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The first-of-its-kind program has connected more than 2,700 Manchester families to care In its 10-year history, the Manchester Adverse Childhood Experiences Response Team (ACERT) has responded to more than 8,000 incidents involving children. The multidisciplinary program has connected more than 2,700 children and families affected by domestic violence and other crimes to the care and support they need to heal. On Thursday, October 8, partners, local organizations, advocates, and elected officials gathered at SEE Science Center to celebrate ACERT’s 10th anniversary and reflect on the program’s impact over the past decade. The nation’s first program of its kind, ACERT has earned the support of Governor Kelly Ayotte, Senator Jeanne Shaheen, Senator Maggie Hassan, Congressman Chris Pappas, and Mayor Jay Ruais. At Thursday’s celebration, Ruais thanked the professionals and community partners who have sustained the program. “This milestone demonstrates the power of collaboration and of supporting children and families. The ACERT approach recognizes that trauma does not have to define a child's future, and that timely intervention, compassionate support, and strong community connections can help children heal and thrive.” The core ACERT team includes advocates from the Manchester Police Department, Amoskeag Health, and YWCA New Hampshire. Each partner delivers unique skills, resources, and services to link families to dedicated, trauma-informed care that addresses both the emotional and physical needs of children. Kris McCracken, President and CEO of Amoskeag Health, said, “I love that the success of ACERT doesn’t belong to any one organization. It is the result of the collaboration among all the core partners, first responders, and community partners who have said yes when a family needed help.” Once a family establishes a connection with the core team, they gain access to a close-knit network of a dozen Manchester-based organizations. These partners provide specialized services focused on the safety and healthy development of children and families. “That lasting impact is possible because of the extraordinary community partnerships that make ACERT what it is today,” said Caroline Knight, Executive Director of YWCA New Hampshire. “We may be the ones who connect families to services, but it's our community partners who open their doors, walk alongside them, and help them move forward. As we celebrate ten years of ACERT, we are deeply grateful for their commitment and look forward to building even stronger partnerships in the years ahead.” ACERT began in 2016 as a small effort to fill a gap in follow-up support for Manchester children. It has since grown into a robust referral network that has expanded to several New Hampshire cities and drawn interest from communities beyond the Granite State. The ACERT Technical Assistance Center (TAC) offers training, tools, coaching, convening, and monitoring and evaluation to communities interested in implementing the program. Manchester Police Chief Peter A. Marr credits ACERT as a contributor to the city’s declining crime rates over the last several years. “As just one piece in a larger puzzle, ACERT can’t take all the credit. But I absolutely believe it’s contributed to the more resilient community Manchester has become,” Marr said. “When we help one child, we help a family, and when we do it for thousands of children, we have an opportunity to change the community.”

About 1 in 8 women in the U.S. will develop breast cancer at some point in her life, and an estimated 382,640 women will receive a diagnosis this year alone. The numbers are sobering, but there is real reason for optimism. When breast cancer is caught early through screening, the 5-year relative survival rate is over 99%. Keep reading to learn how screening works, who is at higher risk, which symptoms to watch for, and what support is available. Why Screening Matters Advances in screening, research, and treatment methods have helped reduce breast cancer death rates by 44% since 1989. Women who get screened regularly are 26% less likely to die of the disease than those who do not receive screenings. Several tests can reveal abnormalities in the breast. Your health provider can perform a clinical breast exam during an office visit by physically examining your breasts. Mammograms are recommended for women 40 and older, as well as for those at higher risk. A mammogram uses low-dose X-rays to capture images of breast tissue and can often spot cancer before a lump can be seen or felt. If your provider finds an area that needs further attention during a screening, or if you have symptoms that align with breast cancer, you may be referred to a specialist to perform additional tests to