Growth in Rural Emergency Department Visits Outpace Urban Increases

MedicalResearch.com Interview with:

Margaret B. Greenwood-Ericksen MD, MScDepartment of Emergency MedicineUniversity of New MexicoAlbuquerque, NM 87109

Dr. Greenwood-Ericksen

Margaret B. Greenwood-Ericksen MD, MSc
Department of Emergency Medicine
University of New Mexico
Albuquerque, NM 87109

MedicalResearch.com: What is the background for this study?  

Response: I’m an emergency physician, so I see first-hand how emergency department use patterns provide a lens into the status of health care delivery in the communities they serve. Troubling declines in the health of rural Americans coupled with rising rural hospital closures – with little access to alternative sites of care like urgent care – all led me to hypothesize that rural populations may be engaging with the health care system differently than their urban counterparts.

Understanding the health care use of individuals in rural areas may yield insights into addressing rural health disparities. Further, this information may help healthcare systems and policymakers to make data-driven decisions informing new models of healthcare delivery for rural communities.

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Town vs Gown – Why Are City Kids More Stressed?

MedicalResearch.com Interview with:
“dog” by Neil Mullins is licensed under CC BY 2.0Prof. Dr. rer. nat. Stefan O. Reber

Laboratory for Molecular Psychosomatics
Clinic for Psychosomatic Medicine and Psychotherapy
University Clinic Ulm
Ulm, Germany 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our hypothesis was that people who grew up in cities with more than 100.000 inhabitants  and without pets will show a more pronounced immune activation towards psychosocial stressors compared with people raised in rural areas in the presence of farm animals. This hypothesis is based on the fact that stress-associated psychiatric disorders, which are linked to or even promoted by an over(re)active immune system and chronic low grade inflammation,  are more prevalent in urban compared with rural areas. One possible explanation for a hyper(re)active immune system in people raised in urban relative to rural environments might be a reduced contact to immunoregulatory microorganisms (the so called “old friends”), which is significantly increased in rural people with regular contact with farm animals compared with urban people in the absence of pets.

Our results show that a standardized laboratory psychosocial stressor causes a greater inflammatory response in young healthy participants with an urban upbringing in the absence of pets, relative to young healthy participants with a rural upbringing in the presence of farm animals. Continue reading

Community Dental Program May Reduce Emergency Dental Admissions

MedicalResearch.com Interview with:
Jonathon P. Leider, PhD
Department of Health Policy and Management
Johns Hopkins University
Baltimore, MD

MedicalResearch.com: What is the background for this study?

Response: The increasing utilization of Emergency Departments (ED) for the treatment of non-urgent and non-traumatic dental conditions among adults in the United States is an increasing policy issue. Research shows that seeking dental care in an ED is often more expensive and less effective when compared to a traditional dental office. Seeking care in the ED for non-traumatic dental conditions is more frequent among low income individuals and people in rural areas, who must often overcome insufficient dental coverage and access to receive office-based care.

Under the Affordable Care Act, there has been considerable expansion in state Medicaid dental coverage for adults. However, not all states are participating in the expansion or extension of dental benefits and dental professional shortage areas are fairly common– over 4,900 exist in the United States. Innovative programs are needed to effectively address the challenges low income individuals in rural areas encounter accessing care. Our study examined the expansion of a Community Dental Program (CDP) in rural Western Maryland and its impact on dental-related visits at a regional ED.

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