In rural America, hospitals are closing their maternity wards
Across the country since 2020, 101 rural hospitals have stopped delivering babies or announced they soon will, according to a recent report from the Center for Healthcare Quality & Payment Reform.
That includes three hospitals in Texas, bringing the state to a total of 93 rural hospitals that do not provide labour and delivery services. Across the state, well over half of rural hospitals do not deliver babies.
State organizations are sounding the alarm. The Rural Texas Maternal Health Assembly reported in November that 47% of Texas counties are "maternity care deserts." That's 14% higher than the national average, the assembly wrote.
Rural hospitals are a lifeline to their communities, which may be located many miles from the next nearest medical facility. In medical emergencies, minutes matter - and long travel time leaves rural residents with lower odds of surviving.
"Travel burden is real, and geography of Texas can be very challenging," said John Henderson, the president and chief executive of the Texas Organization of Rural & Community Hospitals.
"That's okay for certain things. ... It's not okay if you're having a heart attack or a stroke or delivering a baby."
For some rural Texans, labour and delivery department closures could be the difference between life and death.
'Canary in the coal mine'
It's not just about maternal health - across the board, many rural hospitals are struggling financially.
Half of rural Texas hospitals are at risk of closure, according to the Center for Healthcare Quality & Payment Reform. For some hospitals, the threat has already become a reality. Mid Coast Medical Center Trinity, north of Houston, announced in April that it was closing before the end of the month.
"It kind of feels like a death in the family," Henderson said of the closure.
For a struggling rural hospital, closing the labour and delivery unit may be an alternative to closing the entire hospital.
That's in part because labour and delivery units can be costly to operate. They must be staffed around the clock, since births can't always be scheduled or sequestered to regular business hours.
In rural hospitals, which often have low patient volume, the unit could go long stretches without seeing any births at all.
"You're basically paying people to sit in the hospital waiting for births that are very unlikely to happen on the majority of days," said Harold Miller, the chief executive of the Center for Healthcare Quality & Payment Reform.
Labour and delivery is also not a required service - unlike other services such as emergency medical care - which makes those units more likely to be chopped.
"In some ways, it's the canary in the coal mine on these things," Miller said. "If they're in trouble, where are they going to look first? That's where they're going to look first."
Exacerbating maternal health issues
As an immediate impact of labour and delivery closures, rural residents are forced to drive further to access care. That travel time means worse outcomes for women who are pregnant or in labour, according to the assembly's November report.
"The lack of local services harms the health of mothers and babies," the Assembly wrote.
The impact of travel time means that "rurality in and of itself is a factor in the maternal health crisis," the assembly wrote.
Long travel time also exacerbates an existing problem: Texas as a whole already falls short on maternal health outcomes.
The state's infant mortality rate is about on par with the national average, according to data from The Commonwealth Fund. The maternal death rate, however, is 34.7 per 100,000 live births, the data shows, compared to the national average of 26.3 per 100,000 births.
Overall, the organization ranked Texas as second to last in the country on women's health and reproductive care.
A 'long-term issue'
Advocates say there are potential solutions to rural hospitals' struggles.
Miller said the country as a whole should pay rural hospitals for their standby costs, so they can afford to keep the doors open no matter how many patients walk through.
In the meantime, he said, individual states and the federal government should take steps to protect rural hospitals. In his view, those efforts can't only be one-time grants or other short-term assistance.
"The problem is, this is a long-term issue," Miller said. "There has to be some stream of money that is adequate on an ongoing basis, year after year."
In Texas, Henderson pointed to a proposed bill from Representative Gary VanDeaver, R-New Boston. House Bill 18 aims to stabilize rural hospitals' and clinics' finances through grant programs, training and a new state office focused on rural hospital finance.
"There are Texans who do not currently have access to hospitals and health care services that the majority of us take for granted," VanDeaver said at a public hearing for the bill in March. "We have the opportunity this session to change that."
House Bill 18 was passed by the Texas House in April and is now in the Senate.
Outside of legislation, Henderson said he sees promise in telemedicine.
In order to survive, he said, rural hospitals and advocates need to look at unconventional solutions.
"It's not going to get easier. Rural hospitals aren't going to be less vulnerable in the near term," Henderson said. "We need to be working on innovative projects and finding ways for them to work together better."
