Disability impacts all of us. Chances are that we ourselves or someone we love lives with at least one disability–a physical or mental impairment that substantially limits one or more major life activities. Around 16 percent of the global population (close to one billion people) lives with a disability. And in the U.S., the rate… Read More »
The pharmaceutical industry is a behemoth in the United States. In 2023, the 20 largest pharmaceutical companies had a market capitalization of $3.78 trillion dollars. Pharma companies spent more than $15 million dollars in contributions through political action committees during the 2020 election cycle. Analysts constantly see new avenues of generating revenues and profits for… Read More »
Before we introduce this week’s post about important disparities in 988 utilization, by Lindsey Dawson and Heather Saunders and originally published in KFF Health News, we wanted to highlight an upcoming Symposium on Responding to Behavioral Health Emergencies being held by the Medical Care section of the American Public Health Association (among others). The need… Read More »
Climate change is undeniably a bleak story. Recent data–from the top of a remote volcanic mountain–show that carbon dioxide is accumulating in our atmosphere faster than ever. Its concentration has reached levels far beyond those in any other time of human existence. This bad news is balanced, however, against a highly-regarded good news report that… 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 »
Research shows time and again that Black women are at least three times more likely to die from a pregnancy or childbirth-related cause than white women. Black infants are also over two times more likely than white babies to die before they turn one. Research also shows that people identifying as Black or African American… 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 »
After seemingly endless negative pregnancy tests and a few early losses after rounds of alternate fertility treatments, I felt that in-vitro fertilization (IVF) was my only hope of becoming a mother. As I saw others conceiving naturally, or succeeding relatively quickly with less invasive assisted methods, my longing and desperation for motherhood only grew. I… Read More »
Suicide prevention and intervention programs and services are vital. Mental health services are essential to support individuals, families, and communities struggling with mental health, suicide, and after suicide loss. But we must also recognize that preventing suicide requires a larger collective, systemic response. Suicide deaths are rising steadily every year, with a record high of… Read More »
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 »
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 »
Competition between hospitals in a given market should provide incentives to ensure quality while also lowering costs. Over the past two decades, hospital markets have increasingly consolidated. This consolidation reduces competition and increases the comparative leverage that hospitals and associated health systems have. While there are some theoretical advantages of increased consolidation such as potential… Read More »
A special supplemental issue of Medical Care supports the growing recognition that patient economic outcomes matter in health care. Sponsored by the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services, the issue highlights studies that explore the relationship between economic outcomes, patient care, health outcomes and equity. Patient-centered… 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 »
From The Medical Care Blog: A special consensus statement on climate change and public health In 2021, more than 250 of the world’s leading medical and public health journals released a joint statement about climate change and public health. Published simultaneously, editorial boards of the journals declared climate change to be the “greatest threat” to… Read More »
What comes to mind when you hear the word “weathering”? Perhaps you think of erosion, depletion, and wearing down. Or maybe enduring, surviving, and withstanding. All of these associations accurately describe what happens to our bodies in response to chronic stress. This particular type of physiological stress affects the brain and other parts of the… Read More »
The need for youth activism and civic engagement in public health has never been greater. A mentor once said, “When public health is doing its thing, you will never hear a word about it.” But today, the profession doesn’t have that luxury. We must act if we want public health to remain a strong and… Read More »
The United States Preventive Services Task Force has recommended lung cancer screening for at-risk groups since 2013, and updated again in 2021. This is a simple procedure involving a low dose of radiation used to take a CT image of the chest. If utilized by most eligible Americans, screening could reduce lung cancer mortality by… 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 »
Human Immunodeficiency Virus (HIV) has gone from a deadly infection to a manageable health condition in the last thirty years. Today, we have medications available that can treat those with HIV and prevent HIV in uninfected people. Pre-exposure prophylaxis, also known as PrEP, is a medication given to individuals without HIV to keep them from… Read More »
Representation matters to health. Improving pathways into health care and public health is an important way to increase workforce diversity. This is a crucial step in reducing health disparities and advancing health equity in the U.S. Black, Latinx, and American Indian and Alaska Native communities face higher rates of chronic and life-threatening health conditions. Yet… 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 »
This entry was one of the winners of our Summer 2023 student blog contest! Anti-LGBTQ laws are flooding the United States. As of June, a historic 491 anti-LGBTQ bills have been introduced in 2023 – a 203% increase from the entire 2022 year. More bills were introduced in the first three months of 2023 than… Read More »
The ACA marketplaces continue to be an important source of health insurance for millions of Americans. Achieving health equity for these enrollees may require more than simply providing coverage. The number of individuals who selected a Affordable Care Act (ACA) marketplace plan increased from 8 million [PDF] in 2014 to 16 million [PDF] in 2023.… Read More »
A special dispatch from AcademyHealth’s Annual Research Meeting in Seattle, June 2023 This post recaps a panel discussion focused on Measuring Impact of Policy Strategies on Health Equity. I was fortunate to be among the panelists. My talk focused on 7 common mistakes when conducting evaluation and health equity-focused research. In this post, I share… Read More »
