It’s been 4 years this month since the World Health Organization declared COVID-19 to be a global pandemic. Where are we now? It’s time to take stock of the real impact of the pandemic. Aside from the burden of illness and mortality, the mental health toll, and the strains on the healthcare system, COVID even… Read More »
In this post, we examine how the COVID-19 pandemic affected frequencies of diagnoses and claims costs in the Affordable Care Act (ACA) marketplaces in 2020 and 2021. The ACA marketplaces are critical sources of coverage for millions of Americans and were increasingly so during the COVID-19 pandemic due to job losses and coverage disruptions. The… Read More »
This entry was one of the winners of our Summer 2023 student blog contest! Trends in Life Expectancy The recent decline in life expectancy in the United States is largely attributed to the well-known COVID-19 pandemic and opioid epidemic. However, these recent crises are not the sole drivers of the stagnation and subsequent drop in… Read More »
As California settles into a third year of pandemic, covid-19 continues to pose a serious threat of death. But the number of people dying — and the demographics of those falling victim — has shifted notably from the first two years. Given the collective immunity people have garnered through a combination of mass vaccination and… Read More »
Today we continue our retrospective series with a look at articles on COVID published at The Medical Care Blog. As the U.S. approaches three full years with the pandemic, it continues to see roughly 100,000 diagnosed cases (and about 400 deaths) per day. This is a level of sickness that many other developed countries see… Read More »
Understanding internet access through a human rights framework has been a goal of human rights advocates for years. But COVID-19 has brought the idea of “broadband as a human right” to the forefront as a necessary and urgent human need. A recent study exploring the Social Determinants of Health and COVID-19 mortality, found that individuals without… Read More »
COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and… Read More »
COVID-19 has uncovered and multiplied health workforce equity challenges across the US. In the early days of the pandemic, healthcare workers faced incredible personal risk from an unknown, highly contagious, deadly disease. Insufficient personal protective equipment (PPE) and reprimand and dismissal by employers for speaking out worsened this risk. As waves of COVID-19 swept across… Read More »
In March 2020, the Centers for Disease Control and Prevention (CDC) confirmed COVID-19 as a pandemic. More than 18 months later, the nation has yet to return to ‘normal’. Hope for normalcy increased with the rollout of COVID-19 vaccines in the months that followed. Reluctance and resistance to vaccination, however, have made it difficult to… Read More »
The pandemic has highlighted the challenge health care providers face in translating new scientific findings to actual patient care. The integration of COVID-19 monoclonal antibody treatment is a good example of this challenge. Frustration at a Local Hospital In a year of difficult days, my mom came home from work one evening in March especially… Read More »
Randomized control trials are the commonly held gold standard clinical trial design. The randomized controlled trial (RCT) is the gold standard of clinical research. However, researchers are increasingly asking: must they be? Webster-Clark, Jonsson Funk, and Stürmer discussed single-arm trials: administering a drug to an experimental group and using real-world data (RWD) to select an… Read More »
The inequitable distribution of COVID-19’s terrible burden has been well documented. There are notable disparities by race and ethnicity. COVID-19 rates, including incidence and fatality rates, are higher among Black, Indigenous, and other Persons of Color (BIPOC). This is structural racism at its worst, in which BIPOC individuals are disproportionately represented among essential workers and… Read More »
What is telehealth? Telehealth involves using technology to facilitate healthcare interactions but has not been used extensively in Medicare in the past. The use of telehealth may be particularly relevant where there are geographic barriers such as a lack of local providers or a public health emergency such as the coronavirus pandemic. There are a… Read More »
President Biden released the National Strategy for the COVID-19 Response and Pandemic Preparedness on January 21, 2020. It is an ambitious attempt to decrease the spread of the novel coronavirus and get hundreds of millions of Americans immunized. This COVID-19 vaccine plan, however, is missing a key element. Namely, primary care. An incomplete national strategy for… Read More »
During the past year, the COVID-19 pandemic has highlighted health inequality created by social determinants of health (SDoH) in the United States. SDoH include all aspects of the living environment, social support, safety, well-being, and resource availability, directly or indirectly influencing physical health outcomes. Consideration of SDoH is critical for successful comprehensive COVID-19 vaccine rollout.… Read More »
National Rural Health Day provides an opportunity to reflect on the quality of medical care in rural and medically underserved communities. This year has posed additional challenges to fragile healthcare systems and vulnerable populations. Faced with new barriers, rural communities are adapting and innovating through telehealth. COVID-19 caught the entire country off balance, highlighting structural… Read More »
Our data says a lot about us – where we go, who we see, and what we do. And since our smartphones come with us everywhere, they are almost always collecting our data. To improve my understanding of how our data and devices can be used to fight the COVID-19 pandemic, I sat down with (over… Read More »
