Jump to navigation

The University of Arizona Wordmark Line Logo White
Home
  • About Us
  • Contact
  • Donate
  • About Us
    • Faculty & Staff
      • Martin Caudillo
    • Mission, Vision and Guiding Principles
    • Strategic Plan & Core Strategies
  • Contact
  • Donate
Subscribe to our Newsletter | Connect with us    

Search form

  • Home
  • Policy One-Pagers
  • Programs
  • Events
  • News
  • Map Room
  • Publications
  • Data & Resources

News

Four IHS hospitals complete Baby-Friendly re-designation
Posted: Apr 15 2019

Indian Health Service | by Tina Tah, IHS Senior Nurse Consultant

The Indian Health Service launched the Baby-Friendly Hospital Initiative in 2011. Four of the 10 IHS hospitals that have been designated as Baby-Friendly have recently achieved re-designation, indicating their ongoing commitment to promoting a healthy start for babies.

Baby-Friendly hospitals focus on increasing breastfeeding initiation and duration using quality improvement processes to improve breastfeeding rates through new maternity care and infant feeding practices. Exclusive breastfeeding protects against obesity and type II diabetes , conditions to which American Indians and Alaska Natives are particularly prone.

At the IHS we are proud to be a part of this global effort to provide better support for breastfeeding mothers in maternity wards. The initiative was introduced in 1991 by the World Health Organization and the United Nations Children’s Fund at a time when worldwide breastfeeding rates had fallen to alarmingly low levels, and commercial interests had seeped into maternity care practices. The Baby-Friendly Hospital Initiative was created to reverse that trend by changing some standard practices in the maternity ward, the setting which is most influential in a mother’s decision to initiate breastfeeding and helping her establish lactation and achieve ongoing breastfeeding success.

IHS Baby-Friendly hospitals encourage the broad-scale implementation of the Ten Steps to Successful Breastfeeding   and the International Code of Marketing of Breast-milk Substitutes. These guidelines were developed by a team of global experts and consist of evidence-based practices that have been shown to increase breastfeeding initiation and duration. U.S. facilities that achieve these high standards of care are designated as “Baby-Friendly” by Baby-Friendly USA, the authority for the BFHI in this country.

Achieving Baby-Friendly designation is an important part of the journey, but it is not the endpoint. Routine data collection, monitoring of practices and quality improvement activities are vital to ensuring that the Baby-Friendly standards are maintained. Facilities are responsible for ongoing adherence to the most currentGuidelines and Evaluation Criteria   .

IHS facilities that are designated as Baby-Friendly are required to be surveyed and re-designated every five years. The process to become re-designated can take up to two years.

IHS congratulates the four facilities that have completed re-designation:

  • Claremore Indian Hospital
  • Phoenix Indian Medical Center
  • Quentin N. Burdick Memorial Health Care Facility
  • Zuni Comprehensive Community Health Center

The Baby-Friendly Hospital Initiative has become the standard for obstetrical care in the Indian Health Service. The Indian Health Service credits patient satisfaction, promotion of mother-baby bonding, successful breastfeeding, and outstanding patient care as key factors in these successful results.

Related content:

Promoting Health through Breastfeeding 
IHS Breastfeeding Toolkit 
IHS Breastfeeding Promotion and Support 
United States Breastfeeding Committee  


Ms. Tina Tah is a public health nurse and the senior nurse consultant at IHS headquarters. She has been actively involved in efforts to promote and sustain the health promotion breastfeeding initiative since 2011 as a means to improve the services to American Indian and Alaska Native communities. She retired as a captain from the Commissioned Corps of the U.S. Public Health Service.

 
Top of page

CEO Spotlight: Robert Seamon
Posted: Apr 15 2019

AzHHA Blog | April 5, 2019

Today’s blog comes to us from Robert Seamon, CEO of  Copper Queen Community Hospital.  Here he shares his thoughts on the success, challenges and the future of healthcare in Arizona. Once you’ve had a chance to read it, we’d love to hear your thoughts. Generating meaningful conversations around the health issues facing us here in Arizona is another way we are working to make our state the Healthiest State in the Nation!

AzHHA: What are the biggest hurdles to providing care?

Mr. Seamon: While I am always optimistic about the future, there are many challenges facing rural hospitals. I believe the greatest hurdle to providing patient care centers on a rural facility’s ability to remain financially viable and open for business. Financial margins in rural healthcare can be razor thin.  Cuts from Federal and State funding programs such as Medicare and Medicaid are devastating.

Many rural communities also face significant economic challenges, including the loss of valuable industries.  As a result, populations decline causing a significant decrease in volume and revenue for the hospital. Operating cash then becomes insufficient to cover the high fixed costs. As a result, many rural hospitals have been forced to close.

Another significant hurdle is the ability to attract qualified professionals to isolated areas, when the nation as a whole, is facing critical workforce shortages. In addition, hospitals large and small throughout the country are scrambling to develop effective strategies to address cyber threats, regulatory burden, escalating operating costs, social determinants of health affecting patient care outcomes and a national opioid epidemic that continues to kill thousands of Americans on an annual basis.

