More Iowa communities are struggling with fatal drug overdoses, according to the latest America's Health Rankings report.

State data show Iowa's overdose deaths have risen by more than a third in the last two years. Some 432 people died of drug overdoses in Iowa last year, and since 2019 Iowa's public health department shows those deaths are up by 34%, even higher than the national average.

Dr. Rhonda Randall, chief medical officer for UnitedHealthcare employer and individual, said new data show drug deaths nationwide increased by 30% over last year.

"This is the largest yearly increase in drug deaths since we've been looking at it in 2007," Randall reported. "That means nearly 92,000 additional people died in the United States due to drug injury and overdose."

Recent laws in Iowa have made it easier for people who may need it to access Naloxone, a fast-acting drug which can slow or reverse the effects of opioids, often preventing an overdose from becoming fatal.

Randall pointed out heavy drug use continues to burden families, communities, the health care system and the economy.

"What we see is a substantial amount of that is because of those drug-overdose deaths," Randall explained. "About 70% of it is related to an opioid; in most cases, it's a nonprescription opioid."

The synthetic opioid fentanyl has been blamed in a rising number of narcotic-related deaths nationwide, and the state health and human services department said it is the cause of the vast majority of opioid-related deaths in Iowa, fatalities which have increased in all age groups.

While the rate of frequent mental distress reported by residents soared during the pandemic, Randall pointed out bright spots, including an increase in the number of communities nationwide boosting their supply of mental-health and primary-care providers.

"More people choosing mental health and primary care as a profession," Randall noted. "More access to mental-health providers."

According to the report, suicide is the 12th-leading cause of death among Americans, with mental illness and substance-use disorders being the most significant risk factors for suicidal behaviors. In 2020, more than 45,000 people nationwide chose to end their lives. Iowa ranked 18th in the nation for suicide deaths.

Small-business owners in North Carolina are reaching out to legislators for help, citing hospital mergers as one reason their health-care costs are soaring.

The fusion of former hospital competitors has left employers in the state with fewer options for services, as well as higher expenses for both companies and workers, which could ultimately hinder business expansion.

State Treasurer Dale Folwell revealed that even at the top levels, they're grappling with challenges such as cost transparency.

"The fact," he said, "is that this is the only product in your life that you don't know the value and the price of it, even after you have consumed it."

In a recent national poll, 45% of entrepreneurs said soaring health-insurance costs have forced them to hit the brakes on expanding their businesses. The majority of companies in North Carolina are small businesses, but together they employ more than 1.7 million people. So, Folwell said, the higher rates could signal lasting economic impact.

Greater NC Black Chamber of Commerce regional president Valerie Benton Smith stressed the urgent need for affordable, quality health care for businesses to stay competitive. She emphasized that without regulations on hospital consolidation and pricing, small companies in particular will keep facing obstacles.

"Small-business owners struggling with the expense of providing health-care benefits to their employees face a stark choice when costs rise," she said, "drop or cut health-care benefits, making it hard to attract quality candidates or divert funds to health care."

She said addressing the growing burden of escalating health-insurance costs is essential to ensure the growth and stability of small businesses. In the survey by the group Small Business for America's Future, 86% of business owners said they believe federal and state governments should actively intervene in health-system consolidations.

Doctors in Iowa are studying the brains of babies to learn more about sleep patterns in adults and teens.

The United Health Foundation reports one-third of Americans don't get enough sleep, and about 30% of Iowans fall into that category, which can lead to poor health and affect decision-making abilities. Cognitive processing, mood, blood sugar levels and immune response all are regulated by sleep.

Dr. Ravi Johar, chief medical officer at UnitedHealthcare, said one of the best things someone can do for their health is to prioritize getting enough rest.

"Adults from about 18 to 60 need between seven and nine hours of sleep per night," he said. "Adults 61 to 64 are maybe a little bit less, seven to eight; and adults 65 and over usually need about seven hours of sleep a night."

Johar said insufficient sleep is a risk factor for many chronic diseases, including cancer, depression, diabetes, hypertension and obesity. March has been Sleep Awareness Month.

While sleep research often focuses on teens and older adults, doctors at the University of Iowa are studying neonatal sleep patterns to learn what they can apply to the rest of the population. They have a deep pool of research candidates, because babies sleep so much.

Sleep researcher Mark Blumberg, a professor of psychological and brain sciences at the University of Iowa, said babies also get more of what's known as "REM" sleep than most adults, giving doctors even more to study.

"When you see that there is specific activity, and a lot of activity that is specifically occurring during sleep - even more in some cases than we see during wake - that occurs in early life," he said. "And then, you have to couple that with the fact that we sleep most when we're young. So, you know, when we're born, we spend 16 hours of each day asleep."

Blumberg said the university is now ramping up research on babies who were born prematurely and those less than six months of age, and he's looking for parents of children who fit those guidelines to advance his work.

Two Atlanta facilities are the latest hospital closures in Georgia, reflecting a trend for more than a decade that's left tens of thousands of people without access to hospital care, both in rural and urban areas. The New Georgia Project's "My Hospital, My Community campaign" is fighting to reopen the WellStar Health System facilities.

At the most recent Level One trauma center that closed, said Kierra Stanford, the campaign's lead organizer, more than half the local population is Black. She noted that Atlanta Medical Center blames the closures on Medicaid not being expanded in Georgia. Policymakers and community leaders have asked federal officials to investigate the shutdowns.

"Fulton County Chair Commissioner and the IRS have filed federal complaints with WellStar Health System," Stanford said. "These federal complaints basically call WellStar out for closing these hospitals under the guise of they didn't have the funds, they were losing profits."

Stanford said local residents have told her they've either missed out on their regular checkups or have to get to other hospitals, where they report longer wait times. A statement from Wellstar's CEO said they had been seeking partnerships to stay open, but were unable to secure them because of AMC's infrastructure and finances.

Stanford explained that the lack of access to quality health care is a growing disparity for communities of color. The New Georgia Project's campaign has also expanded into several rural counties including Calhoun, Randolph and Stewart - where, in some cases, people have to travel many miles to another county or state for primary care.

"And they tell me that they have to drive 40 minutes or an hour into Alabama to go to a hospital," she said. "They tell me that they call the ambulance and it takes two hours for an ambulance to come. And I asked them, 'So, what do you guys do?' And they say, 'People die.'"

In an Associated Press article, Atlanta Mayor Andre Dickens said the WellStar Health System didn't give the city a chance to assist or the advance notice that could have helped prevent closing the hospitals.