2023 Print Publication Sources
READ THE FULL 2023 REPORT HERE
Seeds of Change
Food and nutrition insecurity is defined as the limited ability to acquire adequate healthy foods.
“Food Security in the U.S.: Measurement.” United States Department of Agriculture.
Adults who experience food and nutrition insecurity are 2-3 times more likely to have diabetes.
“Food and Nutrition Insecurity and Diabetes: Understanding the Connection.” Centers for Disease Control & Prevention.
44% of people experiencing homelessness struggle to manage their diabetes.
“Diabetes Management Interventions for Homeless Adults: A Systematic Review.” International Journal of Public Health.
In the late 2010s, food insecurity was linked to more than $53 billion in excess annual health care expenditures.
"State-Level and County-Level Estimates of Health Care Costs Associated with Food Insecurity." Preventing Chronic Disease.
One out of every four health care dollars is spent on caring for people with diabetes—a total of $327 billion per year.
"Health and Economic Benefits of Diabetes Interventions." Centers for Disease Control & Prevention.
95% of clients at The Road Home's Midvale Family Resource Center had been food insecure within the last 12 months.
"Planning: CIVIC-PG Track B: A Community-Designed Intersectional Food Access Rights for Marginalized communities (IFARM) Hub." Shannon Jones, proposal to the National Science Foundation.
The U.S. Farm Bill provides $100 billion in subsidies for commodity crops such as wheat, corn, and soy.
"Farm & Commodity Policy: Farm Bill Spending." United States Department of Agriculture.
In 2021, 9 women worked at the farm for 10 months... 42,000 free organic food donations.
James Loomis, director of agriculture operations at Wasatch Community Gardens, in conversation with the author, 2022.
Young single mothers with limited education and resources make up most of the families in homeless services systems.
"Housing and Support Service with Homeless Mothers: Benefits to the Mother and Her Children." Community Mental Health Journal.
A Bridge to Recovery
Nearly 110,000 people died from drug-involved overdoses in the U.S. in 2022.
"Provisional Data Shows U.S. Drug Overdose Deaths Top 100,000 in 2022. Centers for Disease Control & Prevention.
Deaths involving the synthetic opioid fentanyl increased 279% between 2016 and 2021.
"Estimates of Drug Overdose Deaths Involving Fentanyl, Methamphetamine, Cocaine, Heroin, and Oxycodone: United States, 2021. Centers for Disease Control & Prevention.
In Utah, 38% of overdose deaths are attributed to prescription opioids—more than double the national rate.
"Health Indicator Report of Drug Overdose and Poisoning Incidents." Utah Department of Health & Human Services.
In 2017, opioid use disorder in Utah had a combined economic impact of $11.9 billion — including $441 million in health care costs and lost productivity alone.
"State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose — United States, 2017." Morbidity and Mortality Weekly Report.
An average of 25 patients addicted to opioids are admitted to University Hospital's ER each month.
Of the 2,000 patients admitted to the Bridge Program in its first two years of operation, 61% followed through with subsequent appointments for additional health care.
Rebecca Hyde, MA, Patient Services Manager, Huntsman Mental Health Institute, in conversation with the author, 2022.
Without adequate physical and especially mental health care, the odds of recovery from opioid dependency are less than 50%.
"Prevalence and Pathways of Recovery from Drug and Alcohol Problems in the United States Population: Implications for Practice, Research, and Policy." Drug and Alcohol Dependence.
It takes, on average, six to 10 treatment centers before people actually get into long-term recovery.
"Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health." United States Department of Health & Human Services.
Returning to Heal
In 2020, the poverty rate in rural Utah was 10.3% — compared to 7% in urban parts of the state.
"Economic Research Service: State Fact Sheets." United States Department of Agriculture.
In 2019, 28% of Washington County residents did not have health insurance — compared to 12.1% in Utah as a whole.
"2019 Utah State Health Assessment." Utah Department of Health.
21.5% of Utah's population live in rural areas, but only 11% of primary care providers, 16% of dental care providers, and 9% of mental health providers work there.
"2021 Utah Primary Care Needs Assessment." Utah Department of Health, Office of Primary Care & Rural Health.
In rural Utah, there's only 1 mental health provider per 55,000 residents — compared to 1 per 25,000 elsewhere in the state.
"2022 State of Mental Health in America." Mental Health America.