AzHHA: What are the greatest health needs in your community?

Mr. Seamon: Behavioral health services and addiction medicine programs are in desperate need. Moreover, many rural communities have a high prevalence of chronic conditions including hypertension, diabetes, heart failure and chronic obstructive pulmonary disease. The availability of specialty physicians is often severely limited in rural communities. Social determinants of health, including a lack of transportation to and from medical appointments, the inability to pay for prescription medications and lack of safe, affordable housing are all critical needs.

AzHHA: When you think about the future, what are you most hopeful for?

Mr. Seamon: My dream is to work with other healthcare facilities and community leaders to implement effective strategies that dramatically improve the overall health of our population. My goal is for every resident of the communities we serve to have access to the care they need, provided in the safest possible way, in alignment with the most recent evidence-based standards of care. When patients are discharged, I want them to have a safe place to live, hot food, access to needed medicine, a social support system and transportation to their medical appointments. We service three separate communities, and I want them all to be ranked the healthiest communities in Arizona. That’s my vision!

AzHHA: What is your facility’s greatest recent success?

Mr. Seamon: Copper Queen Community Hospital has been blessed with tremendous success. We are seeing solid growth in every service line. In large part, our success is due to the size of the communities we serve. Having a steady volume of patients is critical. Moreover, we have an incredible Board of Directors made up of volunteers who truly care about the communities we serve. We have the best medical staff. Our providers are exceptional and provide safe, quality care to our patients. We have over 300 employees who commit themselves to our success on a daily basis. We are fortunate to have several specialty physicians, including the recent addition of a gastroenterologist. We also have a robust telemedicine program that helps connect our patients to the care they need for good health.

AzHHA: What keeps you up at night?

Mr. Seamon: Interestingly, it’s not the challenges. I’ve spent my entire career in healthcare. There are always serious problems to face; it’s just part of the job. What keeps me up at night is quite positive. I think about my dream. I think about who I can partner with and how I can make it happen. At the end of my career, I don’t want my name on a building. I want to look back and know that my work was meaningful and impactful on the health of my community.

 
Top of page

A long road: Opioid-addicted rural residents travel hundreds of miles to reach methadone clinics
Posted: Apr 15 2019

By LURISSA CARBAJAL | Cronkite News | Apr 5, 2019

MORENCI – It’s just before sunrise as Maggie Phillips wakes her three children in the darkness.

The oldest, Jaxon, a second-grader, is headed to school. For the two youngest, Phillips packs clothes, snacks and toys for the hour long trip to the methadone clinic.

Jesse, 3, runs around the small room he shares with his brother, Jayson, 4, looking for his favorite Spider-Man jacket. All three are dressed and ready by 7:30 a.m., when the school bus arrives for Jaxon. Phillips, Jayson and Jesse say goodbye as he climbs aboard.

Phillips straps her younger sons into their car seats and pulls out of the driveway for their once-a-month trip to Safford. The round trip is long for kids, but it’s half as long as it once was – Phillips used to travel all the way to Tucson, every day, for months, until Community Medical Services opened a year ago.

She has to get there before the clinic closes at 11:30 a.m. If she misses her appointment, she has to make the same trip the next day, or suffer drug withdrawals and miss another chance to beat her addiction.

“I have kids. I want to be sober for them,” said Phillips, 29, a homemaker whose husband stays behind to work. “The treatment helps me stay sober. It’s helped me be where I’m at today.”

Fighting opioid addiction always is tough, but it’s even tougher for rural residents who live miles from treatment clinics. Most clinics in the U.S., built in response to the heroin epidemic of the 1970s, are in big cities. These days, drug abuse has expanded to the suburbs and rural areas but the facilities to treat it have lagged because of funding shortages and the stigma around drug-treatment facilities.

In Arizona, 12 clinics treat addiction with methadone – a synthetic opioid used for decades to stabilize users and minimize withdrawal symptoms – but most are in the Phoenix area.

Tucson and Safford each has one clinic to serve the rest of Arizona outside metro Phoenix, meaning that many rural residents seeking medication for opioid addiction must travel hundreds of miles.

Advocates and opponents wrangle over whether methadone is the gold standard for treatment, if it merely substitutes one drug for another, or whether other treatments, including therapy and medication, are better.

For Phillips, who was once reluctant to take methadone, it’s a necessary step on an exhausting journey to recovery. She said not taking methadone plunges her into darkness.

“That’s the worst place I’ve ever been in my life,” she said. “I’d rather give birth every day for the rest of my life than ever feel withdrawals or feel sick again – it’s awful.”

In 2016, the opioid crisis in the U.S. cost more than $56 billion in law-enforcement costs, emergency-room visits, lost productivity and premature deaths, according to the Centers for Disease Control and Prevention.