The COVID-19 pandemic caused large reductions in in-person office visits, costing primary care practices billions and exposing many of the risks associated with the fee-for-service (FFS) payment system. Capitation arrangements, in which providers are paid a per-member per-month payment, may offer a more attractive, less risky arrangement in the post-COVID-19 world. Almost all US health… Read More »
Historically, women are disproportionately impacted by pandemic illness and COVID-19 is no exception. Addressing domestic violence (DV) and access to reproductive healthcare may reduce the gendered impact of COVID-19. Before the COVID-19 pandemic, we piloted a program to enhance reproductive health literacy, Sexual Health Empowerment for Birth Control (SHE-BC). This program may offer insights to… Read More »
Are COVID-19 resources going to who needs them most? Targeting tests, treatments, supplies, and vaccines to those most at risk of COVID-19, such as communities of color, would go a long way toward preventing the spread of the virus and reducing the health disparities exacerbated by the pandemic. In the face of a dangerous pandemic,… Read More »
COVID-19 has exposed the cracks in the foundation of America’s rural community health system. These cracks include increased risk of facility closures, loss of services, low investment in public health, maldistribution of health professionals, and payment policies ill-suited to low-volume rural providers. As a result, short-term relief to stabilize rural health systems and long-term strategies… Read More »
What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »
Note from the Editors: Last week capped two jam-packed weeks of political nominating convention activities. COVID-19 was discussed at both conventions. The Washington Post fact-checked some of the health care claims at the Democratic convention. Here, with the permission of Kaiser Health News and Politifact, we are republishing their recent fact-checking of the COVID-19 content from the Republican… Read More »
The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »
To be at the intersection of technology and product development in a field as ripe for disruption as healthcare couldn’t be more opportune. But how can we use technology to improve community health, especially after COVID-19? Technology and Health: A Budding Relationship On April 10th 2020 the Apple-Google partnership announced a notification tool for contact tracing to support… Read More »
The U.S. government is reportedly harming people held in immigration detention centers with its excessive use of a common disinfectant. According to reports by immigrant advocacy groups, HDQ Neutral disinfectant is being sprayed dozens of times per day in enclosed environments. This is resulting in concerning health symptoms among detained people. This potentially egregious practice further… Read More »
Current healthcare reimbursements may create incentives for excess use of ventilators to treat COVID-19 patients. Recent research has shown that healthcare providers, including hospitals, have experienced substantial financial losses as a result of the COVID-19 pandemic. Alternative, less-invasive treatments for critically ill COVID-19 patients could potentially improve patient outcomes. But these approaches expose hospitals to… Read More »
As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for… Read More »
Nursing facilities have been in the center of the COVID-19 pandemic and experienced sweeping policy changes. The pace of change has made it difficult to keep track of each new policy, so this post summarizes the key shifts from January through May. Nursing facilities are attempting to protect residents by ramping up existing infection control… Read More »
Like the rest of society, the US health insurance system is going to change in the wake of the COVID-19 pandemic. The question is whether changes will be made deliberately, through policy actions, or reactively, through the markets. The American health care system has been at the forefront of the COVID-19 crisis in more ways… Read More »
May 6 heralded another grim milestone in the United States: the first COVID-19-related death of an Immigration and Customs Enforcement (ICE) detainee, a 57-year-old man from El Salvador. Despite having high blood pressure and possibly diabetes, he had been denied release on bond by a judge. He continued to be held in Otay Mesa Detention… Read More »
We are in the midst of two global public health catastrophes: the rapid spread of COVID-19 and the more insidious, chronic effects of climate change. The swift spread of COVID-19 has devastated many countries and their economies. But global changes in environmental conditions have been harming communities for decades. The World Health Organization estimates that… Read More »
COVID-19 has revealed many vulnerabilities in our societal structure. One particular vulnerability is the risk inherent in our use of congregate institutions to house and treat people. This includes the risks of inpatient psychiatric facilities. Inadvertently, the pandemic has surfaced critical questions that we should seek to answer even when the virus is under control: What is the right… Read More »
Our neighbors who are experiencing homelessness during this SARS-COV-2 pandemic are facing unique risks and extreme hardships. In the corner of American society almost defined by economic and racial disparities, COVID-19 has compounded and taken advantage of these long-standing vulnerabilities. An outsized burden of risk factors for COVID-19 compound the risks of crowded shelters and… Read More »
