Prairie Doc Perspective Week of August 30th, 2026
“The Missing Pillar of Health: Why Rest Is More Than Sleep”
By Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG,
Have you ever slept the recommended eight hours, only to wake up feeling tired and unready to take on the day? In addition to focusing on your sleep habits, consider the health benefits of rest. Because inadequate rest can negatively affect health outcomes, mood and daily participation, rest is a crucial component of supporting and promoting health. If you are unsure when you last rested, it may be time to develop a new rest routine.
Rest is defined as engaging in “quiet and effortless actions” (AOTA, 2020, p. 32). It involves reduced physical, mental and social activity to promote relaxation, restore energy or cultivate calm, thereby supporting renewed engagement. Examples of rest include listening to music, doing a puzzle, meditating or reading. Decisions about when to rest and which types of rest to engage in are influenced by personal interests and choices, as well as sociocultural and contextual factors. 
Rest is a unique experience that involves wakeful restoration across multiple categories and is a critical factor in promoting health. Physical rest includes activities such as stretching, napping or using a foam roller. This form of rest supports muscle recovery and can support the immune system. Mental rest is important for concentration and focus. This type of rest involves reducing stress and supporting emotional regulation, and it supports memory and concentration through breaks from problem-solving or decision-making. Mental rest may include meditation or can be combined with physical rest while walking. 
Social rest involves taking breaks from social experiences or demanding interactions to support connecting in ways that promote energy renewal. Sensory rest focuses on reducing noise or screen time. Strategies such as dimming the lights or using noise-canceling headphones can help reduce excessive background noise. Creative rest involves taking a break from creative stimulation, returning to the task with renewed concentration and appreciation. Engaging with nature or quiet reflection can promote creative rest.
Understanding different types of rest is important; however, recognizing signs that you may benefit from rest is a critical first step. Feeling fatigued even after adequate sleep, having difficulty concentrating, feeling overwhelmed or increased caffeine use may indicate that you could benefit from more rest. 
Developing practical strategies to consistently get rest that align with your lifestyle is a first step toward building more rest into your daily routine. Begin by scheduling short breaks throughout your day. Add these to your calendar and decide which restful activity you will do. When possible, spending time outdoors can be a beneficial way to rest. Another strategy to support rest is to take an inventory of your hobbies and interests. Identify what you enjoy and then set aside time to engage in these activities. View rest as a daily investment in your health and find enjoyable ways to make it part of your day. 
Rest is just as important as getting the recommended amount of sleep. Despite societal, personal and family demands, rest is necessary to support health. Rest is a strategy that promotes health, reduces fatigue and prevents burnout. Begin by identifying which restful activities you enjoy. Building one intentional rest strategy into your upcoming week may be the best way to kick-start a new habit that supports rest.
Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG, is department chair and associate professor in the Department of Occupational Therapy at the University of South Dakota. Her research interests include health promotion and productive aging. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of August 23rd, 2026
Back to School, Back to Bedtime: Why Sleep Routines Matter
By Nikki Eining CSW-PIP, QMHP

If bedtime has drifted an hour or two later over the summer, nothing has gone wrong. Late sunsets, camp schedules, vacations, and relaxed screen rules all nudge a child's internal clock later. Pulling that clock back toward a school-year schedule is real work, and it usually takes a couple of weeks of consistent effort, not one good night. It is also normal to experience some protest, stalling, and a few rough mornings along the way. Sleep problems and irregular bedtimes are extremely common in childhood; roughly 20% to 30% of children are affected by insomnia at some point, so families who struggle with this are in the majority, not the minority.

It is important to be aware of the appropriate amount of sleep for your child’s developing body. The American Academy of Pediatrics endorses these nightly sleep targets:
- Preschool (3–5 years): 10–13 hours, including naps
- School age (6–12 years): 9–12 hours
- Teens (13–18 years): 8–10 hours

Sleep is one of the strongest levers parents have over a child's mood and behavior. Getting the recommended hours is linked to better attention, learning, memory, emotional regulation, and mental health, while too little sleep is associated with depression, obesity, and high blood pressure.

The behavioral effects show up quickly. In studies where children's sleep was experimentally extended or restricted, kids sleeping close to 10 hours had better emotional stability, less restless and impulsive behavior at school, and a more positive mood than kids sleeping about 8 hours. Short sleep impairs the brain's "brakes" (impulse control and flexible thinking), which is why an under-slept child melts down over things they would otherwise shrug off.

If you find yourself just beginning to work on nighttime routine and sleep habits, there is good news. Children whose sleep improves over time show measurable declines in both emotional and behavioral problems. Working on sleep is not just damage control; it is an intervention to support wanted emotional and behavioral outcomes.

What are recommended strategies?

The American Academy of Pediatrics encourages using the 4Bs. Bathe, brush, books, bed. Using a consistent, predictable, calming sequence in the same order each night signals to the brain and the body that sleep is coming. This works for teens too, in an age-appropriate form.

Keep screens off for at least an hour before bedtime, and keep phones, tablets, and TVs out of the bedroom overnight. It is normal for children and teens to play music at night. Instead of using a tablet or a phone, purchase an alarm clock with digital music ability or a radio. Creating a nighttime playlist that can be played nightly is a predictable and consistent habit that signals to the brain and body it is time for sleep.

Consistency is what makes falling asleep and waking up easier. Try to keep weekend and vacation evenings consistent with weekdays.

Sunlight in the morning helps reset the internal clock. Open windows, turn on a light, or even get outside if you can.

Monitor caffeine intake. School-age children should not consume caffeine after noon. Common hidden sources include iced tea, chocolate, soda, and certain flavored waters. In a world where energy drinks and Starbucks are popular, educate your adolescent about how caffeine impacts sleep.  Research identifies that adolescents consuming energy drinks are 4.5 times more likely to sleep fewer than 6 hours

As always, annual well-child visits with your Primary Care Physician are vital. This is an opportunity to work together on strategies to support healthy sleep habits and to discuss if your child snores regularly or has pauses in breathing, is very sleepy during the day despite adequate time in bed, takes a long time to fall asleep most nights, or wakes repeatedly. These difficult experiences are treatable, and they deserve evaluation rather than more willpower.


The American Academy of Pediatrics healthychildren.org is a great resource for parents. Under the “Healthy Living” tab, you will find multiple articles and resources on exploring appropriate curfews, bunk bed safety, separation anxiety, and more.