confirm diagnosis. Who Is at Higher Risk? Breast cancer doesn’t always have a clear cause, but certain factors raise the odds. You’re considered high risk, and should be screened regularly, if any of the following apply: You’ve had breast cancer before Breast cancer runs in your family history You carry a genetic mutation linked to higher risk, such as a BRCA gene change You received chest radiation therapy before age 30 Symptoms to Watch For Although rare, men can get breast cancer as well since all people are born with some breast cells and tissue. Everyone should know the warning signs. The most frequent sign is a new lump or mass, although most lumps turn out to be noncancerous. A lump that is hard, painless, and irregular in shape is more suspicious, but cancerous lumps can also be soft, round, tender, or painful. Other signs include: Swelling in all or part of a breast, even without a lump Dimpled skin that resembles an orange peel Red, dry, flaky, or thickened skin on the breast or nipple Breast or nipple pain A nipple that turns inward Nipple discharge that isn’t breast milk Swollen lymph nodes under the arm or near the collarbone Having one of these symptoms doesn’t mean you have cancer. Hormonal changes and benign breast conditions can cause many of them. Try not to panic, and let your provider help you figure out what’s going on and what to do next. Life After a Diagnosis Breast cancer statistics can be frightening, but there is also hope in the numbers. Roughly 66% of breast cancers are found early, before spreading beyond the breast, when treatment is typically more successful. For cancers caught at this localized stage, the 5-year relative survival rate exceeds 99%. More than 4 million breast cancer survivors are living in the United States today. These figures highlight why proactive screening is so important: it gives you the best chance of finding and treating cancer at its earliest stage. How Amoskeag Health Can Help Amoskeag Health is a Breast and Cervical Cancer Program (BCCP) screening site for the State of NH providing free breast and cervical cancer screening to eligible patients. An Amoskeag Health Nurse provides education, support, and assistance to navigate through the program’s options. The cancer screening program is supported by funding from the State of NH’s Department of Health and Human Services BCCP Program and Dartmouth Hitchcock’s NH Colorectal Cancer Screening Program. Please talk to your Primary Care Provider for more information. If you’ve recently been diagnosed with breast cancer and want help coping with the stress and emotions of treatment, Amoskeag Health’s Behavioral Health Clinicians are also available to support your mental health. To learn more about Amoskeag Health’s screening services, click here.

Dr. Mary Cullen has achieved board certification in the subspecialty of addiction medicine through the American Osteopathic Association, a milestone she says reflects a personal commitment that began more than a decade ago. By 2013, Dr. Cullen had already spent three years providing primary care to Amoskeag Health patients and had grown deeply familiar with their needs and concerns. Recognizing how limited resources were for pregnant women with substance use disorders, she began offering medication treatment for this underserved population. What started as an effort to fill a gap in care soon grew into a major component of the community health center's services, as word spread and more patients sought help. After more than ten years of gaining knowledge about and treating substance use disorder, Dr. Cullen began pursuing her board certification. Among other program requirements, candidates must practice a minimum of 1,000 hours of addiction medicine in a two-year period and complete ongoing medical education. While the extensive certification exam required many hours of studying, Dr. Cullen says it was a welcome challenge because this preparation strengthened the care she provides her patients. "For me, this certification is not simply a professional accomplishment,” says Dr. Cullen. “It reflects my commitment to treating substance use disorders with the same compassion, evidence-based care, and medical expertise that I bring to every other aspect of my practice. I am proud to have pursued this path and grateful for the opportunity to continue helping patients and families affected by addiction." Today, about a third of Dr. Cullen’s practice at Amoskeag Health is devoted to addiction medicine and supporting patients on their recovery journey. In addition to this new certification, Dr. Cullen is board certified in Family Medicine. To learn more about Dr. Cullen, click here. To learn more about Amoskeag Health's Substance Use Treatment Program and Medication Assisted Treatment, click here.

