Saturday, May 03, 2008

Association of Health Care Journalists holds its first Rural Health Journalism Workshop

We're live-blogging today from the first Rural Health Journalism Workshop, being held by the Association of Health Care Journalists at the University of Missouri in Columbia, Mo. We're just hitting the high points, but the sessions are being recorded and will eventually be posted on the association's Web site.

The workshop began yesterday with an overview of rural America and its health-care system, moderated by your blogger. The panelists were Charles Fluharty, director of policy and director emeritus of the Rural Policy Research Institute; Dennis Berens, director of rural health for the state of Nebraska and former weekly newspaper publisher; and Patricia Thomas, who holds the Knight chair in health and medical journalism at the University of Georgia. One unexpected focus of the discussion was trauma care. It's always been an issue in rural areas, but is being complicated by the declining state of volunteer ambulance services in many rural communities, Berens said.

Today's first session was on diabetes, which almost one in 10 Americans have. Many rural areas have high rates of the disorder, which can lead to many other medical complications and disease; most diabetics live 10 to 14 fewer years than non-diabetics, said Dr. David Gardner of the University of Missouri.

Dave Templeton of the Pittsburgh Post-Gazette was not only the moderator but an example. He said he is a Type 1 diabetic who was diagnosed at 11 and has lived all his life in a rural county, but "Not once was I ever asked to take a diabetes education course. . . . Diabetes requires self-management."

The other panelists were Dr. Edwin Fisher of the University of North Carolina, who talked about diabetes self-management in rural communities, including Richland County. Mont., on the North Dakota border, and among migrant farmworkers in southwestern Arizona; and Patty Johnson, a nurse and diabetes educator in three rural counties in the southwest corner of Pennsylvania that have high rates of amputation resulting from diabetes.

Fisher said the best diabetes care is community-based, with support groups and activities to encourage self-management. We think rural journalists should think of themselves as part of the community effort, because many people with diabetes resist doing much about it. Gardner cited what he called "the law of halves:" Half the people with diabetes accept intervention, half of those who accept intervention follow the advice, and it works for only half of those, equaling only one-eighth of the diabetic population. For Fisher's help in covering diabetes, you can e-mail him here.

We think one of the most important roles journalists can play in combating diabetes is helping people avoid Type 2 diabetes, the most common form, in which the body becomes insensitive to the insulin in produces to process sugar in the blood. The major steps are losing weight and being more physically active. One way to approach this would be to find someone who has been diagnosed as pre-diabetic (high blood sugar but not high enough to be diabetic), has friends or relatives with diabetes, and has successfully avoided the disease by taking appropriate measures.

Gardner emphasized the role of genetics in the development of diabetes, and noted that it is a disorder, not a disease, and is not just related to blood sugar; other factors that need treatment include blood pressure, cholesterol and other compounds that harm the body. "it's important that we recognize this as a genetic disease made worse by our environment -- too much food, not enough exercise," he said, adding that it's also the wrong kind of food; Gardner said the closing of supermarkets in rural areas has made proper food harder to find and reduced the quality of diets. He said too many stories over-emphasize the role of obesity in diabetes: "Don't blame the patients in your stories, and at the very least, show the patients hope."

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