Even as deaths have quadrupled over the past decade, the CDC says the number of people in methadone treatment has ticked up by less than 25 percent. Arizona health officials have recorded nearly 20,000 overdoses and nearly 2,800 deaths since 2017.

Phillips has struggled with opioid abuse since she was 15, starting with prescription pills before moving on to heroin. Her life to sobriety began when she was 20 and discovered she was pregnant with her first child, Jaxon, and decided to get sober. Phillips said she stayed away from drugs for a couple of years but relapsed after she was given medication to treat an injury.

Phillips started her methadone treatments when she was 25 and pregnant with her second child. She was reluctant at first, believing she would just be replacing one drug for another.

“I was like, ‘I really don’t want to do the methadone,’ and there was this awesome nurse that explained everything to me.”

Methadone imitates how opiates act within the brain, changing how the brain and nervous system respond to pain. It lessens the symptoms of opiate withdrawal and blocks the euphoric effects of such opiates as heroin, morphine and codeine. The right dose of methadone can eliminate withdrawal symptoms without causing the patient to feel high.

“I never wake up and go, ‘I can’t wait to take my methadone.’ It’s just part of the day, like drinking a cup of coffee,” Phillips said.

Clinics like the one in Safford usually are open for six hours a day, closing by noon or, at the latest, early afternoon. But at least Phillips has her 2014 Chevrolet Impala to drive to the clinic once a month.

“We encounter a large majority of our patients having transportation issues, and living here in a rural area like Safford, Arizona, you don’t know where they’re coming from,” said Keith Jeffery, clinic manager for Community Medical Services.

When patients first start treatment, they must visit the clinic every day – a travel time of one to four hours. Several months later, the trips may decrease to twice a month, later falling to once a month.

Patients spend nearly $50 per week just on travel costs, and they often have to drive backroads. The lack of transportation leads to patients missing treatments, which results in more relapses.

“They can be coming from any of those small towns, so the travel can be treacherous at times,” Jeffery said.

» Read complete article at link below:

 

 

 
Top of page

Arizona's Doctor Shortage Isn't Just Hurting Our Health
Posted: Apr 11 2019

From AzHHA Newsletter | April 10, 2019 

Though much of the work on the state budget is happening behind closed doors, a recent op-ed in The Arizona Republic is keeping the effort to provide state funding for graduate medical education (GME) out in the open.  Yesterday, State Senator Heather Carter and prominent local economist Jim Rounds made the case that GME funding benefits Arizona’s economy as well as its health. Read the full article below.

Arizona's doctor shortage isn't just hurting our health. It hits our wallets, too

By: Heather Carter and Jim Rounds, opinion contributors

Anyone who has been or will be a patient should be concerned about Arizona’s severe shortage of doctors and nurses. They should also be concerned that the shortage may be limiting the state’s economic potential.

In most discussions about building a stronger Arizona economy, policymakers and economists discuss tax rates, economic development programs and regulations. But the provision of a quality health-care system is just as fundamental to economic growth.

Our concern is the current shortage of doctors and nurses across the state will eventually translate into slower economic growth. This would mean fewer new jobs being created in every county, lower levels of income for many, and a declining quality of life for residents.

How bad is Arizona's doctor shortage?

Arizona is one of the fastest-growing states for overall population growth and at the same time, a leader in elderly population growth. This demographic, which brings retirement money to communities and buys second homes and cars and other things, will require quality health-care services.

The state is also a leader in attracting new businesses and encouraging new ones to be formed. Many will locate to the bigger cities, but others will prefer a more rural lifestyle. These businesses and entrepreneurs examine a long list of community attributes, health-care quality among them, before growing roots.

The people in the trenches are seeing the same things that we are seeing as policy professionals. According to the University of Arizona Center for Rural Health, every county is experiencing a severe shortage of doctors and nurses, as well as increases in costs and decreases in quality.

That same policy brief indicates that Arizona ranks 44th nationally in primary care physicians at 77.9 per 100,000 population and meets just 41% of its primary care physician need.

How SB 1354 addresses the shortage

The Arizona Legislature is considering Senate Bill 1354 to alleviate the state’s health-care workforce shortage. The bill provides support for five programs — Graduate Medical Education, the University of Arizona Medical School, primary care provider loan repayment, medical student loan repayments, and nurse training. All of these programs will move the needle on the shortage.

Graduate Medical Education, commonly known as physician residencies, has not been state-funded in a decade, thus leaving matching federal funds on the table. Senate Bill 1354 will contribute $20 million, matched by approximately $47 million in federal funds — a total of $67 million would become available to the GME account.

We know the vast majority of doctors practice where they do their residency. The problem is that Arizona simply doesn’t have enough medical residencies. Only 42 percent of Arizona’s medical students remain in the state after graduation, as reported by the Association of American Medical Colleges.

But when they train in Arizona, they stay in Arizona. According to Dr. Bharat Magu, chief medical officer at Yuma Regional Medical Center, nearly all medical students who finish the hospital’s post-graduate training stay in-state, and 67% stay in Yuma.

