In this episode, researchers Arch G. Mainous III, PhD, and Frank A. Orlando, MD, discuss their recently published study, “Body Mass Index vs Body Fat Percentage as a Predictor of Mortality in Adults Aged 20-49 Years." The study found that body fat percentage is a stronger predictor of 15-year mortality risk among U.S. adults than body mass index (BMI). Although BMI is widely used in clinics as the standard measure of body composition, it can potentially misclassify muscular individuals as overweight and miss cases of "normal-weight obesity," masking serious metabolic and heart disease risks. The study findings support reexamining how body composition is measured in clinical settings.

Other studies mentioned in the episode:

2016 study: "Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend

2022 study: Body fat and risk of all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies

In this episode, researchers Ann Sinéad Doherty, PhD, and Emma Wallace, PhD discuss their recently published study, “Prescribing Cascades Among Older Community-Dwelling Adults: Application of Prescription Sequence Symmetry Analysis to a National Database in Ireland.” The study identified five potential prescribing cascades in Ireland’s national population of older adults, highlighting yet another contributor to potentially inappropriate prescribing.

Primary care improves the health of communities and decreases health inequities, yet workforce shortages have worsened in the United States. This study, titled "Neighborhood Determinants of Primary Care Access in Virginia," aimed to identify geographic disparities of the primary care workforce in Virginia and identify factors associated with primary care physician (PCP) access. In this episode, authors Hannah Shadowen, third-year medical student, and Alexander Krist, MD, MPH discuss the study in detail.

Researchers used the 2019 Virginia All-Payers Claims Database to identify PCPs and the number of patients seen by each physician. They then measured how many PCPs each census tract could reach within a 30‑minute drive, flagging tracts with too few as having poor access. Associations between PCP access and predisposing (age, race), enabling (income, insurance), need and structural (rurality, segregation) factors were assessed.

Main Results:

• Nearly half (44%) of Virginia’s census tracts lacked adequate PCP access.
• Racial segregation and rurality had the greatest associations with PCP access: tracts with higher proportions of Black residents had significantly greater PCP access than those with higher proportions of White residents, while rural tracts had significantly less access.

Authors Shiying Hao, PhD, and Neil Kamdar, MA, discuss their original research study titled "Utilization of Treatment for Chlamydia and Gonorrhea and Practice-Level Variation in Treatment in the Primary Care Setting Using the American Family Cohort.” They talk about barriers to guideline adherence for chlamydia and gonorrhea treatment across primary care practices and recommend efforts to develop management plans for better quality of care.

In this episode, lead author Jade Wexler, a fourth-year medical student at Brown University, and co-author Dr. Elizabeth Toll, a professor of pediatrics and medicine and clinician educator at Brown University, discuss their study, A Qualitative Study of Primary Care Physicians' Approaches to Caring for Adult Adopted Patients. They share insights into their findings and the implications for primary care practice.

Family medicine is demanding, often taking an emotional toll on physicians as they share in their patients' distress and trauma. This essay recently published in Annals of Family Medicine titled "The Day I Almost Walked Away: Trust, Gratitude, and the Power of Teamwork," recounts a moment when a family physician, overwhelmed by the complexities of patient care, felt ready to step away from her duties. When she reached out to a team nurse for support, the nurse's encouragement helped her regain focus and continue caring for her patients. The story illustrates how emotional support and solidarity within health care teams can serve as a powerful antidote to burnout, enabling professionals to navigate the challenges of patient care. The essay advocates for fostering such connections in the workplace, ultimately leading to improved patient care and a more resilient health care workforce.

Black parents and their newborns are more likely to undergo drug testing for prenatal substance exposure by health care professionals, which contributes to Child Protective Services (CPS) reporting, family separation, and termination of parental rights. In this episode, lead authors Dr. Carol Shetty and Dr. Lauren Oshman discuss their study, “Structural Racism in Newborn Drug Testing: Perspectives of Health Care and Child Protective Services Professionals.” This qualitative study, recently published in the latest issue of Annals of Family Medicine, explored how structural racism affects decisions about newborn drug testing by examining the views and experiences of health care and CPS professionals.

Additional Resources:

• State reporting requirements from If/When/How: Prenatal Drug Exposure and CAPTA
• Doing Right at Birth modules for health care professionals: Doing Right at Birth
• Safe mi coalition: https://safemi.org/

Episode 1: Translating the Surgeon General’s Framework on Social Isolation and Loneliness to Actionable Steps in Primary Care

Before COVID-19, 20% of adult primary care patients felt lonely, linked to higher health care use and chronic conditions. Social isolation’s health impact rivals smoking 15 cigarettes a day. This episode offers critical strategies for primary care to address this growing epidemic. Dr. Sebastian Tong, lead author of the special report titled "The Role of Primary Care in the Social Isolation and Loneliness Epidemic," discusses the U.S. Surgeon General’s advisory and outlines practical steps for primary care, including training, patient support, and public health interventions. Listen now to learn about innovative solutions for combating social isolation and improving patient care.