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Compass Rose for Generating Community-based Referrals via Epic: Best Practices and Lessons Learned [Social determinants and vulnerable populations]

Annals of Family Medicine

Population Studied: Three sites, representing 13 urban and rural primary care practices in Minnesota, Wisconsin, and Florida participated in the Compass Rose pilot. The most common type of support requested related to transportation needs (42%), followed by assistance related to food insecurity (25%), utilities (12%), and housing (9%).

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Addressing diabetes management in the context of social needs: a qualitative study of primary care providers [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Diabetes management (DM) for patients with Type 2 Diabetes (T2D) can be hindered by non-medical, health-related social needs. Objective: To describe how primary care clinics have considered social needs in DM, and identify opportunities to support primary care clinics. Setting: Ambulatory clinics (e.g.,

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MN Legislative Session 2025: MAFP Priorities Remain in Play

Minnesota Academy of Family Physicians

These include health care, jobs and labor, K-12 education, energy, higher education, taxes, transportation and bonding. Sticking points remaining include reinsurance, paid family and medical leave and whether undocumented residents can qualify for MinnesotaCare. We are hopeful they will be included in a final agreement.

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Relationship between Social Risks and Diabetes Metrics in a Large US Health System [Social determinants and vulnerable populations]

Annals of Family Medicine

Primary care settings may be an appropriate environment to address social risk factors, however much is not known about the characteristics of patient reported social risk among patients with diabetes in a general primary care setting. Context Type 2 diabetes impacts 11.3%

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Association between patient reported social risks and HOUSES index: A rural-urban comparison [Social determinants and vulnerable populations]

Annals of Family Medicine

Rural patients are more likely to be older, female, white, more medically complex with fewer outpatient visits. vs 3.4%, transportation risk 3.3% Conclusions SES as measured by HOUSES index is the predominant driver of patient-reported social risk among both urban and rural populations in this primary care population.

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What to know about High Blood Pressure (Hypertension)

Georgetown Pediatrics & Family Medicine

Blood pressure is the pressure of blood “pushing against the walls of your arteries” As blood rushes from your heart to other organs, it helps to replenish nutrients and transport oxygen. Depending on your personal medical history and open discussion with your physician, this will guide your treatment plan.

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How to Manage Prediabetes with Food (What Actually Works)

Vida Family Medicine

At Vida Family Medicine, I’ve helped hundreds of patients improve their blood sugar without extreme dieting or cutting out the foods they love. Its job is to transport sugar from your bloodstream to the cells that need it—like your brain, muscles, or liver. Small, sustainable changes that work with your body—not against it.