Identifying these so-called "social determinants of health" helps doctors determine the root causes of their patients' medical conditions and is critical to improving whole-person health. The Physicians Foundation found that nearly 90 percent of doctors have patients whose health is affected by these key factors.1

Below are some examples to illustrate how social factors can affect you and your health:

* Loneliness and social isolation. More than a quarter of the U.S. population live alone. Loneliness and social isolation are associated with increased mortality and poor health outcomes. Identifying individuals at risk for these factors allows doctors to recommend prevention and care strategies to improve their patients' health.

* Food insecurity. The U.S. Department of Agriculture defines food insecurity as a lack of consistent access to enough food for a healthy life. According to Feeding America, food insecurity exists in every state in the United States. Seniors face challenges that put them at risk of food insecurity, such as being on a fixed income and having to choose between buying food or medicine, or struggling to obtain food without reliable transportation.

* Transportation Barriers. A lack of transportation affects an individual's health and well-being - from accessing health care services and healthy food options to maintaining social connections. Lack of transportation is the leading cause of patient no-shows for medical appointments, and missed appointments are associated with increased medical care costs and increased emergency room visits.2

But many Medicare Advantage plans, provided by private health insurers such as Humana, offer their members health and wellness benefits, programs and services to help address social determinants, with rides to medical appointments, meal benefits, social interaction and screening for food insecurity.

Humana is working to address social determinants of health through its Bold Goal, by working with Humana care teams, physicians, nonprofit organizations, and business and government leaders to identify, screen and refer members to community resources and long-term support.

The Bold Goal is a population health strategy to help improve the health of the communities we serve by 20 percent by 2020 and beyond.

For more information, visit populationhealth.humana.com.

1 https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf

2 http://www.aha.org/transportation  

Y0040_GHHKP2EEN_C

According to Fidelity Investments' 2020 New Year Financial Resolutions Study, 82 percent of respondents said they're in a similar or better financial position than last year. Perhaps surprisingly, most credited their success to their own good habits - saving more (47 percent) and budgeting (29 percent) - rather than their investment gains (18 percent) from a stock market that made one high after another. Less than 25 percent put it down to having been able to work more hours in a strong economy.

And, as the study makes clear, they want to keep the momentum going.

Of the 67 percent considering making a financial resolution, "saving more" and "paying down debt" topped the list, respectively, at 53 percent and 51 percent.

"Living a debt-free life was the biggest motivator for them," said Melissa Ridolfi, Fidelity's vice president of retirement and college products.

Heck, given the choice between the classic New Year's resolution of losing five pounds or socking away $5,000, a resounding 84 percent in the national survey of 3,012 adults opted for savings.

But you want to know some of the biggest and smallest mistakes or setbacks they fessed up to, right? See if you can relate to any of these:

* Dining out too much (36 percent).

* Spending too much on non-essentials like unused apps, streaming media services, and subscription retail boxes (29 percent).

* Taking on debt or adding to existing debt (28 percent).

*Splurging on something they couldn't really afford (28 percent).

* Unexpected medical expenses (24 percent).

* Failing to save as much for retirement as they should (18 percent).

So with all the interest in getting a grip on debt, who seems to be faring the best at it?

Boomers, the study found, with 29 percent crediting being better off financially at year's end to having refinanced, paid off, or reduced debts or loans. Generation X, the next oldest, trailed at 21 percent, followed by 19 percent of millennials, and just 6 percent of Generation Z.

"Boomers are getting the message that the closer they get to retirement, the more essential it becomes to get their debt under control to make the most out of retirement savings," Ridolfi said.

Certainly there's no law that says you have to make a New Year's resolution - financial or otherwise - but even a huge chunk of those surveyed who weren't contemplating explicitly doing so still said they were planning on, say, building up emergency funds. As for what you might call the "traditionalists" out there? Fidelity has some tried-and-true tips that can help ensure your financial vows don't wind up being among the 80 percent of all resolutions that U.S. News says, alas, fail by the second week of February.

The firm also has an impressive, free online "Moments" tool designed to help you plan for lifestyle changes or react to a myriad of curveballs - i.e., the unexpected medical expenses cited as a big setback in the study - that life throws at you. And accessing the Fidelity Retirement Score gives you a quick look at where you stand with your savings.

