June 20, 2011

California Rural Elders Have Highest Disease Rates

Gretchen Becker has a very excellent tongue-in-cheek blog about some California research by UCLA that deserves reading. In the article that started all this, there are some statements that are a little hard to take and that is why I like Gretchen's take on the article in ScienceDaily.

The reasoning of why the rural elderly in California are more likely to be overweight, physically inactive, and food insecure leaves a lot to be desired. Granted the risk factors from these conditions are heart disease, diabetes, and repeated falls. It seems true that many elderly in rural California are in need of better health care.

Did the researchers have some reasonable ideas for improving the situation for the rural elderly? Yes, some were acceptable, but some were clearly from fantasy land and no doubt because the authors live on Los Angeles, and do not have a clue of what rural life is like.

What also makes this a tragedy is the financial condition of the State of California. This tells me that few, if any, of the recommendations will receive any action, and there is a need. Approximately 710,000 or one-fifth of the elderly in the state aged 65 and over are in rural areas and are challenged by the lack of physicians and other medical offices and must travel long distances to get care.

Do people living in rural areas need or even want sidewalks or street lights. I doubt it as that is why people live in rural areas – to get away from these and be able to see the true stars of the sky – not the fake ones from Los Angeles.

It is true that living in a rural area can have an isolating effect – often desired – but can be to isolating for some seniors who do become “trapped” in their homes. One of the better suggestions of the researchers was bringing broadband infrastructure into the rural areas so that the elderly could have access to in-home monitoring, patient self management, and online ordering of prescriptions. They suggest increasing the size of the information technology workforce. Not mentioned is the probable need to training of many of the elderly to use this technology.

They also did right in suggesting that there be assurances that medical insurance companies will fully reimburse rural providers that use telemedicine. The last key point is the promotion of federal subsidies and assistance programs for rural areas, expanded transportation services, and better incentives for primary care providers who work in rural areas. Hopefully, this will not be in the form of “Hi, I'm from the government, and I am here to help you” nonsense that plagues much of America.

Read the health policy in a PDF file here.

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