The New Hampshire Area Health Education Center (AHEC) Network has honored Jessica Montemayor, PA-C, and Darlene Estevez of Amoskeag Health with 2026 Preceptor Recognition Awards. The awards celebrate New Hampshire healthcare workers who provide exceptional teaching and mentorship to students in the health professions. A Physician Assistant practicing family medicine at Amoskeag Health, Montemayor precepts PA and medical students from Massachusetts College of Pharmacy and Health Sciences, Franklin Pierce University, and the Geisel School of Medicine at Dartmouth. After a decade of mentoring, she remains struck by how eager her students are to learn. "My patients absolutely love the care they receive from my students," says Montemayor. "Being a mentor and having the privilege to guide students in their journey to become well rounded practitioners is so rewarding. Seeing them move on to their next rotations with more confidence and conviction makes me feel like I did my job." Estevez, Amoskeag Health's Community Outreach and Engagement Manager, has mentored students since November 2025. Stephanie Savard, Director of Strategic Initiatives at Amoskeag Health, praises Darlene's gift for putting people at ease as they learn. "I really appreciate how patient and approachable Darlene is, especially when the material gets challenging. Any time someone needs help, she is there to guide them and offer support without making them feel uncomfortable." The NH AHEC Network is a statewide organization dedicated to improving access to healthcare by strengthening New Hampshire's health a nd public health workforce. Its Preceptor Recognition Awards launched in 2021 to honor healthcare workers who show dedication to investing in the healthcare workforce pipeline. To learn more about all of the 2026 Preceptor Recognition Award recipients, click here.

New location expands healthcare access on Manchester’s West Side Following Tuesday’s ribbon-cutting celebration for the Mark Stebbins Community Center, Amoskeag Health has officially opened its newest Manchester location, bringing expanded access to comprehensive healthcare services to residents on the city’s West Side. The new location is Amoskeag Health’s fifth office in Manchester and expands the organization’s capacity to serve up to 2,500 additional patients. “We are excited to open our doors on Manchester’s West Side and bring more of our services directly into the community,” said Kris McCracken, CEO and President of Amoskeag Health. “This new location gives us the opportunity to reach more patients and provide the comprehensive, affordable care that has been at the heart of our work in Manchester for more than 30 years.” Amoskeag Health has served the Manchester community since 1993 and provides integrated physical and behavioral healthcare for patients of all ages, regardless of insurance status. Services at the new location include primary and acute/sick care, behavioral health counseling, nurse visits, vaccinations, and case management. Patients may also access additional support services, including transportation assistance, medical interpreters, a sliding fee scale and prescription assistance for uninsured patients. The location is open Monday through Friday from 8:00 AM to 5:00 PM. The opening of Amoskeag Health’s new location coincides with the official opening of the Mark Stebbins Community Center on September 9. The center represents the realization of a long-standing vision to bring nonprofit organizations together in one accessible location and expand resources available to West Side families. The Mark Stebbins Community Center honors the late Mark Stebbins and his vision for accessible, affordable opportunities for children and families. Amoskeag Health is proud to be an anchor tenant and to partner with the Stebbins family, the Boys & Girls Clubs of Greater Manchester, community organizations, donors and other supporters who helped make the center possible. For more information on the new community center, visit https://markstebbinscommunitycenter.org/.

As fall hiking season approaches, it's important to take preventative measures to reduce your risk of tick bites and illnesses like Lyme disease. New Hampshire is in one of the highest-risk regions in the country for tick-borne illness, largely because of its dense woodlands and high deer population. With areas of the Granite State creating ideal conditions for deer ticks to thrive, a little knowledge goes a long way toward keeping you and your family safe. Understanding Tick Risk A tick is a small arachnid that survives by feeding on the blood of animals and humans. Because ticks gravitate toward wooded areas, tall grasses and brush, you can expect to find them on hiking trails, stone walls, woodpiles and shaded, moist ground. In New Hampshire and the greater New England region, tick season runs from roughly April through November. Tiny nymph-stage ticks are most active from May through July, while adult ticks are active in the spring and again from September through November. They can even be found on warmer winter days, so some caution is warranted year-round. Not all tick bites result in illness, but some ticks carry disease-causing pathogens that can be transmitted to their hosts during feeding. The most common illnesses associated with tick bites include: Lyme Disease: A bacterial infection transmitted to humans through the bite of a blacklegged (deer) tick carrying the Borrelia burgdorferi bacterium. Rocky Mountain Spotted Fever: A potentially serious bacterial infection caused by Rickettsia rickettsii, most commonly transmitted by the American dog tick, wood tick, or brown dog tick. Alpha-gal Syndrome: A food allergy triggered by Lone Star tick bites that causes a reaction to molecules found in red meat and other mammalian products. While AGS is still primarily a southeastern/south-central U.S. condition, the range is expanding northward to the New England region. Anaplasmosis, babesiosis, and ehrlichiosis: Each of these tick-borne illnesses