DES MOINES, Iowa - Health disparities in the United States are getting more attention, between the pandemic and last year's social-justice protests. In Iowa, certain barriers are being addressed, including mistrust of health agencies and providers.

State health officials have said Iowa mirrors national data for people of color experiencing negative health outcomes. They have noted that the state's Black population has the highest rate of mortality in almost every cause of death, not including suicide.

Izaah Knox, executive director of Urban Dreams, a statewide nonprofit that helps reduce racial barriers, said he feels that, in terms of outreach, the health-care industry has lacked a strong presence in marginalized neighborhoods.

"I think the biggest thing," he said, "is that too many times organizations, hospitals - or anybody that all of a sudden wants to reach out - only comes out every once in a while, and if it's of benefit to them. "

He said that's why his group is partnering with others, such as the American Heart Association, to maintain a consistent presence. The Heart Association is advocating for increased state funding for a program to help marginalized Iowans get healthier foods at a lower cost. The group has said expansion of tele-health is another priority in closing these gaps.

Nalo Johnson, division director of health promotion at the Iowa Department of Public Health, agreed that improved engagement can help make these communities more resilient, especially during public-health emergencies. She said the state is trying to ramp up support for lower-level agencies in this area.

"Providing resources around translation; providing connections from what we are hearing or seeing at the federal level, in terms of resources or information," she said.

Through grant opportunities, the department also is trying to reduce disparities for diseases such as hypertension. Community groups have said policymakers need to bolster infrastructure in poorer neighborhoods, so residents can be more mobile and improve their physical health. On its website, the American Heart Association has more information on efforts to end structural racism and other initiatives to improve health outcomes in states such as Iowa.

Iowa has enlisted the help of businesses across the state to take on human trafficking.

Tomorrow marks World Day Against Trafficking in Persons, and the state is calling on residents and employees alike to be aware of the signs that someone could be a victim.

The widepread use of social media has made it harder to corral sex traffickers in recent years.

Secretary of State Paul Pate launched the Iowa Business Against Trafficking Initiative in 2022, to ask 300,000 employees of 800 Iowa businesses to be the eyes and ears if they sense a person is being trafficked.

"Well, we're not asking anyone to be a hero here," said Pate. "What we're asking them to be is good neighbors. It's like a neighborhood watch program. You watch for suspicious or unusual behavior, activities that are going on, and let law enforcement know - because they can't be everywhere all the time."

Pate has enlisted the help of the U.S. Department of Homeland Security this year - which has started an initiative to remind people that if they suspect they spot human trafficking, they should say something to local authorities.

Tom Ruck is the senior engagement manager for the Department of Homeland Security's Blue Campaign against human trafficking, and has been in Iowa to boost Pate's efforts at confronting it.

He said it's important not to try to physically step in and rescue a person who appears to be a trafficking victim, even if that's the natural inclination of someone who wants to help.

"But we could put you at harm for doing something," said Ruck. "The trafficker may try to hurt you - and definitely the person being trafficked could be put in harm's way, down the road. So we say, 'Call your local authorities.'"

He added that traffickers often prey on young people who report feeling isolated, depressed, or estranged from their parents - and the criminals work those angles to make contact with prospective victims.




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A new survey shows there's been an increase in the number of police officers on the streets since the COVID-19 exodus, but some Americans are still behaving badly when they think no one's looking.

A survey by the Police Executive Research Forum shows more sworn officers were hired in 2023 than any of the previous four years, and fewer officers overall resigned or retired.

Lance LoRusso, founder of the Blue Line Lawyer Institute, said bad behavior is still evident in communities where not enough officers were available to patrol parks or other public spaces.

"There is a segment of the population that if they don't believe there's consequences for their actions, they will not act in a lawful manner," LoRusso asserted. "They don't, because there's nobody making sure that they're taking care of their obligations and they're treating each other in a civil manner."

More than 200 law enforcement agencies responded to the survey. It showed that while small and medium departments had more sworn officers than they did in January 2020, large departments are still more than 5% below earlier staffing levels.

In March, New Mexico's Bernalillo County Sheriff's Department announced a crackdown on drivers traveling at excessive speeds, which LoRusso said became a problem during the pandemic coast to coast and has not subsided in some areas. He says citizens should not hesitate to report such incidents.

"People racing cars is dangerous. It's completely anti-social, unlawful, dangerous behavior that shows a complete disrespect for the other people in your community. And yet, it's tolerated," he said.

Car break-ins also increased during the pandemic, which LoRusso said might feel like an isolated incident, but is usually indicative of a larger problem.

Missouri residents are gaining new insights into the powerful role of food in health care as experts and organizations advocate for a shift toward food-as-medicine initiatives.

Kelsey Gardiner, assistant professor of nursing and health studies at the University of Missouri-Kansas City, emphasized the critical link between access to healthy food and improved health outcomes. She noted individuals facing food insecurity often experience higher rates of chronic diseases, highlighting the urgent need for systemic changes to enhance food access.

"There are things we can do and there are certain shifts nationally that are happening, whether that be through policy or through infrastructure changes," Gardiner pointed out. "We can be doing more in the state of Missouri in order to help increase access to healthy food that can directly tie into better health outcomes."

Gardiner underscored the potential of food-as-medicine interventions in preventing chronic conditions and reducing health care costs. She said recent studies show such interventions can lead to $13.6 billion over one year in cost savings and several improved health outcomes, making them a valuable addition to health care strategies.

Kael Martin, people impact strategist for the Health Forward Foundation, said focusing on communities affected by structural racism, socioeconomic challenges and limited health care access is paramount. Food as medicine is seen as a strategic approach to promote health equity, particularly in areas where systemic barriers hinder optimal health.

"We know that eating healthy can prevent chronic disease, but it can be a treatment option as well," Martin stressed. "To have that connection within our health care system, to really integrate these interventions, can be really impactful for many patients."

While progress is underway nationally and in other states such as Massachusetts, California and North Carolina, Missouri is still developing its approach to integrate food as medicine into health care systems and policies. Efforts to push for legislation supporting these initiatives are in progress, with some federal legislation around medically tailored meals garnering support.