We often need to be reminded how the smallest changes in our overall rate of growth, both in income and job counts, can have a dramatic impact on state and local finances.

This issue matters.

If passed, this initiative will improve the well-being, both economic and physical, of all Arizonans.

Sen. Heather Carter represents Legislative District 15 in north Phoenix. Reach her at hcarter@azleg.gov. Jim Rounds is an economist and president of Rounds Consulting Group. On Twitter: @_jimrounds.

 
Top of page

Bike Ajo Program is Model for Rural Communities
Posted: Apr 8 2019

Lo Que Pasa | By Gerri KellyMel and Enid Zuckerman College of Public Health | March 29, 2019

A partnership meant to increase physical activity and prevent chronic disease has led to the creation of a community cycling center in Ajo, Arizona.

Lily Williams describes Ajo as a trusting and safe town where you can see the stars at night. Her parents still live in the same house she grew up in. Located in western Pima County, the small rural community of Ajo is a former mining town with Organ Pipe Cactus National Monument for a backyard, and a total population of 3,165. 

Like many rural communities across the country, Ajo has its challenges. Recent studies found that 71 percent of families in Ajo are living below the federal poverty line and there is a 15 percent unemployment rate – both significantly higher than other areas within Pima County. Nearly half of the population identifies as Hispanic or Latino, a group that continues to experience significant chronic disease disparities for conditions such as diabetes and cardiovascular disease.

Data from the Ajo Unified School District shows that each grade had an obesity rate of at least 32 percent, with sixth grade reaching an alarming 57 percent.

"The residents of Ajo have significant disparities due to multiple social determinants of health including a lack of access to opportunities for physical activity and other resources necessary to prevent chronic disease," said Martha Monroy, program manager and lecturer in the Department of Health Promotion Sciences at the Mel and Enid Zuckerman College of Public Health.

After 10 years of city living, Williams moved back home to Ajo with her husband and young daughter. 

"So here I am back in my community ready to be involved but now a parent. How do I live a healthy lifestyle for both myself and my family in a community that I am learning has so much chronic disease? And since we are a community that is like family, how do we as a community come together and alter or even change our culture so that we can take advantage of what Ajo has to offer," Williams says in a digital storytelling video for the Bike Ajo Coalition. 

Monroy and colleagues applied for the Arizona Planning Association's Plan4Health grant and with a dedicated group of people, the Bike Ajo Coalition was formed. Today, the town has two bike hubs open to children and their families, one located at the Ajo Unified School District office and the other based at Desert Senita Community Health Center.

This isn't Monroy's first ride around the block when it comes to building a coalition to create healthy communities. She worked with community partners to create the Bike Center at the Roy Drachman Clubhouse on Tucson's south side and the Docs on Bikes project in collaboration with the Department of Family and Community Medicine at the UA College of Medicine – Tucson.

» Read more at link below:

 
Top of page

‘Association’ health plans may provide more choice, but critics fear consumer harm
Posted: Apr 1 2019

Stephanie Innes | Arizona Republic| April 1, 2019 

Lauren Klinkhamer of Tucson speaks during a protest in Sen. Jeff Flake’s Capitol Hill office. Klinkhamer said she has 16 chronic medical conditions, but fears the current Senate plan to replace Obamacare will cost her health insurance. 

A bill that would expand access to “association” health-insurance plans in Arizona would put into state law elements of a Trump administration rule that was just rejected by a federal judge.

Senate Bill 1085, which is moving through the Arizona Legislature, expands the ability for small businesses, including sole proprietors, to band together and purchase health insurance as an “association.”

The bill codifies into state law elements in a final rule issued by the U.S. Department of Labor in June that loosened some of the regulations on association health plans to make them more attractive to businesses that have not previously used them. It also added sole proprietors into the category of people who could join associations and buy health insurance.

The federal judge’s ruling Thursday casts some uncertainty on the proposed Arizona legislation. The judge's opinion says the Trump administration's final rule is an intentional “end-run” around the federal Affordable Care Act.

“I would think associations looking to form plans would need to think twice about doing so, given this uncertainty,” said Larry Levitt, vice president of the Kaiser Family Foundation. “If this ruling stands, it would limit states’ ability to open the door to more association health plans.”

Debbie Hann, chief operating officer for the Arizona Small Business Association, said her organization remains positive, in spite of the ruling, and is moving forward with plans to offer health insurance to members.

Hann said her association began taking steps to offer health insurance after Trump issued an executive order in October 2017, calling for expanded access to association health plans.

What is an association health plan?

Under SB 1085 and the federal rule, an association of people working in a similar trade, for example, would have negotiating power to get its members cheaper insurance options. Associations could purchase insurance as a large-group employer, and some may choose to self-insure, which critics fear will increase the risk for insolvency. The Arizona Department of Insurance did not take a position on SB 1085.

Proponents say broadening access to the plans will allow everyone from self-employed millennials in the tech industry to small-business owners access to insurance that is otherwise unaffordable for them. Association plans may charge higher rates based on factors such as age and gender, but the association cannot use health status to determine eligibility, premiums, or benefits. 