With close to half the community living below the poverty line. Medical neglect, diabetes, hypertension, heart disease, and many other chronic diseases run rampant in Short Creek — particularly among women and children. In recent years, the community had also been plagued by mental health struggles and suicides.
"Health Indicator Report of Utah Population Characteristics." Utah Department of Health & Human Services.
For the Love of Mothers
One in five U.S. women suffer from perinatal and postpartum mood disorders.
“Perinatal Mental Health Disorders.” Postpartum Support International.
In 2015-2016, three-fourths of pregnancy-related deaths in Utah were associated with a mental health condition.
“Perinatal Mortality Review.” Utah Department of Health & Human Services.
Until 2022, in 14 states including Utah, suicide and overdose were among the most common reasons pregnant people die in the first year postpartum.
Jamie Hales (LCSW, clinical manager at Huntsman Mental Health Institute), in discussion with the author, 2023.
Utah currently ranks 48th in the country for providing sufficient access to mental health care.
“Ranking the States 2022.” Mental Health America.
These conditions, occurring throughout birth and up to a year after delivery, are startlingly common—more common than preterm birth, diabetes, even high blood pressure.
“What are some common complications of pregnancy?” National Institute of Child Health and Human Development.
“Moms’ Mental Health Matters.” National Child & Maternal Health Education Program.
Only 143 mental health providers in the state’s database have specialized training in perinatal mood disorders.
“Maternal Mental Health Referral Network.” Utah Department of Health & Human Services.
For a state that counted 46,000 live births in 2021, and whose birth rate regularly tops the national average, that’s just not enough.
“Complete Health Indicator Report of Birth rates.” Public Health Indicator Based Information System (IBIS).
Experts from the Kem Gardner Policy Institute estimate that Utah must double its mental health workforce over the next 15 years to adequately address these growing needs.
“Utah’s Mental Health System.” Kem C. Gardner Policy Institute and the Utah Hospital Association. August 2019.
Mothers of color are more likely to be uninsured and face barriers to adequate health care overall, increasing the rates of pregnancy-related complications and a death rate that is 2-3 times that of White women. Mothers of color experience discrimination while seeking care, their concerns often dismissed and necessary tests and interventions denied.
“Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them.” KFF Health News. November 1, 2022.
“Racial Disparities in Maternal Health.” Blue Cross Blue Shield. May 20, 2021.
Utah Department of Health & Human Services’ Maternal Mental Health Referral Network lists only two psychotherapists statewide who specialize in treating BIPOC clients.
“Maternal Mental Health Referral Network.” Utah Department of Health & Human Services.
We (Utah) consistently rank among the highest birth rates in the U.S.
“Complete Health Indicator Report of Birth rates.” Public Health Indicator Based Information System (IBIS).
A recent survey found that 42.8% of Utah women who delivered a live infant reported symptoms of depression or anxiety before pregnancy, or during the prenatal or postpartum period.
“A Pregnancy Risk Assessment Monitoring System (PRAMS) Report – January 2021, Maternal Mental Health in Utah.” Utah Department of Health & Human Services.
Women in Latendresse’s first study had much lower depression scores after being in the group, even six months after it ended.
“A group telehealth intervention for rural perinatal depression and anxiety: A pilot study.” American Psychological Association.
40 percent of U.S. births and 22 percent of Utah births are covered by Medicaid.
“National Vital Statistics System, Birth Data.” Centers for Disease Control and Prevention, National Center for Health Statistics.
The federal poverty level for an individual is $14,580.
“Federal Poverty Level (FPL).” Healthcare.gov.
The average U.S. birth can cost between $10,000-$16,000.
“Health costs associated with pregnancy, childbirth, and postpartum care.” Peterson-KFF Health System Tracker. July 13, 2022.
A recent Health Affairs article found that among prenatal Medicaid enrollees who lost coverage in the early postpartum period, two thirds remained “consistently uninsured” at nine and 10 months postpartum.
“Late Postpartum Coverage Loss Before COVID-19: Implications for Medicaid Unwinding.” Health Affairs. July 2023.
In April 2022, Medicaid offered some relief. Through a new amendment, each state could choose to extend their postpartum coverage to a year post-delivery.
“Medicaid, Children’s Health Insurance Plan (CHIP), and Basic Health Program (BHP) Related Provisions in the American Rescue Plan Act of 2021.” Department of Health & Human Services Centers for Medicare & Medicaid Services.
