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.

A bill in the Tennessee General Assembly is reigniting debate over how rural hospitals can staff anesthesia providers. House Bill 979 would address the shortage of anesthesiologists in rural Tennessee by allowing hospitals in counties with fewer than 105,000 residents to directly employ physician anesthesiologists.

Hospitals now have to use third-party anesthesiology services.

Dr. Louis Chemin III, anesthesiologist and physician with Tennessee Anesthesiology Consultants Exchange, supports physician supervision in what's known as the "Anesthesia Care Team" model. He said anyone hired as an anesthesiologist would be required to follow strict medical guidelines.

"Currently under state law, a hospital cannot employ an anesthesiologist, a radiologist, a pathologist or an emergency medicine physician. If this bill were to pass, it would allow hospitals in these rural communities the option to hire an anesthesiologist," he contended.

Chemin said the bill would allow a hospital anesthesiologist to perform anesthesia in one operating room, or to supervise the process in up to four operating rooms.

On Wednesday, the bill passed the House with a vote of 72 to 5, with 11 members "present but not voting." It now heads to the state Senate.

When a physician anesthesiologist provides medical direction to Certified Registered Nurse Anesthetists or Anesthesiologist Assistants, Chemin explained, they must comply with seven steps outlined by the Centers for Medicare and Medicaid Services to qualify for reimbursement under Medicare.

"This law means that if a hospital employs an anesthesiologist, that they must allow the anesthesiologist to practice in a way that is safe and is in agreement with these seven steps," he continued.

Chemin added that these requirements would ensure the anesthesiologist's active involvement in the patient's care and safety.


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A new report found Missouri's public health agencies are not sharing information effectively and fixing the problem could lead to better health care for people in the state.

The Missouri Department of Health and Senior Services released its first assessment of the state's digital health system, highlighting ways to improve how health data is shared and used. The evaluation uncovered significant gaps in sharing critical information such as disease rates, hospital visits, birth outcomes and access to care.

Joshua Wymer, chief health information and strategy officer for the department, shared key insights from the report.

"Data is still often siloed," Wymer pointed out. "There was an opportunity with data to advance inoperability, there's an opportunity to always be better at privacy and security because we know that the threat of that is always evolving."

The report recommended establishing clear rules and strong leadership for better data management. More than 200 organizations took part in the assessment, through 25 meetings across nine regions.

A separate study found health care providers said patient access to electronic health records improved communication and treatment discussions. Wymer also shared what citizens expect from the systems as health data grows in importance.

"They expect their data to not only be available and readily accessible, but they expect it to be private and secure," Wymer reported. "And they expect an experience that moves closer and closer to them and their routine and their priority."

The assessment revealed Missouri's public health agencies have different digital capabilities but are ready to adopt new data systems.


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Wednesday is National Healthcare Decisions Day and advocates are calling attention to Florida's pressing need for advance care planning, particularly among vulnerable groups.

About one in five Floridians is over 65 and the state also struggles with one of America's highest uninsured rates, at 10.7%, significantly above the 8% national average.

Brandi Alexander, chief engagement officer for the national end-of-life advocacy group Compassion & Choices said Latino residents have nearly double the uninsured rate of white Floridians. She noted there are good reasons for anyone to plan for their future health care needs.

"Nearly half of the population are people of color in Florida," Alexander pointed out. "A 2021 study found that the preventable mortality rate for Black individuals was 1.5 times higher than it was for their white peers."

The annual awareness day encourages families to discuss and document their medical preferences before a crisis strikes. Florida's 52 licensed hospice organizations serve patients through hundreds of care teams statewide, according to state health data. Alexander emphasized clarifying care wishes can alleviate burdens on families and reduce preventable suffering.

Alexander added normalizing the conversations can empower patients and reduce disparities.

"The more we have tools and the more we normalize the conversation, we can start changing some of the negative stigma that comes with talking about death," Alexander stressed. "Because once you're talking about it and you know what options are available to you, you can then really advocate for yourself within the health care system - and that's how we really create change."

Free resources, including advance directive forms and multilingual guides, are available through the state health department and advocacy groups like Compassion & Choices.