Oh, and here's one last thing to see if you can relate to: Seventy-eight percent of those surveyed predicted they'd be even better off financially in 2020.

* Are my doctors in network? Use online tools to confirm which doctors and hospitals are in a plan's network. A licensed health insurance agent can also help you see if a specific doctor or hospital is in a plan's network and taking new patients, and can determine what's in network if you're a seasonal resident.

* Are my prescription drugs covered? Although Original Medicare does not cover most prescription drugs, many Medicare Advantage plans include prescription drug coverage, or you can sign up for a Part D Prescription Drug Plan separately. A licensed sales agent can look up the medications you would like covered and help you estimate what the cost of each drug would be on a plan.

* What new, innovative benefits are available? Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctor visits are helpful when you can't see a doctor right away. Most Medicare Advantage plans now offer transportation to doctor appointments and the gym, when a fitness center membership is offered as a plan benefit.

* What if I'm still working? If you or your spouse have health insurance from an employer, you may be able to delay enrolling in Medicare until the employment or the coverage stops. At that point, you would be entitled to a special enrollment period of up to eight months to sign up for Medicare without incurring any late penalties. Talk with your employer to find out how your coverage works with Medicare.

While the clock is ticking until the Dec. 7 Medicare annual enrollment deadline, remember that you're not alone.

Take advantage of resources including licensed sales agents and websites such as medicare.gov and www.humana.com/medicare. You can also call 1-800-MEDICARE (1-800-633-4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week, or call Humana at 1-800-213-5286 (TTY: 711) 8 a.m. to 8 p.m. local time seven days a week.

Y0040_GCHKND9EN_C

First, as a cardiovascular physician I want to reinforce that no one should stop or alter their aspirin regimen before speaking with their doctor or health care provider. And second, I will help sort through the news and the research on this topic.

There are two main categories of patients who take a daily low-dose aspirin for cardiovascular (CV) event prevention: patients who have not yet had serious cardiovascular problems but may be at risk of having these problems AND patients who have already experienced serious cardiovascular problems like a heart attack or clot-related stroke. What the updated guidelines tell us is that certain individuals in the first category (have not yet had an event, often called primary prevention) may not need to continue taking aspirin due to the increased risks of bleeding outweighing the cardio-protection benefit. Whether or not you are one of these individuals in this category depends on your own personal risk factors, which is why it is important to consult your doctor who can help you understand the benefits and risks and what is best for your health.

For people in the secondary category - those who have already experienced a cardiovascular event - aspirin can be a lifesaver. Not only is it proven to help prevent another heart attack or clot-related stroke, aspirin is also one of the most extensively studied drugs in history. This is why aspirin remains the cornerstone preventative therapy for secondary prevention. In the United States, aspirin's professional label is approved for secondary prevention of a CV event.

Some of the media coverage around the new guidance was not clear on this crucial distinction. For those who have already experienced a heart attack, or clot-related stroke there is evidence that discontinuing an aspirin regimen without a doctor's guidance can increase the risk of another heart attack by 63 percent and a clot-related stroke due to a blood clot by 40 percent.

Cardiovascular disease is the number one cause of death in the United States, affecting more than 92 million American adults and causing about 2,200 deaths per day. That's one life every forty seconds. Each year 790,000 Americans alone will suffer from a heart attack, while another 795,000 will have a stroke.

Many factors can contribute to a person's risk of cardiovascular disease, including high blood pressure, high cholesterol and smoking - and almost half of Americans (47 percent) have at least one of these risk factors.

Clinical studies and cardiovascular professional guidelines have continued to support the lifesaving benefits of aspirin. Studies have found that an aspirin regimen under the direction of a doctor can help reduce the chances of a second heart attack by 31 percent and a second clot-related stroke by 22 percent.

Importantly, even though aspirin is the gold standard of preventative therapy for those who have experienced a heart attack, clot-related stroke, chronic stable and unstable angina, a stent placement (PCI) or open heart surgery (CABG), it may not be for everyone. Anyone who has questions about starting or continuing an aspirin regimen should talk to their doctor.

