April 2019, Volume XXXIII, No 1
Social determinants of health
Customizing patient care
Our work in health care is only part of what contributes to overall health. Social Determinants of Health (SDoH)—people’s education, employment, finances, legal status, literacy skills, English fluency, transportation, housing, and, most importantly, their neighborhood—can be just as important. SDoH factors contribute to health disparities in Minnesota; our communities with high SDoH burdens experience higher rates of disease and disabilities.
April 2019, Volume XXXIII, No 1
interview
Shaping our health and well-being
John R. Finnegan Jr., PhD, University of Minnesota School of Public Health
cover story One
Social determinants of health: Customizing patient care
By Kathleen A. Culhane-Pera, MD, MA, and Chris Singer, MAN, RN, CPHQ
Our work in health care is only part of what contributes to overall health. Social Determinants of Health (SDoH)—people’s education, employment, finances, legal status, literacy skills, English fluency, transportation, housing, and, most importantly, their neighborhood—can be just as important. SDoH factors contribute to health disparities in Minnesota; our communities with high SDoH burdens experience higher rates of disease and disabilities.
cover story two
Health care legal partnerships: A team-based approach
By Kathryn Freeman, MD, and Meghan Scully, JD
Walter, a patient with uncontrolled diabetes, walks into your exam room. You have been working with Walter over the past 12 months to get his blood sugars and A1C under control. Walter has been homeless for the past three years and without a safe place to store his insulin. Each visit you check his lab values and review his medications, titrating up on his insulin. You refer him to diabetes education.
Pain Management
Dialing down opioid use: Alternative treatments
By David Schultz, MD
The opioid crisis currently gripping the U.S. presents significant challenges for the treatment of chronic pain. For much of the 2000s, opioids were liberally prescribed to treat pain, but in recent years, it has become clear that prescription opioids may lead to abuse, addiction, and overdose death in a certain population of chronic pain patients.
Heartburn: Individualizing diagnosis and treatment
By Kourtney Kemp, MD, FACS
Patients with heartburn often begin a lengthy journey of diagnosis and treatment before their conditions are accurately identified and their symptoms resolved. A new, comprehensive, personalized approach to diagnosing and managing patients with heartburn is necessary, taking into account the unique needs and issues of each patient.
Ophthalmology
Advances in treating eye disease: A look at new FDA-approved devices
By Thomas Samuelson, MD, and David Hardten, MD, FACS
The field of ophthalmology continues to change dramatically, with advancements in technology—tested and approved following clinical trials—drastically improving treatment options for patients facing vision-threatening eye disease. New FDA-approved prostheses and devices, implanted surgically, hold great promise for patients with glaucoma and those with damage or injury to the iris.
Neurology
Obstructive sleep apnea: Examining the adverse consequences
By Tacjana K.E. Friday, MD
bstructive sleep apnea (OSA) is a common sleep disorder affecting at least 25 million adults in the U.S. Those at increased risk for OSA include males; post-menopausal women; overweight/obese individuals; and patients with larger neck circumference and crowded oropharynx, positive family history of OSA, and use of sedative hypnotics. Associated chronic medical
Special Focus: Senior and Long-Term Care
AGE to age: Connecting generations
By Zane Bail, MA, and Chandra M. Mehrotra, PhD
ocial connection is a fundamental human need—one that, unfortunately, can become limited as people age. This is especially true for older adults who lose mobility, lack transportation options, or live alone or away from family. The American Medical Association reports that 43 percent of older adult Americans experience social isolation and feelings of loneliness. Social isolation—the lack of meaningful connections with other people and community—has been linked to a myriad of health risks,
Pediatrics
Parenteral nutrition: Helping youth thrive at home
By Lisa Tollefson, PharmD; Sarah Keyes, RN, BSN; and Maria Mahady, RD, LD
In many ways, Amanda is a typical teenager. She loves shopping, practices yoga, and hangs out with her boyfriend on the weekends. If you saw her, you might not realize that Amanda is able to live a more-normal teenage life thanks to a therapy called parenteral nutrition (PN), which can be administered in homes, hospitals, and long-term care facilities.
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