has unique symptoms but can be effectively treated when caught early. Preventing Tick Bites Prevention is by far your best defense against tick-borne illness. If you're spending time in outdoor areas where ticks may be prevalent: Use an EPA-registered insect repellent. Products containing DEET or picaridin are effective on exposed skin. For extra protection, treat clothing, shoes, and gear with permethrin. Dress smart. Wear long sleeves and pants, tuck pants into socks, and choose light-colored clothing so ticks are easier to spot. Stick to trails. Avoid brushing against tall grass and leaves when hiking or exploring outdoors. Do a full-body tick check. Immediately after outdoor exposure, check you and your companions’ bodies for ticks. Pay special attention to your scalp, ears, underarms, groin and behind the knees. Check pets, too! Pets can carry ticks indoors even if they aren't infected themselves. Routine checks of pets when they come indoors can prevent transfer to other household members. Shower after outdoor activities. This helps wash off unattached ticks and gives you another chance to spot one. Treat your yard. Keep grass trimmed, clear leaves and brush and consider a wood chip or gravel border between lawn and wooded areas to reduce tick migration. Treating Tick Bites Attached ticks aren't cause for panic, but you should act fast to reduce potential harm. Remove the tick properly. Use fine-tipped tweezers to grasp the tick as close to the skin as possible and pull straight up with steady, even pressure. Avoid twisting or crushing the tick. Clean the area with rubbing alcohol or soap and water. Save the tick if possible, in a sealed bag or container, and note the date. This can help your healthcare provider assess risk if symptoms develop. When to Seek Medical Attention The good news is that tick bites caught early typically don't lead to lasting health issues. Most bites don't require antibiotics like doxycycline, but if you're unsure about infection risk, call your primary care provider to determine the best course of action. We can help assess the type of tick, how long it was attached, and local infection rates to determine whether medical intervention is needed. Please call Amoskeag Health at 603-626-9500 to make an appointment if you notice: A rash at or near a bite site, even if it doesn't look like a classic bullseye (Erythema migrans) Fever, chills, fatigue, or body aches within a month of a known or suspected tick bite, especially if you've spent time outdoors in wooded areas Facial weakness or drooping Joint swelling or pain that develops weeks after a bite Heart palpitations, chest pain, or shortness of breath following a tick exposure Neurological symptoms such as numbness, tingling, or severe headaches Ticks have become part of life in New Hampshire, but bites and disease don't have to be. Consistent prevention habits, prompt and proper tick removal, and awareness of early symptoms will help keep you and your family healthy as you explore the great outdoors! Contact Amoskeag Health: 603-626-9500 Patient Portal

Amoskeag Health has been awarded recognition by the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home Program for its commitment to delivering coordinated, patient-centered care that improves access, communication, and care coordination for patients across Greater Manchester. The NCQA Patient-Centered Medical Home Program evaluates whether primary care practices are functioning as medical homes and recognizes organizations that demonstrate systematic, coordinated, and patient-centered care. The program emphasizes access to care, communication between patients and care teams, and active patient involvement in health decisions. The recognition reflects Amoskeag Health’s integrated approach to care, which connects primary care, behavioral health, substance use disorder treatment, prenatal care, pediatric care, and community-based support services within one coordinated system. For patients, this model of care can mean easier access to services, stronger communication between providers, and more coordinated support for managing chronic conditions and overall health needs before they become emergencies. As a federally qualified health center serving Greater Manchester and surrounding communities, Amoskeag Health provides care for patients of all ages regardless of insurance status or ability to pay. Last year, Amoskeag Health served more than 14,700 patients across the region, including 43% covered by Medicaid and more than 3,300 individuals without health insurance. “Achieving and maintaining NCQA Patient-Centered Medical Home Recognition reflects Amoskeag Health’s deep commitment to providing high-quality, coordinated, and compassionate care for every patient we serve,” said Maureen Cassidy, Chief Nursing Officer and Chief Compliance Officer for Amoskeag Health. “For our patients, this means better access to care, stronger communication among providers, and a healthcare experience that is truly centered around their individual needs. For the community we serve, it reinforces our role as a trusted healthcare partner dedicated to improving health outcomes, advancing equity, and supporting the overall well-being of our neighbors.” “NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that Amoskeag Health has the tools, systems and resources to provide its patients with the right care, at the right time.” Patient-Centered Medical Home Recognition is awarded by NCQA to healthcare organizations that demonstrate consistent, high-quality, patient-centered care and continuous improvement in care delivery systems. About Amoskeag Health Amoskeag Health is a nonprofit, federally qualified health center dedicated to improving the health and well-being of our patients and the Greater Manchester community through comprehensive healthcare services that address both physical and mental health under one roof. We’ve proudly served Manchester, NH, since 1993. About NCQA NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.

