Minnesota is often credited for having an overall healthy population, but disparities exist for certain racial groups. A prevention effort now taking shape gives patients the tools to keep tabs on a crucial part of their health: blood pressure.

Through the American Heart Association (AHA), the Native American Community Clinic in Minneapolis recently secured 220 self-monitoring blood pressure cuffs to give to at-risk patients.

Moriah Johnson, community health manager for the Clinic, said the rollout of the program, along with an emphasis on telehealth, coincides with recent improvements in patients’ hypertension management levels, including those who are diabetic.

“Coupling both of those together could be a factor in why we actually did see some pretty marked improvement in hypertension control,” Johnson explained.

She noted challenges include general lack of engagement with the public because blood pressure is not considered a visible health threat. Johnson added following up with some patients, especially if they lose track of their devices, can be a barrier.

Minnesota is below the national average for adults with high blood pressure, but Indigenous populations in the state are well above U.S. levels.

Johnson hopes the emergence of another component of the program, which is a web-based Bluetooth platform, will bolster the effectiveness of the effort. It allows the clinic to get a closer look at levels being taken from a patient outside the facility.

“From a care perspective, it’s concrete data, which is really nice,” Johnson acknowledged. “We can log onto that those patients that do engage in it, see where their readings are at home. “

The AHA hopes to ramp up the monitoring program, so it can reach other populations. It recently partnered with two other community sites, the Phyllis Wheatley Community Center and the Cultural Wellness Center in Minneapolis, to help with educating patients.

Nearly half of U.S. adults have hypertension. Medical experts said left untreated, it can lead to poor health outcomes and is a key risk factor for heart disease and stroke.

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Oregon’s residency requirement to access the state’s medical aid-in-dying law is no more, after a settlement in federal court.

The Oregon Death with Dignity Act allows terminally ill adults of sound mind with six months or less to live to access end-of-life treatment. The law had mandated state residency since it passed by ballot referendum in 1994.

Dr. Nick Gideonse, a plaintiff in the Oregon case, practices in Portland and has patients living in Washington state. He pointed out no other aspect of care is limited by state residency.

“While, you know, I certainly understand that it made sense when Oregon was the first state to allow medical aid in dying, it just no longer served a purpose and was an artificial barrier to people trying to get end-of-life care,” Gideonse asserted.

Gideonse noted nearly a third of Americans live in states where medical aid in dying is legal. It includes Washington state, although more than 60% of hospitals beds in Clark County across the Columbia River from Portland are in health care facilities with religious prohibitions on aid-in-dying care.

Under the settlement, Oregon officials have to issue directives halting enforcement of the residency provision, and request legislation to remove the residency language from the law.

Amitai Heller, senior staff attorney for Compassion & Choices, which represented Gideonse in the case, said the residency requirement is unconstitutional because it directly discriminates against people who are trying to access end-of-life care from other states.

“The United States Constitution requires equal treatment for people living in different states to be able to access the services of neighboring states under the Privileges and Immunities Clause,” Heller explained. “And the Commerce Clause prevents undue restrictions on commercial transactions in between states.”

Washington, D.C., and eight other states, including California and Washington, also have residency requirements in their medical aid-in-dying laws. Heller noted the settlement could have repercussions in those states.

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March marks two years since COVID-19 first devastated the lives of people across the country. A new report aims to look at lessons learned in Connecticut, and efforts to ensure health equity for people of color in the state going forward.

Nearly one in three Black residents said they had a close friend or family member who died from COVID-19, according to a fall 2021 survey, along with one in four Hispanic respondents.

Tiffany Donelson, president and CEO of the Connecticut Health Foundation, which published the report, said it is important to recognize the barriers to health care access for communities of color in the state contributing to disparities.

“What we saw is that people of color also have less financial security,” Donelson observed. “That made the economic impacts more disruptive, and that individuals of color were also more likely to have jobs that required them to be on the front lines.”

Donelson pointed out research shows people of color are less likely to have a primary-care provider. As of February, 10,000 Connecticut residents had died from COVID-19.

The report also included recommendations for how state and local governments can achieve racial health equity.

Donelson noted health care accessibility was a big issue during the pandemic. She added people of color in the state have less access to transportation and bringing health care directly to the community is key.

“We use the example of doing a vaccine clinic at a Walmart parking lot,” Donelson remarked. “Again, meeting people where they are, and doing it on the weekend, so that you know people are going there, and it’s an accessible place, and it’s convenient for people to get there.”

Other recommendations in the report for state officials included building relationships with community-based organizations, that can act as trusted messengers on public health issues by sharing information, conducting outreach and soliciting feedback.

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Burnout from the pandemic has caused a nursing shortage in some parts of the country. But at one Oregon hospital, some nurses say they’re leaving because of what they see as a hostile work environment.

Union members in the Oregon Nurses Association at Columbia Memorial Hospital in Astoria are speaking out about conditions there. One member, who has asked to remain anonymous to protect her job, said management is creating a “culture of bullying and retaliation.”

Oregon Nurses Association spokesperson Kevin Mealy said the nursing staff has been called “disposable.”

“This is the type of behavior you’re seeing from management during COVID crisis, when nurses are papering over so many holes in the health-care system,” said Mealy. “The lack of respect and appreciation for the job nurses are doing, and the skills they bring to the profession, is shocking, quite frankly.”

Two grievances have been filed, one for what’s described as the “bullying nature” of the workplace; the other for short-staffing in the hospital’s family birthing center.

Nancee Long, director of communication for Columbia Memorial Hospital, said as in other parts of the country, nurses have left during the pandemic. But she said the hospital “has filled these vacancies with the help of competent agency nurses.”

Mealy said nurses have expressed concern at the high number of agency or traveling nurses working in the hospital. He said some of the nurses, who are highly specialized, aren’t necessarily able to do all the tasks nurses normally would.

“These substitute, short-time nurses don’t have the same skills as the experienced nurses who left,” said Mealy. “So they can only solve half the equation.”

Mealy added nurses are quitting and going elsewhere, although some offered to stay on longer until the hospital found their replacements – especially in the family birthing center.

“These nurses, who are core members of the community in Astoria, still live there and drive further to get to work at a different location,” said Mealy. “And they offered to stay because they don’t want to see the family birth center closed for any amount of time – but they also can’t stand being abused.”

The Columbia Memorial Hospital spokesperson said the family birthing center is “fully staffed and has continued to meet the needs of patients through the pandemic.” She said it has never closed due to low-staffing.

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