Resources
The Role of the Pediatrician in the Promotion of Healthy, Active Living. Pediatrics. 2024. Muth ND, Bolling C, Hannon T, Sharifi M.


Longitudinal Association of Nighttime Sleep Duration With Emotional and Behavioral Problems in Early Childhood: Results From the Danish Healthy Start Study.
Sleep. 2021. Zheng M, Rangan A, Olsen NJ, Heitmann BL.


Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. lullab2016. Paruthi S, Brooks LJ, D'Ambrosio C.


Association Between Objectively Measured Sleep Duration and Symptoms of Psychiatric Disorders in Middle Childhood. JAMA Network Open. 2019. Ranum BM, Wichstrøm L, Pallesen S.


Nikki Eining is a private independent practice licensed social worker who serves as the Statewide Pediatric Mental Health Care Access Program Coordinator for The USD Center for Disabilities and Owner of Grace Grit Growth Counseling LLC in Brookings, SD. Nikki brings a diverse set of experiences and passions spending over 18 years working in the mental health field. Her previous experience has focused on supporting youth and families in office, school, and community settings without outpatient behavioral health services and prevention programming. She has professional experience in clinical mental health, education, research design, non-profit, program development, and trauma-informed care practices.
Nikki is passionate about trauma and healing-informed practices, the power of protective factors and collaboration across communities to help decrease barriers for youth and families. Nikki is a Theraplay Level 1, 2 and Group trained therapist, SAPST trained prevention provider, and an ACE Interface Certified educator.Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of August 16th, 2026
Anatomical Variations: Inherent Challenges in Comprehending Cancer
By Ethan L. Snow, PhD, MA
Human anatomy is fascinatingly and frustratingly complex. In each body, 600 muscles, 206 bones, and 360 joints provide structural stability and movement; two lungs circulate air through 1,500 miles of airways to 480,000,000 alveoli with every breath; one heart circulates 5-6 liters of blood through 60,000 miles of vessels every 30 seconds; 600 lymph nodes activate the immune system and filter foreign invaders (e.g., bacteria, viruses), cellular debris, and cancer cells coursing through 100,000 miles of lymphatic vessels; and the list continues.
As human anatomy applies to clinical medicine, some concepts are fundamentally more conceivable than others. For example, if an individual breaks a bone, they can often logically identify the etiology, understand the inhibited function, and realize the immediate need for urgent care. A radiologist would then localize and visualize the fracture, and an orthopedic surgeon would reduce and fix the bone. Cancer, however, is generally more arduous to conceptualize.
Cancer develops from a single cell, and comprehending the size of one cell is inherently challenging. There are around 30,000,000,000,000 (30 trillion) cells that compose each human body, and the average cell diameter is about 5 micrometers. For reference, the smallest object an unaided human eye can identify is approximately 100 micrometers (0.1 millimeters, or comparatively about one-tenth the thickness of a standard office staple), so it would take about 8,000 average-size cells arranged in a 20x20x20 cluster to be perceived by the naked eye as a minimally visible “speck.”
A single cell becomes cancerous when it acquires a mutation in its genetic code that causes it to grow and divide uncontrollably, ultimately creating many copies of its dysfunctional self. The microscopic scale at which this initially occurs makes it highly implausible to notice, and this is why signs and symptoms of cancer do not present until replication has created enough cellular mass to manifest physical or functional effects. To complicate matters further, while cancer can develop essentially anywhere in the body, cancer cells can relocate (metastasize) throughout the body via the extensive vascular, respiratory, and lymphatic pathways.
Thorough surface examinations (e.g., skin observation, breast/testicle self-exams, digital rectal exam, colonoscopy) are important routine screening procedures, and specialized imaging techniques (e.g., CT, MRI, PET, US) can confirm the presence and location of suspicious lesions (abnormal tissues). A biopsy of an alleged cancer tissue is normally collected to allow a pathologist to observe the associated cells, much like how a radiologist views bones in radiographs. A histologist slices the tissue thinly (~5 micrometers thick) and applies pigmented stains so each cell in the plane can be easily examined. A pathologist then inspects the tissue using a microscope to determine if cancer cells are present and what characteristics they exhibit.
Based on the diagnostic findings, an oncologist can establish the best treatment plan with the patient. Unfortunately, as cancer originates as part of the body’s tissues, treatment via surgical resection, chemotherapy, or radiation often also destroys healthy tissue as it is difficult to confidently target all and only the microscopic cancerous cells.
Ethan L. Snow, PhD, MA is a Clinical Anatomist and Associate Professor at South Dakota State University in Brookings, South Dakota. Dr. Snow leads the Snow Lab Research Team – a collaborative and interdisciplinary team of undergraduate students, professional students, faculty, and clinicians who analyze rare and unique clinical cases involving anatomical variations. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and TikTok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (Sundays at 6am and 1pm).

Prairie Doc Perspective Week of August 9th, 2026
“Allergies during pregnancy”
By Rebecca M. Duron, MD, MSPH


Pregnancy is such an incredible state of anticipation. Each day it seems like you’re finding something new to wonder or worry about! Having an allergic or immune system condition can certainly add a few questions and considerations to the list, though.
- Is my nose congested from seasonal allergies?
It could also be something called rhinitis of pregnancy- fluctuating hormones and increased blood volume lead to increased nasal congestion independent of allergies. Fortunately, over the counter nasal steroid sprays (such as fluticasone, triamcinolone, or budesonide) and oral antihistamines (such as cetirizine and loratadine) are still safe for most while pregnant.
- Will my asthma get worse while pregnant?
For about of third of patients, the answer is unfortunately yes. However, another third of patients experience improvement in their asthma control! It is very important to have the medical team managing your asthma ready to manage either situation.
- What if I have a severe allergic reaction while pregnant, such as to a bee sting or a food?
Please do still use your epinephrine device and get in touch with your allergist and obstetrician!
- What if I need an antibiotic while pregnant, but I have a penicillin allergy?
Penicillins are usually the preferred antibiotic class for many common situations in pregnancy, because they are very effective and safe for both mom and baby. The allergy should be evaluated by a specialist, especially if the initial reaction occurred a long time ago! Many people who think they are allergic to penicillins no longer are.
- Why am I so itchy!?
There are unfortunately many reasons this can happen in pregnancy, some more serious than others. Talk to your obstetrician first, but if it seems like it may be classic hives know that this is unfortunately common in the postpartum period. If the hives just aren’t going away, an allergist should help you manage them in the long term.
- What if I have an immunodeficiency?
Ideally, your immunology team has had the chance to optimize your care prior to pregnancy, limiting the number and severity of infections as much as possible with treatments that will be safe for mom and baby. During pregnancy, you will likely need to be followed closely and have medication doses adjusted frequently leading up to and after delivery.
- Is there anything I can do to prevent my baby from having allergies?
Unfortunately, if you have an allergic condition, then your child is at higher risk to also have one. Eczema is a very common infant condition and may not be lifelong- a good start would be to use very gentle soaps and bland, thick creams or ointments regularly. To prevent food allergy, allergists recommend introduction and regular ingestion of commonly implicated foods between 4 and 6 months of age (once you have clearance from your pediatrician to begin solid foods). Small servings of cow’s milk yogurt, scrambled or boiled egg, and peanut butter which has been thinned with a liquid are all that’s needed! Just remember to feed these items at least 2-3 times per week, long term.  
Don’t forget to enjoy your pregnancy! Before you know it you’ll have a newborn to enjoy instead.
Dr. Durón provides allergy and asthma care for patients of all ages in Sioux Falls at Dakota Allergy & Asthma. She is board-certified by the American Board of Allergy and Immunology and completed her fellowship at the University of Texas Southwestern Medical Center in Dallas, Texas. She is a new mother to twins. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB,  YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of August 2, 2026
“Connection is the answer”
By Leah Hendrickson CSW-PIP, QMHP


