Despite a more challenging environment, rural hospitals still are finding ways to provide critical care. That includes stroke patients, and South Dakota's medical community says keeping these facilities open is necessary in seeing better outcomes.

May is National Stroke Awareness Month, and a family physician with Avera Health in Parkston said treatment has really evolved for these patients. Dr. Jason Wickersham pointed to specialized facilities where neurologists provide new therapies that can drastically improve a person's recovery.

But he said for rural residents, local health-care centers are a key first step.

"Even in a rural facility now, I think the training is very good," said Wickersham. "The ball gets going right away. The CAT scan gets done. If they meet criteria, they'll get a clot-buster drug in our rural facilities that don't have that neuro-interventionalist right there."

He said that buys them time before a patient is transported to a regional stroke center.

But financial stress has left many rural hospitals in danger of closing. This fall, South Dakota voters will decide whether to expand Medicaid, a move supporters say would make smaller health-care operations more stable.

Despite federal incentives, some skeptics worry about costs to the state. But supporters stress the federal government covers most of those costs, and the state's share is offset by economic activity though local care.

Tony Burke - advocacy campaign Manager for the American Heart Association of South Dakota - said having previously worked as a first responder, he knows timing is critical after a stroke.

"Whether it's a few minutes or a few seconds," said Burke, "it really does matter because the longer a person is in a stroke, the more damage there's going to be to the brain. So, it's critically important to have those resources close and local so that they can get access to the best possible care."

The Association feels that with financial relief, that first line of defense stands a greater chance being there for stroke patients. And Wickersham said keeping it local means maintaining a sense of trust through follow-up care.

"Sometimes those patients need some fairly intensive physical therapy, occupational therapy, maybe speech therapy," said Wickersham. "So, a lot of our rural facilities are set up with those services."

The Heart Association says stroke is the leading cause of preventable disability in the U.S.

With Black History Month underway, Wisconsin researchers and support groups are highlighting the disparities in cases of Alzheimer's disease.

The Centers for Disease Control and Prevention said older Black Americans are about two times more likely than whites to have Alzheimer's and other dementias.

As drugs designed to treat conditions accelerate toward the market, the University of Wisconsin School of Medicine and Public Health noted Black adults are less likely to be included in the research. The school has made it a priority to focus on the Black population in an ongoing study.

Diane Beckley Milner, director of diversity, equity and inclusion for the Alzheimer's Association Wisconsin Chapter, said participation is important.

"Without us being involved in those clinical trials as Black Americans, then the research, it's not going to lend itself to giving accurate information," Milner pointed out.

The university acknowledged Black individuals can be reluctant to participate in studies, citing historical trauma from events such as the Tuskegee experiment. Officials say when it comes to the study, Black volunteers account for 27% of the people enrolled, which is much higher than the state's Black population, suggesting it provides hope in boosting research inclusivity.

Milner emphasized partnerships her group has with organizations such as the African Methodist Episcopal Church can help ease fears and create more awareness within the Black community.

"Having that partnership has proved to be very, very important and critical to making sure that people get information that they can trust," Milner explained.

She added a common challenge her group has found in outreach is many Black Americans view cognitive decline as simply a sign of aging, and not a disease. The association also works with nursing organizations in hopes of educating more people within the Black population.

Preventing maternal and infant mortality in Georgia is a top priority for health care providers in the state.

Georgia already has the nation's highest maternal mortality rate, with more than 46 deaths per 100,000 live births, and ranks 16th for infant mortality.

In Lawrenceville, Obria Medical Clinics has what it calls a Supportive Pregnancy Care program, where people meet monthly in two-hour group sessions during pregnancy.

Robin Mauck, executive director of Obria, said they ask questions, learn how to take their own vital signs, and also meet with their providers for checkups.

"And then, March of Dimes has provided a curriculum that our facilitator goes through that has been proven to reduce maternal mortality," Mauck explained. "The great thing we see in this program is, it creates community for these girls. A lot of them don't have support in the community, they don't have family close by."

Mauck pointed out the group discussions help the participants build confidence, and the clinic also offers resources to help ensure new parents can take the best care of themselves and their babies.

Shelmekia Hodo, maternal and infant health director for the March of Dimes, said her organization is also focused on reducing health inequities in Georgia, with programs to address postpartum care and preterm birth, plus maternal and infant mortality.

One is a Neonatal Intensive Care Unit Family Support program, to help improve the experience for new parents. Hodo noted the program has been around for more than 20 years, with more than 70 sites across the country.

"March of Dimes provides an in-house coordinator that is on-site in the NICU, that does patient education with the actual moms, as well as staff education," Hodo outlined. "We know that so many moms are facing so many challenges and barriers having to be away from their babies, with their babies being in the NICU."

She added Georgia took a big step last year to address the maternal mortality rate, by extending Medicaid coverage to low-income mothers to a full year after giving birth, instead of only six months.

With the increasing use of digital devices and computers in daily life, we're all exposed to more and more blue light. They may be convenient and help us stay connected, but prolonged exposure could pose real health risks.

One of those risks is interfering with the body's circadian rhythm, the "internal clock" which regulates a person's sleep cycle. Throwing it off can cause insomnia, headaches and eye strain.

Dr. Joseph Nezgoda, president of the Florida Society of Ophthalmology, said it does not mean a person should completely block out blue light, because a broad spectrum of light is needed throughout the day. But it is important to manage exposure.

"Individuals are just usually on their devices much longer and later than usual," Nezgoda pointed out. "Potentially during those times, it may be good to limit the exposure. Again, there's been convincing data in animal models, but in humans, the jury's still out."

One tip is scheduling an eye exam, others include taking breaks around every 20 minutes from digital screens, by looking at something else at least 20 feet away for 20 seconds. And of course, limit screen times before bed.

Dr. Scott Edmonds, chief eye care officer for UnitedHealthcare Vision, said eye specialists became concerned during the pandemic about blue-light exposure as more people started using digital devices for longer time periods at home. He worries soon, some of the same concerns will surface about blue light that happened with ultraviolet light.

"The photo receptors can certainly process blue light, but it puts a lot of strain on them," Edmonds noted. "We're concerned that over time, the retina will become damaged, and we'll start to see age-related macular degeneration from this, like we did with UV light."

In addition to taking screen breaks, eye-care professionals recommend making sure your computer screens are clear and clean, as researchers continue to study potential dangers.