What's Stress Got To Do With It?

Recently National Public Radio (NPR), Robert Woods Johnson Foundation, and the Harvard School of Public Health conducted a study entitle “The Burden of Stress in America.” The results are being broadcast on NPR stations over the next few weeks, but the complete results have already been published here.

The study, conducted between March 5^th and April 8^th of 2014, attempted to examine the role that stress played on Americans in the last year, the perceived effect of stress and the causes of stress, and individual methods of managing stress.

The study found nearly half of the public (49%) reported having an event or experience in the last year that they considered to be majorly stressful. Of the 49% that reported a stressful event or experience, over four in ten (43%) reported health related problems – citing illness and disease, or death of a loved one.

The study went on to find that a quarter of people reported a great deal of stress within the past month, with those in poor health more than twice as likely to report a great deal of stress in the past month (60%), followed by disabled individuals (45%), those with chronic illness (36%), and individuals suffering from poverty (36%). Nearly seven out of ten (72%) of those who experienced a great deal of stress in the past month perceive that stress has a major impact on most people’s health.

Additionally, those who reported a great deal of stress in the last month most commonly reported negative effects on emotional well-being (63%), trouble sleeping (56%), and difficulty in thinking, concentrating, or making decisions (50%). For the same group, those who identified themselves as having a chronic illness or disability, over half stated that it made their symptoms worse (53%) or made it harder to manage their chronic illness or disability (52%).

The results of this survey may come as no surprise to rural health care providers in Kentucky, where high rates of disability, poverty, and chronic disease are prominent. Many rural providers see an overwhelming number of patients with one or more of these factor - so what will happened to these rural providers in a value-based health care system when it becomes nearly impossible to manage?

Another Supreme Court ACA Ruling Announced Yesterday...

The Supreme Court ruling yesterday on the contraceptive mandates under the Affordable Care Act seems to have kicked the hive in health care reform again. It seems that amidst the plethora of information outlets, the truth behind the ruling remains unknown to the majority of the public.

Hobby Lobby and their two sister companies sued the Department of Health and Human Services (HHS) stating that the contraceptive mandates of the ACA violated their religious beliefs as an employer. Hobby Lobby cites four specific contraceptive methods described as “abortifacients”, arguing that by providing the coverage they are facilitating abortions or facing severe penalties for non-cooperation.

 The HHS argued that as a for-profit entity, Hobby Lobby and their familiars were exempt from citing religious beliefs in a defense and as such their argument was a moot point.

The Supreme Court has released their 95-page syllabus and opinion by the justices identifying that this case had to do with whether or not a for-profit entity could be exempt from the contraceptive mandates, just as a non-profit religious entity is. Citing a variety of definitions, the court ruled that a “closely held corporation” (one having more than half the value of its stock owned by five or fewer individuals) like Hobby Lobby is eligible for exemption from the ACA contraceptive mandates.

Short and sweet, what’s this mean?

This means that not all for-profit entities will have to provide contraceptives free of cost-sharing to their employees if doing so conflicts with their religious beliefs. Don’t be confused though, there will be a variety of obstacles that an employer will face before they can completely do away with their portion of the mandate.

Those effected the most, the female consumers of the insurance, will see no current change; the Supreme Court ruling recommends that by extending the same opportunities to women working in non-profit and religious sectors (who are currently exempt), these women can continue to be provided with the exact same coverage at no additional cost.

Is there a rural impact for health care professionals?

To providers and health care administrators in rural regions, being correctly informed of this decision is important. The lifeblood of many rural communities are the family-owned for-profit companies that provide goods, services, and jobs to the areas that they serve. It is equally as important that health care professionals understand the impact of health care policy as it relates to those that they serve.

As a health care professional, assure your patients and consumers that the changes occurring do not hinder their ability to receive FDA-approved contraceptives without cost-sharing at this time. The ruling of the Supreme Court simply means that there will be a difference in the future to who “foots the bill”, and hopefully it will be placed back on Congress to find that out – not the patient.

"The road to health is paved with good intestines!" - Sherry A. Rogers

Healthcare is a rapidly evolving landscape, but unlike true terrain we don’t get the luxury of millions of years adjusting to small incremental changes. Changes come in many forms – legislative mandates, technology enhancements, consumer expectations, and more. The only constant in health care is change; that inevitable shift that can benefit so many, while unfortunately destroying others.

All of us, at some point or another in our lifetime, will be affected by health care as a consumer; but not all of us must deal with the changes on a consistent and nearly burdensome basis. In order to stay abreast it is often difficult to find the time to muddle through literature and find a particular piece of relevant information. In this blossoming digital age – as our attention spans shorten, and our demand for instant gratification heightens - it is important that information be accurate, well researched, and pertinent.

Rural health care professionals face obstacles and challenges of a different breed than their urban counterparts. It is no mystery that access to advanced equipment, dwindling funding streams, shortages of providers, and other obstacles make practicing in a rural environment difficult.

The goal here is not to berate ideology, or even to necessarily take a stance on specific health care related topics. Rather, the goal is to assist in creating a more informed network of health care professionals serving in rural communities all across the Commonwealth of Kentucky.

I hope that you enjoy.