Opportunity Atlas Creates Opportunities for Legal Epidemiology

By Amy Cook

Public health experts know that the social determinants of health—the environments in which we live, work, learn, and play—all have important effects on our health and well-being. As further evidence of this, in October 2018, researchers from Opportunity Insights collaborated with the Census Bureau to unveil the Opportunity Atlas, an interactive tool tracking data from more than 20 million Americans from childhood through their mid-30s, across each of the country’s 70,000 census tracts. The Opportunity Atlas gives us crucial insight into the level of geography that can impact adult outcomes: beyond the state and city, the neighborhood matters, sometimes tremendously. Read More

Close up on a pile of yellow pain pills

Addressing the Opioid Epidemic Starts with How We Treat Pain

As a nurse practitioner in a busy suburban emergency department, pain is my job. Pain is one of the most common reasons people come to an emergency department (ED). It could be abdominal pain, chest pain, back pain or even emotional pain, including depression or suicidal ideations. Pain is a driver for people seeking medical care. We have made pain into a vital sign, and we ask, “How would you rate your pain on a scale of 1 to 10?” a mandatory question for any patient who steps through our door.

This whole concept evolved circa 1987 when the Institute of Medicine urged healthcare providers to use a quantified measure for pain. It gained even more traction in 1990 when then president of the American Pain Society, Dr. Mitchell Max, called for improved means to assess and treat pain. The term “oligoanalgesia” gained popularity in the published literature, meaning that we weren’t giving enough pain medication to patients in the ED, in clinics or in any other healthcare setting. Healthcare providers responded. We asked about and we thought, more effectively treated pain to address this issue.

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Abortion rights protest following the Supreme Court decision for Whole Women's Health in 2016

Louisiana TRAP Law Challenge Could Leave Thousands of Women without Abortion Access

By Adrienne Ghorashi

UPDATE: Late Thursday, February 7, the Supreme Court granted Plaintiff’s stay application, meaning Louisiana’s TRAP law may not be enforced while the challengers file an appeal. The Supreme Court will then decide whether to hear the case or deny the petition, letting the Fifth Circuit’s ruling stand.

Justice Roberts sided with the Court’s liberal justices to grant the stay, while Justices Alito, Thomas, Gorsuch, and Kavanaugh would deny it. Kavanaugh also wrote a dissent, saying he would want to see the law go into effect before deciding whether the stay was necessary.

Although this is only a temporary win for the women of Louisiana, these actions could be a sign that a majority of justices have their doubts as to the law’s constitutionality in light of Whole Woman’s Health.

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Repayment for Training as an Optimal Solution to Medical Brain Drain

In an earlier post I offered two arguments for why wealthy nations have a moral obligation to address medical professional brain drain from resource-scarce developing nations. But once one acknowledges that wealthy nations have this obligation, a question remains as to what the best way to fulfill that obligation is.

Some have suggested that the solution is for wealthy nations to train an ample amount of doctors in their home countries so that they no longer need to take talent from developing nations to make up for the gap. This idea has intuitive appeal. After all, it allows more medical doctors to be trained in wealthy nations like the U.S. and results in more doctors being trained overall (assuming that developing nations would continue to train the same amount of doctors under such a model). Read More

Security and Health: Police as Key Players in Public Health

For more than a decade, a variety of scholars and practitioners in public health, policing and the broader domain of security have been stoking a conversation about the links between their disciplines and the need to do a better job integrating the disciplines and practices.

This week, The Lancet published a special series on Security and Health. A global set of authors, myself included, make the case that military and police forces should be recognized as key players, rather than intruders, in public health, and therefore we need these relationships to be backed by investment in partnerships and reform. Take a look. You may even be inspired to put the next global Law Enforcement and Public Health Conference on your agenda, set for Edinburgh in October.

 

A protester holds a sign with a quote that reads: "Pf all the forms of inequality injustice in health care is the most shocking and inhumane."

We Shouldn’t Be Focusing on Whether Healthcare Is a Right

The call for “Medicare for All” has grown louder and its cadence more frequent. Even President Obama has expressed support for it. Increasingly, as policymakers and stakeholders debate the path forward for healthcare in the U.S., a familiar invocation of human rights language can be heard.

The sentiment that “healthcare is a right” — rather, that it should be a right — has many layers. Its complexity is more accurately captured as “health(care) is a (human) right”. These parens make my head spin, too. They also suggest that Medicare for All is at best a piecemeal solution to the causes of poor health in the U.S. Read More

blurry, shadowy human figure in black and white

Measuring the Opioid Crisis: The Need for Standardized Cause-of-Death Reporting

By J. Alexander Short

All too often, the modern opioid epidemic is reduced to numbers. Over 70,000 drug overdose deaths occurred in the United States in 2017. This marked a substantial increase from the more than 63,000 deaths reported in 2016. So many news articles, books, and even policymakers depend on these numbers as an accurate measure of the opioid crisis. However, can we rely on their accuracy?

Unfortunately, there are surprising inconsistencies in the reporting of drug overdose deaths that warrants further investigation. Read More

Successful HIV Criminalization Reform in California: Q and A with Sen. Scott Wiener

The majority of states have laws that criminalize activities by HIV-positive people that are not criminalized when the rest of the population engages in them.

Many of these laws improperly single out HIV over other infectious diseases and reflect a lack of understanding of both how HIV spreads and how it can be treated.

In 2017, California passed legislation which modernized and improved California’s HIV criminalization law. One of the authors of the law was State Senator Scott Wiener. I recently had a chance to ask Sen. Wiener some questions about that process.

His responses are given here in hopes of supplying useful information for legislators, lobbyists, and activists in other states who are interested in starting the reform process in their own states or other jurisdictions around the world. This interview has been edited for clarity.

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A doctor in Mtimbwani, Tanzania helps a woman and child.

Two Reasons Why Wealthy Nations Ought to Address Medical Brain Drain

African governments spend millions of dollars every year training physicians who will leave their home countries to live and work in wealthier nations. The result is that for countries like Ethiopia, Kenya, and Sierra Leone, more of their native physicians are now in the United States and Europe than at home. This massive movement of physician has likely contributed to health crises in many African nations, where citizens die of easily curable diseases each year.

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