MEDFORD, Ore. – La Oregon Health Authority (Autoridad de la Salud en Oregon) afirma que los adolescentes son uno de los grupos de edad más sub-atendidos en exámenes y otros cuidados preventivos, y las Community Care Organizations (CCOs, Organizaciones de Cuidados de la Comunidad) del estado están organizando esfuerzos para contactarlos.

Una de las prioridades de Oregon en materia de salud es lograr para más adolescentes la atención regular y preventiva que les ayude a desarrollar hábitos saludables en su edad adulta.

Pero los adolescentes están ocupados – y a algunos hay que convencerlos de que está bien que hablen de sus problemas con un adulto.

Como grupo, los adolescentes frecuentemente parece que no necesitaran atención, pero el Dr. Matt Hough, pediatra y director médico de Jackson Care Connect en Medford, dice que hay bastantes problemas serios en sus vidas, desde depresión y ansiedad hasta drogas, alcohol y sexo antes del matrimonio. Hough dice que un consultorio médico debe ser un lugar seguro para hablar sobre todo esto.

"Se trata realmente de descifrar dónde están y cómo podemos apoyarles. Los adolescentes se enganchan en conductas de riesgo, no importa lo que piensen los padres, así que en verdad es una oportunidad de que otro adulto entre ahí y realmente hable con ellos con el afán de apoyarles y regresarlos al camino correcto."

Hace un año, Jackson Care Connect comenzó dando a pacientes adolescentes un cuestionario para llenar, con el fin de comenzar a conversar sobre temas delicados. Hough dice que se sorprende y se alegra de cuántos jóvenes son cándidos sobre sus problemas, y destaca que los adolescentes también tienen derechos en términos de que su información sea confidencial en manos de los médicos.

En la Organización de Atención Comunitaria en Yamhill (Yamhill Community Care Organization), en McMinnville, una aproximación que está funcionando para que los jóvenes acudan a las clínicas locales es la llamada "Teen Swag Night" – algo así como "Noche de Obsequio Adolescente" – que son citas nocturnas en un ambiente de “open house” con juegos y regalos aportados por los comerciantes locales.

Sean deportes físicos o una inmunización, la Dra. Jackie Eriksen, médica familiar en la Community Care Organization (Organización de Cuidados de la Comunidad) de Yamhill, dice que es una oportunidad de que se pongan al día con sus revisiones – y con sus amigos.

"En nuestra comunidad vimos unos 137 jóvenes esa noche. Dijeron que era muy divertida porque había otros jóvenes, fue como un ambiente agradable. Y también tratamos de hacerla una noche divertida, para que puedan ver la clínica con una óptica un poco diferente."

Las autoridades sanitarias de Oregon han hecho llamados a los adolescentes, una de las medidas cualitativas que usa para detectar qué tan bien las Organizaciones de Atención Comunitaria están satisfaciendo las necesidades de los pacientes del Oregon Health Plan o con Medicaid.


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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"