19th Annual Morning Matters Event Draws Advocates, Community Leaders, and Supporters Earlier this month, Amoskeag Health was pleased to hold its 19th Annual Morning Matters Breakfast at the Derryfield in Manchester. “Morning Matters is among our most critical fund and awareness raising events each year,” said Kris McCracken, President and CEO of Amoskeag Health. “All proceeds raised directly benefit health care and supportive services for our patients under the age of 18.” McCracken said that the event builds upon and celebrates the public health legacy of the late Dr. Selma Deitch, a local pediatrician who founded Child Health Services in 1979 to offer full-service healthcare to lower income families. “Selma recognized that in addition to quality healthcare, many pediatric patients and their families needed other services, such as access to transportation, interpretation services, specialized testing, and other societal needs,” said McCracken. “Today, our approach provides individualized treatment plans which puts our patients and their needs at the center of all we do.” Those in attendance heard from a broad array of speakers and local leaders including McCracken, Jay Ruais, Mayor of Manchester, Thom Lavoie, Board Chair of Amoskeag Health, Betsy Burtis, Chief Operating Officer of Amoskeag Health, Steve Paris, MD, Anna Thomas, Director of Public Health for the City of Manchester, Stephanie Pagliuca, Senior Director of Workforce Recruitment at Bi-State Primary Care Association, and Susan McKeown, APRN (ret). Among the many highlights of the event was a talk from Kristine Stoddard, who shared her family’s experiences in receiving specialized care for her son from Amoskeag Health. “Sponsors play a critical role at Morning Matters and we are very grateful for their kind support,” noted McCracken. Program sponsors include AmeriHealth Caritas, Catholic Medical Center, CGI, Efficient Energy Investments, the Harbor Group, Orchard Medical Management, and John Sigel and Sally Reid. Advocate sponsors include Elliot Health System, Needham Bank, NH Healthy Families, Sarah and Rich Sigel, and WellSense Health Plan. Table sponsors include Associated Grocers of New England, Berry Dunn, Granite State Credit Union, Harvey Construction, Lindner Dental, Manchester Community College, Massachusetts College of Pharmacy and Health Sciences, Primary Bank, Northeast Delta Dental, Sheehan Phinney, and Solvere Health. McCracken also thanked the many individuals who have donated thus far. “We’re also excited to announce that an anonymous donor has pledged $1,000 match for any additional donations made by June 30th. Click here to make your donation today.

