West Nile virus has had a presence in the United States for a quarter of a century. A mild winter and rainy spring sets the stage for more mosquitoes flying around North Dakota this summer, and health officials hope long-standing prevention tips still resonate.

West Nile was first detected along the East Coast in 1999. The mosquito-borne virus usually does not result in symptoms for infected humans, but serious cases still happen. North Dakota had 26 hospitalizations last year, with two fatalities.

Amanda Bakken, West Nile virus surveillance coordinator for the North Dakota Department of Health, said the virus is still in boom-or-bust mode for infections, with North Dakota starting to trend upward again in 2023.

"We always want to make sure that the population is keeping an eye out for mosquitoes because those swings can happen quite rapidly," Bakken explained. "If we do start to have an increase in cases, we don't want that to affect large amounts of our population."

She acknowledged it is not exactly clear why peaks in human cases only happen around every five years. But there are factors, such as bird migration patterns because mosquitoes feed on them, setting off a chain of infections. To avoid mosquito bites, people are encouraged to buy bug spray containing DEET, make sure your home's window screens are not punctured and eliminate standing water around your property.

Federal health and environmental officials have looked at how climate change and West Nile overlap. Bakken pointed out one way is extended droughts, which have recently occurred in North Dakota.

"Those hotter and drier environments can really push mosquitoes and birds into concentrated areas for water sources," Bakken noted. "In those circumstances, we can start to see an increase in West Nile cases."

While most people infected are not symptomatic, Bakken emphasized you still want to avoid such situations or spreading it to vulnerable populations.

"There can be very long-term effects associated with a West Nile infection," Bakken observed. "Years to a decade of having lingering symptoms."

Some of the rare, serious symptoms include muscle weakness, vision loss, numbness and paralysis.


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Clinica Family Health and Mental Health Partners have announced plans to merge operations by September of this year.

Mental Health Partners co-CEO Dixie Casford said the move will create an integrated care model that can better meet the needs of historically under-resourced populations.

Patients will no longer have to navigate complex referrals, hunt for new providers, or explain their medical history over and over.

"Whether it's oral care, and mental health care," said Casford. "Whatever combination that looks like, you come in, there's no wrong door. They can come into that system and get what they need."

The new Clinica Family Health and Wellness will offer physical, behavioral, and oral healthcare to all patients regardless of their insurance status or ability to pay from locations across Adams, Boulder, Broomfield, and Gilpin counties.

Casford said the new, larger organization will also benefit workers by providing a host of new opportunities across areas of specialization.

She said the aim is to magnify the talents and skills of the compassionate, expert staff across both organizations.

"There's going to be different positions that don't exist now across both organizations," said Casford. "And so there's going to be multiple layers of professional development, and career advancement opportunities that just don't exist in the singular organizations."

Casford said the merger is also an opportunity for new innovations. Teams of providers will be able to work collaboratively to see the full picture of an individual's physical, mental, and social needs.

She said this whole-person model can better identify and manage problems before they develop into crises. And with this merger, the new operation will be better set up to deliver a lifetime of care.

"And we really believe what that will do is move people from more acute situations farther upstream in the health care system to more prevention and wellness eventually."




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Nevada's marketplace insurance program wants people who no longer qualify for Medicaid or the Children's Health Insurance Program to know it has extended its special enrollment period through the end of November.

Russell Cook, executive director of the Silver State Health Insurance Exchange, encouraged individuals who lost coverage due to Medicaid's redetermination process to check to see if they are eligible to enroll through Nevada Health Link. He said it takes minutes to find out what type of financial assistance Nevadans could qualify for to lower their monthly premium.

"We do want to emphasize that at a high level, if anyone in your household has lost Medicaid or CHIP coverage starting in May of 2023, you are still eligible to enroll through NevadaHealthLink.com," Cook pointed out.

Since Nevada Medicaid began redetermining eligibility in April of last year, only about 4% of Nevadans who were deemed ineligible for Medicaid benefits have enrolled in a plan through Nevada Health Link. Cook explained the two main reasons people lost coverage during the unwinding process were because of procedural reasons, meaning Medicaid needed updated information to determine eligibility, or because of an increase in income.

In addition to the extension of its special enrollment period, Nevada Health Link has also launched an SMS texting initiative created to raise awareness and engage Nevadans who no longer qualify for Medicaid or CHIP. Cook described it as a direct-to-consumer approach to simplify the process of selecting affordable health insurance.

"At least through the end of September, probably the end of the year, we are going to be reaching out to these folks who have lost Medicaid coverage, again all the way back as far as May of last year," Cook emphasized. "So it really helps us reach those folks, if we have an SMS-enabled phone on file, which of course we receive from Nevada Medicaid."

Cook added it is important everyone have health insurance and receive preventive care, especially children. He warned some health conditions can quickly turn into complicated situations if not taken care of.


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Almost half of the Asian Americans and Pacific Islanders who live in Texas are skipping routine healthcare because of cost, according to a survey by Episcopal Health Foundation.

The report focuses on the overall health experiences of AAPI Texans and found that high medical bills, lack of affordable housing and reliable transportation have a negative impact on their lives.

Brian Sasser, chief communications officer for Episcopal Health Foundation, said non-medical factors can put a person's health at risk.

"Not being able to get reliable, affordable transportation to go to a doctor's visit, to go to a check-up, to get a test done, to get a prescription filled," Sasser explained. "You can't go to the grocery store to get health food so you may go to the closest convenience store, and if you can't get to a park or somewhere to exercise, you don't exercise."

One in five of those surveyed say when they receive medical treatment, they struggle to pay the bills.

More than 1.8 million Asian Americans and Pacific Islanders live in Texas. The population of Asian Americans in the Lone Star State has grown at a faster rate than any other group over the past 20 years. According to the U.S. Census Bureau, Texas counties with the highest numbers of AAPI residents are Collin, Denton, Fort Bend, Travis and Williamson.

Sasser said because of the continued population growth, future surveys will focus on the community. Their survey answers mirror those of other races and ethnic groups.

"No matter which Texans we talk with, no matter where they live in Texas, non-medical factors do make an impact. And I think what is most important is under-resourced neighborhoods hit all populations and those under-resourced neighborhoods not only have an effect on someone's life, but also their health," he explained.

More than half (55%) of those polled say the state isn't doing enough to make sure low-income adults get the health care they need, and over half say Texas should expand Medicaid to cover more low-income residents, specifically children, pregnant women and immigrants.