Image of a hand holding up a cutout of a small house to a sunset, with light streaming through the house and creating a shadow.

The Need to Improve Housing to Improve Health

Housing is a central social determinant of health, and there is extensive evidence of the negative impacts on health from a lack of access to affordable and stable housing. In March 2019, the County Health Rankings & Roadmaps program, (CHR&R) a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, released its 2019 County Health Rankings, this year highlighting the impact that secure and affordable housing has on how well and long people live.

The report discussed how the location of homes—such as proximity to good schools, jobs, grocery stores, and parks—quality of homes—such as the presence of mold or lead—and cost burdens and opportunities to accumulate wealth associated with different housing conditions—such as renting versus homeownership—all influence the health of individuals and communities. Read More

Image of a child in a blue dress with pigtails receiving a vaccination injection.

Social Media’s Anti-Anti-Vaxxer Fight Ramps Up

According to the World Health Organization (WHO), “vaccine hesitancy,” which is “the reluctance or refusal to vaccinate despite the availability of vaccines” is among the top ten threats to global health in 2019. While there are many complex reasons why people may choose not to vaccinate their children, social media has received a great deal of scrutiny for its role in empowering and financing the movement opposing vaccines. Platforms have taken a wide range of actions in response.

Pinterest, for example, demonstrated an aggressive tactic, banishing results that are associated with certain searches related to vaccines, “regardless of whether those results might have been reputable.“In 2017, the platform altered its “community guidelines” after a 2016 study revealed that 75 percent of vaccine-related posts were negative. The guidelines aim to prevent misinformation and advice that has “immediate and detrimental effects on a pinner’s health and public safety,” and explicitly state that “[t]his includes . . . . anti-vaccination advice.” Now, if a user attempts to search “vaccination,” they’ll see a result stating “Pins about this topic often violate our community guidelines, so we’re currently unable to show search results.” And while users can still pin images related to vaccines, their posts won’t be visible in searches.

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Report: Maternal Mental Health Must be a Top Priority

The U.S. Preventive Services Task Force (USPSTF), published recommendations recently urging clinicians to refer pregnant and postpartum women to counseling if they are at risk of depression.

The recommendations respond to the prevalence of perinatal depression, which is considered to be the most common pregnancy complication. Perinatal depression, affects up to one in seven women and can develop at any time after a woman becomes pregnant, immediately following the brith of a child, or even up to a year after.

Among the many concerning potential consequences of maternal depression are premature births and low birth weights, as well as neglect and inattentiveness from mothers after the baby is born, which can subject infants to risk of additional problems, according to Karina Davidson, a USPSTF member who helped write the recent recommendations. Read More

President Trump speaks to reporters in the rose garden

Shutdown Fever: How Washington’s Standstill Impacts Health

While Federal Employees Health Benefits (FEHB) coverage will continue during the shutdown, with 800,000 federal employees going without paychecks, there are a range of fears looming in terms of health, for federal workers specifically, as well as for public health more generally.

Kaiser Health News recently reported the story of Joseph Daskalakis, a federally employed air traffic controller in Minnesota whose son was born on New Years Eve, about 10 weeks earlier than expected. The very premature baby was taken to a specialized neonatal intensive care unit (NICU) in a hospital outside of the father’s insurer’s network. Ordinarily, he would be able to file paperwork and switch insurers. But this isn’t possible during the shutdown. And while Mr. Daskalakis’ insurer and the Office of Personnel Management’s (OPM, which oversees federal health benefits programs) website have indicated that his requested change of carriers to have that hospital in his network would be effective retroactively, his family still received an initial bill of $6,000, with more charges likely yet to come. And as long as the shutdown lasts, none of those federal employees can add spouses or newborns to existing plans or change insurers in the case of unexpected circumstances.

Uncertainty surrounding medications during the shutdown can also present incredibly difficult decisions for federal workers, as it already has for Mallory Lorge, an employee of the U.S. Fish and Wildlife Service. Lorge is diabetic and began rationing her insulin because “‘the thought of having more debt was scarier than the thought of dying’ in her sleep.” Lorge went an entire weekend without using her insulin pump, experiencing skyrocketing blood sugar levels, but knowing she couldn’t afford the copay if she needed more insulin.

