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PerspectiveBased on Science, Built on Trust
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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:
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). “Every Story Is an Act of Power: Why Direct Service Providers Must Practice Dignified Storytelling”6/8/2026
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). |
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