HEALTHY LIVING
Health care solutions for rural Americans
(Family Features) Heart disease, cancer, unintentional injuries, chronic lower respiratory disease and stroke. These top five causes of death in the United States all have a higher incidence of death among rural residents and research points to lack of access to health care as a culprit.
Today, rural hospitals are closing at a rapid pace, expanding an already vast health care desert (defined as inhabited areas more than 60 minutes away from an acute care hospital) across the country.
According to the University of North Carolina’s Rural Health Research Program, since 2010, more than 105 of America’s 1,700 rural hospitals have closed. Additionally, a Navigant report found that 21% of rural hospitals are at high risk of closing unless their financial situations improve.
Every day, rural Americans find themselves farther from medical care.
Practical challenges facing patients
Fatal injuries and illnesses aside, rural residents face other practical concerns related to the health care in their communities.
- Doctors are more concentrated in urban areas, while there are shortages in rural communities. A shortage of doctors can mean less availability for appointments, difficulty capturing enough attention from a busy provider, longer distances to reach a physician and limited access to specialists.
- Statistically, rural residents tend to be older and need more frequent visits to their primary doctors and other specialists.
- Pregnant women have to travel even farther to deliver a baby, leading to an increased risk of complications at birth. Similarly, pre-natal and post-natal care are harder to access.
- Rural residents often enjoy more outdoor activities (such as hunting, hiking and riding ATVs) than urban residents and therefore are at a greater risk of injury that requires treatment at a trauma center.
Airborne answer
One solution to fill the gap in rural health care is air medical services, which transport patients to critical care facilities in minutes. With nearly 90% of patients transported living in rural areas, air ambulance services are an essential part of health care access in these communities.
However, just like rural hospitals, air ambulances are threatened as well. Medicare and Medicaid reimbursement rates have remained steady for decades, while operational costs required for air medical services have increased, creating a financially unsustainable situation. Some private insurers also refuse to cover air medical services or pay minimal costs, requiring patients to assume the balance.
How to take action
The challenges facing rural health care access may be significant, but rural residents can take individual actions to make a difference for themselves, their families and even their communities.
- Express support to elected officials. Rural residents can call or write letters to their senators and representatives and demand they keep local hospitals open and protect access to air medical services. Reaching members of Congress at their local offices may be more effective than contacting their federal offices.
- Support efforts to secure grants. Some universities have been given grants from the Health Resources & Services Administration, an agency of the U.S. Department of Health and Human Services, to create or expand community health initiatives and facilities in rural areas.
- Explore alternative sources of care. Many rural areas have community health workers who complete home visits to assist people with chronic diseases like diabetes and high blood pressure. Although their training is limited compared to that of a doctor or nurse, their service increases health care access and they’re able to spend more time with patients.
- Get educated about your care. One role of community health workers is teaching patients about how to manage their own medical needs. This education helps residents be proactive and preventative in their health care, which can reduce the need for hospitalizations in certain cases, such as learning how to properly manage diabetes.
- Make an emergency plan. For families who reside in a rural community, it’s a smart idea to have a plan in place for how to respond in the event a medical emergency. The plan should include information about the location of the closest hospital, emergency contact information in the community and other details necessary to gain emergency care.
- Consider remote access care. Another option for both rural and urban residents alike is telemedicine, which allows patients to connect with a doctor or nurse virtually using technology and without having to travel. The two-way communication can facilitate evaluation and treatment for minor conditions. The service is offered as a cost-saving incentive through some insurance plans, as well as private providers.
Protecting Patients Against the Unexpected
With increasing frequency, insurance companies are not covering the full cost of medical emergencies, leaving families with out-of-pocket expenses they didn’t expect.
If you need medical transport and a physician or first responder determines air evacuation is the best – or only – option to get you to care, you shouldn’t have to worry about the bill you’ll receive afterward. Many emergency service providers have support efforts in place to help you focus on recovery, not finances.
For example, many air medical companies provide patients access to their patient advocates, who work with the patient’s insurance provider to properly cover air medical transport, taking the patient out of the middle. This process can result in significantly lower costs for the patient, often amounting to just the usual copay and deductible.
Visit globalmedicalresponse.com/protect-patients to learn more about these services in your area.
Photos courtesy of Getty Images (doctor and man, woman speaking with doctor on computer)
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Global Medical Response
(Family Features) These days, wellness information is practically everywhere you turn. Do this; don’t do that. Eat more of this; eat less of that. This is good for you; that is bad.
It can be hard to cut through all the noise, but the reality is, when it comes to something as serious as your heart health and LDL cholesterol – the “bad” cholesterol – ignoring it can be downright dangerous for your health.
