Counties at Risk of Having No Insurer on the Marketplace (Exchange) in 2018

This map shows the counties at risk of having no insurer on the marketplace (exchange), created by the Affordable Care Act, in 2018, based on a Kaiser Family Foundation analysis of insurer rate filings and news reports

Source: Counties at Risk of Having No Insurer on the Marketplace (Exchange) in 2018 | The Henry J. Kaiser Family Foundation

Our historical analysis of insurer participation on the marketplaces from 2014-2017 can be found here.

These data are preliminary and subject to change as more information becomes public. Insurer participation in 2018 will not be finalized until the fall of 2017. It is possible that another insurer will expand into the counties that currently appear bare, and it is also possible that insurers will exit from other counties not shown on this map.

If a county has no exchange insurer, consumers would not be able to purchase marketplace plans with federal subsidies, including advanced premium tax credits (APTCs) and cost-sharing reductions (CSR). Tax credits make coverage more affordable throughout the year by lowering consumers’ monthly premium costs; cost-sharing reductions help lower out-of-pocket costs. In 2017, 8.7 million people (84% of all marketplace enrollees) received tax credits to cover a share of their premium and 5.9 million people (57% of all marketplace enrollees) received cost-sharing reductions.

This map only shows participation by on-exchange insurers. It is possible that some people in counties with no exchange insurers in 2018 will be able to purchase individual plans off-exchange, though this coverage would not qualify for financial assistance. If no exchange insurer participates in their county, people that rely on these subsidies may be unable to afford insurance off-exchange.

FDA announced its intention to extend the compliance date for the Nutrition Facts Label final rules

FDA announced its intention to extend the compliance date for the Nutrition Facts Label final rules

Source: Labeling & Nutrition > Changes to the Nutrition Facts Label

Original vs. New Format – Infographics to Help Understand the Changes (New Food Label Side by Side Comparacion Paralela)

Compliance Date

On June 13, 2017, the FDA announced its intention to extend the compliance date for the Nutrition Facts Label final rules. The FDA will provide details of the extension through a Federal Register Notice at a later time.

In May 2016, the U.S. Food and Drug Administration finalized the Nutrition Facts and Supplement Facts Label and Serving Size final rules and set the compliance date for July 26, 2018, with an additional year to comply for manufacturers with annual food sales of less than $10 million. After those rules were finalized, industry and consumer groups provided the FDA with feedback regarding the compliance dates.

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Above-normal blood sugar linked to dementia – Harvard Health Blog – Harvard Health Publications

There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans. A study published in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia.

Source: Above-normal blood sugar linked to dementia – Harvard Health Blog – Harvard Health Publications

There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans.

A study published in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia. This finding goes beyond previously seen links between diabetes and dementia. “It establishes for the first time, convincingly, that there is a link between dementia and elevated blood sugars in the non-diabetic range,” says study author Dr. David Nathan, a Harvard Medical School professor and the director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital.

Dr. Nathan teamed up with researchers across the country to look at blood sugar levels in more than 2,000 older adults—the average age was 76—taking part in the Adult Changes in Thought study. The vast majority of the study participants did not have diabetes. What the researchers found is that any incremental increase in blood sugar was associated with an increased risk of dementia—the higher the blood sugar, the higher the risk.

Why? There are only theories. “The speculation is that elevated blood sugar levels are causing more vascular disease, but it may be other metabolic issues. For example, people with elevated blood sugar often have insulin resistance which may be the link that affects our brain cells,” says Dr. Nathan.

The study does not prove that high blood sugar causes dementia, only that there is an association between the two. For that reason, don’t start trying to lower your blood sugar simply to preserve your thinking skills, cautions Dr. Nathan. There’s no evidence that strategy will work, although he says it should be studied.

But it is worth keeping an eye on your blood sugar to try to avoid developing type 2 diabetes. This disease is at epidemic proportions. Almost 26 million Americans—one in 12—have diabetes. High blood sugar is hallmark of this disease. Normal blood sugar is under 100 milligrams per deciliter of blood mg/dL after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher after a fast. People with a blood sugar reading of above 100 but below 126 have what’s called prediabetes. Nearly 80 million Americans are in that camp.

Excess blood sugar is a problem because it can lead to a variety of health problems including heart, eye, kidney, and nerve disease.

Taming blood sugar

What if your blood sugar is above normal? There’s good news in that department: You can lower your blood sugar by exercising and, if needed, losing weight. Shifting to a healthier diet with more vegetables, fruits, and whole grains and cutting back on highly refined grains can also help.

Try to get 150 minutes per week of moderate intensity activity, such as brisk walking. If that’s daunting, know that even a little activity can make a big difference in lowering blood sugar levels. Short but frequent walking breaks—as brief as a minute and forty seconds every half hour—can lower blood sugar. So can taking a walk after a meal.