“This is going to be a game-changer for our members. It will level the playing field for recruitment and retention,” said Hann of the Arizona Small Business Association.

Supporters include Blue Cross and Blue Shield of Arizona, the Arizona Association of Health Underwriters, and the Arizona Technology Council.

Trump has called association health plans “tremendous insurance at a very low cost.” 

“I think we are all supportive of things that are more affordable for consumers and choice is always great. But you have to read the fine print,” said Swapna Reddy, a clinical assistant professor at Arizona State University's College of Health Solutions. 

» Read the full article at link below or download PDF.

 
Top of page

U.S. District Judge Strikes Medicaid Work Requirements
Posted: Mar 28 2019

AzHHA Newsletter | Debbie Johnston, Senior Vice President of Policy Development

A federal judge on Wednesday struck down Medicaid work requirements for able-bodied adults in Arkansas and Kentucky. The requirements are somewhat similar to community engagement requirements that the Centers for Medicare & Medicaid Services has approved in Arizona. The rulings, which were made by U.S. District Judge James E. Boasberg, found the requirements pose numerous obstacles to getting health care that have not been adequately addressed by federal officials and state officials in Arkansas and Kentucky. Consistent with the ruling, matter has been remanded back to the Department of Health and Human Services.

 
Top of page

Arizona MD Creates mHealth App for Pregnant Women Dealing With Substance Use Disorder
Posted: Mar 27 2019

A University of Arizona Doctor is using a $10,000 HRSA prize to fine-tune an mHealth platform designed for people dealing with substance abuse to help pregnant women and new mothers.

By Eric Wicklund | mHEALTH INTELLIGENCE

March 25, 2019 - A University of Arizona physician is modifying an mHealth platform to give new and expecting mothers a digital health connection to substance abuse treatment.

Maria Manriquez, MD, director of the Addiction Medicine curriculum and professor in the Department of Obstetrics and Gynecology at the University of Arizona College of Medicine-Phoenix, is using a $10,000 prize from the US Health Resources and Service Administration to modify the connected care platform developed by iTether Technologies, a Phoenix-based telehealth company.

iTether had developed the mHealth app for people dealing with substance abuse disorder (SUD). Manriquez’ goal is to personalize that app for pregnant women and new mothers.

» Read more at link below:

 
Top of page

Pinal County ranks last in doctor ratios, work commutes
Posted: Mar 21 2019

By Kevin Reagan Staff Writer | March 21, 2019 | Casa Grande Dispatch

  
 

Pinal County ranked last in the state by having one doctor for every 6,440 residents. Darker blue indicates worse ratios of primary care physicians to population. 

RWJ County Health Rankings and Roadmaps 2019. University of Wisconsin Population Health Institute: 

http://www.countyhealthrankings.org

CASA GRANDE — Data released this week shows Pinal County has the worst ratio in Arizona for primary care doctors per capita.

The University of Wisconsin’s Population Health Institute recently released its annual rankings of the healthiest counties in Arizona. Based on a number of health factors, Pinal County ranked seventh — a few spots down from the fourth ranking it held in 2017.

Higher rates of adult obesity, air pollution and sexually transmitted diseases were a couple factors observed in Pinal County, which the Health Institute calculated through more than 50 sources of public data.

The county has continued to not show improvement in its number of licensed primary care physicians. According to the Health Institute, Pinal County has had the largest ratio of primary care doctors per capita in Arizona for the last few years.

Sixty-five primary care doctors were listed as working in Pinal County — a lower number than surrounding counties with smaller populations. Yuma County was listed as having 84 doctors and Mohave County had 94.

Dr. Shauna McIsaac, Pinal County’s director of public health, said she wasn’t surprised to see the data on doctor ratios. The shortage of health providers has been known for a while, she said, since many residents travel to Maricopa or Pima counties for health care.

Sun Life Family Health Center, which operates several clinics around Pinal County, agrees there’s been a drop in doctor ratios. But Kim Collins, Sun Life’s chief operations officer, told Pinal Central health care is not being compromised because more nurse practitioners have entered the workforce.

The Health Institute’s definition of primary care doctors does not include nurse practitioners or physician assistants, who also provide primary care services to patients.

This may explain why numbers contained in a 2017 health assessment on Pinal County differ from the Health Institute’s. According to the assessment, which was done by the Pinal County Public Health Department and Banner Health, the county had one primary care provider for every 944 residents — a ratio still three times larger than the state’s average. The Health Institute’s ratio was one primary care physician for every 6,439 residents. Coconino County had a ratio of one physician for every 1,200 residents.

Several areas of Pinal County have been designated by the federal government as being medically under-served. These include Eloy, Coolidge, Maricopa and Apache Junction.

The University of Arizona’s Center for Rural Health estimates Pinal County needs to recruit at least 64 more primary care providers in order to meet its current demand.

