UK diabetes research featured in group's annual research report

Brittany Smalls, Ph.D., is at upper right.

By Hilary Smith
University of Kentucky

One of the cover stories in the annual reserach report from the American Diabetes Association is about a University of Kentucky researcher devoted to helping rural Kentuckians — specifically in Appalachia — better manage their diabetes.

highlighting investments in advancing diabetes research and clinical practice. ADA research grants focus on innovative projects with high impact and help researchers establish collaborative networks to move their innovations into the hands of people living with diabetes.

Brittany Smalls an associate professor and the Dr. Claire Louise Caudill Professor in Family Medicine in the UK’s Department of Family and Community Medicine. Her futire work in Appalachia will look at intergenerational households, where large extended families often live together in the same home or throughout shared pieces of land. These families share everything from living spaces, meals, household chores, caregiving and more.

Such househodls are common in Appalachia, and so is a disproportionately high risk for Type 2 diabetes. The prevalence of Type 2 diabetes reaches 23% in Kentucky’s most rural counties, more than twice the state average.

Throughout her career of helping older adults with type 2 diabetes, Smalls quickly noticed that the adult children and grandchildren of those she worked with could also benefit from her research.

Thanks to an award from the ADA, Smalls will expand her focus from older adults with type 2 diabetes to entire families living with or who are at risk for the disease.

“By tapping into tight-knit family units, we can start to shift how people think about their health and how they think about each other,” Smalls said.

The cover story from the ADA’s report details Smalls’ work resulting from the award:

“She is piloting a health intervention that leverages social support within family units to promote nutrition and physical activity, which are key to mitigating obesity and type 2 diabetes. Each participating family will receive a tailored six-month lifestyle plan. 

“Only one adult needs a type 2 diabetes diagnosis for a household to be eligible, and a dietitian will engage them in medical nutrition therapy based on available foods. Participating families will receive ADA-backed recommendations for physical activity based on family members’ physical ability.”

Poll of rural Americans finds them more aware of, and more willing to discuss, opioid problems; 47% still see stigma

Morning Consult graph: 2017 and 2022 responses to question about access to care. Click to enlarge.

Rural Americans say they are more aware of, and more willing to talk about, the opioid problem in the nation and their communities than they were five years ago, according to an online poll of rural adults sponsored by the American Farm Bureau Federation and the National Farmers Union.

Sixty percent said adults are more aware of the crisis than they were five years ago, and 77% said they would comfortable having a conversation about opioids, but 47% said there is stigma or shame associated with opioid abuse in their community.

Rural adults increasingly regard drug addiction as a disease. Asked if addiction to opioids is a disease or is due to a lack of will power or self-control, 57% said it's a disease and 21% said otherwise. In 2017, the numbers were 46% and 26%, respectively. Likewise, 78% said someone can accidentally or unintentionally get addicted to opioids; five years ago, 71% said that.

The poll found that more rural adults than five years ago believe there is a higher rate of opioid misuse in rural communities than in urban and suburban areas), and 48% said they know someone who is or has been addicted to opioids or prescription painkillers.

Asked if they had taken an opioid or prescription painkiller without a prescription, 5 percent said yes. The same percentage said they had abused opioids or prescription painkillers or been addicted to them. Asked how comfortable they would feel talking about that, 70% said they would feel very or somewhat comfortable discussing it with friends, 52% with siblings and 46% with parents. Beyond their immediate families, most said they would be not too comfortable, or not comfortable at all.

The margin of error for that subsample of 110 people is plus or minus 9.3 percentage points. The error margin for the whole sample of 2,010 rural adults is 2.2 percentage points. The poll was conducted online Oct. 6-13 by Morning Consult and the results were weighted to reflect gender, age, race, ethnicity, census region and education. The results are available from Farm Bureau here.

Farm Bureau and NFU, long rivals in representing farm interests, "have consistently worked to publicize and compile useful material to help address rural stress, mental health challenges and opioid misuse," they said in a press release. NFU President Rob Larew said, “We must continue to reduce the stigma to connect our loved ones with health care and treatment they may need. I thank AFBF for being a teammate on this project, and the survey results show what is possible when farm organizations work together.”