The human race has never been more connected to one another. We can reach family, friends and strangers across the world in mere seconds. Despite this alleged connectedness, loneliness is everywhere. The U.S. Surgeon General referred to loneliness as an epidemic that is literally killing us, stating that lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day. We all know smoking is dangerous, so why do we ignore the danger of loneliness? Ignoring it won't make it go away.


Human connection is crucial to our survival, and it isn't something technology can manufacture for us. Connection allows us to feel seen, heard, and valued. Most importantly, it allows us to feel like we belong. Belonging is a foundational, biological need. We are social creatures who need one another to survive. For early humans, being in a group increased the odds of survival. Rejection meant isolation which, at that time, meant death. No wonder it physically hurts to be rejected or lonely! Our brain is desperately alerting us that we are in danger. We need to start paying attention and stop trying to override the signal.


As a health professional, I have yet to come across a single person who doesn't feel lonely. Many of us do nothing about it due to fear of rejection, fear of judgment, and a lack of confidence in how to connect with others. So what do we do? First, we need to remind ourselves that we all deserve to belong and to love and be loved. We all have value and no one can take that from us.


To connect and feel we belong, we need to put ourselves out there. Yes, it's scary and we won't always be successful but you try anyway. And you try again. Finding common ground and being willing to listen is vital. Listening doesn't mean being in agreement; it means recognizing and respecting another person's human experience, allowing them to feel seen and heard.


To feel seen and heard yourself, you'll need to be a little vulnerable. This is often where people stop. Vulnerability feels like risk, and it is. But it's a necessary one. Sharing about yourself appropriately helps build trust, and trust is the foundation of any relationship. Start small. You don't need to bare your soul to a stranger. Tell someone what you're actually enjoying lately, admit when you're having a hard week, or simply say "I miss you." These small acts of openness signal to another person that you're real, approachable, and wanting to connect. More often than not, they'll reciprocate.


We also need to be present. This is tough when the world is full of stimuli competing for our attention. We must sit with the temporary discomfort of presence in order to rid ourselves of the chronic discomfort of loneliness. Set aside your device, ask someone about their day, and be curious. Share a meal, go for a walk, play cards, or simply sit with another human being. Take the risk of connection. We already know where loneliness leads.


Leah Hendrickson CSW-PIP, QMHP currently works as an outpatient mental health therapist in Brookings, SD. Leah Hendrickson is passionate about helping others live healthier, happier, and more resilient lives. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB,  YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of July 26th, 2026
“Replacing Missing Teeth; 21st Century Solutions to an Age Old Problem”
By Dr. Bradley Jordan


Your tooth broke, it was painful, the dentist said it couldn’t be fixed and it had to be pulled. Now what?  


That missing tooth, like a critical bolt missing from an engine, is a problem that may take months or years to show its face.  Missing one or more teeth can lead to changes in bite, space between teeth resulting in food getting stuck and difficulty chewing and speaking.  Every week I see patients that are starting to break front teeth because they have no back teeth to chew with.  When back teeth are missing, the front teeth take all the force of chewing and start to wear down.  


The great news is that we have modern solutions for missing teeth!


Quickly becoming the standard of care to replace teeth are dental implants. The process begins when a titanium post is placed to mimic the tooth root and is finished when the final crown is attached to the dental implant. Patients report that their dental implant looks, feels and works just like a natural tooth. A dental bridge is another simple tooth replacement option and can be utilized to replace 1 or 2 missing teeth.  The process involves placing dental crowns on the teeth adjacent to the missing tooth with an artificial tooth in between.  The adjacent teeth are effectively the anchors for the bridge.  


For patients that are missing all of their teeth, the Teeth-in-a-Day procedure or also known as All-on-X is the preferred treatment plan.  All-on-X refers to having all the replacement teeth anchored with X number of implants.  That X number of implants can range from 4 to 8.  While dentures can look nice and provide minimal chewing force, most people cannot tolerate a lower full denture due to how uncomfortable it is.  When a patient leaves the office after having the Teeth-in-a-Day procedure, they take home a fixed set of teeth that look great and can provide some chewing ability.  After healing and the final prosthetic is made, the patient is allowed to eat their favorite foods again and can laugh with confidence knowing that their teeth are not going to fly across the room.  