“That’s a pretty big shortage,” said Dr. Daniel Derksen, director of the Center for Rural Health. An aging doctor population and low salaries are some reasons the center believes Arizona doesn’t have enough primary care physicians.

Derksen added that the number of residency slots for medical students is limited in Arizona, so many must go out-of-state to complete their training.

“Once people leave, they don’t come back, unfortunately,” Derksen said.

A bill was recently introduced in the Arizona Senate that would infuse more money from the general fund to fix the state’s doctor shortage.

The Health Institute’s annual rankings also examined quality-of-life factors that may negatively impact a person’s health. For example, Pinal County was found to have the highest percentage of residents who must drive alone to work for more than 30 minutes.

The institute said it collected this data because long commutes have been found to cause high blood pressure and obesity. Fifty-two percent of Pinal residents reported having long work commutes — a rate much higher than Pima and Maricopa counties.

McIsaac said Pinal County is beginning to incorporate public health into community planning as a strategy to get more residents physically active.

Many areas of the county require a car to get from one place to another, the director said, so planners are looking at designing communities that allow and encourage residents to walk more.

The Health Institute report shows Pinal County has seen fewer teen pregnancies and adult smokers in the last couple of years.

» Download PDF version.

 
Top of page

More States Say Doctors Must Offer Overdose Reversal Drug Along With Opioids
Posted: Mar 20 2019

In a growing number of states, patients who get opioids for serious pain may leave their doctors’ offices with a second prescription — for naloxone, a drug that can save their lives if they overdose on the powerful painkillers.

New state laws and regulations in California, Virginia, Arizona, Ohio, Washington, Vermont and Rhode Island require physicians to “co-prescribe” or at least offer naloxone prescriptions when prescribing opioids to patients considered at high risk of overdosing. Patients can be considered at high risk if they need a large opioid dosage, take certain other drugs or have sleep apnea or a history of addiction.

Such co-prescribing mandates are emerging as the latest tactic in a war against an epidemic of prescription and illegal opioids that has claimed hundreds of thousands of lives over the past two decades.

The Food and Drug Administration is considering whether to recommend naloxone co-prescribing nationally (an FDA subcommittee recently voted in favor), and other federal health officials already recommend it for certain patients. And the companies that make the drug are supportive of the moves. It’s not hard to see why: An FDA analysis estimated that more than 48 million additional naloxone doses would be needed if the agency officially recommended co-prescribing nationally.

Most states have limited the volume of opioids doctors can prescribe at one time and dramatically expanded access to naloxone. In California, for example, pharmacists can provide naloxone directly to consumers who are taking illegal or prescription opioids or know someone who is.

In the states with co-prescribing rules, patients aren’t required to fill their naloxone prescriptions, and those with cancer or who are in nursing homes or hospice typically are exempted.

» Full article at link below:

 
Top of page

‘Historical trauma’: Native communities grapple with missing and murdered women
Posted: Mar 20 2019
By Kelsey Mo | Cronkite News
Monday, March 4, 2019

SELLS – One day they were there and the next they weren’t. No one talked about the Native women and girls who simply disappeared.

April Ignacio knew they existed. She did not forget. 

How many were there? 

Nearly three years ago, she started a quest to help others recount how many of her Native sisters disappeared. 

Ignacio talked to fellow members of the Tohono O’odham Nation and began listing women who had gone missing or were murdered in her community. She pored over newspaper archives. Word of her inquiries spread and the project picked up speed. 

She tried working with tribal police and the tribal prosecutor’s office, asking whether they could remember cases in which women were missing or murdered. Some retired officers told her they didn’t want Ignacio “kicking over these types of rocks.” 

She spoke with family members of the lost women, building a catalogue to track them. 

“That was the hardest part of doing something of this magnitude,” Ignacio said, recalling a mission that began in July 2016. “It’s still a very sensitive subject for a lot of small communities.”

One woman. Four women. Then more. 

So far, at least 33 women, stretching back to the 1960s, are on the list.

Limited data exist on the number of missing and murdered indigenous women – one account recorded 506 cases in 71 urban areas – but experts say it’s likely undercounted because authorities inconsistently collect data. A bill in the Arizona Legislature would establish a committee of community leaders from tribes and police departments to officially track and analyze missing and murdered indigenous women. 

Legal issues surrounding violent crime on reservations further complicates the issue. Native American tribes, under federal government law, have limited jurisdiction to indict and sentence defendants in tribal courts. Sometimes, cases are sent to federal court. Figuring out whether the federal or tribal courts have jurisdiction to prosecute violent crimes can drag out cases for years. 

Advocates say the process often leaves behind questions for the families and perpetuates historical trauma.

» Read full article at link below:

 
Top of page

Study: Poverty, obesity, lack of services weigh down Pima County health
Posted: Mar 19 2019

By Patty Machelor | March 18, 2019 | Arizona Daily Star

Arizona residents in Maricopa, Yuma and Greenlee counties have better overall health scores and easier access to health services than those living in Pima County, a new study shows.

