A new report by the United Health Foundation shows some good news in Maryland along with concerning trends in chronic conditions.
The America's Health Rankings report found the state ranked 11th overall with positive noted including Marylanders having a low incidence of adults with multiple chronic conditions.
But overall, the report found the number of Americans dealing with chronic conditions has increased, and eight conditions including things such as diabetes, cancer, cardiovascular diseases, COPD and chronic kidney disease reached their highest levels since the foundation began tracking them.
Dr. Marie Kanagie-McAleese, a pediatrician at the University of Maryland's Upper Chesapeake Medical Center, sees the maintenance of chronic conditions as an expensive way to approach the problem.
"When we look at how much money the United States spends on health care, we're looking at about $4 trillion a year," Kanagie-McAleese pointed out. "And it's estimated that about 90% of these health care costs are going towards management of chronic conditions. And so this is critically important for our medical system as a whole right now."
She emphasized the prevention and treatment of chronic diseases through changes in lifestyle would go a long way to reducing costs associated with disease management.
The report showed more than 29 million adults in the U.S. are dealing with three or more chronic conditions. The study's authors also noted in the past year, 15% of adults in the country with two or more chronic conditions avoided needed medical care, including prescription medicines due to high cost.
Kanagie-McAleese is board certified in lifestyle medicine and believes the public has yet to fully appreciate how our habits can affect health.
"There's not enough education for the general public about how tremendously important our lifestyle is at helping to prevent these chronic diseases from occurring," Kanagie-McAleese asserted. "But also once you have any of these chronic diseases, making lifestyle changes can really help in treatment and sometimes even reversal."
She said Type 2 diabetes is one example of a chronic condition which is very responsive to lifestyle changes.
Among the strengths in Maryland the report found a low prevalence of excessive drinking, and few cigarette smokers. Although one of the problem areas for the state was a high prevalence of insufficient sleep. In Maryland, 38% of adults are not getting enough sleep, which is higher than the national average, and ranked the state 39th in the nation for sleep.
Kanagie-McAleese added when people are chronically sleep-deprived, it promotes an increase in inflammation in the body.
"Inflammation is linked to the majority of these chronic diseases that we're seeing," Kanagie-McAleese explained. "Sleep is absolutely an underrepresented factor that can assist in your drive to be healthier, or it can work against you and help to promote some of these chronic diseases."
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A Pennsylvania nurse is sounding the alarm about proposed cuts to Medicaid funding now in Congress, cuts she said could jeopardize care for her son as well as millions of Americans.
The House version of the budget reconciliation bill would slash federal Medicaid spending by at least $700 billion to fund a tax-cut extension and other Trump administration priorities.
Jennifer K. Graham Partyka, a registered nurse in Northeast Pennsylvania, joined the "Fair Share for Americans" bus tour in Scranton this week. She said Medicaid is a lifeline for her 28-year-old son living with Crohn's disease.
"We were lucky, because when he was very sick, he qualified for Medicaid," Partyka recounted. "He was fully disabled until he started getting the treatments and started getting better. There's a version of that Medicaid called, like, 'Medicaid for working disabled people.'"
Medicaid covers about one in four Pennsylvanians, including 750,000 with disabilities. Partyka pointed out her son, who works full-time, would not be affected by the work requirements Congress wants to add for Medicaid eligibility. It would mean adults without children would need to work or volunteer 80 hours a month to keep their coverage. Republicans are pushing to pass the reconciliation bill by July 4 but debate could delay it.
Partyka emphasized Medicaid is one of the top five sources of payment to every hospital in the nation. With many already struggling to stay open and fully staffed, she thinks cutting Medicaid would also be disastrous for people's access to care.
"My professional experience with Medicaid is that most of the recipients of Medicaid are children," Partyka stressed. "I'm also going to share that 60% of people in nursing homes list Medicaid as their primary payer."
She added voters ultimately have the power to hold lawmakers accountable for the fallout from major budget decisions, noting many congressional seats will be up for grabs in 2026.
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Diabetes diagnoses are climbing, with about 37,000 adults diagnosed in Indiana every year, and doctors caution they are seeing more cases in younger patients.
Diabetes means the body is unable to maintain a healthy blood glucose or blood sugar level. Type 1 is caused by an autoimmune process affecting the pancreatic cells which make insulin. Type 2 diabetes means the body has reduced sensitivity to the insulin it naturally produces.
Dr. Tamara Hannon, pediatric endocrinologist at Indiana University's Riley Hospital for Children, explained why the body's response function changes.
"The pancreas can stop making enough insulin for a number of reasons," Hannon noted. "Could be genetic, the cells get damaged over time by having to work too hard, an infection, high blood fat levels, or just getting exhausted over time."
The Centers for Disease Control and Prevention predicts if the rate of new diagnoses in kids and teens continues to climb, Type 1 diabetes cases would increase by about 65 % and Type 2 by about 700% by the year 2060.
There is no cure for Type 1 diabetes but its progression can be delayed with medication. For the more common Type 2, cell damage can be delayed or even reversed through weight loss, exercise, lifestyle changes and medication.
Hannon pointed out with the epidemic of childhood obesity, younger people are developing diseases traditionally diagnosed in adults, in part because of their food and beverage choices and other environmental factors. She added research shows sugary drinks in particular increase the risk for not only Type 2 diabetes, but liver disease and cardiovascular disorders.
"If you think about when you drink sugar versus when you eat foods that contain sugar, there's a different way that is absorbed and metabolized," Hannon observed. "If you drink something that's sugary, the sugar goes into your bloodstream quite quickly."
Hannon stressed the body has to mount a quick metabolic response to a rapid sugar download but the natural sugars in whole foods, like fresh produce and certain vegetables, are not absorbed by the body as quickly. According to the American Diabetes Association, 12%, or about 666,000 Hoosiers, are diabetic.
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The Missouri Foundation for Health has named the first five winners of its new "Spark Prize," an award backing Missourians who are working to promote health equity.
Each winner gets $200,000 in no-strings-attached funding to fuel their vision. Awardees were chosen for their potential to create meaningful, lasting change in the Show-Me State.
Evonnia Woods, a community organizer and movement builder, was one recipient, chosen for her progress and vision to advance racial, reproductive and economic justice across Missouri. She shared why the award from the foundation is unique.
"A lot of foundations, they want to see evidence that you're already doing what you're asking for funds to continue doing," Woods explained. "In this regard, it's like, 'Oh, you believe in me. This is good because I believe in me.'"
Unlike traditional grants, the Spark Prize is flexible and trust-based, given directly to individuals and not organizations. The recipients were selected from more than 170 nominations from diverse backgrounds, regions and sectors across Missouri.
Ciearra "CJ" Walker, founder and CEO of the Community Health Worker Coalition, which has trained more than 300 community health workers in St. Louis and supported more than 600 statewide, was a recipient. Walker, a Detroit transplant, shared the motivation behind starting her organization and her vision for the future.
"What we are hoping to do is to replicate across the country what's possible when we position ourselves," Walker noted. "Not just to extract from our community leaders, but to truly allow them to be architects of the system that they participate in and benefit from them accordingly."
Walker added her coalition also reinvested $30,000 dollars into its members through pay, training and growth support.
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