Whether you’re replacing one missing tooth or restoring your entire mouth, there’s a solution to fit your lifestyle and goals. Take the first step toward a more comfortable smile by consulting your dentist today.
Dr. Bradley Jordan is the owner and dentist at Lone Oak Dental in Brookings, South Dakota.  He is a graduate of the University of Minnesota and completed an Advanced Education in General Dentistry residency at the Audie L. Murphy VA Clinic in San Antonio, TX.  He is happily married and has two teenage boys.  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB,  YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of July 19th, 2026
“The Critical Need for More Nurses in the State of South Dakota”
By Dawn R. Warren, Ed.D., MSN, BSN, RN, University of South Dakota Department of Nursing
As a registered nurse (RN) in South Dakota for the past 35 years, I can honestly say that it has been one of the greatest blessings in my life and yet is a profession in dire need of more, especially in our rural areas. According to Klinski (2025), South Dakota is projected to have the third-worst nursing shortage in the United States by 2030, needing an additional 1,900 registered nurses (a 14% deficit). The state faces an estimated 1,000 nursing job openings annually as rural healthcare systems struggle with an aging workforce and geographic challenges. 
I have had the honor of working as an RN in South Dakota in a multitude of areas, all with similar, yet different, benefits. I have worked in home health nursing, critical care, progressive care, the emergency department at Monument Health, a small rural critical access hospital, and currently, as a nurse educator at the University of South Dakota. I have been involved in the birth of a newborn baby, the peaceful death of a terminal client dying at home, the tragic deaths of children in the emergency department, the joy of discharging a patient who received life-saving treatments, the sense of pride when my nursing students have graduated and everything in between. Don’t get me wrong- it’s not all good. There are days that are incredibly sad, days that are exhausting, patients that are challenging and days I have left in tears.  Fortunately, those days are far and few between compared to the days that are filled with joy and a great sense of accomplishment.    
With nursing being such a rewarding career with so many different areas to work in, and with the extreme nursing shortage, it is important to share how people can become a nurse. South Dakota is fortunate to have multiple nursing programs available.  People can become a licensed practical nurse (LPN) in approximately one year, with multiple vocational schools in South Dakota offering the degree. A second option is to become a registered nurse (RN) with an associate degree, taking approximately two years to complete, and offered at a number of vocational schools and universities. The third option is to become an RN with a Bachelor of Science in Nursing (BSN) degree. The BSN degree takes approximately four years to complete, often times opens the doors to more leadership positions, and is offered at many universities in South Dakota.  
Living in South Dakota has many benefits and challenges all at the same time. We are blessed to live in beautiful wide open spaces, but with that comes the challenges of sparse healthcare resources and a lack of nurses to staff them. It is not uncommon for a farmer in South Dakota to have to drive two hours one way to get basic healthcare, and further to get advanced care. Despite this challenge, for those who choose to practice as a nurse in rural underserved facilities, it can be extremely rewarding. While working at Dell Rapids hospital, I had the honor of caring for women in labor, pediatrics, medical surgical patients, trauma victims in our ER, patients with mental health needs and more, all while enjoying the culture of a small rural town where everyone truly cared about each other. 
It is my overall hope that more people in South Dakota will look into the many benefits of being a nurse, especially rural South Dakota, and that they will choose to get educated at one of the many excellent nursing programs our state offers.
Dawn has had the honor and privilege of being a registered nurse for 35 years. She earned her BSN in 1991, her Master of Science in Nursing Education in 2000, and her Doctor of Education in 2016. Dawn’s areas of expertise as an RN are critical care nursing, emergency nursing and in nurse education at the University of South Dakota. Dawn and her husband have two sons, both of whom are in college studying to become nurses.  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of July 12th, 2026
Sip to Stay Strong: Why Hydration Matters More Than We Think
By Carissa Regnerus, RDH, MA, FADHA
During the warm summer months in South Dakota, many of us spend extra time outside walking, working or enjoying community events. The heat and wind can pull moisture from the body faster than we realize. Hydration becomes important for everyone, from kids running around at the park to adults juggling busy schedules to older adults who may not notice thirst as quickly. Water supports our health in every season, but summer reminds us just how essential it is.
We often think of dehydration as something that only happens when a person is ill, running a marathon or working outside on a hot day. But in reality, our bodies lose two to three liters of water every day just by breathing, urinating and through our skin. If we don’t replace that water, the body begins borrowing it from tissues, including the mouth and brain.
And here’s the remarkable truth: every single cell in the human body requires water to function. We can survive for weeks without food, but only a few days without fluids. Water fuels energy production, carries nutrients, removes waste, regulates temperature and supports the electrical signals that keep our hearts and brains working. It is the foundation of life.
Hydration needs change across the lifespan
While everyone needs water, the reasons vary across the lifespan. Children lose water faster and may forget to drink while playing. Teens and adults often push through busy days relying on caffeine instead of water. Athletes and outdoor workers lose more fluid through sweat.  
Although dehydration can affect anyone, it can be especially impactful on older adults and is a well-recognized contributor to confusion. Older adults are more prone to fluid loss because they don’t sense thirst as easily, many take medications that cause the body to lose water, and they naturally have about 15-20% less total body water than younger adults.
Hydration and oral health: a connection for all ages
Saliva is 99% water, and dehydration can cut salivary flow by half. When the mouth dries out, problems follow:

• Higher risk of cavities and gum disease
• Denture discomfort
• Difficulty chewing and swallowing
• Changes in taste that reduce appetite

Hydration and the brain
The brain is about 73% water, and losing just 1-2% of that water can affect you even before you feel thirsty and negatively impact things like attention span, memory, mood and reaction time. For kids, this can mean trouble focusing in school. For adults, it may feel like brain fog. For older adults, it can increase fall risk.
Simple habits that help everyone

• Keep a bottle or glass nearby at home, school or work and sip it regularly even if you’re not thirsty
• Choose infusions that don’t lower pH, such as mint, basil or cucumbers. If you enjoy citrus, use it occasionally rather than sipping it all day to protect enamel. 
• Choose hydrating foods like fruits, yogurt, soups and smoothies
• Avoid excessive salt and alcohol intake which can both contribute to dehydration

As we move through the warm months, staying hydrated is one of the simplest ways to support comfort, clarity and wellbeing. Water helps us enjoy the activities we love- working, learning, playing and aging well. Small habits that support hydration can help people of all ages stay healthy and strong throughout the South Dakota summer and beyond.


