In North Carolina, the gap between Medicaid reimbursement rates and the actual cost of dental care has reached a crisis point, impacting both patients and providers.

Dr. Rafael Rivera, a member dentist with the North Carolina Dental Society and owner of Smile Starters, said the gap is impacting quality dental care around the state.

"It's about 30 cents on the dollar, about 30% of what we should be getting paid for the procedures. And that's not exact, but 30 to 35% somewhere in that range. It's actually a lot worse if you're an oral surgeon in the state treating the patient population," he said.

Those reimbursement rates haven't been updated since 2008. Rivera added that a lack of funding hinders dental practices from attracting and retaining skilled professionals. He said as a result, Medicaid patients often resort to emergency rooms for dental issues-an option that is both more expensive and less effective.

To address these challenges, Rivera suggested expanding the network of Community Dental Health Coordinators. He believes these coordinators could play a crucial role in bridging the gap between patients and dental providers, particularly for those who face language barriers or lack knowledge about available services. He also called for increased funding and safeguards that help dental offices keep up with inflation.

"Our legislator ideally will find a way to not only just put an increase in place, but more importantly have a mechanism that requires them to reevaluate it on a regular basis so that we don't have to go another 16 years before an increase is in place again," he said.

Rivera underscored that this issue extends beyond just dental care, pointing out that data show strong dental health is linked to better overall well-being. Since the expansion of Medicaid, the program has enrolled over 500,000 people.

Two specific types of cancer are showing up in high numbers among people in jail and prison and Illinois is no exception.

A new study found a lack of resources for on-site treatment is one reason for the high rates. The data showed diagnoses and mortality numbers for liver and lung cancer are more prevalent among county jails and state prisons.

Dr. Jingxuan Zhao, senior scientist for the American Cancer Society and lead author of the study, said individuals may need to be transferred to outside facilities to receive cancer treatment, which is often denied or delayed, and people with cancer and those behind bars share some characteristics or risk factors.

"For example, some of the risk factors for developing liver cancer included hepatitis B and C," Zhao pointed out. "As we know that for lung cancer, smoking is a huge risk factor and those factors are also very common among people who are currently incarcerated or with incarceration history."

She added studies have shown people who have been incarcerated are actually more likely to receive breast and colorectal cancer screenings, compared to their counterparts. The Prison Policy Initiative estimates about 28,000 people are in Illinois state prisons, with another 17,000 in local jails.

The study examined the association of county jail and state prison incarceration rates and cancer mortality rates in the U.S., using data taken from nearly 3,100 counties and every state. Zhao noted researching incarceration and cancer care comes with some built-in challenges.

"There are several reasons, such as privacy and ethical concerns, also legal protection of incarceration data, and more importantly, the decentralization of the U.S. correctional system," Zhao outlined. "There are some ongoing efforts to link state cancer registry data and the state correctional facility data, but that's only among some single states."

Zhao added there is no multistate linkage for data, which is an important part for their research. The study stated the U.S. has one of the highest incarceration rates in the world. In one recent year, there were 350 people in prison and another 192 in jail per 100,000 population.


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Medical professionals and advocates in the Latino community are using National Hispanic Heritage Month to encourage residents to prepare for the upcoming cold and flu season.

The nonprofit Latinx Voces has teamed up with the drug company Pfizer to dispel myths about vaccines.

Paulina Sosa, founder of the group, said a recent webinar focused on the importance of immunizations and now they are taking the message out into the community.

"Explain what is a vaccine, what makes it safe, and how do you know if you can trust it," Sosa outlined. "Hopefully walking people through this will really help educate and inform them, but also helps remove that hesitancy or the fear they have around this vaccine."

According to the latest information from the U.S. Department of Health and Human Services, Hispanic adults were 30% less likely to have received a flu vaccine than non-Hispanic whites. A link to the webinar is available at LatinxTaskForce.org.

Sosa pointed out a lot of fear about vaccinations within the Latino community is fueled by misinformation.

"A lot of people still believe that they're going to get the chip, or it's gonna affect fertility," Sosa explained. We still are finding that there is a lot of misinformation that's really creating this consistent fear and hesitancy around all kinds of vaccines."

She said as we enter the respiratory season, they want to ensure residents have correct information about COVID, flu, pneumonia and RSV vaccines.

"We want to give you the information but we also want to remove the barriers to access," Sosa emphasized. "How can we do that? Partnering with health fairs, partnering with clinics, making sure that information is in Spanish and that you feel safe to ask your questions."


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October is Health Literacy Month and a medical professional is educating Pennsylvanians about heart inflammation, a condition which can lead to serious cardiac events if left untreated.

In 2021, the age-adjusted death rate of heart disease was 180 per 100,000 Pennsylvania residents.

Dr. Philip Nimoityn, clinical assistant professor of medicine at Sidney Kimmel Medical College and Cardiology Consultants of Philadelphia, said recent medical research has uncovered new preventive measures and treatments for heart attacks, the leading cause of death in the U.S. He added within the past year, a new drug has become available to directly target inflammation in the heart and can significantly decrease risk.

"This drug, which is low-dose Colchicine, which is marketed under the name of Lodoco, has been shown in individuals with either coronary artery disease or multiple risk factors for coronary artery disease to be able to decrease heart attack, stroke, cardiovascular death," Nimoityn outlined.

According to the Centers for Disease Control and Prevention, three primary risk factors for heart disease are hypertension, elevated cholesterol and smoking, with nearly half of Americans having at least one of the conditions.

Nimoityn emphasized the importance of maintaining heart health, including avoiding gut problems through a healthy diet. He added gut microbiome, a population of microorganisms, live in your gut.

"It's estimated there are 10 trillion organisms in your gut, and they produce 10% of your body's chemicals, which are called metabolites," Nimoityn explained. "The type of bacteria that grow are influenced by what you eat. So, for instance, if you were to eat beef, that would increase the growth of bacteria which release inflammatory metabolites."

He added the new treatment has seen a substantial 31% increase in the demand for coronary revascularization procedures such as stenting and bypass surgery. He recommended Pennsylvania start screening for heart disease early in life, especially if you have a family history.


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