RALEIGH, N. C. - Outsmarting the enemy will take a team effort. That's the message for the "Get Smart About Antibiotics" campaign from the Centers for Disease Control and Prevention (CDC). Its goal is to educate the public, doctors, and the agriculture industry that antibiotics must be used more judiciously to reduce the spread of antibiotic-resistant infections.

Dr. Lauri Hicks, medical director for the project, says there is a new sense of urgency because resistant bacteria are spreading rapidly. The trend is connected to the overuse and misuse of antibiotics, while the rate of new antibiotic discoveries has slowed in recent years – dropping from 16 developed between 1983 and 1987, to one new antibiotic created since 2008.

"And what happens is now, common infections may be difficult to treat. When you really need an antibiotic, it may not work."

As an example of the problem, the CDC cites one type of antibiotic-resistant pneumonia, Klebsiella pneumoniae carbapenemase, first found in North Carolina in 1999 – that has now spread to 35 states.

Dr. Gail Hansen, a veterinarian and senior officer of the Pew Campaign on Human Health and Industrial Farming, says getting farmers and ranchers to phase out the routine use of antibiotics for food animal production is just as urgent. She says an estimated 70 percent of the antibiotics sold in the United States are used on industrial farms to help animals grow faster and stay healthy in crowded conditions.

"We've seen bacteria that have become resistant to antibiotics - bacteria that are found predominantly in animals, that then get into our food supply and make people sick."

Those who support using antibiotics in food animal production claim there's no proof that antibiotic-resistant bacteria come from animals. But Hansen explains that drug resistance is a shared risk, just as effective antibiotics are a shared resource. She wants to see farmers and ranchers get assistance in changing production methods, to ensure that antibiotics are used only for medical reasons.

"We need to be looking forward to how do we come up with answers that more match what's being done on the farms today. What works on the farms? What doesn't work on the farms?"

Details of the CDC's campaign are online at www.cdc.gov/getsmart. Additional information about the issue is at www.SaveAntibiotics.org.




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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"