Carissa Regnerus, RDH, MA, FADHA, has been a licensed dental hygienist for more than 25 years and a faculty member in the University of South Dakota’s Department of Dental Hygiene since 2001. She teaches courses in dental public health, nutrition and preventive care, with a focus on helping students understand the oralsystemic connections that shape overall health. Her work in medical mission settings reflects her dedication to improving oral and systemic health across diverse communities. She can be reached at [email protected].  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of July 5th, 2026
“Finding Balance in a World That Never Stops”
By Curstie Konold MPH, CSW-PIP, QMHP


Finding Balance in a World That Never Stops
Stress surrounds us every day. We experience it in our personal lives, at work, in our relationships, and through the constant stream of information from the news and social media. We live in a world of endless notifications, growing expectations, and competing demands that pull us in multiple directions at once. We are often expected to be constantly available and do more than our time and energy allow. However, our body and brain were not designed to handle this level of continuous stress and demand. As a result, many people struggle to maintain balance, manage stress effectively, and protect their overall well-being.
In healthy amounts, stress can be beneficial. It can motivate us to try new things, work toward our goals, and overcome challenges. Our bodies and brains are designed to respond to stress by addressing a stressor and then returning to a state of balance and recovery. However, when stress becomes constant or overwhelming, the body may struggle to return to this balanced state. Instead, it can remain in a prolonged state of stress, which may have lasting effects on both physical and mental health, as well as overall quality of life.
In a world of constant news, social media, and other sources of stress, it is important to be intentional about disconnecting from these influences and reconnecting with the habits and practices that support overall well-being. One framework for achieving balance is the eight dimensions of wellness identified by the Substance Abuse and Mental Health Services Administration (SAMHSA): emotional, spiritual, intellectual, physical, environmental, financial, occupational, and social wellness. By supporting each of these dimensions, individuals can build resilience, manage stress more effectively, and improve their overall quality of life.
Wellness is about creating balance between different areas of life. Being mindful of the dimensions of wellness can help you better understand where you are thriving and where you may need additional support. Taking time to reflect on each dimension individually by asking yourself what is going well and what feels challenging can provide valuable insight into your overall well-being. The dimensions of wellness are interconnected, and challenges in one area can impact other areas. For example, occupational stress may influence emotional wellness, while financial concerns can impact social relationships and physical health.
Regularly checking in with the dimensions of wellness can help you better understand what your mind and body need in a given moment. If you identify an area where you are struggling, consider what actions or resources might be helpful. Writing down specific, achievable steps can be an effective way to address your needs and restore a greater sense of balance.
Stress is a natural part of life, and it is not something we can eliminate completely. However, we can take intentional steps to care for ourselves while navigating life's challenges. The eight dimensions of wellness provide a practical framework for understanding our needs and identifying areas that may require additional attention.
Wellness is not about achieving perfection in every area of life. Instead, it is an ongoing process of self-awareness and growth. By making small, consistent choices that support our well-being, we can build resilience, find greater balance, and feel better equipped to meet the demands of everyday life


Curstie is a certified social worker in private or independent practice and holds a Master of Public Health degree. Curstie owns Mindful Matters, LLC, where she provides mental health services and promotes trauma-informed care to her clients. Curstie is also the Associate Director at the Center for Rural Health Improvement at the University of South Dakota, where she supports projects that advance rural health initiatives, strengthen community partnerships, and improve access to quality care across rural communities. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of June 28th, 2026
A Critical Time for Public Health Advocacy
By: Jennifer Noll Folliard, MPH, RDN and DenYelle Baete Kenyon, Ph.D.
There is a common saying in public health: "Everything is public health." That is because public health touches nearly every aspect of our daily lives. It is the clean water we drink, the air we breathe, the safety of the food we eat and the environments where we live, work, learn and play. These conditions do not happen by accident; they are shaped by policies, systems and collective investments. Much like public education, public health reflects a shared commitment to creating the conditions where all people have the opportunity to thrive.
Public health is your local school nurse caring for children, your extension agent helping families and farmers, your WIC dietitian supporting healthy pregnancies and babies and your food inspector ensuring meals are safe to eat. Public health is as dynamic as the communities it serves. As communities change, public health must adapt to meet new challenges, respond to emerging threats and address evolving needs.
Yet we are facing a troubling reality. For the first time in generations, today's children are not on track to live as long as their parents. One reason for this is that public investment in health has not kept pace with the growing challenges facing our communities. We have seen significant disinvestment in public health infrastructure, prevention programs and community-based services. These decisions have consequences. When we underinvest in public health, we increase the risk of chronic disease, infectious disease outbreaks, preventable deaths, higher health care costs and reduced quality of life.
In South Dakota, nonprofit organizations, faith communities, health systems and private businesses often step in to fill gaps and support community well-being. Their contributions are essential. However, preparing for large-scale challenges such as natural disasters, emerging infectious diseases and public health emergencies requires coordinated local, state and federal systems. The COVID-19 pandemic reminded us that diseases do not recognize city, county, state or national borders. Maintaining strong public health infrastructure requires ongoing investment so communities can respond quickly and effectively when threats emerge.
Public health works best when science and community experience inform one another. The most effective solutions are rarely simple, and they are seldom captured in a single headline or sound bite. They emerge when community members, health professionals, policymakers, businesses and local leaders work together to understand problems and develop practical, evidence-based solutions.
The South Dakota Public Health Association (SDPHA) serves as a trusted source of public health information, and our role goes beyond sharing data and research. We want to help elevate the stories, challenges and successes happening in communities across South Dakota.
Is your community struggling to access healthy food? Are you concerned about air quality, housing, transportation or other factors affecting health? Have local residents come together to solve a problem in an innovative way? Policy makers and community leaders want to hear those stories.
Public health is strongest when it reflects the experiences of the people it serves. Now is the time to share your stories of challenges and successes in your communities. SDPHA can help amplify community voices, share promising solutions and connect local experiences to state and local decision-makers.
Together, we can build healthier, stronger and more resilient communities. We invite you to share your challenges, successes and ideas so that we can learn from one another and create solutions that work for all South Dakotans.


Jennifer Folliard, MPH, RDN, is the founder and principal consultant at Health + Nutrition First and lead of the rapid response team for South Dakota Public Health Association. She is a registered dietitian with expertise in public health systems and policies. Jenn received her Bachelor of Science in human nutrition and food/nutrition in business from Purdue University and her Master of Public Health, focused on public health policy and systems of care, from the Johns Hopkins Bloomberg School of Public Health. In her previous position as the maternal child health director for the South Dakota Department of Health, Jenn worked with multi-sector partners to develop and advance priorities that would improve the health of South Dakota families. Before moving to South Dakota, she worked in Washington, D.C., for 10 years, conducting state and federal policy research and advocating for these policies to build effective public health systems.