By December, 27 states had approved extensions; eight others were in the process of implementing their own.
“Medicaid Postpartum Coverage Extension Tracker.” KFF Health News. August 28, 2023.
Utah joined them with S.B. 133, a bill passed in March 2023 that modified Medicaid coverage to cover a full year postpartum with some restrictions.
“S.B. 133 Modifications to Medicaid Coverage.” Utah State Legislature.
Lesser was the sponsor of H.B. 220, another Utah bill that—though it did not pass—also raised awareness about the urgent need for extended postpartum coverage.
“H.B. 220 Pregnancy and Postpartum Medicaid Coverage Amendments.” Utah State Legislature.
Academics in Action
And yet it's estimated that more than 40% of people who live in the U.S. don't have dental insurance. Those disparities are compounded for historically excluded populations. Black, Hispanic, and Asian Americans endure higher rates of gum disease and tooth decay. And nearly one-third of low-income adults say that poor dental health affects their ability to interview for a job. Overall, it's estimated that untreated oral disease causes $45 billion in lost productivity.
"Disparities in Oral Health." Centers for Disease Control & Prevention.
But when it comes to the number of primary care physicians per 100,000 residents, we have some work to do. The Beehive State currently ranks 48th out of 50, meaning that many communities do not have access to the care they need to stay healthy.
"2021 State Physician Workforce Data Report." Association of American Medical Colleges.
Community Co-Creation
They're the ones who best understand Utah's second largest city — a thriving and diverse place where 30% of residents speak a language other than English at home and 17% are foreign-born.
"Quick Facts: West Valley City, Utah." United States Census Bureau.
2020 Print Publication Sources
READ THE FULL 2020 REPORT HERE
Mental Health
Utah's suicide rate (per 100,000) is nearly double the national rate.
“Complete Health Indicator Report of Suicide.” Public Health Indicator Based Information System. Utah Department of Health.
Suicide is the leading cause of death among one of Utah’s youngest groups: teens aged 15-19.
“Community Health Needs Assessment.” University of Utah Health.
Suicide is the #1 cause of death for Utahns aged 10-17.
“Complete Health Indicator Report of Suicide.” Public Health Indicator Based Information System. Utah Department of Health.
Utah children as young as 9 years old have expressed thoughts of depression and suicide.
“Depression in children on the rise—how to help your child with their mental health.” The Scope Radio. University of Utah Health. June 15, 2020.
Utah’s youth suicide rate has tripled in the last decade alone.
“Violence and Injury Data.” Violence & Injury Prevention Program. Utah Department of Health.
Utah’s overall suicide rate has soared above the national average for more than 20 years.
“Complete Health Indicator Report of Suicide.” Public Health Indicator Based Information System. Utah Department of Health.
“Suicide.” National Institute of Mental Health.
Lilith Shlosman suicide attempt
Aaron, Rick. “High school bullying drove Utah teen to attempt suicide.” abc4 News. December 2, 2017.
Dylan Aranda suicide
“Dylan Scott Aranda”. Legacy obituary. January 18, 2013.
Chandler Voutaz suicide
Lovett, Ian. “One Teenager Killed Himself. Six More Followed.” The Wall Street Journal. April 12, 2019.
More Utah teens die from suicide than the four other leading causes of death—poisoning, car accidents, homicide, and other injuries—combined.
“Utah Deaths by Age and Gender.” Utah Health Rankings.
In 2015, the nation’s average teen suicide rate stood at 4.2 per 100,000. That same year, Utah’s stood at a horrifying 11.1.
Dark, Stephen. “Saving Lives”. University of Utah Health. March 4, 2019.
Graph: Utah teen suicides 2000-2019
“Violence and Injury Data.” Violence & Injury Prevention Program. Utah Department of Health.
In 2015, more than 4,500 Utahns tried to commit suicide.
“Suicide in Utah Youth.” Utah Department of Health Violence & Injury Prevention Program.
Utah ranks 6th in the nation for highest # of suicides.
“Suicide Mortality By State.” National Center for Health Statistics. Centers for Disease Control and Prevention.
There are only 6 child psychiatrists for every 100k kids in Utah. The national average is twice that.
“Utah’s Mental Health System.” Kem C. Gardner Policy Institute and the Utah Hospital Association. Last updated July 2020.
“AACAP Releases Workforce Maps Illustrating Severe Shortage of Child and Adolescent Psychiatrists.” American Academy of Child & Adolescent Psychiatry. April 12, 2018.
