A new report highlights what Tennessee could focus on to improve the health of its residents.
The latest America’s Health Rankings report ranks Tennessee 44th among states for overall health outcomes. The report found nationwide, diabetes prevalence has increased to 11.5%, affecting nearly 32 million adults.
Dr. Millard Collins, professor and chair of the Department of Family and Community Medicine at Meharry Medical College, an HBCU in Nashville, said in order to ensure people are reaching their full health potential, facilities like his are charged with measuring care gaps in treating and managing such chronic conditions as diabetes.
“What we are fortunate to do at Meharry, we have these other individuals that are not just the providers to call these patients,” Collins explained. “To follow up with these patients, to engage them and teach them how to use home blood pressure monitoring and blood sugar devices, so that we can capture these and intervene in real time.”
Collins added diabetes is one of the leading causes of amputations among people of color, so services like podiatry and eye exams are especially important. Other challenges listed in the report for Tennesseans include high levels of what’s described as “frequent mental distress,” multiple chronic conditions and high numbers of smokers.
The report documented disparities in nearly all measured demographic groups in their prevalence of chronic conditions. Collins explained some reasons why people of color may have worse outcomes.
“Access. They just don’t have a trusting relationship. And they either have limited access because of their insurance, or distrust of the system also affects the access, serves as a barrier,” Collins outlined. “Two, resources, because it’s one thing to diagnose someone with a condition, but another to tell them to go and spend $60 or $70 on one medication, when they need seven to control all their heart diseases.”
Dr. Rhonda Randall, chief medical officer of employer and individual for UnitedHealthcare, said the new health ranking data reveals more than 29 million adults in the U.S. are living with three or more chronic conditions. She pointed out income and education are both strongly linked to these health challenges.
“Those who make less than $25,000 a year have the greatest number of chronic conditions,” Randall reported. “Those who haven’t received a high school diploma, have a tendency to have the greatest number of chronic conditions.”
Randall also encouraged policymakers to find ways to incentivize people going into health care professions, with so many communities experiencing a shortage of health care professionals.
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Starting Monday, California becomes the first state to cover health care for all income-eligible people regardless of their age or immigration status.
In 2016 California opened up Medi-Cal to undocumented children, then to young adults in 2020, and then to adults 50 and older in 2022.
Sarah Dar, policy director for the California Immigrant Policy Center, said now we close the gap and add undocumented adults ages 26 to 49.
“It’s completely life-changing,” said Dar, “for people who in many cases have gone years, maybe an entire lifetime, without regular access to care, doctor’s appointments, or medications.”
Prior to this, undocumented adults ages 26 to 49 had to rely on restricted-scope Medi-Cal, which only covers people experiencing a life-threatening emergency or giving birth.
The state will automatically upgrade those people to full-scope Medi-Cal.
Opponents cite concerns about cost. The state has budgeted $1.4 billion from the general fund this fiscal year, and $3.4 billion a year going forward.
Community health workers are fanning out to spread the word about the new coverage. Dar said they are tamping down fears that using Medi-Cal could affect a person’s ability to get a Green Card.
“It’s been a big source of confusion,” said Dar. “Many people may not understand that this wouldn’t be a consideration in a public-charge determination because it is a state-funded program – and because now the Trump administration’s rule has been overturned, and so Medicaid is not counted towards the public-charge test.”
People can sign up via the website CoveredCA.com or get a paper application at their county health department.
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Healthcare advocates in Maine say people who missed the most recent open enrollment deadline for healthcare coverage through the Affordable Care Act have another chance to sign up.
Mainers have until January 16 to enroll for coverage beginning in February, and the majority of those who enroll are expected to qualify for premium subsidies to lower their monthly payments.
Ann Woloson, executive director of Consumers for Affordable Healthcare, said the CoverME.gov website has helpful tools for users to compare plans.
“Some people are getting comprehensive coverage for as little as $10 a month,” said Woloson. “There are thousands of other people who are eligible for assistance, with deductibles depending on their income.”
Woloson said people who had coverage last year can be automatically re-enrolled but should check to make sure specialty or primary care providers and any prescription needs are still included in their plan.
An extended special enrollment period continues for individuals eligible for MaineCare – the state’s version of Medicaid.
The program has been undergoing an “unwinding” process since April, when pandemic-related coverage policies ended.
Woloson said the process has been confusing for many MaineCare recipients but she commends the state for working to ensure as many people as possible are covered.
“You can apply for MaineCare anytime,” said Woloson, “but if people have lost their coverage because their income, for example, has increased, that would provide them with a special enrollment period to apply for marketplace coverage.”
Woloson said while the state’s marketplace website is navigator friendly, questions often arise when choosing a healthcare plan.
She said Consumers for Affordable Healthcare offers enrollment assistance both in-person and through their help hotline at 1-800-965-7476.
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As festive as the holidays can be, isolation and loneliness peak at this time of year.
A 2022 survey finds 55% of Americans experience increased loneliness and sadness around the holidays. Some reasons for these feelings include not being around loved ones, seasonal depression, and grief.
Deb Bibbins, founder and CEO of For All Ages, said images of togetherness at this time of year play a role in this growing problem.
“The reality is that these images represent an unachievable possibility of connection for many people,” said Bibbins, “which can lead to feelings of sadness that they won’t be able to achieve the level of happiness portrayed. Which, in turn, results in disinterest in being social, and finally, results in loneliness.”
She said reaching out for positive social connections is important. Whether it’s calling friends or visiting family, these can have tremendous effects.
The benefits include an increased sense of well-being and better health. Other options like volunteering can give people a sense of purpose, which can eradicate loneliness too.
But one of the hardest steps for trying to leave holiday-related loneliness behind is the first one – acknowledging it. This can enable people to move forward since this can go beyond feelings of inadequacy.
Bibbins said isolation and loneliness can have health impacts.
“Loneliness is a root cause of anxiety, of depression,” said Bibbins. “It can be a root cause of substance abuse and even suicide. And, for older adults, loneliness increases the probability of having a stroke, of developing heart disease, and even developing dementia.”
Anyone suffering from suicidal thoughts should contact 988 or find mental health treatment options.
Outside of the holidays, the U.S. has been experiencing an epidemic of loneliness and isolation.
Part of the National Strategy to Advance Social Connection includes strengthening social infrastructure in local communities and reforming digital environments.
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