DenYelle Baete Kenyon, Ph.D., holds several positions, including legislative chair of the South Dakota Public Health Association; University of South Dakota associate dean of Community Health & Engagement and Master of Public Health Program director; and professor of pediatrics at the Sanford School of Medicine. She received her B.S. in family social science from the University of Minnesota and went on to receive a Ph.D. in family studies and human development from the University of Arizona. DenYelle worked at Sanford Research for 11 years as a public health researcher, focusing on teen pregnancy/STI prevention, undergraduate research training and helping lead the Collaborative Research Center for American Indian Health. At USD for the past seven years, DenYelle leads community health and engagement efforts for the medical school and the Master of Public Health program, where she is fortunate to work with teams on increasing underrepresented students in health care careers and training future medical and public health practitioners on achieving health equity. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​

Prairie Doc Perspective Week of June 21st, 2026
“Dementia and Home Safety: Tips for Caregivers”
By Ranelle Nissen, Ph.D., OTR/L and Allison Naber, Ph.D., OTD, OTR/L
Caregivers of people with dementia are often tasked with keeping their loved ones safe at home. Unpaid family members or friends, referred to as care partners or caregivers, dedicate significant time and resources to assist the person with dementia as their needs intensify. Caregivers may find themselves providing increased assistance with everyday tasks like cooking and cleaning, and self-care tasks like dressing, bathing and toileting. This is often due to a decline in the person with dementia’s awareness of time and place, ability to solve problems or assess situations, strength and mobility, and senses (vision, hearing or depth perception). These declines also put people living with Alzheimer’s disease or other related dementias at increased risk of injury, especially as the disease progresses. 
Caregivers can take steps to create a safe home environment that minimizes the risk of injury or harm while maximizing the person’s independence for as long as possible. First, organize important information, including insurance information, names and contact information for healthcare providers, medications and allergies, emergency contact numbers, legal papers (living wills, advance directives and power of attorney), and contact information for friends and family members. Next, assess the home and outdoor spaces for potential barriers, such as uneven terrain or thresholds, poor lighting, chemicals or other potentially hazardous items. Once safety concerns are identified, caregivers can implement helpful strategies and adaptations to keep their loved ones safe, including: 

• Checking the temperature of food, beverages and bathwater
• Removing throw rugs, cords or other items that could cause someone to fall
• Installing adaptive equipment in the bathroom, like grab bars or shower chairs
• Adding extra lighting or nightlights in entryways, stairwells, bathrooms and hallways
• Using a hidden breaker or gas valve, or removing knobs to limit use of the stove when unattended
• Storing hazardous items or tools in a secure location
• Locking up medications and supplements

Some people living with dementia may exhibit wandering behaviors, such as forgetting how to get to familiar places in the home or community, talking about past obligations like going to work, restlessness or pacing, or being nervous in crowded or new locations. Structured routines, exercise or movement, deadbolts or locks on upper doors and cabinets and increased supervision or support can decrease the risk of wandering. 
While the journey with dementia brings many challenges, creating a safe home can help foster peace of mind for everyone involved. A sense of purpose and connection through participation in familiar routines, favorite activities and nurturing relationships with family and friends can promote safety, comfort and quality of life for people living with Alzheimer’s disease or other related dementias. 
If you or someone you love is impacted by Alzheimer’s disease or other related dementias, resources are available through organizations such as the Alzheimer’s Association and the Veterans Affairs, as well as state agencies such as the Department of Human Services. No one needs to face this journey alone. These organizations provide education, home safety checklists and recommendations, extra help in the home and support groups. Check with your state to see what resources may be available to you. 
Ranelle Nissen, Ph.D., OTR/L, serves as an associate dean and associate professor in the School of Health Sciences at the University of South Dakota. Nissen is a licensed occupational therapist in South Dakota. She has helped families and individuals affected by dementia through both her professional work and her volunteer work with the South Dakota Alzheimer’s Association.
Allison Naber, Ph.D., OTD, OTR/L, is the academic fieldwork coordinator and an associate professor in occupational therapy at the University of South Dakota. Naber is a licensed occupational therapist in Minnesota and South Dakota. She volunteers for the South Dakota Alzheimer’s Association as a support group facilitator and community educator. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of June 14th, 2026
“Don't Rub Your Eyes!”
By Dr. Vance Thompson


Keratoconus is one of the most important eye diseases for parents, teachers, coaches, and adults to understand because, if caught early, we now have the ability to help save vision and reduce the chance of future corneal transplantation. One of the most overlooked contributors to this disease is something many people do every single day without thinking about it: rubbing their eyes.
People often do not realize how much repetitive eye rubbing can damage the eye. When we rub our eyes, we are pushing on the eyeball and especially on the cornea, the clear front window of the eye that provides most of the eye’s focusing power. Over time, repeated pressure can weaken this delicate structure. For many people, rubbing begins innocently because their eyes itch from allergies, dryness, or irritation. Unfortunately, rubbing can become habitual. Patients often push harder and harder over time to achieve the same temporary feeling of relief, without realizing they may be harming their vision.
In some individuals, especially those genetically predisposed, repeated rubbing or pressure can contribute to the development or progression of keratoconus. Keratoconus occurs when the cornea becomes weakened and begins to thin and bulge outward into a cone-like shape. When this happens, light no longer focuses properly, leading to blurred vision, increasing astigmatism, glare, halos, ghosting, and progressive visual distortion. If left untreated, severe cases can eventually require corneal transplantation.
Eye rubbing is not the only source of pressure. We also see damage from what some doctors call “pillow diving,” where patients press their eye into a pillow while sleeping, particularly stomach sleepers or side sleepers. Sometimes we see one eye with very little astigmatism and the other eye with a large amount, and the patient will tell us that the worse eye is the one they constantly rub or sleep on against the pillow. Many patients later say, “I wish someone had warned me earlier.”
Children are especially important to watch because keratoconus often begins during the teenage years and can progress rapidly in younger patients. Parents may notice frequent eye rubbing, squinting, changing glasses prescriptions, headaches, or declining school performance related to vision. Kids with allergies are particularly at risk because itchy eyes drive the urge to rub. Treating allergies and dry eye disease early can help reduce this cycle.
That is why comprehensive eye examinations are so important. Modern corneal imaging called corneal topography allows eye doctors to map the shape of the cornea and detect early keratoconus, sometimes even before vision becomes severely affected. Detecting the disease early can be life changing.
One of the greatest advances in eye care has been corneal crosslinking. In this treatment, riboflavin (vitamin B2) eye drops and ultraviolet light are used to strengthen and stabilize the cornea. Crosslinking does not simply treat symptoms, it addresses the underlying weakness of the cornea itself. When performed early, especially in children and young adults, it can dramatically reduce progression and lessen the likelihood of needing a corneal transplant later in life.
It is very important to stop rubbing your eyes, treat the underlying causes of itching, and make sure children and adults at risk are screened for keratoconus. Early detection and modern treatments like crosslinking are helping preserve vision for an entire generation of patients.
A Gregory, South Dakota native, Vance Thompson, MD has been Refractive, Corneal, and Cataract surgery in Sioux Falls, South Dakota, the state he grew up in, since 1991. He is an internationally recognized specialist in refractive corneal laser, phakic IOL, and lens replacement surgery. He is the Founder of Vance Thompson Vision Sioux Falls, SD which has grown to serve the mid and mountain west with nine locations.  Dr. Thompson also serves as a Professor of Ophthalmology at the Sanford USD School of Medicine. As a leading international researcher, he has played a key role in the development of the most advanced technologies and techniques for both laser and implant vision correction. He has served as the medical monitor or principal investigator in over 130 FDA monitored research trials studying laser and implant surgery.  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of June 7th, 2026
“Every Story Is an Act of Power: Why Direct Service Providers Must Practice Dignified Storytelling”
By Darla Biel, Ed.D.