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A row of colored medical records folders

The Troubling Prevalence of Medical Record Errors

With plenty of potential healthcare concerns and complications arising out of medical diagnoses and treatments themselves, errors in medical records present an unfortunate additional opportunity for improper treatment.

A recent article from Kaiser Health News (KHN) discussed several examples of dangerous medical record errors: a hospital pathology report identifying cancer that failed to reach the patient’s neurosurgeon, a patient whose record incorrectly identified her as having an under-active rather than overactive thyroid, potentially subjecting her to harmful medicine, and a patient who discovered pages someone else’s medical records tucked into in her father’s records. In addition to incorrect information, omitting information on medications, allergies, and lab results from a patient’s records can be quite dangerous.

The goal of “one patient, one record” provides a way to “bring patient records and data into one centralized location that all clinicians will be able to access as authorized.” This enables providers to better understand the full picture of a patient’s medical condition. It also minimizes the number of questions, and chances of making errors, that a patient must answer regarding their medical conditions and history when they visit a provider.

Other benefits, such as cost and care coordination, also add to the appeal of centralized records.

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Literally Sick (and Tired) of Daylight Saving Time

Healthcare was at the top of many voters’ minds in last week’s election, with a range of health-related issues appearing on ballots across the country. Among other health-related measures, three states voted to expand Medicaid, Massachusetts rejected a ballot measure that would limit nurse-to-patient ratios, and Nevada exempted menstrual products from the state sales tax. But a California measure regarding daylight saving—less clearly health-related on its face—could also have some important implications for health.

Proposition 7 asked California voters whether they supported allowing the State Legislature to establish permanent, year-round daylight saving time (DST). It received about 60 percent of the votes. Following the vote, in order for California to actually end the tradition of turning clocks back in the fall and forward in the spring, the State Legislature would first have to approve this decision by a two-thirds majority. It would then need to be approved by Congress.

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millennial man at home sick with scarf and thermometer talking on the phone

The Millennial Need for Speed in Healthcare

According to a recent Kaiser Family Foundation (KFF) poll, shockingly large swaths of Americans have reported that they don’t have a primary care provider.

The July 2018 report found that 45 percent of 18-29 year olds, as well as 28 and 18 percent of 30-49 and 50-64 year olds, respectively, also lack designated primary care.

Kaiser Health News (KHN) explained that the price transparency, convenience, and speed of alternatives to office-based primary care physician (PCP) visits appear to be some of the preferences driving these patterns. Retail clinics, urgent care centers, and telemedicine websites satisfy many of these preferences, and are therefore appealing alternatives to scheduled appointments with a PCP. For example, extended hours and shorter wait times at increasingly widespread retail clinics have attracted young patients who want to avoid the hassle and wait times involved in scheduling and attending a traditional doctors office.

A 2015 PNC Healthcare survey similarly found that millennials saw their PCP significantly less (61 percent) than baby boomers and seniors (80 and 85 percent, respectively). The study emphasized the effects of technology on millennials’ trends in healthcare acquisition, such as higher utilization of online reviews to shop for doctors (such as Yelp). It also found that millennials are much more likely to prefer retail and acute care clinics, and are more likely to postpone treatment due to high costs than older generations.

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Mary Mayhew: The New Anti-Medicaid Head of Medicaid

Mary Mayhew, a fierce opponent of Medicaid Expansion under the Affordable Care Act, was announced on October 15 as the new Deputy Administrator and Director of the U.S. Center for Medicaid and CHIP [Children’s Health Insurance Program] Services. As the House Ways and Means Committee Democrats put it in a recent tweet, the Trump Administration’s choice “is like hiring an arsonist to be a city’s fire chief.”

Mayhew spent years as commissioner of Maine’s Department of Health and Human Services under outgoing Governor Paul LePage. She stepped down in May 2017. After her time as commissioner, Mayhew pursued an unsuccessful race for Governor of Maine, coming in third in the Republican Primary this past June.

The Maine Department of Health and Human Services’ approach to Medicaid under Mayhew’s leadership does not exactly suggest she will take an expansive approach to Medicaid in her new role. According to the ACLU of Maine, enrollment in MaineCare, Maine’s Medicaid program, decreased by 37 percent during her time in office, eliminating coverage for about 80,000 people.

The state also dropped from 10th to 22nd in national health rankings.

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