SafeUT provides counseling to more than 734k students across the state.
“2018-2019 Annual Report.” SafeUT. Huntsman Mental Health Institute (formerly UNI).
In first six months alone, SafeUT NG was downloaded by more than 1,000 service members.
“2019-2020 Annual Report.” SafeUT. Huntsman Mental Health Institute (formerly UNI).
SafeUT launched in 2016
“2018-2019 Annual Report.” SafeUT. Huntsman Mental Health Institute (formerly UNI).
In its most recent year, SafeUT received more than 30,000 tips and chats.
“2018-2019 Annual Report.” SafeUT. Huntsman Mental Health Institute (formerly UNI).
Since its creation, SafeUT app use has soared by more than 600%.
“2018-2019 Annual Report.” SafeUT. Huntsman Mental Health Institute (formerly UNI).
1 in 5 adults suffer from poor mental health.
“Utah’s Mental Health System.” Kem C. Gardner Policy Institute and the Utah Hospital Association. Last updated July 2020.
Utah ranks 51st for mental health resource access.
“Utah’s Mental Health System.” Kem C. Gardner Policy Institute and the Utah Hospital Association. Last updated July 2020.
In last 3 years, U has conducted 131 suicide research projects across 18 departments with funding of $125 million.
Office of Sponsored Projects Database, accessed by Nafisa Masud, June 2020.
SafeUT NG supports 7,000 service members and their families.
Utah National Guard. Official Department of Defense Website.
A third of Utah adults suffer from depression, and more than half lack access to treatment.
“Utah’s Mental Health System.” Kem C. Gardner Policy Institute and the Utah Hospital Association. Last updated July 2020.
The Huntsman Foundation pledged $150 million to mental health care.
Winchester, Suzanne. “$150 Million Commitment from Huntsman Family Will Establish Mental Health Institute at the University of Utah.” University of Utah Health. November 4, 2019.
UNI provides care through 170 licensed inpatient staff.
Juliana Briscoe, in an email message to Nafisa Masud. March 30, 2020.
UNI provided 51,000+ unique encounters for inpatient, outpatient, and day treatment services.
Juliana Briscoe, in an email message to Nafisa Masud. March 30, 2020
For the first time in a decade, Utah’s suicide rate has stabilized.
“State Suicide Prevention Programs FY 2019 Report.” Utah Department of Human Services.
Julia worked with Ben McAdams to secure $2 million in funding for school suicide prevention programs.
Tabin, Sara. “McAdams calls for more focus on suicide prevention in Utah, where it’s the No. 1 cause of death for children ages 10-17.” The Salt Lake Tribune. July 8, 2019.
Gallery
Teen Mother & Child is one of 16 services offered at South Main.
“Serving the South Salt Lake Community.” South Main Clinic. University of Utah Health. Accessed July 2020.
South Salt Lake experiences, on average, more crime, unemployment, and poverty than other parts of the state.
“QuickFacts Utah; South Salt Lake City, Utah.” United States Census. Accessed July 2020.
In the US, only 40% of teen mothers finish high school, and less than 2% go on to earn a college degree by age 30.
“Teen Pregnancy Prevention.” National Conference of State Legislatures. October 11, 2018.
The Ryan White Act funds more than 2,500 HIV/AIDS prevention programs in the US.
“About the Ryan White HIV/AIDS Program.” Health Resources & Services Administration. Accessed July 2020.
As of 2016, nearly 60% of new HIV diagnoses are among Utahns aged 35 and younger.
“2018: Annual HIV Surveillance Report.” Utah Department of Health Bureau of Epidemiology. Accessed July 2020.
PrEP is over 95% effective at preventing HIV.
“Pre-Exposure Prophylaxis (PrEP).” Centers for Disease Control and Prevention. Accessed July 2020.
This PrEP clinic is the 2nd in the nation.
Dark, Stephen. “The PrEP Revolutionaries.” University of Utah Health. November 29, 2018.
Since 2018, the clinic has served over 300 patients.
Adam Spivak, MD, interview with Nafisa Masud, July 2020.
The VA Salt Lake City covers 124,000 square miles and serves more than 143,000 veterans across Utah, Idaho, and Nevada.
Jill Atwood, interview with Nafisa Masud, August 2020.
Redwood Health Center has 23 programs.