Amoskeag Health has welcomed three new medical providers to care for patients at our Manchester doctor’s offices. In an effort to diversify our offerings as a comprehensive care provider, each of these new team members brings a unique perspective, training background, expertise and passion to our growing team of medical professionals. Named one of New Hampshire's Top Doctors by New Hampshire Magazine in 2025, Keith Dominick, MD is a pediatrician 17 years experience. Formerly with a private group practice, Dr. Dominick joined Amoskeag Health as a primary care pediatrician to fulfill a desire to work with a more diverse patient population and to provide excellent pediatric healthcare to the Manchester community. On what fuels his passion for healthcare, Dr. Dominick states, "I believe healthcare is a 'right' and not a 'privilege'. I am confident I will find this next professional adventure very rewarding." Dr. Dominick began seeing patients at our Elm St. office in May 2026, and he is currently accepting new patients. Khai Ngo, PA-C, started his role as Physician Associate at our Hollis Street office in June 2026. With a background in biology and a passion for medicine and human physiology, Khai pursued a master’s degree in physician assistant studies from Massachusetts College of Pharmacy and Health Studies. “Community health has always been my calling, and at Amoskeag Health, I am able to care for patients who need support the most,” Khai says about choosing this next step in his career. “I am dedicated to caring for all individuals with the same compassion and respect, with a strong focus on preventative medicine that supports long‑term health and reduces the risk of hospitalization.” Khai speaks both English and Vietnamese. Tonya Younger, MSN, APRN, FNP-C, is a Family Nurse Practitioner who started seeing patients at 145 Hollis St. in June 2026. She brings 12 years of experience providing nursing care in both family practice and federally qualified health center environments. Tonya values the continuity of care that comes working in family medicine, as she can support patients through different stages of life, from childhood and adolescence to adulthood and older age. By caring for multiple generations within a family, she hopes to better understand the social, environmental, and familial factors that influence health and well-being. “My passion for adolescent health has been a particularly strong influence on my career choice,” Tonya shares. “Adolescence is a critical period of physical, emotional, and social development, and I am committed to helping young people navigate these challenges while establishing healthy habits that can last a lifetime.” Amoskeag Health is excited to welcome several additional providers later in 2026, with the goal to improve access to care for our existing panel of patients and expand our capacity to welcome new patients to the organization. Check out all of our provider profiles to learn more about each of our team members, including education history, board certifications and clinical interests.

With spring in full swing, it can be difficult to identify the culprit of your runny nose, itchy throat and congestion. While colds and seasonal allergies share several symptoms, they have distinct differences that can help inform your approach to wellness. Seasonal allergies are triggered by environmental allergens like pollen from trees, grasses, and weeds. If your symptoms come on quickly after spending time outdoors or being in a new environment, allergies may be the cause. Allergy symptoms persist as long as you're exposed to the trigger, which can mean weeks or even months of symptoms during peak pollen season. Cold symptoms, on the other hand, typically last 7–10 days and tend to worsen before they improve. Because the common cold is caused by a virus, the immune system follows a fairly predictable response. First, inflammation slows the virus down. Then, mucus production ramps up to flush it out. Finally, white blood cells move in to clear the infection. That shift to thicker, discolored mucus many people notice toward the end of a cold is actually a good sign that your immune system is doing exactly what it's supposed to do. Key signs of seasonal allergies: Itchy, watery eyes Persistent sneezing Clear, thin, watery nasal discharge throughout the entire episode No fever More typical for colds: Fever (can be mild or severe) Thick, yellow or green mucus as the illness progresses Body aches and fatigue Cough So, how can you resolve your symptoms and start feeling better? For the common cold, resting and staying hydrated are key to your treatment plan. Limit physical activity, use a humidifier to ease congestion, and drink fluids to help thin mucus and support your immune system. Over-the-counter remedies don’t cure a virus, but they can ease symptoms. Talk to your doctor about use of decongestants, antihistamines, pain relievers, saline sprays or cough suppressants or expectorants. Allergy symptoms can also be managed through over-the-counter or prescription medications, depending on the severity of symptoms. Because allergies are a chronic condition, reduced exposure to the trigger is an important component of long-term management. Limiting outdoor time and closing windows on high-pollen days and wearing sunglasses to protect your eyes are just a few ways to avoid irritation from environmental allergens. When to contact your provider: Symptoms last more than 10 days Symptoms worsen significantly You have a high fever (~103 F in adults) You need help deciding which medications are appropriate The Amoskeag Health team is available to answer questions, schedule appointments and guide you through the best course of action. We can help confirm whether allergies, a virus, or another condition is at play and recommend the right treatment plan for you. As always, if you experience severe symptoms like difficulty breathing or chest pain, call 911 or go to your nearest emergency room for evaluation and treatment. To schedule an appointment at one of our four office locations in Manchester, NH, please call 603-626-9500.