According to the American Heart Association, about every 40 seconds, someone in the United States has a heart attack, and strokes occur at about the same frequency.
High LDL cholesterol, often called “bad” cholesterol, significantly increases your risk of heart disease.
A poll conducted by The Harris Poll for the American Heart Association revealed 75% of heart attack and stroke survivors reported having high cholesterol. Yet nearly half (47%) of heart attack and stroke survivors are unaware of their LDL cholesterol number. This lack of awareness shows more knowledge is needed to help survivors proactively manage their health.
In fact, knowledge is key to reducing your risk of heart disease. Understanding the impact of LDL cholesterol and knowing your LDL number can help you make informed decisions.
Cholesterol: The Good and The Bad
Cholesterol is a waxy, fat-like substance your body needs to build cells and produce hormones. However, not all cholesterol is created equal:
- LDL (low-density lipoprotein) Cholesterol: This is the “bad” cholesterol. When too much LDL cholesterol circulates in the blood, it can build up in the inner walls of the arteries that feed the heart and brain, forming plaque that can narrow and eventually block these arteries, leading to heart attack or stroke.
- HDL (high-density lipoprotein) Cholesterol: Known as the “good” cholesterol, HDL helps remove the “bad” cholesterol from the arteries, protecting against heart attack and stroke.
A Silent Threat
Many people think high cholesterol has obvious signs, but that’s not always the case. In fact, about half of U.S. adults and 42% of heart attack and stroke survivors mistakenly believe high cholesterol has clear symptoms. However, high LDL cholesterol typically doesn’t show any signs, which is why it’s known as a silent threat to your heart.
People who have had a heart attack or stroke are at higher risk of future cardiovascular problems, which is why it’s important to monitor your cholesterol regularly to help prevent future events.
It’s also important to know high LDL cholesterol can be genetic, meaning someone who eats a healthy diet and exercises regularly can still have high cholesterol. Additionally, the risk of high LDL cholesterol increases with age.
That’s why the American Heart Association’s “Lower Your LDL Cholesterol Now” initiative, nationally sponsored by Amgen, emphasizes the importance of regular cholesterol checks regardless of your weight, diet and physical activity levels. Knowing your LDL cholesterol number – and understanding the target levels based on your health history – gives you the opportunity to manage your health proactively. This enables you to make informed decisions to prevent future heart issues.
Know Your Number
You can reduce your risk of a heart attack or stroke by knowing and addressing your LDL cholesterol number.
Working closely with your doctor allows you to actively manage high LDL cholesterol – often a key risk factor you can help control – and together, you can develop a personalized treatment plan. Ask your doctor or health care provider for a cholesterol test to know your LDL number. Understanding your cholesterol number is the first step toward managing it effectively. If necessary, appropriate management of your LDL cholesterol can help reduce your risk of a heart attack or stroke.
Your doctor may also talk with you about your personal and family medical history; previous heart-related medical events such as a heart attack or stroke; lifestyle habits such as tobacco use, obesity, unhealthy living or aging; racial and ethnic backgrounds; and reproductive health.
Lower is Better
When it comes to your cholesterol, guidelines from the American Heart Association and the American College of Cardiology recommend “lower is better” to reduce your risk. Studies show that an LDL number or below 100 mg/dL is ideal for healthy adults.
If you have a history of heart attack or stroke and are already on a cholesterol-lowering medication, your doctor may aim for your LDL to be 70 mg/dL or lower.
Talk to your doctor about the right treatment plan for you. Positive lifestyle habits, such as exercising and eating a healthy diet, may also help.
However, if you’ve had a heart attack or stroke before, lifestyle changes alone may not be enough to lower your risk of another event. Your doctor may recommend cholesterol-lowering medications to protect your heart health.
Learn more about LDL (bad) cholesterol by visiting heart.org/LDL.
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(Family Features) Strokes can happen to anyone, at any age – even young people. Despite being one of the leading causes of death and long-term disability in the United States, strokes are largely preventable, treatable and beatable – if you can control your risk factors.
According to the American Stroke Association, a division of the American Heart Association, every 40 seconds, someone in the U.S. has a stroke. Keeping blood pressure in check, living a healthy lifestyle and knowing stroke warning signs may help protect you and your loved ones.
Here are key insights from the American Stroke Association’s Together to End Stroke initiative, nationally supported by the HCA Healthcare Foundation.
Controlling Risk Factors
Up to 80% of strokes may be preventable, according to the American Stroke Association. You can take action to prevent strokes by managing your risk factors, like high blood pressure, a leading cause and controllable risk factor for stroke and heart disease.