Stories are at the heart of direct service and clinical work. Whether written in case notes, shared in supervision, included in grant reports, or told at community meetings, stories help others understand the impact of our work. They build emotional connection in ways data alone cannot. But storytelling is also an act of power, and when we’re not careful, that power can unintentionally cause harm.


For many families, their stories are told about them, not with them. Direct service providers often hold the microphone through professional language, reports, and presentations. Even with good intentions, stories can strip dignity, reinforce stereotypes, or expose families to stigma, especially in small or close-knit communities where anonymized details are often still identifying.


Dignified storytelling asks us to slow down and be intentional. At its core is a simple truth: it’s not our story. The direct service provider’s role is not to extract compelling narratives for program promotion, but to honor people’s humanity, safety, and agency while still communicating the value of direct service work.


One of the most common pitfalls is what some call “hardship” or “bootstrap” storytelling. This is the idea that success comes only from individual effort and that suffering must be emphasized to prove impact. These stories often rely on pity-inducing language, exaggerate trauma, or cast providers as heroes while families appear passive or broken. Not only does this framing erase strengths and resilience, it ignores the real systems that shape people’s lives, such as access to housing, healthcare, childcare, and economic opportunity.


A more ethical approach focuses on balanced, multidimensional stories. Dignified storytelling acknowledges challenges while also highlighting strengths, goals, decision-making, and progress. It shows people as parents, workers, community members, and partners and not just as clients or problems to be solved. It shifts the narrative from rescue to relationship.


Consent is another critical piece of ethical and dignified storytelling. Consent is not just a form signed once and filed away. True informed consent requires that people understand why their story is being shared, what will be created, where and how it will be shared, and for how long. It must happen in accessible language, in settings where it’s genuinely safe to say no, and with the clear understanding that consent can be withdrawn at any time. What felt acceptable at intake may not feel safe months or years later.


Sometimes, the most ethical storytelling choice is not to share a story at all. If there is any risk of harm, retraumatization, stigma, or identification,  especially in situations involving young children or families facing substance use, violence, or child welfare involvement. The answer may need to be no. Saying no to sharing a client’s story isn’t a failure; it’s ethical leadership.


Fortunately, there are always alternatives. Aggregated data, composite stories, systems-level insights, and reflective narratives can demonstrate impact without putting individuals at risk. And when individual stories are shared. Co-creation, with families reviewing and approving how they’re represented, offers one of the strongest safeguards.


A useful litmus test is this: If you wouldn’t want the family to read what you wrote about them in an article or report, don’t write it. People are always more important than program promotion.


Every story is an opportunity to honor or to harm. The choices that clinicians and other direct service providers make every day shape not only individual experiences, but organizational culture and public understanding. Practicing dignified storytelling helps ensure that the stories we tell today build trust, respect, and dignity for years to come.


Darla Biel, Ed.D. is Assistant Director of the Center for Prevention of Child Maltreatment (CPCM) within USD's School of Health Sciences. Her research interests include community-engaged scholarship, social determinants and health, and cross-sector collaboration efforts in primary prevention of childhood adversity. Biel leads the Early Childhood Comprehensive Systems (ECCS) grant funded by HRSA and is a member of the SD Childcare Task Force's executive committee. She lives in Brookings with her husband, Marc. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of May 31st, 2026
Understanding the Ups and Downs of Pain During Recovery
By Kory Zimney, PT, DPT, PhD
Many equate pain with injury and thus assume that pain should be a straight line when recovering. So, if pain flares up a bit, they worry that something is wrong. Maybe the injury is getting worse, or they “overdid it” the day before. In reality, pain often rises and falls during normal recovery, and these ups and downs do not automatically mean you’re injuring yourself. Pain is more complex than a simple measure of tissue damage.
Healing tissues and a sensitive alarm system
Pain is best thought of as your body’s alarm system. Early after an injury or surgery, that alarm is turned up on purpose to protect healing tissues. Even as the tissues recover normally, the alarm may remain slightly sensitive for a while. This means everyday movements, increased activity, or changes in routine can trigger pain, even when the tissues themselves are safe.
This sensitivity usually settles with time, movement and confidence. A short-term increase in pain does not automatically mean damage has occurred. It often reflects a nervous system that’s still learning what is safe again.
Next day pain
Pain that shows up later, such as soreness the next day, is often blamed on “overdoing it.” While extreme overload can contribute to flare-ups, changes in pain from one day to the next are often a normal response to increased movement. Your body adapts to activity gradually, and mild soreness or stiffness can be part of that process, especially when trying something new or returning to activities you’ve avoided.
Pain levels don’t always match how well your body is healing. You are recovering successfully, even on days when pain feels worse.
Stress, sleep and mood matter
Your nervous system doesn’t work in isolation. Poor sleep, emotional stress, worry or fatigue can increase pain sensitivity. We often say, “You’re getting on my nerves” when someone stresses us out. Biologically, that’s true. Stressful events release chemicals that make nerves more sensitive. On stressful days, the pain alarm becomes easier to trigger, which is why pain may spike during busy weeks, after poor sleep or during emotional strain without any change in the injury itself.
These influences are real and biological; they are not imagined or “in your head.”
Your body’s healing chemistry
Your body naturally produces both pro-inflammatory chemicals (which increase sensitivity) and anti-inflammatory chemicals (which reduce sensitivity) as part of the healing process. This balance shifts from day to day, like a teeter-totter. Some days you may feel more sensitive, and other days less so. These shifts are a normal part of recovery and help explain why pain often fluctuates.
Pain doesn’t equal harm
One of the most important principles of recovery is this: pain does not always mean damage. Pain is often a sign of sensitivity rather than danger. Gradually continuing to move, even with some discomfort, is often part of restoring normal function and confidence.
When to check in
While fluctuating pain is common, steadily worsening pain, new symptoms or pain accompanied by significant swelling, weakness or loss of function should be discussed with a health care provider. Otherwise, ups and downs are a normal and expected part of recovery.
Healing isn’t about eliminating every painful moment. It’s about helping your body and nervous system feel safe enough to move forward, one step at a time.
Kory Zimney, PT, DPT, PhD is a professor at the University of South Dakota, School of Health Sciences Physical Therapy Department and director of the PhD in Health Science program. Dr. Zimney is part of the Center for Brain and Behavioral Research at the University of South Dakota and the Therapeutic Neuroscience Research Group, conducting research specifically in the areas of pain science and therapeutic alliance. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