And it doesn’t always have to be official “exercise.” Try taking the stairs more often, parking farther away from the store, and getting up and moving if you’ve been sitting too long. “It’s common sense,” says Dr. Nathan. “The more active you are and the less sedentary, the more likely it is that your muscles can uptake glucose, and the insulin you make will be more effective.”

Also helpful is cutting back your intake of highly refined carbohydrates, especially foods with added sugars such as sucrose, high fructose corn syrup, and also molasses, cane sugar, corn sweetener, raw sugar, syrup, honey or fruit juice concentrates. The American Heart Association recommends no more than 100 calories from sugar or six teaspoons of sugar per day for women, and 150 calories or nine teaspoons of sugar per day for men. If you’re in the prediabetic or diabetic range, you’ll want to work with a dietitian to determine your exact needs.

Making these changes is an investment, to be sure. But the payoff—better physical and mental health—is definitely worth it.

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Embedding Cultural Diversity and Cultural and Linguistic Competence: A Guide for UCEDD Curricula and Training Activities

Source: UCEDDs at Georgetown, Georgia State, and Children’s Hospital Los Angeles, and in collaboration with AUCD

A new project and website from the UCEDDs at Georgetown, Georgia State, and Children’s Hospital Los Angeles, and in collaboration with AUCD.
This project is designed to research, develop, and disseminate a set or resources for the national network of University Centers for Excellence in Developmental Disabilities (UCEDDs) to embed cultural diversity and cultural and linguistic competence (CLC) in their curricula and training activities. The project will build the capacity of network programs to embed widely accepted CLC policies, structures, and practices across the four UCEDD core functions of pre-service training and continuing education, community services, research, and information dissemination. The project has a special focus on unserved and underserved communities in the United States, its territories, and tribal communities.

Healthy People 2020 Health Disparities Data Widget

Source: Office of Minority Health

The Office of Disease Prevention and Health Promotion (ODPHP) and the Office of Minority Health (OMH) are pleased to announce the release of a new HealthyPeople.gov data search function. The Health Disparities widget is a new way for you to access this health disparities information.

The new widget provides an easy way to find health disparities data related to the Healthy People 2020 objectives for the Leading Health Indicators (LHIs). LHIs are critical health issues that when addressed will help reduce the leading causes of death and preventable illnesses.

It’s easy to embed the widget on your site and give your stakeholders easy access to the latest available disparities data. Once you’ve added the widget, there’s no technical maintenance required. The content will update automatically with the latest available data.

The widget provides charts and graphs of disparities data at your fingertips. Use the widget to browse data by:

  • Disparity type—including disability, education, income, location, race and ethnicity, and sex)
  • Leading Health Indicator

Explore, use and share the widget to help inform issues related to health equity.

A Roadmap to Success in LTSS

Source: National Committee for Quality Assurance (NCQA)

States and managed care organizations need assurance that their partners can coordinate care effectively across medical, behavioral and social services and help keep people in their preferred setting—often, their home and community. NCQA has released Roadmap to Success in LTSS, a compilation of resources to guide organizations through standards for Long Term Services and Supports (LTSS). NCQA’s LTSS programs provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state and MCO requirements.

Roadmap to Success in LTSS:

  • Helps you understand the accreditation process and standards
  • Guides you through the steps of preparing for the accreditation review process
  • Provides examples, tools and resources you can use to prepare your organization for the accreditation journey
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Women with Disabilities Need Better Access to Preventive Cancer Screening

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

In NH, women with disabilities are significantly less likely than the general population to comply with breast and cervical cancer screening recommendations of the U.S. Preventive Services Task Force.  Preventive screenings are especially challenging for women with disabilities due to barriers, such as:

  • Lack of accessible health care facilities and medical equipment; and
  • Health care providers who lack cultural competence with disability and awareness of needed accommodation.

Download Disability & Women’s Health

Adults with Disabilities Need Better Diabetes Prevention Care

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.Several factors contribute to a higher risk of diabetes, including:

  • Unhealthy eating habits that result, in part, from uninformed and limited food choices;

  • Lack of physical activity due to social, environmental, and behavioral barriers; and

  • Lack of knowledge and support to address risk factors for diabetes.2

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Include “Low-Tech” Options to Share Health Information with People with Disabilities

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

Adults with disabilities in New Hampshire (NH) are significantly less likely than adults without disabilities to have access to information electronically. This can affect access to:

  • Online communities that encourage healthy behaviors;
  • Electronic health records & appointment reminders;
  • Knowledge & strategies to maintain & improve health.

Download Health Communication Needs

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