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15 longevity foods: Healthy aging guide
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Along with research showing that green tea could support a longer lifespan, green tea drinkers may also enjoy a variety of other benefits from this elixir, including healthy cellular activity, metabolic function, cardiovascular and cognitive health. 5. Olive oil This Mediterranean diet staple is high in monounsaturated fatty acids (MUFA), especially oleic acid, as well as polyphenols including oleuropein and hydroxytyrosol. Many of the health benefits of olive oil are thought to be a result of its polyphenol content, and the antioxidant activity from it. Monounsaturated fats are known to be beneficial for heart health. The cardiovascular benefits of olive oil include maintaining healthy cholesterol levels, blood pressure, and more! Interestingly, olive oil can also positively influence gene expression. In a large study in U.S. adults, daily olive oil intake was associated with an increased likelihood of living a longer, healthier life. Pro tip : contrary to popular belief, olive oil can be used for cooking foods at temperatures of 375-400°F or below. Characteristics of Longevity Foods As you go through this list, you may notice a pattern of foods that are rich in polyphenols, which are bioactive compounds found in foods that act as antioxidants in our bodies. Another theme is heart-healthy types of fat and foods that support cardiovascular health. Foods that benefit our major organs such as the heart and liver (those that support detoxification, for example) make a big difference for the long haul. There are also nutrients that support processes in the body that are known to decline or stop working properly with age, including the inflammatory cascade, oxidative stress, cellular senescence, and autophagy. Nutrients can even influence our gene expression (or suppression), which is known as nutrigenomics. Foods that impact these processes, and therefore hallmarks or biomarkers of aging, also make the list. 6. Blueberries Known for being among the lower-in-sugar fruits, these berries are high in health-promoting antioxidants, including anthocyanins and pterostilbene. Wild blueberries in particular have one of the highest amounts of antioxidants when compared to other types of blueberries. You can find wild blueberries in the freezer section of your grocery store or as an extract in a dietary supplement. Research shows that blueberries support cardiovascular, metabolic, brain, and cellular health. Aim to consume at least one cup per day to get the benefits. You can meet this goal by adding frozen blueberries to your smoothie or adding fresh blueberries atop Greek yogurt with a drizzle of honey. 7. Mushrooms Fungi are our friends! Mushrooms are a source of beta-glucans (fiber), selenium (mineral), and crucial sulfur-containing antioxidants, ergothioneine and glutathione. Researchers compared the health status of those who included mushrooms in their diets, including those who consumed mushrooms in place of processed meat, to individuals who had low mushroom consumption. The results showed that eating more mushrooms (and less processed meat) may equate to an increased likelihood of living a longer life. To get the benefits of mushrooms, aim for four cups per week of varieties such as porcini, oyster, shiitake, and maitake. You could also replace a daily serving of processed meat with mushrooms (but be sure to make up the protein equivalent elsewhere in your diet), or take a mushroom extract. 8. Salmon Could a meal of baked salmon add 16 minutes to your life? Yes, according to researchers who investigated the health effects in minutes of healthy life gained or lost of 5,853 foods in the U.S. diet. A large body of evidence suggests that including non-fried seafood in your diet is beneficial for health. Fish is included on the list of foods for those following eating patterns commonly recommended by experts, such as the Mediterranean, DASH, or MIND diets. And wild salmon is among the best fish in the sea! Salmon is a fatty fish (contains omega-3 fatty acid) and is low in environmental contaminants. Salmon is also a source of vitamin D, selenium, iodine, choline, and more. 9. Yogurt Need another reason to eat this popular fermented food? Researchers looked at high daily intake of yogurt compared with low daily intake and found that daily yogurt consumption was associated with an increase in lifespan and maintenance of heart health. One of the proposed reasons for the finding was the favorable influence of yogurt on gut health, though it is important to note that yogurt varieties will vary greatly not only in the amount of beneficial bacteria it contains, but also its nutritional profile. Choose yogurt with no added sugars and sweeten it yourself with fruit and a touch of honey. Also, keep an eye on the fat and protein content to ensure it aligns with your health goals. 10. Spinach I think we can all agree that the heart is a pretty important organ to maintain for the long haul, and spinach may be just the ticket for your ticker. Aside from spinach containing an impressive variety of vitamins and minerals, it also contains nitrates, which is a precursor to nitric oxide. The nitrates found in leafy greens like spinach can support heart health, according to researchers who evaluated the effects of a spinach-containing meal and found that even a single nitrate-rich meal containing spinach supported healthy blood pressure and other measures of cardiovascular health. Honorable mention: beets, which are also a great option to support nitric oxide production. 