Un nuevo informe revela que invertir en zonas rurales puede mejorar los recursos esenciales para las personas que viven allí. A pesar de una importante población de que 46 millones de personas viven en zonas rurales en los Estados Unidos, estas regiones reciben sólo una cantidad mínima de subvenciones. En 2012, Kate B. Reynolds Charitable Trust lanzó la iniciativa Healthy Places North Carolina y asignó 100 millones de dólares a 10 condados rurales. El objetivo era mejorar la accesibilidad a los recursos y, después de una década, su informe de impacto revela avances significativos en áreas como alimentos saludables, recreación y recursos de atención médica. Adam Linker, del Reynolds Trust, dice que la clave para empoderar a estas comunidades depende de una estrecha colaboración con los propios residentes.

"Las personas que mejor conocen sus problemas son las que están más cercanas a los problemas de la comunidad, por lo que hay que invertir en esos lidéres, en esas organizaciones, para que puedan liderar ellos mismos los esfuerzos de cambio," indicó también el entrevistado.

Linker enfatiza el poder de las soluciones impulsadas por la comunidad para lograr un cambio real y duradero. El informe se hace eco de este sentimiento y destaca casi 600 subvenciones distribuidas a 61 organizaciones locales en el este y centro de Carolina del Norte. Sus esfuerzos están marcando una diferencia, desde la creación de centros de recuperación por adicciones hasta la mejora del acceso a la atención médica, abordando necesidades cruciales en las zonas rurales.

Una comunidad que está cosechando los beneficios de primera mano es West Marion en el condado de McDowell. Linker insiste en la importancia del Foro Comunitario de West Marion, la única organización sin fines de lucro dirigida por negros en el condado. Históricamente desatendida, la comunidad destaca por su papel fundamental en el inicio de iniciativas como el transporte público gratuito, el establecimiento de un próspero jardín comunitario y la ampliación del acceso a recursos vitales.

"West Marion, que es predominantemente afroamericana, en un momento fueron los últimos en limpiar la nieve y, a través de su trabajo para conocer a los líderes de la ciudad, ahora son los primeros, relató además Linker. La ciudad ha comenzado a prestar mucha atención a lo que la comunidad tiene que decir."

La Dra. Kristen Burwell Naney, del Reynolds Trust, cree que la última década ha demostrado que no sólo es importante que los financiadores creen organizaciones comunitarias, sino que también cambien su forma de pensar sobre el éxito. Ella asegura que este trabajo requiere una estrategia a largo plazo.

"En lugar de esperar ver cambios rápidos en los resultados de salud de la población, descubrimos que es necesario centrarse en cosas como la detección de cambios en las redes, las relaciones, el poder y la resolución de problemas dentro de una comunidad," argumentó Burwell Naney.

El informe destaca lecciones clave para los financiadores que desean cambiar las condiciones que producen desigualdad para impulsar el cambio. La Dra. Burwell-Naney explica que una conclusión importante que hay que entender es que las diferencias en las capacidades de las organizaciones a menudo se deben a un acceso desigual a los recursos financieros y de desarrollo de capacidades. El informe sugiere que los financiadores tienen la oportunidad de abordar estos desequilibrios ofreciendo un apoyo más específico a grupos que históricamente no han recibido financiación suficiente o han sido excluidos.

World Hepatitis Day is this Sunday, and for the Oregon Health Authority, it's an opportunity to promote its plan to eliminate hepatitis across the state.

Released in March, the plan includes major goals and strategies to limit the spread of hepatitis A, B and C over the next six years. It's gotten new attention after 2,400 patients in Oregon hospitals were potentially exposed to hepatitis and HIV earlier this month.

Concerns are high, but epidemiologist Dr. Dean Sidelinger, Oregon's state health officer, said people should be aware of the threats of hepatitis, but not anxious.

"In day-to-day times, people should feel safe and confident in going to the doctor," he said. "The risk of exposure to these viruses is extremely low in most cases."

Hepatitis is inflammation of the liver, and contagious viruses are among the causes. Sidelinger said he's confident Oregon has the technology and resources to fully eliminate the threat.

While many people may have heard of hepatitis, they may not fully understand how prevalent it is in their communities. According to OHA data, the proportion of chronic hepatitis C cases among people in their 20s tripled between 2010 and 2019.

Sidelinger said there's a good chance most Oregonians know someone who is affected by chronic hepatitis.

"It can seem out of the blue to be talking about hepatitis and [a] hepatitis awareness day, but this is a disease that affects many individuals," he said. "But the good news is, everyone can take steps to protect themselves."

The OHA says you can help prevent the spread of hepatitis by washing hands and fresh produce, staying current on vaccinations, avoiding sharing needles, and getting tested regularly. These tips and more are part of the state's plan to eliminate hepatitis by 2030.


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CoveredCA announced Wednesday that the average premium for plans on the marketplace will rise 7.9% in 2025, but subsidies are expected to blunt the impact and even lower costs for many consumers.

The Biden-Harris administration's Inflation Reduction Act caps premiums at 8.5% of income for many, and goes even further for those with low incomes.

Rachel Linn Gish, director of communications for the nonprofit Health Access California, said the state has put the federal funds to good use.

"Because of this financial help," she said, "California has been able to take even further steps to lower costs for many CoveredCA enrollees by eliminating deductibles and reducing copays for many health services such as doctors' visits, lab work, generic drugs."

However, the enhanced premium subsidies in the IRA will expire next year, sending costs soaring unless Congress extends them. If not, Gish said, she expects premiums to rise 60% to 80%, costing thousands more per year. Opponents of the extension have cited the need to limit federal spending.

Gish said if the federal premium help ends, people could start seeing much higher deductibles.

"Without the federal assistance, California stands to lose $1.7 billion in assistance, which the state can only backfill a fraction of," she said, "which means consumers could again see deductibles of $5,000 or more."

Other big changes are on the way. Starting Nov. 1, about 40,000 income-eligible DACA recipients in California will be able to apply for premium subsidies through Covered California.

Connecticut insurance companies are requesting rate increases. Companies want a more than 8% increase for individuals and an almost 12% increase for small groups. However, insurance costs are already problematic for residents. A 2022 survey shows 46% of people delayed important medical care due to coverage costs.

Liz Dupont-Diehl, associate director of the Connecticut Citizen Action Group, said unaffordable insurance is all too common.

"It is an unfortunate American right of passage to spend hours a week appealing claims denials, or dealing with rising copays, and surprise costs. Even those of us lucky enough to think we have good coverage are continually surprised by hings that are not covered," she said.

Of the legislative solutions lawmakers can take, polls show voters across party lines support the government setting limits on out-of-pocket medical care costs for people with insurance.

Connecticut's Insurance Department will host an informational meeting for people to share their experiences and hear testimony. It will be held from 9 a.m. to 1 p.m. on August 20 at the Legislative Office Building in Hartford and over Zoom.

One way Connecticut's General Assembly can better regulate insurance companies is by increasing transparency surrounding pharmacy benefit managers. A recent Federal Trade Commission report finds the six largest pharmacy benefit managers manage 95% of the country's prescriptions.

Dupont-Diehl said this can help people better understand why certain claims get denied.

"We would be interested in knowing exactly which claims are denied based on ZIP code, based on race and ethnicity, based on age, based on gender," she continued.

She notes that much of what needs to be done to fix health care can be done at the federal level, although states can take the lead. Part of Connecticut's 2023 budget calls for the state's Insurance Department to work with the Office of Health Strategy to study ways to make care more affordable.