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Rural Veterans Face Long Paths to Health Care

Posted: August 20, 2017

While long drives and limited access to health care are familiar burdens for many rural residents, the problem is particularly acute for veterans in those areas. They are far older than other rural residents, and far more likely to be disabled, meaning more of them are in need of medical care. And there are a lot of them—one in four veterans lives in rural areas, compared to one in five adults in the general population, according to 2015 census data.

While there is a general lack of doctors and hospitals in rural areas, the situation is even worse for veterans who rely on the VA, said John Hoellwarth, a spokesperson for American Veterans, the nation’s largest veterans’ organization. In recent years, the VA has set up more community-based clinics, and the Obama administration created a program, called Choice, that allows non-VA clinicians to serve rural veterans and receive reimbursement from the VA. But the problem persists.

Many rural veterans rely on a combination of VA health insurance and other forms of insurance, such as private insurance, Medicaid (the joint federal-state health insurance program for the poor and disabled), or Medicare (federal health program for the elderly), according to census data. The number of veterans enrolled in Medicaid increased by about 340,000 under the Affordable Care Act, according to an analysis by Families USA, a nonprofit that advocates for high-quality, affordable health care.

For veterans in rural areas, “Medicaid could mean the difference between them getting care, and them not getting care,” said Andrea Callow, Families USA associate director of Medicaid initiatives.

To improve care for rural veterans, the VA needs to expand both the services it provides and the services it pays others to provide, said Margaret Puccinelli, chairwoman of the Veterans Rural Health Advisory Committee, which makes recommendations to Secretary of Veterans Affairs David Shulkin.


Local Jail Inmates Take a Step toward Turning Their Lives Around

Posted: August 18, 2017

The McLennan County Jail in Waco Texas hosted a graduation ceremony for nine inmates in the McLennan County Reintegration Program (MCRP) on July 24. The program helps inmates who have been in-and-out of jail and often struggling with substance abuse by providing services like counseling, substance abuse treatment, education, and job training including a six-week workforce training certification through McLennan Community College.

The help appears to be working: only one of the 67 program participants have “recidivated” (returned to jail) since the pilot program launched in November of 2016.

MCRP is created and initially funded through a partnership with McLennan County, the City of Waco, and the Heart of Texas Region Mental Health and Mental Retardation Center. Recent grant funding has added to the program’s continuation.

The program, which was in the works back in 2012, allows services to begin during incarceration, rather than waiting until release. The inmates who participate in the six-part program receive support with employment, housing, education, social connection, and mental health and substance use disorder treatment, including Alcoholics Anonymous and Narcotics Anonymous classes.

The pre-release part of the program has four phases, and provides individuals with the skills needed for successful reintegration, according to officials. Participants work on the final two phases once they’re released back into society and are no longer incarcerated.


Lower-Income Children Raised In Counties with High Upward Mobility Display Fewer Behavioral Issues

Posted: August 15, 2017

Children who grow up in urban counties with high upward mobility exhibit fewer behavioral problems and perform better on cognitive tests, according to a study led by Princeton University. Children in these counties display fewer behavior problems at age 3 and show substantial gains in cognitive test scores between ages 3 and 9. Growing up in a county with higher intergenerational mobility reduces the gap between economically advantaged and disadvantaged children's cognitive and behavioral outcomes by around 20 percent.

The study, published Aug. 14 in the Proceedings of the National Academy of Sciences, provides further evidence that place, measured at the county level, has a significant influence over the economic prospects of children from .

The study results are based on data from the Fragile Families and Child Wellbeing Study, of which McLanahan, who is founding director of the Bendheim-Thoman Center for Research on Child Wellbeing, is a principal investigator. The study is a population-based birth-cohort study of children born in 20 large U.S. cities between 1998 and 2000.

For their analyses, the researchers looked at 4,226 children from 562 U.S. counties whose developmental outcomes were assessed at approximately ages 3, 5 and 9 years old. The researchers divided these children into low- and high-income groups based on household income at birth. Children from low-income families were born in households earning below the national median household income (mean of $18,282), while children from high-income families were born in families earning above the national median (mean of $73,762).

