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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Groups across the state are working to reduce overdose deaths among minority populations.
According to state data, overdose deaths are on the decline but among Black residents, there were around 68 deaths per 100,000 people last year; more than 51% greater than the overall rate of deaths.
Matt Johnson, board member of the nonprofit CARES Coalition in Franklin County, said the county is struggling with a lack of emergency shelter and medical services for undocumented individuals. The coalition's Community Connectors Project aims to go door-to-door in neighborhoods to help residents access the services they need.
"People who don't necessarily have a visa or a green card, or even health insurance," Johnson outlined. "We need them to be able to go and receive services; for kids to be able to see dentists, especially within our minority population has been a challenge."
The coalition is one of 10 organizations awarded $50,000 grants from the Foundation for a Healthy Kentucky's Funding for Recovery Equity and Expansion program, a partnership with the Cabinet for Health and Family Services' Kentucky Overdose Response Effort.
In Western Kentucky, the Four Rivers Foundation has expanded mental health and health care services in underserved schools.
Dr. Alex Wright, CEO of Wright Medical who works with the foundation, said gaps in access often result in students either not receiving or experiencing long delays in care. He noted so far, more than 3,000 students have been served in the classroom.
"In some of our districts, we estimated up to 50% of children were lacking any continuity of health care," Wright reported. "Many of these children haven't had a pediatrician or primary care provider, usually since they were an infant or a toddler."
Research points to increased stigma surrounding substance use disorder and mental health in communities of color. According to the Yale School of Medicine, treatment inequities persist. Nationwide in 2018, the majority of Black and Hispanic people diagnosed with the substance use disorder did not receive treatment.
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By Cat Sandoval for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration
Respiratory syncytial virus (RSV) is on the rise in Indiana, according to the Centers for Disease Control and Prevention, and it's forcing some hospitals to implement visitor restrictions.
Dr. Christopher Doehring, of Franciscan Health in Indianapolis, spoke with News 8 about why this respiratory virus increases during winter months and what hospitals are doing to prevent its spread.
"Like most of the respiratory viruses, as the weather turns cooler and people spend more time inside and around each other, its a just a highly contagious respiratory virus," Doehring said. "Like all respiratory viruses, we tend to see an increase in cases this time of year."
Holiday get-togethers can help spread the virus.
"You start to see around Thanksgiving time, you start having families coming together," Doehring said. "They're spending times in doors and it's multiple generations together. It's a natural epidemiologic phenomenon."
According to medical experts, RSV causes infections in the lungs. In healthy adults and older children, symptoms are mild, similar to the common cold.
RSV can be prevented by using good hygiene, such as washing hands and avoiding touching one's face.
Doehring said babies, premature babies, and immunocompromised elderly adults can experience severe cough, shortness of breath, and pneumonia, or even death. Doehring recommends getting vaccinated.
"Once you have the symptoms or are under the weather, take the time to recover, heal, and minimize exposing others as best as you can," Doehring said.
At Franciscan Health Hospital, masks and hand sanitizers stations are readily available to prevent the spread. Those under the age of 18 because younger visitors are more likely to spread respiratory viruses. Other hospitals in Marion County are doing the same.
Doehring says he has seen an increase of RSV cases, which is typical this time of year, but it's not alarming.
"Certainly in our hospitals and around other hospitals in central Indiana, we're not at a point where we're overrun or overcrowded in our ICUs or emergency department," Doehring said.
Cat Sandoval wrote this article for WISH-TV.
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A coalition of Montana groups will rally at the Capitol Wednesday to advocate for the protection of Medicaid expansion, which legislators will debate this session before the program's scheduled expiration in June.
The state's 10-year-old Medicaid expansion program covers 75,000 low-income Montanans at an annual cost of about $1 billion, according to KFF Health News. The state picks up about 10% of the tab.
Kristen Stewart of Billings is a caregiver for her 90-year-old grandmother, and enrolled in Medicaid herself. As an organizer with the advocacy group Big Sky 55+, she noted many Medicaid enrollees work but the work is often undervalued.
"Medicaid supports a lot of people who are doing unpaid work," Stewart pointed out. "Things that were we to monetize, you would see an economic boost from their production level, often more than the cost of their care."
The Gianforte administration already tightened eligibility for the program, cutting the number of enrollees by nearly 40% between May 2023 and October 2024. The program currently covers nondisabled adults ages 19 to 64 who make less than $21,000 a year.
Jeannie Brown, a bus driver for the Belgrade Public School District and a full-time caregiver and legal guardian for her teenage granddaughter, said if Medicaid expansion does not get reauthorized, she will be on a "slippery slope."
"Because I'm 60 years old and I'm having my own health issues after being a caregiver, it's hard work and it takes a toll on you physically, financially and emotionally," Brown explained. "I'm hoping these legislators really take all of these things into consideration and reauthorize it."
Any laws passed on the issue could also affect the state's behavioral health services, which Gov. Greg Gianforte has made a priority.
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