“Redwood Health Center.” University of Utah Health. Accessed July 2020.
In FY19, the clinic saw more than 170,000 unique encounters.
Scott Hunt, in an email message with Nafisa Masud, June 2020.
Approximately 60,000 refugees live in Utah….
“Refugees in Utah.” Kem C. Gardner Policy Institute. April 2017.
Originating from more than 46 countries and speaking 90 languages.
“Admissions and Arrivals.” US State Department Refugee Processing Center. Accessed July 2020.
Rural Health
The 20 percent of Americans who live in rural regions.
"What Is Rural America?" Census Bureau. August 9, 2017.
80 percent are considered medically underserved.
"Health Care Deserts: Nearly 80 Percent of Rural U.S. Designated as 'Medically Underserved'. KHN.org. September 30, 2019.
Their life expectancies run a full decade shorter.
"Widening rural-urban disparities in life expectancy, U.S., 1969-2009." American Journal of Preventive Medicine. February 2014.
Rates of poverty, obesity, and diabetes are nearly 25 percent higher.
"CDC: More Obesity in U.S. rural counties than in urban counties." CDC. June 14, 2018.
While 130 rural hospitals across the US have closed since 2010, not a single one in the Beehive State has suffered the same fate.
"State-by-state breakdown of 130 rural hospital closures." Becker's Hospital Review. June 8, 2020.
Of Utah's doctors aged 35 and younger, only 3 percent practice in rural counties.
"The Racial and Ethnic Composition and Distribution of Primary Care Physicians." Journal of Health Care for the Poor and Underserved. March 28, 2018
In 2017, no doctors practicing in San Juan County were under the age of 35.
"Complete Health Indicator Report - Physician Distribution." Utah's IBIS. October 17, 2019.
10% of Utahns live in rural areas.
"Utah - Rural Definitions. State Level Maps." USDA. 2018.
7.9% of physicians practice in rural communities.
Every year, so many rural physicians retire that the state would need 19 new ones just to fill their shoes.
Rural students who receive multiple years of medical training are 1- times more likely to practice in a rural setting.
Intensive third-year rural curriculum and community preceptorships can increase the recruitment rate of rural students by 59%.
RUUTE's Impact Across the State
75 Medical residents and students worked 800 hours in clerkship rotations in 23 rural communities
Last year, they visited 52 schools in 15 Utah counties
They devoted 107 hours to presentations for 2,885 students
Little RUUTEs reached an additional 307 K-12 students
In total, RUUTE staff and students drove 27,547 miles around Utah and spent 149 total weeks volunteering in rural communities
University of Utah School of Medicine Rural and Underserved Utah Training Experience program.
The unemployment rate on the Navajo Nation hovers around 55 percent.
"Navajo Nation 2010 Population Profile." Navajo Division of Health and Navajo Epidemiology Center. December 2013.
A quarter of the population lives without running water or electricity.
"For many on the Navajo Nation, getting water requires travel, a wait in long lines and lots of patience." Salt Lake Tribune. July 25, 2020.
Only 13 grocery stores serve an area the size of West Virginia.
"Thirteen grocery stores: The Navajo Nation is a food desert." Planet Forward. December 10, 2019.
One-third of residents struggle with diabetes and prediabetes while nearly half are obese or overweight.
"Obesity and Growth." Navajo Epidemiology Center. Accessed July 2020.
In May, the Navajo Nation had the highest per-capita infection rate in the US; through October, the virus had killed more than 565 residents.
"Navajo Nation surpasses New York state for the highest Covid-19 infection rate in the US." CNN. May 18, 2020.
The 27,000-square-mile Navajo Nation doesn't have a single ophthalmologist.
Eye Exams: 1200, Sight-restoring Surgeries: 200, Pairs of Custom-Fit Eyeglasses: 1,100, Hours of Service: 25K
"Moran's Outreach Work: Navajo Nation." Moran Eye Center. Accessed July 2020.
Through October, they've had more than 10,675 cases of COVID-19.
COVID-19 Dashboard. Navajo Nation Department of Health. Accessed October 2020.
The Urban Indian Center of Salt Lake and U of U School of Medicine collected and donated nearly 25,000 pounds of food, supplies, and PPE.
"Supporting the Navajo Nation." @TheU, University of Utah. June 12, 2020.
All Telehealth Statistics
University of Utah Health Office of Network Development & Telehealth. Accessed October 2020.