Other risk factors include diabetes and obesity, which can be kept in check with healthy lifestyle behaviors such as good nutrition. Quitting smoking and being physically active are important. Atrial fibrillation, or AFib, which is a quivering or irregular heartbeat, also increases stroke risk. In fact, people with AFib are five times more likely to have a stroke, according to the American Heart Association.
Preventing a Second Stroke
Nearly 1 in 4 strokes occur in people who had a previous stroke, sometimes because they don’t know what caused the first, making identifying the cause of the stroke a key step toward future prevention. Treatment depends on the type of stroke someone is having, which can be determined with a series of medical evaluations and tests.
Work with your health care professional to develop a plan that helps you move forward after a first stroke while preventing a second. This plan should include controlling risk factors, like achieving and maintaining healthy blood pressure, blood sugar and cholesterol levels.
“Preventing a second stroke is possible with the right approach,” said Teresita Casanova, MD, HCA Healthcare affiliated neurologist and American Stroke Association volunteer expert. “Taking medicines as prescribed, monitoring health numbers, and making small, consistent lifestyle changes can make a big difference. Stroke survivors should feel empowered to take control of their health and work with their care team to build a strong prevention plan.”
To help you in your journey, you can rely on tools such as the Heart & Stroke Helper, a free self-management app available for stroke survivors and their caregivers. The app allows patients to oversee their health in one place with features that track progress on lifestyle habits, manage medications, track health numbers, provide information about stroke and allow patients to connect with others for inspiration.
Find more ways to manage second stroke risk at Stroke.org
Act F.A.S.T.: How to Detect Signs of Stroke
Most adults in the U.S. don’t know the stroke warning signs, nor that stroke is largely treatable if you call 911 as soon as you recognize the symptoms.
Learning the acronym F.A.S.T. can help you recognize that someone may be having stroke symptoms so you can take life-saving action.
F: Face Drooping. Does one side of the face droop, or is it numb? Ask the person to smile. Is the person’s smile uneven?
A: Arm Weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S: Speech. Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.”
T: Time to Call 911. If you or anyone else shows any of these symptoms, call 911 immediately.
Photo courtesy of Shutterstock
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Time spent soaking up the summer sun is one of the things that makes the season so appealing. Warm outdoor air has a calming effect that can make anyone feel more relaxed and comfortable.
As good as warm summer sun can feel, overexposure to the sun can be dangerous. The World Cancer Research Fund reports there were more than 330,000 new cases of skin cancer diagnosed across the globe in 2022. A significant percentage of skin cancer cases can be prevented, and prevention is a multifaceted process that includes skin care self-examinations. Self-exams do not take up much time, and individuals can speak with their physicians about how frequently they should check their skin for signs of skin cancer. The U.S. National Library of Medicine offers the following instructions for how to conduct a skin self-exam.
Choose the right time to examine your skin. The USNLM recommends conducting a skin exam after bathing. Women who routinely conduct breast self-exams can check their skin at this time as well.
Use a full-length mirror. ItÕs not always easy to examine skin throughout the body. But signs of skin problems can occur anywhere on the body, including areas that might be hard to see without help. If possible, conduct a self-exam of the skin in front of full-length mirror in a brightly lit room.
Identify what youÕre looking for. The USNLM notes you should be looking for any new skin markings. This includes bumps, moles, blemishes, and changes in skin color.
Pay close attention to preexisting moles. A potential sign of skin cancer includes moles that change over time. Examine preexisting moles to see if they have changed in size, texture, color, and shape.
Look for unusual moles. The USNLM characterizes certain moles as Òugly duckling moles.Ó These unique moles look and feel different from nearby moles and may be indicative of skin cancer. Speak with a dermatologist if a self-exam uncovers the presence of moles with uneven edges or differences in colors or asymmetric shapes. Moles that look different from one side to the other also should be brought to the attention of a dermatologist. Moles that do not stop bleeding or will not heal also merit examination by a skin care professional.
When the time comes to conduct the exam, the USNLM recommends following these steps:
- Look closely at your entire body, both front and back, in the mirror.
- Check under your arms and on both sides of each arm. Be sure to examine the backs of your upper arms, which can be hard to see.
- Bend your arms at the elbow, and examine both sides of your forearm.
- Examine the tops and palms of your hands.
- Examine the front and back of both legs.
- Examine your buttocks and between your buttocks.
- Examine your genital area.
- Examine your face, neck, the back of your neck, and scalp. Use both a hand mirror and full-length mirror, along with a comb, to see areas of your scalp.
- Examine your feet, including the soles and the spaces between your toes.
- Ask a person you trust to help examine hard-to-see areas.
Skin cancer poses a formidable threat, but many cases of the disease are preventable. Routine skin self-exams are a vital component of skin cancer prevention. TF256909
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