By: Laura Fry, MD January is Cervical Cancer Awareness Month! Many of you know me as the “queen of everything cervical,” so with that title, let’s dive into some information that might help all of us work together to prevent and treat this disease. Why Does Cervical Cancer Awareness Matter? Cervical cancer is a type of cancer that begins in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. On a global scale, cervical cancer is the fourth most common cancer in women, with 604,000 new cases leading to 342,000 deaths annually. However, cervical cancer affects people around the world very differently. In 2020, almost 90% of the deaths occurred in countries with lower incomes due to delays in getting vaccines, screenings, and treatment. In the United States, there are about 11,500 new cervical cancer cases per year and 4,000 deaths linked to this cancer. Cervical cancer usually develops slowly over many years. Early signs of cervical cancer include abnormal changes in the cells of the cervix, which is not noticeable from the outside. However, these changes can be detected through tests at your doctor’s office. If abnormal cells are left untreated, they can progress to become cancerous. So, it’s important to be seen regularly by someone like me! What Causes Cervical Cancer? Nearly 100% of cervical cancer cases are caused by the Human Papilloma Virus (HPV), mostly through sexual intercourse. HPV has many subtypes, and over 11 of them are considered “high risk” types. Globally, about 40% of women were unaware that HPV causes most cervical cancers. Can Cervical Cancer Be Prevented? YES! Primary prevention (preventing a disease before it occurs) can be done through HPV vaccines. These vaccines are given in the US to girls and boys preferably before the age of 15. Two doses are recommended. Secondary Prevention (identifying disease at its earlies stages) is done through a pap test and HPV testing. Testing should start at age 21 and be done every three years, with HPV added at age 30 and repeated every 5 years for women who do not test positive. Paps and HPV testing can detect pre-cancerous conditions, which can often be treated easily and can prevent progression to invasive cervical cancer. WHO’s Global Efforts to Reduce Cervical Cancer There is a global campaign from the World Health Organization (WHO) called “90-70-90” by the year 2030. This campaign has three goals: 90% of girls worldwide will be vaccinated against HPV by age 15. 70% of women will have been screened by a high-quality screening method at age 35 and 45. 90% of women with invasive or pre-invasive disease will receive treatment. Now, What Can You Do to Protect Yourself and Your Family from Cervical Cancer? If you have not been vaccinated and are below the age of 24 – GET IT DONE! There are some situations in which you can be vaccinated later than age 24. Talk to your provider at your next appointment about your options. Make sure your children are vaccinated. There are lots of parents who don’t think it’s needed, or they think that giving the vaccine will give their children permission to start having sex younger. This has been proven NOT to be the case! Get screening done for yourself if you’re assigned female at birth. Talk to any of the providers or nurses here at Amoskeag Health if you have questions. Spread the news and help us dispel myths and misinformation about vaccines, screenings, and treatment. Think about it this way: we have a cancer that is very effectively prevented through a vaccine! How cool is that? Let’s eliminate cancer one cervix at a time! If you’re interested in the HPV vaccine or are overdue for a screening, we can help! To schedule an appointment with an Amoskeag Health provider, please call 603-626-9500.

By: Katherine-Starr Goodwin Managing blood sugar levels is very important for overall health, especially for those with diabetes. The Glycemic Index (GI) is a valuable tool that helps us choose foods wisely to keep blood sugar stable. Here’s how you can use the Glycemic Index, along with portion control, to make healthier choices. What is the Glycemic Index (GI)? The Glycemic Index ranks foods based on how quickly they raise blood sugar levels. Foods with a high GI (70 or more) cause a rapid spike in blood sugar, while those with a low GI (55 or less) cause a slower, more gradual rise. Using the Glycemic Index to Make Better Choices: Green (Go): Choose low GI foods (55 or less) most often. These include items like whole grains, legumes, and many fruits. See a list of low Glycemic Index