RAND Study Examines Access to Dental Care in Pennsylvania

Although it is preventable, dental disease is perhaps the most prevalent chronic childhood illness in the United States. According to the Centers for Disease Control and Prevention, 20 percent of children 5 to 11 years old have one tooth with untreated decay, a situation that may lead to more severe health problems. Youth from lower-income families have a higher rate of untreated tooth decay than their peers.

As dental care has long been a component of public health policyRAND examined access to dental care across Pennsylvania using a series of indicators to determine the distribution and available of dentists and dental hygienists. Two counties (Potter and Juniata) did not meet the guideline of full-time dentist per number of residents. Other counties varied greatly across study indicators. A sample of findings:

  • Two counties do not have dentists that accept Medicaid.
  • 58 percent of counties in Pennsylvania do not have pediatric dental specialists.
  • High unemployment rates were associated with fewer providers of dental care.
  • The Head Start program appears to be a successful method in getting dental care to children who might not otherwise have access to it.

The full report, including a discussion of associations of the study’s access-to-care indicators to each other, as well as to county demographics, is available for download on the RAND website.

 

 

Citation:  Baird, Matthew D., Michelle K. Baird and Joseph V. Vesely. Access to Dental Providers in Pennsylvania: Exploration of the County-Level Distribution of Dental Providers and Populations in 2013. Santa Monica, CA: RAND Corporation, 2016. http://www.rand.org/pubs/research_reports/RR1351.html.

 

More Evidence that Social Connectivity is Linked to Better Health Outcomes

As a kind of addendum to my previous post, I wanted to note that another study has identified links between social interaction and health, not just with the elderly but at two distinct stages of life. Researchers associated with the University of North Carolina Chapel Hill used data from four national samples to determine if an association existed between elements of personal relationships and physical health markers. Published in the Proceedings of the National Academy of Sciences, the study concluded that level of social involvement and size of social network are associated with the risk of poor health.  Among senior citizens, social connection was associated with lower risk of disease development, particularly around obesity and hypertension. An even more interesting finding – the level of social engagement among adolescents predicted their risk of health complications later in life.

 

 

 

Citation: Yang Claire YangCourtney BoenKaren GerkenTing LiKristen Schorppand Kathleen Mullan Harris. Social relationships and physiological determinants of longevity across the human life span. PNAS 2016 ; published ahead of print January 4, 2016, doi:10.1073/pnas.1511085112

 

Chronic Loneliness Can Make You Sick

At this time of year there is heightened awareness of the needs of others. We donate dollars, coats, toys and gifts, bags of food, or whatever else is needed to help make the holiday season a little less difficult for those facing economic hardship.  But social needs are also important, and when they are neglected due to self-imposed or situational isolation, there is an emotional and physical toll.  A holiday advertisement from the German store chain Edeka has been in the news this week for its powerful imagery of a lonely widower who is only able to bring his children and grandchildren together at Christmas by his (fake) death. Well played, Grandpa.

Sniffle inducing commercials aside, there are scientific links between loneliness and poor health. Studies released this year indicate that loneliness can make you ill and can be detrimental to longevity. Research out of Brigham Young University suggested that social isolation is as much of a risk factor to well-being as obesity, regardless of whether a person prefers solitude or is around others but feels alone. Even for younger people in the sample, little or weak social connection was a mortality risk.

Advancing their research on how loneliness results in changes at the molecular level, a research team including experts from the University of Chicago, UCLA and the California National Primate Research Center at the University of California-Davis, found that perceived social isolation leads to stress signaling, which affects genetic expression and cell production and lessens the body’s resistance to infection and illness.  The cells of lonely individuals contained “conserved transcriptional response to adversity” or CTRA (genes linked to inflammation in previous research). In this study however, loneliness was identified as a predictor of future genetic changes and a related decrease in the effectiveness of the immune system.  The team plans to continue their work on the links between loneliness, disease, and mortality to better understand the health risks and outcomes related to social isolation.

 

 

Citations:

Holt-Lunstad, T. B. Smith, M. Baker, T. Harris, D. Stephenson. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science, 2015; 10 (2): 227 DOI: 10.1177/1745691614568352

Steven W. Cole, John P. Capitanio, Katie Chun, Jesusa M. G. Arevalo, Jeffrey Ma, John T. Cacioppo. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. Proceedings of the National Academy of Sciences, 2015; 201514249 DOI: 10.1073/pnas.1514249112

Cancer Patients and Survivors Want to Work but Face Challenges

This week the CEO of Goldman Sachs announced that he had been diagnosed with lymphoma and would continue to work while receiving treatment.  Whether one remains at/returns to work after a cancer diagnosis depends greatly on an individual’s situation, but an online survey of American cancer patients and survivors found the majority (73 percent) want to work, citing financial concerns but also the belief that working helps in their overall recovery.

According to the survey, conducted by the Harris Poll for Cancer and Careers, although most respondents enjoy working, they also face challenges balancing their health needs with the workplace. For example, women were more likely than men to report working a reduced schedule due to treatment, and people of color were more likely to be advised by a medical professional to stop working while in treatment. Other findings from the poll,

  • fatigue was the primary daily challenge of employed respondents,
  • 20 percent have concerns that taking days off will weaken their employment stability, and
  • 65 percent feel that additional information is needed around navigating employment and workplace issues after a cancer diagnosis.

Additional data from the study is at the Cancer and Careers website, along with a resource library and employment search services and tools.