time traveling than whites (29.1 vs. 20.6 minutes).

5. Rural Minorities Are More At Risk For Death
With so many factors working against rural minorities it comes with little surprise that rural minorities are more at risk for death. In another study written by Janice C. Probst, it looked at whether or not health outcomes were effected among rural minority populations. In the study, it found that rural African Americans and rural Hispanics were more at risk of early death compared to Whites. Like before, when resources are accounted for in the analysis, the disparities between the groups were eliminated.


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, Glover SH, Samuels ME (2004). Person and place: the compounding effects of race/ethnicity and rurality on health. American Journal of Public Health 94(10): 1695-703.

Glover S, Moore CG, Probst JC, Samuels ME (2004). Disparities in access to care among rural minority adults. J Rural Health, 20(3):193-205.

Probst JC, Bellinger JD, Walsemann KM, Hardin J, Glover SH. Higher risk of death in rural blacks and whites than urbanites is related to lower incomes, education, and health coverage. Health Aff (Millwood).2011 Oct;30(10):1872-9

Probst JC, Laditka SB, Wang J-Y, Johnson AO. Effects of Residence and Race on Burden of Travel for Care: Cross Sectional Analysis of the 2001 US National Household Travel Survey. BMC Health Serv Res. 2007 Mar 9;7:40.

Wonderment Wednesday: Hitting it BIG

Happy Wednesday everyone! Unless you have not been reading the news, you might have heard that the lottery has now grown to $1.3 Billion. I don't know about you, but I have sold all belongings, including my entire collectible marble set. I'm going to use all that money, including my life savings, just for just an infinitesimal chance at winning the Powerball.

What do I plan to do with the winnings? Buy an alpaca farm of course. The internet on the other hand is convinced that with the winnings alone could solve U.S. poverty (hint: do the math and it doesn't). While it may not be true, it does allow us to segue into today's Wonderment Wednesday topic on

5 Facts About Rural Poverty

1. The More Rural A County Is, The More Likely The Residence Live in Poverty
In a report written by Charity Moore, PhD, it ventured into the concept of whether or not rurality had an effect on poverty. What the study found was as rurality increase, the likelihood of poverty increased as well.

2. A Disproportionate Amount Of Minorities Live In Poverty
In the same report as before, it also looked at how rurality effected minority children. Unfortunately, rural minority children were much more likely to be in poverty than White rural children.

3. Rural Poverty Has High Rates Of Obesity
A study written by Kevin J. Bennett, PhD looked at the relationship of obesity among resident in rural counties. What made this study significant was that it broke up rurality by Urban, Rural, and Rural Persistent Poverty counties. By breaking the analysis like so, we find that residents in Rural Persistent Poverty counties had higher rates of obesity than Rural and Urban counties.

4. People In Poverty Are Much More Likely To Have Tooth Loss 
In a study Jordan Mitchell, PhD, it looked at whether poverty in rural area had an effect on tooth loss. During the course of the study, it found that people that lived in poverty were much more likely to have tooth loss. Most importantly, the study highlighted that socioeconomic-level factors played a significant role in the likeliness of tooth loss.

5. Parental Stress Are Effected By Poverty
The report that looked into poverty by Charity Moore, PhD also looked into how poverty effected parental stress levels of parents. In general, populations were much more likely to have parental stress the lower the income. However, looking deeper into the information, minority populations were found to have higher stress levels than Whites when it came to parental stress.

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

Note: SCRHRC does not condone the Powerball or gambling of any sort.

References
Moore C, Probst JC, Tompkin M, Cuffe S, Brock- Martin A. Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior. May 2005
Mitchell J, Bennett K, Brock-Martin A. Edentulism in high poverty rural counties. J Rural Health. 2013 Winter:29(1):30-8.   
Bennett KJ, Probst JC, Pumkam C. (2011). Obesity among working age adults: The role of county-level persistent poverty in rural disparities. Health Place. Jun 10.              

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: It's National Pastry Day!

It's National Pastry Day folks!

Like any good unofficial national day of celebration it gives us a good excuse to eat poorly. So get out your favorite pies, eclairs, macaroons, pecan pies, or chomp down on a bevy of pastry options in the celebration of this fine day.

But before you do, the South Carolina Rural Health Research Center insists that you practice good oral hygiene. With all the extra sugar you will be chomping down it causes you to be prone to cavities. Since we're already on the topic of oral hygiene how about we talk about

5 Facts About Rural Oral Health

1. 80% of cavities are found in 25% of children
Okay, this is not really a rural oral health fact, but it is a fact from the National Institutes of Health. This means that only a small group of children are making up a HUGE amount of the cavities. Let's dig into this a little more.

2. Rural children are less likely to have excellent teeth
In a report published by Dr. Amy Martin, it asked  the parents of both rural and urban children the condition of their children's teeth. Guess what? Like all our Wonderment Wednesday posts rural children once again got the short end of the stick.

It found that rural children were less likely to report having teeth in "excellent" condition than urban children. But what are the causes of this?

3. Rural children are less likely to have dental insurance than urban children

In a paper written by Dr. Jihong Liu, found that rural children were more likely to be uninsured than urban children. What does this mean? Going deeper into the results, children who lacked dental insurance were less likely to receive preventative care. Less preventative care means a higher chance of dental problems. A possible reason why this occurs according to the study? I'll let you take a gander:

Talking about preventative care...

4. Preventative care helps, but not as much if you don't live in urban areas

According to this study by Dr. Amy Martin, it looked personal health provider status and how often children received preventive dental care. Based on the results, personal health providers for children were more likely to receive preventive care then people who did not personal health providers. However, if the child lived in a rural area, they were less likely to receive preventive care. But not all the news is bad for rural

5. Dental sealants are about the same for both rural and urban children
Dental sealants are used as to prevent tooth decay. Based on this report, urban and rural children have about the same amount of dental sealants. Huzzah!

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: 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

It's A Wonderment Wednesday! Diabetes Awareness

Good Morning!
Before we begin, we at SCRHRC want to remember and thank all the veterans that have served for our country.  

On a totally different subject, I don't know about you, but I've finally put away all my pink based Breast Cancer Awareness items and updated my my entire wardrobe for Diabetes Awareness Month. That's right, the same diabetes that effects over 29 million Americans currently. Diabetes doesn't play around. Diabetes can lead to blindness, kidney disease, cardiovascular damage, and a slew of other problems. So make sure you wear a grey or a blue circle pin and promote Diabetes awareness this November 14th (Saturday) and for the rest of the month! 

Remember it's a blue circle pin, not a blue pin.
 Blue pins are for colon cancer in March. 

Because we are slightly fond of rural health at SCRHRC, let's put on our research caps to see the difference between urban vs. rural for diabetes. According to a research brief written in 2009 by Dr. Kevin J. Bennett et al. at SCRHRC:

• Rural adults were more likely to report having diabetes than were urban adults (9.6% versus 8.4%).  

• The proportion of adults with diabetes who reported receiving at least two hemoglobin A1c tests within the past year was lower among rural  (33.1%) residents  than urban (35.0%) residents

• Rural black adults were nearly 20% more likely to report having diabetes than were urban black residents. 
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If you would like to read the full report you can click here. Don't believe the results here? In this paper, written by Dr. Nathan Hale et al. in 2010, reported similar results of higher prevalence of diabetes and poorer access to care by rural residents. In addition, they are more likely to report retinopathy and foot sores. That's right, people in rural areas are more likely to have diabetes, less likely to receive quality care, and have worse health outcomes! Can you say.....mind blown?

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