foods here. Yellow (Caution): Moderate GI foods (56 to 69) should be eaten less frequently. These include some fruits, whole wheat products, and couscous. See a list of moderate Glycemic Index foods here. Red (Stop and think): High GI foods (70 or more) should be limited. These include white bread, sugary cereals, and some types of potatoes. See a list of high Glycemic Index foods here. By opting for more foods with a lower GI, you can help manage blood sugar levels more effectively, reducing the risk of complications from diabetes and promoting better weight management. Portion Control and Diabetes Management Watching portion sizes can help manage diabetes. We suggest a balanced approach to portioning meals: Fill half your plate with vegetables and fruits: Choose more vegetables than fruits, as most vegetables have less sugar. This helps control calorie intake and provides essential nutrients. Divide the other half of your plate: Distribute this portion between protein-rich foods and whole grains. Examples include lean meats, fish, beans, whole wheat pasta, and brown rice. Combining GI and Portion Control Understanding the Glycemic Index and practicing portion control can significantly impact your health outcomes, particularly if you have diabetes or are aiming for better overall well-being. By choosing low GI foods and controlling portion sizes, you can better manage blood sugar levels, support weight loss efforts, and improve your overall health. Remember, consult with a healthcare professional or Registered Dietitian to tailor these principles to your individual needs and health goals. Each small step towards healthier eating habits contributes to a more balanced and fulfilling lifestyle. Low Glycemic Index (55 or less) Foods. Choose these most often! Grains and Starches Breads: Heavy Mixed Grain Breads Spelt Bread Sourdough Bread Tortilla (Whole Grain) Cereal: All-Bran™ Cereal Oat Bran Oats (Steel Cut) Grains: Barley Bulgur Mung Bean Noodles Pasta (Al Dente, Firm) Pulse Flours Quinoa Rice (Converted, Parboiled) Other: Peas* Popcorn Sweet Potato* Winter Squash* *Most starchy/sweet vegetables (e.g. peas, parsnip, winter squash) provide 15 g or more carbohydrate per 1 cup serving Fruits Apple Apricot (Fresh, Dried) Banana (Green, Unripe) Berries Cantaloupe Grapefruit Honeydew Melon Mango Orange Peach Pear Plum Pomegranate Prunes Milk and Milk Alternatives Almond Milk Cow Milk (Skim, 1%, 2%, Whole) Frozen Yogurt (An occasional food) Greek Yogurt Soy Milk Yogurt (Skim, 1%, 2%, Whole) * Milk, alternatives, and other beverages listed include flavored (e.g. chocolate), sweetened and unsweetened varieties Meat and Alternatives Baked Beans Chickpeas Kidney Beans Lentils Mung Beans Romano Beans Soybeans/Edamame Split Peas * Poultry and fish do not have a GI because they do not contain carbohydrates Moderate Glycemic Index (56 to 69) Foods. Choose LESS often! Grains and Starches Breads: Chapati (White, Whole Wheat) Flaxseed/Linseed Bread Pita Bread (White, Whole Wheat) Pumpernickel Bread Roti (White, Whole Wheat) Rye Bread (Light, Dark, Whole Grain) Stone Ground Whole Wheat Bread Whole Grain Wheat Bread Cereal: Cream of Wheat™ (Regular) Oats (Instant) Oats (Large Flake) Oats (Quick) Grains: Basmati Rice Brown Rice Cornmeal Couscous (Regular, Whole Wheat) Rice Noodles White Rice (Short, Long Grain) Wild Rice Other: Beets Corn French Fries (An occasional food) Parsnip Potato (Red, White, Cooled) Rye Crisp Crackers Fruits Banana (Ripe, Yellow) Cherries (Bottled) Cherries (Fresh) Cranberries (Dried) Figs (Fresh, Dried) Grapes Kiwi Lychee Pineapple Raisins Meat and Alternatives Lentil Soup (ready-made) Split Pea Soup (ready-made) *Poultry and fish do not have a GI because they do not contain carbohydrates High Glycemic Index (70 or more) Foods. Choose LEAST often! Grains and Starches Breads: Bread (White, Whole Wheat) Naan (White, Whole Wheat) Cereal: All-Bran Flakes™ Cereal Corn Flakes™ Cereal Cream of Wheat™ (Instant) Puffed Wheat Cereal Rice Krispies™ Cereal Special K™ Cereal Grains: Jasmine Rice Millet Sticky Rice White Rice (Instant) Other: Carrots Potato (Instant Mashed) Potato (Red, White, Hot) Pretzels Rice Cakes Soda Crackers Fruits Banana (Brown, Overripe) Watermelon Milk and Milk Alternatives Rice Milk *Milk, alternatives, and other beverages listed include flavored (e.g. chocolate), sweetened and unsweetened varieties Want to learn more to help manage your blood sugar and feel your best? Schedule an appointment with an Amoskeag Health provider today by calling 603-626-9500.