​

Prairie Doc Perspective Week of May 24th, 2026
“Adverse Childhood Experiences: From Public Health Crisis to Clinical Opportunity”
By Chrissie Young, MS
Since the landmark 1998 study conducted by the CDC and Kaiser Permanente, it has been understood that Adverse Childhood Experiences (ACEs), traumatic events occurring before age 18, have a profound and lasting impact on adult health. These experiences, ranging from abuse and neglect to household dysfunction like substance misuse or mental illness, are remarkably common. Approximately 62% of adults have experienced at least one ACE, and one in six report four or more.
The evidence for a dose-response relationship between ACEs and negative health outcomes is striking. Individuals with high ACE scores (four or more) face significantly increased risks for nine of the ten leading causes of death in the United States. This includes a 2.1-fold increased risk of heart disease, 2.3-fold for cancer, and 3.1-fold for chronic lower respiratory disease. The impact on behavioral health is even more acute, with high ACE scores associated with a 4.7-fold increase in depression, a 10.2-fold increase in substance dependence, and a staggering 37.5-fold increase in suicide attempts.
The biological mechanism driving these outcomes is the toxic stress response. When significant adversity is experienced without the buffering protection of safe, stable relationships, it leads to prolonged activation of the body’s stress response systems. This disruption to neuro-endocrine-immune-metabolic (NEIM) function, alters gene expression via epigenetic markers, and accelerates cellular aging through the shortening of telomeres.
However, the most critical takeaway for clinicians is that ACEs are not destiny. The brain and body remain malleable throughout the life course, and targeted interventions can improve outcomes even for adults with high ACE scores. A modern clinical response requires moving beyond isolated medical treatments toward a multidisciplinary "Network of Care" that leverages the expertise of Community Health Workers (CHWs).
CHWs are essential mitigating factors because they are uniquely positioned to solve for social determinants of health (SDOH). Because ACEs often co-occur with challenges like housing instability, food insecurity, and economic hardship, CHWs help patients secure these basic needs. By addressing these external stressors, CHWs effectively lower the "cumulative dose" of adversity the patient experiences, which is necessary for the body to return to a state of homeostasis. Furthermore, as culturally congruent navigators, they build the trust needed to coach patients in self-care and "stress-busting" strategies.
Robust evidence suggests that seven key evidence-based strategies can mitigate NEIM disruptions and enhance neuroplasticity:

1. Supportive Relationships: Buffering stress through strong emotional connections.
2. Quality Sleep: Improving immune regulation through healthy sleep habits.
3. Balanced Nutrition: Counteracting pro-inflammatory states with anti-inflammatory diets.
4. Regular Physical Activity: Promoting neurogenesis and metabolic health.
5. Mindfulness Practices: Reducing stress hormones and improving emotional regulation.
6. Access to Nature: Lowering blood pressure and calming the stress response.
7. Mental and Behavioral Healthcare: Trauma-informed therapies to reverse cellular "wear and tear".

Implementing trauma-informed care (TIC) allows providers to move the clinical inquiry from "What is wrong with you?" to "What happened to you?". By recognizing toxic stress as a treatable health condition and utilizing CHWs to address underlying social needs, we can offer genuine healing. In doing so, we not only improve individual adult outcomes but also interrupt the intergenerational transmission of adversity, providing a healthier foundation for the next generation
References:
Bhushan, D., Kotz, K., McCall, J., Wirtz, S., Gilgoff, R., Dube, S. R., Powers, C., Olson-Morgan, J., Galeste, M., Patterson, K., Harris, L., Mills, A., Bethell, C., & Burke Harris, N. (2020). Roadmap for resilience: The California Surgeon General's report on adverse childhood experiences, toxic stress, and health. Office of the California Surgeon General. https://doi.org/10.48019/PEAM8812
Centers for Disease Control and Prevention. (2021). About the CDC-Kaiser ACE study. https://www.cdc.gov/violenceprevention/aces/about.html
Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71(2), 243–250. https://doi.org/10.1097/PSY.0b013e3181907888
Felitti, V. J. (2002). The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal, 6(1), 44–47. https://doi.org/10.7812/TPP/02.994
Merrick, M. T., Ford, D. C., Ports, K. A., Guinn, A. S., Chen, J., Klevens, J., Metzler, M., Jones, C. M., Simon, T. R., Daniel, V. M., Ottley, P., & Mercy, J. A. (2019). Vital signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention — 25 states, 2015–2017. MMWR. Morbidity and Mortality Weekly Report, 68(44), 999–1005. https://doi.org/10.15585/mmwr.mm6844e1
Schultz, K. (2018, September 18). We have to talk about childhood trauma and chronic illness. Healthline. https://www.healthline.com/health/chronic-illness/childhood-trauma-connected-chronic-illness
Tan, H., Zhou, H., Chen, J., Ren, H., Guo, Y., & Jiang, X. (2024). Association of early life adversity with cardiovascular disease and its potential mechanisms: A narrative review. Frontiers in Public Health, 12, Article 1341266. https://doi.org/10.3389/fpubh.2024.1341266
UCLA Health. (2021, November 23). Is there a link between childhood trauma and adult neurologic conditions? https://www.uclahealth.org/news/article/is-there-a-link-between-childhood-trauma-and-adult-neurologic-conditions


Chrissie Young, MS, is the Director of the Center for the Prevention of Child Maltreatment at the University of South Dakota. She leads statewide efforts to strengthen child- and family-serving systems through training, technical assistance, prevention initiatives, and cross-sector collaboration. Her work focuses on building community and professional capacity to better recognize, respond to, and prevent child maltreatment and adverse childhood experiences. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on,YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
​