The study, County Health Rankings, was released Monday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. It compares Arizona counties to one another as part of a nationwide study. The study looks at more than 30 factors including education, housing, jobs and access to medical care to see how these influence how long, and how well, people live.

It shows Pima County’s fourth-place ranking within Arizona is driven by its rates of obesity and related chronic diseases, such as diabetes, as well as problems people have accessing health and behavioral-health services. It’s also tied to a lack of affordable housing, which the report says is a barrier to accessing health care.

Overall, Arizona has a substantial number of people who are underserved living in both urban and rural areas, said Dr. Daniel Derksen, associate vice president for health equity and outreach at the University of Arizona who did not take part in the study.

Some Arizona residents live in areas where they have to travel 30 or 40 miles to get basic health care, he said. The state ranks 44th out of 50 states when it comes to physician shortages, according to a recent study by the UA’s Mel and Enid Zuckerman College of Public Health’s Center for Rural Health.

“We really need to address our primary care shortages,” Derksen said. “We need to strengthen our primary and preventive services, and make them more readily accessible both in rural areas, where it’s quite alarming, but also in underserved urban areas.”

» Read full article at link below:

 
Top of page

Arizona Hospital and Healthcare Association Names Ann-Marie Alameddin New President & CEO
Posted: Mar 17 2019

Greg Vigdor Retires after Six Years of ‘Major and Positive Change’

PHOENIX—The Arizona Hospital and Healthcare Association (AzHHA), the organization giving Arizona hospitals a voice to collectively build better healthcare and health for Arizonans, has named Ann-Marie Alameddin as its President and CEO, effective April 2, 2019. Ms. Alameddin, AzHHA’s Vice President of Strategy and General Counsel since 2015, succeeds Greg Vigdor, who is retiring after six years.

The AzHHA Board of Directors selected Ms. Alameddin after a search for the most qualified candidate. “This role is so unique in the world of healthcare,” explains AzHHA Board Chair and President and CEO of Havasu Regional Medical Center Mike Patterson. “A lot will be expected at all levels of expertise, and Ann-Marie’s background, patient-centered orientation and deep expertise with the needs of Arizona hospitals fits our expectations for the advancement and expansion of AzHHA’s mission to a T.”

A third-generation Arizonan, Ms. Alameddin is well-known in healthcare circles around the state. After receiving a B.A. from Creighton University, she went on to earn a Master’s degree from the University of San Francisco with a focus on healthcare and bioethics, and a Juris Doctorate and health law certificate from Arizona State University.

Since that time, she has worked tirelessly to promote collaboration and dialogue across sectors, in the development of health policy that benefits both Arizona hospitals and patients alike.

With an extensive background in community service and organizing, she also is well-versed in bringing people and organizations together not only to exchange ideas, but to take affirmative action and achieve desired results.

AzHHA will continue to advocate positive industry changes, just as it did in the nationally historic ruling for Medicaid Restoration and Expansion, and what it is doing to help combat the opioid epidemic.

“I’m inspired to continue the path Greg Vigdor has forged these last years, including with Medicaid Expansion,” says Ms. Alameddin. “I have a laser focus on doing what is right for patients, while building consensus among hospitals and navigating this dynamic and complex healthcare environment.”

Ms. Alameddin succeeds Greg Vigdor, who the Board selected as AzHHA President and CEO in 2013. Mr. Vigdor came to Arizona after 20 years at the Washington Health Foundation, and is well-known for helping pass Medicaid Restoration in Arizona and, along with Ms. Alameddin, defending it in subsequent years.

“My charge was to create major and positive change at AzHHA and for the patients of Arizona, and much has been accomplished,” says Mr. Vigdor. “It is now time to turn it over to a new leader who can carry AzHHA’s values and plans into the future, and Ann-Marie is the right choice for that.”

 
Top of page

OpEd: Syringe service programming is good public health policy
Posted: Feb 26 2019

By Beth Meyerson Special to the Arizona Daily Star | Feb 20, 2019

As a recent Arizona transplant and co-director of the Rural Center for AIDS/STD Prevention at the Indiana University School of Public Health-Bloomington, I watch with interest Arizona’s policy process to allow syringe-service programs. SSPs are public-health efforts providing sterile syringes and myriad other services to people who inject drugs.

While states are unique laboratories for policy innovation, bilateral state learning is often helpful. In 2015, Indiana considered and passed syringe-access policy following an HIV outbreak among people who injected drugs in Scott County. Prior to this, it was illegal to distribute and possess syringes for non-prescription drug use. As a result, 231 people are now infected with HIV in that rural community.

I offer a few insights for Arizona’s consideration in the spirit of bilateral learning.

First, SSPs are expressions of good public-health policy because they provide critical linkage to public-health services for populations disconnected from them. Services often include HIV and hepatitis C (HCV) testing, access to clean syringes and naloxone — the opioid overdose-reversal medication — and primary care, addictions treatment and social-service referrals. These actions directly benefit those receiving them, their families and the wider community because they decrease overdose death, HIV and HCV infection, and facilitate access to addictions and primary-care treatment.