11. Seaweed Did you know that Japan has been known to have a high percentage of centenarians (people over 100 years of age) per capita? Seaweed is a staple in the Japanese diet, and researchers who investigated this eating pattern found that adherence to a Japanese diet is associated with a longer life. Other longevity food research has shown that seaweed intake supports healthy blood flow among a Japanese study population. 12. Cruciferous vegetables Could just over one cup of broccoli daily (which is about 91 g) move the needle when it comes to our health? Yes! A study that included a dose-response analysis reveals that a 100 g/day increment of cruciferous vegetables (which also includes cauliflower, Brussels sprouts, watercress, and others) was associated with a longer lifespan. Isothiocyanates are one of the bioactive phytonutrients found in cruciferous vegetables that researchers attribute to their multiple health benefits. This longevity food group is known to support healthy cell division, healthy DNA, healthy estrogen metabolism, and more. 13. Dark chocolate If you love chocolate like I do, I know you're excited to see this one on the list! Indeed, choosing 70% dark chocolate or higher with little-to-no added sugar (in other words, we're not talking about candy bars here) can not only be a part of a healthy diet, but may actually be considered a longevity food. Cacao beans contain phytonutrients, including flavanols, which are a rich source of antioxidants. A study on post-menopausal women found that moderate chocolate consumption of 1 to 3 servings per week was associated with a longer lifespan. Sprinkle cacao nibs on your acai bowl, yogurt parfait, and more for texture, taste, and of course, antioxidants. 14. Legumes More commonly known as beans, the term "legumes" encompasses a variety of nutritious foods, including chickpeas and lentils. Legumes are high in fiber, a source of plant protein, and offer B vitamins, minerals, and phytonutrients. Research has linked higher legume intake with an increase in lifespan, so be sure to include these satiating and surprisingly versatile foods in your meal rotation. 15. Coffee Daily coffee drinkers, rejoice! Not only does your morning java put some pep in your step, but coffee is also a source of antioxidants like chlorogenic acid and can support healthy blood sugar and liver health. Studies show that moderate coffee consumption (2-4 cups daily) is associated with a longer lifespan. Interestingly, the time of day you drink your coffee could make a key difference. A study looking at morning coffee drinkers versus all-day coffee drinkers found that higher intakes of coffee in the morning were associated with a longer lifespan, but not in those with an all-day drinking pattern. So go ahead and enjoy your morning pick-me-up (preferably without added sugar, as it may actually negate some of the benefits). Does a plant-based diet help with healthy aging? Yes! As you may have noticed, this list is heavily plant-based. That is because a diet rich in plant foods can help support healthy aging. Plants contain important nutrients, such as phytonutrients. ("Phyto" refers to the Greek word for plant.) "Plant-based" often refers to a dietary pattern that includes primarily plant foods, which differs from veganism, in which no animal food sources are included. When it comes to choosing longevity foods for healthy aging, a plant-forward approach, or simply adhering to the recommended 5-7 servings of fruit and vegetables daily can go a long way. So no need to put a label on it, but focus on an eating pattern that includes plants with every meal and snack. How does the Mediterranean diet support healthy aging? By emphasizing plant foods and limiting red meat, the Mediterranean diet helps ensure a variety of key nutrients that support healthy aging are consumed. The Mediterranean diet is a healthy dietary pattern that mimics the traditional dietary habits of countries neighboring the Mediterranean Sea. It emphasizes the consumption of plant foods (fruits, vegetables, whole grains, nuts, legumes) and healthy fats such as olive oil. It's not strictly vegetarian, though. This way of eating includes a moderate intake of poultry, fish, and dairy, and limited intakes of red meat. There is strong evidence that processed red meat is not a good choice for increasing lifespan; however, the evidence for non-processed red meat is mixed. When you do eat meat, choose lean cuts and grassfed meats. An observational study of adults older than 18 noted that adherence to the Mediterranean diet was associated with an increased lifespan. Another study with elderly participants older than age 65 showed that closer adherence to the Mediterranean diet was associated with prolonged lifespan. Easy ways to add longevity foods to meals It's always nice to find new recipes that you enjoy, but you could also add them to your existing meal rotation! The dishes below are easily customizable, so you can add foods like walnuts, blueberries, pomegranates, and dark chocolate as toppings or in the mix to: Smoothies Yogurt Smoothie bowls Acai bowls Chia pudding Oatmeal Cereal For the more savory items, such as legumes, seaweed, mushrooms, garlic, and olive oil, build your own bowl! Start with some whole grains or legumes as carbs and/or greens as a base, layer on your favorite protein, and top with veggies. Voila! Longevity is served. This story was produced by Life Extension and reviewed and distributed by Stacker. Solve the daily Crossword
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2 hours ago
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