Aspirin is not appropriate for everyone, so patients should talk to their doctor before they begin an aspirin regimen. For more information on safe and responsible use of OTC medicines, visit www.KnowYourOTCs.org.

Disclosure: Dr. Gurbel is compensated by Bayer to advise on cardiovascular health issues.

Dr. Gurbel is the Director of Cardiovascular Research at Sinai Hospital of Baltimore, MD and Director of the Sinai Center for Thrombosis Research and Drug Development. He is also Professor of Medicine at Johns Hopkins University School of Medicine and Adjunct Professor of Medicine at Duke University School of Medicine.

"I figured if I was going to buy a house, I'd better do it sooner rather than later because prices just kept going up," explains Erin.

However, with only $7,000 in savings at the time, she felt she didn't have enough money for a down payment. But the timing became a dilemma for her. Should she wait to save more money for a house that would probably cost more in a year? Or, use all her savings to buy a house now - at the risk of leaving herself with no funds for a rainy day or future expenses?

The answer came when Erin visited the new home of a friend who had used a down payment assistance program to purchase her house. Her friend explained how down payment assistance programs give first-time homebuyers money to pay for a portion or all of their down payment, with some programs even helping with closing costs. 

Free money for eligible borrowers 

While there are more than 2,500 down payment assistance programs available throughout the country, Erin decided to apply for the same state-offered program her friend had used.

The program, called North Carolina 1st Home Advantage Down Payment, makes homeownership more affordable for state residents. It offers down payment assistance of up to 5 percent for FHA, VA and USDA loans, and up to 3 percent for a conventional loan. And because Erin had a decent credit score and met the program's income limit, she qualified.

Erin received down payment help in the form of a zero-percent, deferred second mortgage. As long as she doesn't sell or refinance the house for 15 years, her down payment assistance will be forgiven, meaning she won't have to pay it back.

Let the house hunting begin! 

Once Erin knew she was eligible for help with her down payment, she earnestly began her home search. She found a historical 3-bedroom, 1-bath home that was built in 1925. The price of the home was $152,000. She used conventional financing with private mortgage insurance because she was putting less than 20 percent down. With her 3-percent down payment assistance ($4,560), Erin successfully purchased her home in 2016.

"And, I didn't have to use all my savings!" says Erin. Plus, she's built up equity over the last two years due to home values going up.

Aside from the financial perks of owning her own home, Erin enjoys other benefits. "I've got so much more space for the money than when I was renting," says Erin. "And I like being a permanent part of the neighborhood and getting to know my neighbors."

For more homebuyer resources, visit readynest.com.

To find down payment assistance programs in your area, visit downpaymentresource.com/

The project involves the creation of a wind power farm and the installation of up to 52 wind turbines to produce green energy.

During the 15-day, pre-sale period, 10 percent of the Renewable Energy Tokens (RETs) will be sold at a 50-percent discount via a cryptocurrency system. The discount will not be available after the pre-sale period. "Ownership of one RET is equivalent to owning one asset in Eco Smart Energies," according to a company press release.

"These turbines are capable of producing mechanical energy that can be transformed into electrical energy, using wind energy converters linked to power distributors," according to a company white paper.

Cryptocurrency, an internet-based system for financial transactions, has the advantages of minimal processing fees, decentralization, and blockchain to confirm and provide security. The exchanges are quick and can be conducted on a global scale, which makes life easier for investors. According to a recent opinion piece on the Bloomberg website by former risk manager Aaron Brown, cryptocurrency is not without risk, but neither is investing, and "there are plausible scenarios in which crypto grows to become a significant part of the economy."

Investors are seeing the potential of green energy companies and the convenience of cryptocurrency. Wind energy is one of the most strongly recommended alternatives to the use of fossil fuels, and Eco Smart gets investors involved in the environmental angle with an application that will allow the token owners not only to send or receive tokens, but also to view how much wind power is being produced from the turbines. "The token holders can also actively participate in issues that are related to the future of the wind farm," according to the company.

Visit renbdo.io for more information about how cryptocurrency will shape the future and for investment opportunities.