Second, SSPs are “public-health multipliers” because program participants extend the public-health reach deep into their communities by providing peers with clean syringes and naloxone kits. This is important, because 50 percent to 80 percent of those who inject drugs will become HCV-positive within five years of initiation. Further, according to a 2014 national study, 82 percent of those who administered naloxone at the time of overdose were drug-using peers. Reducing HCV, HIV and overdose among those who inject drugs would not be possible without SSPs.

Third, SSPs are not emergency response programs, but are part of the “upstream” public-health effort to create environments where healthier choices can be made — such as whether or not to use contaminated syringes, test for HIV, HCV or fentanyl, deliver naloxone to someone overdosing or access health services. This point should not be missed here in Arizona.

I recall an 11th-hour legislative amendment last year that mirrored our Indiana law requiring communities to declare an “epidemic” of HIV or HCV in order to establish an SSP. This requirement killed Arizona’s bill last year and continues to strangle Indiana’s efforts because it is untenable. Indiana Representative Ed Clere, R-Floyd, who led the effort for syringe access equated this thinking to “waiting to install smoke detectors after the house is engulfed in flames.” I would ask Arizona policy partners to recognize such a requirement for what it is: a public-health barrier.

Fourth, there are 30 years of solid public-health research documenting that SSPs are cost-effective, lead to reduced syringe sharing, disease and adverse health outcomes among program participants, and do not facilitate increase drug use or increases of discarded syringes . The evidence is overwhelming and conclusive.

Finally, to those feeling cautious about syringe-access policy because they may not be acquainted with drug use or addiction in their families, and to those who hold positions of zero tolerance, I can only offer this: Public health is about collectively creating the conditions for health. This means having a harm-reducing approach (think: nicotine patches, seat belts, etc).

Public health is about making lives less dangerous and more healthy. Everyone — every one — in our communities deserves public-health access. Together, we can strengthen our community’s health through syringe-services programs. With this effort, Arizona can teach Indiana something.

 
Top of page

Arizona, other states in ‘governors challenge’ target veteran suicides
Posted: Feb 12 2019

BY ANDREW HOWARD/CRONKITE NEWS | FEBRUARY 11, 2019 AT 4:21 AM

WASHINGTON – Arizona was one of seven states that met with federal officials and veterans groups in Washington last week to map out a strategy for reversing the complex problem of suicides among vets.

The problem is real in Arizona, which had the sixth-highest veteran suicide rate in the nation in 2016, due in part to the state’s aging veteran population and the wide-open spaces that make access to behavioral services difficult.

“That’s just terrible,” said Wanda Wright, director of the Arizona Department of Veterans’ Services. “And being in the position I’m in, I felt like I had some influence on that.”

Wright was in Washington as part of the inaugural Governors Challenge to Prevent Suicide Among Service Members, a joint effort by the departments of Veterans Affairs and of Health and Human Services. Health care experts, veterans and state and federal officials collaborated for three days to find local solutions to the ever-climbing veteran suicide rate.

In 2016, the most recent year for which the VA has reported data, veterans were committing suicide at a rate of 30.1 deaths per 100,000 vets, compared to an overall national rate of 17.5 suicides per 100,000 people. The numbers were sharply higher in Arizona, with an overall rate of 23.4 suicides per 100,000 and a vets’ rate of 44.1.

The Arizona Violent Death Reporting System claimed an even higher veteran suicide rate of 54.8 per 100,000 in 2016. It said the rates ranged from a high of 90.9 in Mohave County to 39.1 in La Paz County.

Arizona officials at the Washington meeting pointed to several factors driving the state’s high veteran suicide rate.

“We tried to make a correlation between how veterans were dying,” and what officials could do to address that, Wright said. “What we found is that older veterans that have access to firearms – that are in isolated places – they have a higher risk for suicide.”

And residents of rural areas face a lack of access to health care – or to reliable Internet that could bring care to them, experts said. That makes it harder for veterans in rural areas to get treatment during the transition from deployment to home life.

Getting health care providers to rural areas is difficult, said Jill Bullock from the University of Arizona’s Center for Rural Health.

“If you tend to grow your own providers, they come back, but that is not always the case,” Bullock said. “It’s harder to train and get your residency programs out to the rural areas because you don’t have the patient volume that you do in the urban areas to get all of your … requirements.”

» See complete article at link below:

 

 
Top of page

  • « first
  • ‹ previous
  • …
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • …
  • next ›
  • last »
View All

Tweets by @UACRH

Latest Newsletter

Home

Mel and Enid Zuckerman College of Public Health
1295 N. Martin Ave. - P.O. Box 245163
Tucson, Arizona 85724
All contents copyright © . Arizona Board of Regents.
Privacy | Webmaster | Sitemap | Center for Rural Health


University Privacy Statement


© 2021 The Arizona Board of Regents on behalf of The University of Arizona.

The University of Arizona