Health Wanted: Rural Health

HEALTH WANTED, a weekly radio show and podcast produced in partnership with WABE, brings need-to-know public health headlines and breaks down the science behind trending topics.

The Episode

The topic: Rural communities face many significant health challenges due to inaccessible health care, economic instability, and occupational hazards. This week on Health Wanted, host Laurel Bristow and guest Hannah Cooper, ScD, discuss rural health disparities and the impact of the opioid epidemic on rural communities.

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The takeaway: Rural communities face numerous health challenges, including limited access to health care, mental health services, and substance use treatment, which are compounded by economic struggles and geographic isolation.

• The economic decline in rural areas is largely due to the loss of once-flourishing industries like farming and mining. These changes have led to widespread job insecurity, poverty, and reduced access to essential services. This economic instability perpetuates health disparities, often pushing residents to rely on informal support systems rather than formal health care and social services.
• Many residents of rural areas are forced to travel long distances to access health care services as providers and specialists are often in short supply. This limited access results in delayed diagnoses, poor health outcomes, and an overburdened health care system that struggles to meet community needs.
• Rural areas face high levels of mental health issues, including depression and anxiety, but have limited access to mental health services. Additionally, social stigma around mental health contributes to untreated conditions and the reluctance to seek help, increasing the risk of suicide and substance use disorders.
• Many residents of rural communities are exposed to environmental hazards such as pesticides, coal dust, and unsafe working conditions, which can lead to chronic respiratory issues, cancer, and other long-term health problems. These exposures are additionally exacerbated by limited environmental regulations and the limited access to health care in these areas.

The Interview

The guest: Hannah Cooper, ScD

The key takeaways:

• Opioid addiction has been a significant issue in rural communities since the 1990s. Big pharmaceutical companies targeted these areas to pressure doctors to increase opioid prescriptions, telling them that opioid pain relievers were not addictive for patients. The occupational nature of rural areas, like farming and mining, created a high demand for pain relief, which contributed to widespread addiction.
• Rural areas face poor access to substance use treatment programs due to a lack of local funding and limited infrastructure. This makes it harder for residents to receive the care they need, as many live in counties far from or entirely without access to crucial treatments for opioid use disorder like buprenorphine.
• Overdoses from opioid use are particularly dangerous in rural communities. In rural areas, response times for ambulances are slow, and sometimes there is limited to no cell service to call for help. This has led people to rely on carrying naloxone and depending on other community members for assistance in case of an overdose.
• An innovative solution emerging in rural areas is community vending machines for harm reduction. These vending machines offer supplies like naloxone and hygiene products and are accessible at all hours. This is especially helpful for people who cannot attend harm reduction programs, which are typically open only during the day.

The Listener Questions 

Is bird flu making flu season worse this year?

We are having a horrible flu season right now. Outpatient visits for respiratory illnesses have just surpassed the peak of the 2009-2010 season, and hospitalizations for lab-confirmed flu have surpassed the 2017-2018 season, which was particularly bad.

With the limited communications from the CDC knowing what exactly is driving this flu season is hard. Typically, we’d be getting reports that have more granular information about this season compared to past seasons.

But even without these reports, it’s unlikely this season’s uptick is being driven by undetected bird flu. We’ve had similarly bad flu seasons, and even seasons with higher deaths, even before this current bird flu outbreak. 

Additionally, the data from public health labs that do subtyping show the vast majority of cases are H1 or H3, not H5, which is what bird flu is.

On January 16, the CDC released a Health Alert Network notification recommending that all patients who are hospitalized with the flu who have subtypes that come back as something other than H1 or H3 get their samples sent off immediately for subtyping at specialized labs, rather than waiting for batched testing once a week.

This is good advice that more health departments should take.

Can beige fat cells be used in cancer treatment?

Our bodies have three kinds of fat cells: white, beige, and brown. White fat stores energy, brown fat releases energy as heat, and beige fat is in between. It’s made from the same stuff as white fat, but burns calories like brown fat.

Researchers thought: “What if we could take someone’s white fat, turn it into beige fat, and then let it eat up all the nutrients for energy that a tumor would want to eat? Would the tumor then starve?” The answer was basically “yes” for five types of cancer, at least in the experiments they did in Petri dishes and engineered mice.

It’s not exactly the cure for cancer yet. The results will need to be repeated by others and tweaked and refined before this method can be tried in humans. But it’s very promising considering the process of fat transfer is already regularly used in cosmetic procedures. 

Catch all the listener questions and Laurel’s answers on the full episode of Health Wanted by:

• Streaming at wabe.org or the WABE app
• Subscribing on Apple or Spotify
• Watching on WABE's YouTube channel