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A common misconception about teen pregnancy is the belief that it is a problem mainly among the urban poor teenagers.  Not true.  The teen birth rate in rural areas is nearly one-third higher than in the rest of the U.S., according to a study released on Thursday by the National Campaign to Prevent Teen and Unplanned Pregnancy.
The study examined county-level data from the National Center for Health Statistics from 2010 and defines rural counties as those with populations under 50,000 and metropolitan counties as those with populations of 50,000 or more.
Key Findings from the Report
•In 2010, the teen birth rate in rural counties was nearly one-third higher compared to the rest of the country (43 per 1,000 girls age 15 to 19 vs. 33).

•The teen birth rate in rural counties surpassed that in suburban counties and even that in major urban centers.

•The teen birth rate was higher in rural counties than in other areas of the country regardless of age or race/ethnicity.

•Even so, rural counties accounted for a minority of teen births (20%), which is not surprising given that only 16% of teen girls live in rural counties.

*Between 1990 and 2010, the birth rate among teens in rural counties declined by 32%, far slower than the decline in major urban centers (49%) and in suburban counties (40%)
Factors Behind Variation in Teen Birth Rates
So what does this all mean?   While teen pregnancy risk is dropping overall nationally,  it is dropping at slower rates among rural teens.   The report suggests that there is a need for more teen pregnancy prevention efforts in rural communities and that perhaps rural teens should be considered as a particularly high risk group among those who set health priorities.
In addition, rural teens’ ability to access birth control “lags far behind availability for teens living in urban and metro areas,” said Julia De Clerque, a research fellow and investigator at the University of North Carolina who was not involved in the study (Healy, USA Today, 2/21).
To view the whole report, click HERE.

Are electronic toothbrushes better?  When I first started using an ‘electric’ toothbrush with an automated shut-off system,  it surprise me how long it ran (about 2 minutes per use).   I had gotten into the habit of brushing my teeth in 30 seconds or less during my morning rush to get to work.   So when I asked my dentist if the electric ones were ‘better’ she told me it probably had a lot to do with how long one brushed.
However, a new research paper was release this month in Clinical, Cosmetic and Investigational Dentistry, that studied this very question.  Dental health is ultimately related to the plaque that builds up on your teeth. When there is excessive plaque build-up, there is increased risk for caries and inflammatory gingival and periodontal disease.  Daily tooth brushing and using other oral hygiene aids is the best way to control plaque.  The researchers compared overall plaque scores for  manual vs. powered toothbrushing in a small randomized clinical trial.  They concluded that “powered toothbrushes offer an individual the ability to brush the teeth in a way that is optimal in terms of removing plaque and improving gingival health, conferring good brushing technique on all who use them, irrespective of manual dexterity or training.”
 

There is growing evidence that the more engaged patients are in their health care decision, the better the outcomes.    Much research — including several studies published in the current issue of Health Affairs — found that patients with the lowest involvement in their care  had average costs 8% higher than those with the highest range on an activation (involvement) scale.
But doctors still aren’t using that information to their advantage and better engaging patients, panelists at a recent  Institute of Medicine (IOM) workshop on patient engagement said.   More resources need to be invested in getting physicians and healthcare systems to increase patients’ involvement in decisions about their care, advocates said here.
“We just haven’t spent enough time helping clinicians develop these skills,” Eric Holmboe, MD, chief medical officer at the American Board of Internal Medicine, said.
Despite the availability of continuing medical education (CME) courses for physician  in the topic of patient engagement, few are attending them.
Monday’s IOM workshop follows a report last month that found Americans live sicker lives and die younger than those in other countries despite the impression that the US has the greatest health care in the world. Many believe there is the need to change the physician culture and convince doctors to accept a greater dialogue with patients, and a representative of GroupHealth, a health plan in Seattle, described his plan’s successful patient engagement initiative.
The provider organization, which serves 600,000 Washington residents, undertook a multi-pronged program that included offering patient education on joint-replacement surgeries and alternatives. They offered a half-day CME opportunity on how to discuss options with patients and emphasized to physicians that this was a patient safety issue.
GroupHealth experienced a 26% drop in the number of hip replacements and a 12% to 21% cost reduction after 3-plus years in the program, David Arterburn, MD, MPH, of GroupHealth, said.
Jonathan Welch, MD, Harvard Medical School, said providers need to find better ways to listen to patients and their families. He said the healthcare sector, unlike other service industries, doesn’t listen well to feedback from its consumers.
Excerpted from MedPage Today, Feb. 25, 2013 by David Pittman

Today, February 28, the U.S. House of Representatives  voted to pass the Senate’s bipartisan reauthorization of the Violence Against Women Act. Initially, the House bill excluded specific protections for gay, bisexual or transgender victims of domestic abuse — eliminating “sexual orientation” and “gender identity” from a list of “underserved populations” that face barriers to receiving victim services — and stripped certain provisions regarding Native American women on reservations.  Representative Gwen Moore from Wisconsin, and a victim of domestic and sexual violence herself, advocated the need to pass the Senate version and her efforts prevailed.   This is a significant victory for all women.
To read more visit:  http://www.nytimes.com/2013/03/01/us/politics/congress-passes-reauthoriz...