Behavioral problems—like aggression and rule-breaking—were assessed by parents and teachers using the Child Behavior Checklist, a report used in both research and clinical settings, along with the Social Skills Rating Scale, a system that evaluates social skills, problem behaviors and academic competence. Cognitive abilities were assessed through a series of vocabulary, reading comprehension and applied problems tests in the children's homes. Both assessments were collected as part of the Fragile Families and Child Wellbeing Study.

After analyzing the data, the researchers found that children from low-income families who grew up in counties with high upward mobility had fewer behavior problems and higher cognitive test scores when compared with children from counties with lower mobility. These differences were significant even after controlling for a large set of  characteristics, including parents' race/ethnicity, education, intelligence, impulsivity and mental health.


Strong Ethnic Identity, Social Support Help Latino Youths Cope with Racism

Posted: August 14, 2017

What coping resources help ethnic minority adolescents deal with racial/ethnic discrimination? A new study published in Child Development addressed this question by testing the role of ethnic identity, social support, and anger regulation as potential buffers that may help offset the negative impact of discrimination on the mental health of Mexican-origin adolescents living in the Midwestern United States.

In prior research, racial/ethnic discrimination has consistently been associated with poor mental health outcomes. Consequently, it is important to help identify effective coping strategies for youths who experience discrimination. However, many questions remain unanswered regarding which coping strategies are effective in reducing the detrimental impact of discrimination on psychological adjustment, particularly among immigrant Latino youths.

Study participants were 269 Mexican-origin adolescents who were 12-17 years old, recruited from public schools, churches and community-based organizations in a Midwestern region. Youths completed survey questionnaires on laptop computers at three time points, spaced approximately four months apart. The majority of the youths were born in the U.S. (71 percent), with the remainder born in Mexico (29 percent). All adolescents came from families where both biological parents were also from Mexico. The adolescent participants were asked to complete questions about their discrimination experiences (e.g., if they had been called an insulting name or witnessed a family member being treated unfairly because of the color of their skin, accent, or cultural background), ethnic identity (e.g., how good or proud they feel about being Mexican, how much they engage in cultural practices or how much time they spend trying to find out about their cultural background), social support from their family, friends or significant others, and the degree to which they suppressed or expressed their anger.

Overall, the authors found that a strong ethnic identity and greater social support were protective factors in the link between discrimination and adjustment problems in this sample of Mexican-origin youths. That is, having a stronger ethnic identity or more social support weakened the link between discrimination and adjustment problems. Anger suppression also acted as a protective factor. On the other hand, we found that outward anger expression was a risk factor. That is, outward anger expression tended to exacerbate the association between discrimination and adjustment problems. Importantly, these protective and risk factors differed according to the level of analysis.

Read more on Read the abstract of the study.

2018 Robert Wood Johnson Foundation Culture of Health Prize Call for Applications

Posted: August 12, 2017

The Robert Wood Johnson Foundation (RWJF) Culture of Health Prize (the Prize) recognizes communities that have placed a priority on health and are creating powerful partnerships and deep commitments that will enable everyone, especially those facing the greatest barriers to good health, the opportunity to live well. A Culture of Health recognizes that health and well-being are greatly influenced by where we live, learn, work, and play; the safety of our surroundings; and the relationships we have in our families and communities. The Prize elevates the compelling stories of local leaders and community members who together are transforming neighborhoods, schools, businesses, and more—so that better health flourishes everywhere.

There are characteristics shared by communities that catalyze and sustain positive change. Because the Prize recognizes whole communities, applicants must think beyond their own individual organizations and initiatives to what has been accomplished across the community. Prize communities will receive $25,000, have the opportunity to share their story and lessons learned with the country, and join a national network of past winning communities.

Application deadline is November 3, 2017, at 3:00 pm ET.

Learn more about the Prize.

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