Women do not stop needing access to abortions in a pandemic. They should not need to place themselves and others at risk of COVID-19 to access one. But that is exactly what is happening — due in part to new bans, but mostly as a result of years of dwindling access across the country. The current… Read More »
In early April, President Trump, in his daily press briefing, told Americans to take the drug hydroxychloroquine, calling it a “game changer” for people with COVID-19: “I really think they should take it. But it’s their choice. And it’s their doctor’s choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you’d like.”… Read More »
There is a lot of attention being paid to the proportions of severe and fatal cases in discussions of COVID-19. Unless you’ve been living under a rock since January, you know that there are groups who are more likely to get very sick or die during this pandemic. In this post, we explore the evidence… Read More »
We have seen hospitals filled, high daily death tolls, and exhausted healthcare workers in large cities, like New York and Seattle. How will COVID-19 affect rural America? While initially many rural Americans felt protected by nature of their location, they are now feeling the effects of COVID-19 close to home. Small towns may serve as… Read More »
The first reports of COVID-19, the name now used to describe the disease caused by a novel coronavirus, first emerged around New Year’s day of 2020. Since then, the conversation has shifted from containment efforts in Wuhan, China to social distancing and mandatory closures across the U.S., including in New York, California, Illinois [pdf], Massachusetts,… Read More »
The rapid emergence of COVID-19 reminds us of the importance of the public health system. Local health departments (LHDs) play a central role in emergency preparedness and response. Effective epidemic response rests on the performance of the essential public health activities— assessment, policy development, and assurance—by LHDs. Evidence suggests that LHDs can improve population health… Read More »
Racial residential segregation in the US is persistent and associated with racial health inequities. This month’s special guest is Dr. Kristen Brown, a senior research associate at Urban Institute. We discuss her recent publication Still Separate, Still Not Equal: An ecological examination of redlining and racial segregation with COVID-19 vaccination administration in Washington DC. We… Read More »
Note: It’s election season. And time to take a look at the health policy positions of the presidential candidates. KFF published this thorough and well-sourced analysis of the candidates’ competing positions on everything from health care and abortion to public health and gun violence. Enjoy. -The Editors The general election campaign is underway, spotlighting former… Read More »
It’s September! That means it’s our blogiversary =) This month marks the 10-year anniversary (blogiversary) of The Medical Care Blog, where we focus on the intersection of public health and medical care. To celebrate this milestone, we are dedicating this month’s podcast to a blog-focused episode featuring special guests Greg Stevens and Ben King, co-editors… Read More »
Consolidation, broadly, and private equity, specifically, is threatening the survival of primary care. Because of its life-extending, quality-improving, cost-reducing, and equity-promoting benefits, primary care has been declared a common good, worthy of the public stewardship and investment provided to the justice system, highways, and public schools. Through its core functions – coordination, comprehensiveness, access, and… Read More »
Every older adult should have the opportunity to age successfully. And the growing older LGBTQ+ population is no exception. This group is diverse, with unique health and social needs. On average, LGBTQ+ older adults experience poorer physical and mental health, but this is by no means the case for all LGBTQ+ older adults. The adversity… Read More »
Food is life. A consistent, nutritious diet can improve overall health and protect against chronic conditions. But not everyone can access or afford a nutritious diet. In 2022, 1 in 8 households in the U.S. and 1 in 6 households with children were food insecure. Black and Latinx households experience more than double the rates… Read More »
I asked the question as a panelist at a health equity gathering, “Who does our health system serve?”. As a family medicine physician who sits perilously between patients and corporations (insurance, pharmaceutical, durable medical equipment, etc.), my answer was quite simple. Our health system serves the profit motives of those with hands in the jar.… Read More »
Patient-provider racial/ethnic concordance (i.e., physician and patient identify as the same race/ethnicity) has emerged as one key suggestion for mitigating healthcare disparities. Past research has underlined its benefits, including improved infant mortality and more appropriate prescription regimens. However, the sum of the evidence remains unclear and many facets of the patient-provider relationship have yet to… Read More »
It was the tweet heard around the healthcare world. In 2018, after the American College of Physicians had published their position paper advocating gun control as a public health imperative, the National Rifle Association posted a tweet starting: “Someone should tell self-important anti-gun doctors to stay in their lane.” Clinicians immediately began posting images and… Read More »
This month’s podcast focuses on structural racism. Welcome to the Healthy Intersections podcast for November, 2023. This month’s podcast focuses on structural racism in the United States. Joining us to talk about the new Structural Racism Effect Index (SREI) is Dr. Zach Dyer, lead author on the analysis. Check out the dashboard at SREIndex.com and… Read More »