The percentage of Colorado children in their first 15 months receiving preventive medical and behavioral health services rose by 23% from 2013 levels, and stayed constant during the COVID public-health emergency - according to new data released by the Center for Improving Value in Health Care.

But Dr. David Keller - a pediatrician and professor of pediatrics at the University of Colorado School of Medicine - said that was not the case for many children ages three and older who missed out on regular screenings.

"We're seeing an epidemic of children's mental-health problems," said Keller. "We are seeing lots of kids with anxiety disorder, lots of kids with depression, kids who are suicidal."

The focus of visits for kids age three and older is kindergarten readiness - making sure they are developmentally equipped, and screening for mental health to ensure children are in the best head space to succeed.

Those visits dropped significantly between 2019 and 2020 at the start of the pandemic. Keller added that school disruptions created even bigger mental-health problems for teenagers.

Despite overall positive trends, in 2020, 40% of children 15 months of age and younger did not receive the recommended six or more well-child visits with a primary-care provider. Kids covered by commercial health insurance did better than kids covered by Medicaid.

Keller said making it to appointments can be especially challenging for families struggling economically.

"I know a lot of families who work two jobs," said Keller. "I have a lot of families where the father works nights and the mother works days because they can't afford day care, and so that makes it really hard to schedule a well visit."

Children in rural parts of Colorado had similar visit rates compared with urban kids, even though there are fewer providers and families have to travel greater distances.

Keller said most families have a lot on their plate, and it's easy for wellness visits to slip down on their list of priorities.

"One of the things I love about being a pediatrician is that I get to actively practice primary prevention," said Keller. "There's so much we can do to help families help their children be the best they can be. And that would be my best message, is: Come on in, we want to see you."

This week is Crohn's and Colitis Awareness Week, shedding light on what some call an invisible disease.

Crohn's disease and ulcerative colitis are also known as inflammatory bowel disease, and they affect a person's food choices and many other aspects of life.

Ryan Boyce - executive director of the Northwest chapter of the Crohn's and Colitis Foundation - said symptoms include abdominal pain, rectal bleeding and diarrhea.

But Boyce said many suffer in silence because those symptoms aren't usually visible.

"It's a difficult disease to diagnose and it's very common for folks to really struggle with these symptoms for a while," said Boyce, "before they get properly diagnosed and can begin a treatment path to help improve their health."

A recent study found about one in 100 Americans has been diagnosed with inflammatory bowel disease, or IBD.

Boyce said there's no cure for the disease, although there are a few approaches that can alleviate symptoms, such as medication and changes to a person's diet.

"The unique thing with IBD is that it impacts everyone a little bit differently," said Boyce. "So, there's not one set strategy and plan, or a blueprint if you will, that if everyone follows then it kind of limits symptoms. There's just so much variance with the disease."

Boyce said there have been major strides in the search for solutions for this affliction.

"What we're really trying to do is find cures," said Boyce, "and cures, plural, because it will take more than one cure depending on the disease and the treatment - and pushing toward that."




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November has been Diabetes Awareness Month - but heading into the holidays, people who are diabetic know they can't lose their focus on keeping it in check. And technology is making it easier to monitor the disease from home.

More than 520,000 Washingtonians have been diagnosed with diabetes.

Dr. Mamatha Palanati is the medical diabetes program director for Kaiser Permanente Washington. She said the disease needs to be managed closely, because it can lead to serious health complications.

Palanati noted that fortunately, people don't need to leave their homes to do this in some cases.

"In today's world, there's a much easier way to do it, like telehealth," said Palanati. "Telehealth provides multiple ways for the follow-up and connection to the health care for any individual."

Palanti said people managing diabetes still should plan to see their physician in person at least once a year. Management of other factors, like blood pressure and cholesterol, can also help reduce complications.

Palanati said monitoring technology can also assist people.

"The family members and caregivers, or anyone who can take care of that particular individual," said Palanati, "can do it remotely and manage their diabetes in a much better way."

Palanati stressed that diabetes is a chronic disease.

"Don't look at this as an additional chore or anything," said Palanati. "Make it as a part of your life. So, be active, making sure you adapt to the healthy lifestyles. It may not be perfect, but try your best to get what you can do."




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As World AIDS Day turns 35, the mother of an Indiana teen who became the public face of the disease is a reminder of the importance of never forgetting the hard work of medical researchers and the victims lost in the frenzy to find a cure.

More than 40 million people have died from AIDS, including Ryan White, who grew up in central Indiana at a time when not much was known about it and medicine offered few treatments. Ryan contracted the disease during a blood transfusion at age 13. He became a staunch advocate against discrimination and helped change how Americans view AIDS.

Jeanne White-Ginder, who eventually left Indiana for Florida, said it is imperative to remember all the lost lives.

"That is so important that we remember all the people who got us to where we are today, because they are no longer here," White-Ginder noted. "And I'm not just talking about Ryan, because Ryan was a face, but there are so many people that did all the work."

Just five weeks after Ryan's death in 1990, Congress overwhelmingly passed the Ryan White CARE Act with bipartisan support. The legislation helps more people get tested for HIV and offers assistance to patients in all stages of the disease.

Ryan's mom emphasized AIDS affects people across the spectrum, regardless of labels.

"A gay person has it, a straight person has it, a blood transfusion person has it; it was for everybody," White-Ginder explained. "Once you have AIDS, you're just like everybody else who has AIDS; you're fighting to stay alive. And people fought to stay alive, and people dedicated their lives to get us to where we are today."

She added Ryan would have turned 52 next week.

His mom plans to travel to Indiana University on his birthday, where the Rural Center for AIDS/STD Prevention will present the Ryan White Distinguished Leadership Award to Dr. Joe and Sarah Ellen Mamlin.


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