Welcome to the July 2023 episode of the Healthy Intersections podcast! This month, we talk about the state of Florida with Lauren Pierce, who formerly worked at the Florida Department of Public Health and is a long-term resident of Tallahassee. We debut the brand new RTI Rarity™ interactive national dashboard and focus on northern Florida,… Read More »
Last month, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced its newest alternative payment model for primary care, Making Care Primary (MCP). MCP builds upon lessons learned from previous CMS primary care models: the Comprehensive Primary Care Initiative, the Comprehensive Primary Care Plus (CPC+) initiative, the Maryland Primary Care Program, and Primary… Read More »
The way we’re addressing substance use and overdoses in the United States isn’t working. Let’s be perfectly clear: the “war on drugs” isn’t, and never was, really a war on drugs. It’s been a war waged on communities who are Black, Indigenous, and People of Color (BIPOC). The war on drugs started well before President… Read More »
Over the past 25 years, significant strides have been made in shifting services for people with dementia and Alzheimer’s disease to home and community settings. Home and community-based services (HCBS) enable people with various forms of dementia to receive care in a familiar setting while promoting their independence, well-being, and overall quality of life. As… Read More »
Welcome to the June 2023 episode of the Healthy Intersections podcast! This month, we sit down again with Carol Schmitt, Chief Scientist at RTI International, along with Juliet Sheridan, to talk about another of the RTI Rarity interactive state maps. This time, we are looking at North Carolina. We talk about historical redlining, climate change,… Read More »
Racial justice reframing is the process of shifting our attention from individual choices to the many structural and societal factors that contribute to health inequities. This framing allows us to picture a world where values of equity, shared responsibility, and community care are paramount. We see a world where everyone – regardless of their identities… Read More »
Welcome to the May, 2023 episode of the Healthy Intersections podcast! This month, we sit down again with Carol Schmitt, Chief Scientist at RTI International, to talk about another of the RTI Rarity interactive state maps. This time, we are looking at Oklahoma. You can watch the episode, download the audio file, and read the… Read More »
“Access for the sake of access or inclusion is not necessarily liberatory, but access done in the service of love, justice, connection, and community is liberatory and has the power to transform.” – Mia Mingus, community organizer, disability and transformative justice advocate Are you designing with equity and inclusion in mind? For public health and… Read More »
The disproportionate impact of COVID-19 on underserved communities underscored the need for systemic change and renewed efforts to reduce health disparities in people with social risks. This post describes a partnership between Inovalon and Humana to develop a new health equity composite quality measure to identify disadvantaged populations with the largest care disparities and determine… Read More »
Primary care in the US is segregated by racial/ethnic identification. What are the implications? Most people in the US are aware that our neighborhoods are often highly segregated by race and ethnicity. Racism — historical and current, structural and individual — plays a role in neighborhood demographics. The same forces also result in segregated workplaces,… Read More »
Originally published April 6, 2023; updated April 24, 2023 to add audio links. Welcome! April 2023 marks a new milestone for the Healthy Intersections Podcast (HIP), sponsored by the American Public Health Association’s Medical Care Section. I’m taking on the role of the main producer of HIP. We’re also moving to a video AND audio… Read More »
This month’s podcast features a round-up of this month’s blog posts and an interview with Sungchul Park of Drexel University about his recent Medical Care paper on Medicare Advantage Star Ratings and disparities in ambulatory care sensitive hospitalizations. Listen here or via your favorite podcast platform! Transcript (partial): Hello listeners, and welcome to the Healthy… Read More »
To address calls for improving health equity, organizations could consider using CLAS Standards to advance diversity, equity, and inclusion (DEI). In recent years, health organization leaders have prioritized the need to address systemic inequities. A 2021 survey of health care organizations identified health equity as a top priority [pdf]. This focus has grown since the… Read More »
Community-based clinicians sometimes see patients who have been recently released from immigration detention. Those encounters can be challenging, especially when patients reveal health harms experienced while in detention. It is obviously critical that clinicians provide high-quality medical care and address any health issues potentially brought about or exacerbated by their detention history. But do they… Read More »
In this month’s podcast, co-editor Jess Williams recaps blog posts from November and talks about some December journal articles. Listen here or wherever you get your podcasts. Transcription Welcome back to Healthy Intersections, the podcast of themedicalcareblog.com. In this month’s episode, I’ll review some of our blog entries from November and give you a preview… Read More »
Telehealth–the ability for providers to care for patients using computers, tablets, or smartphones–has the potential to expand access to healthcare by allowing people to interact with providers remotely. However, there are disparities in access to the technology that makes it possible to use telehealth. For example, in analyzing Census data on availability of widely used… Read More »
The pursuit of health equity requires public health and medical professionals to become adept at policy in their health advocacy work. The American Public Health Association (APHA), in fact, defines policy work as one of its 10 essential public health services. APHA says professionals should be capable of “creating, championing and implementing policies, plans and laws”.… Read More »
The Medical Care Blog is returning from its summer break this month. We hope you are feeling recharged and ready to dig deep again into health care and public health. We’re beginning with a series of retrospective posts to highlight the work of our contributors on prominent topics. This week, we focus on a collection… Read More »
Measuring and addressing social drivers of health are important in cancer research. Part 1 of this series, published in March 2022, described three commonly used area-level SDoH indices. None are not able to explain much variation in cancer mortality rates. In this post, I share results from a new model that shows promise. Methods in… Read More »
It is not too late to fix the US healthcare system. But every day spent in this folly, the problem gets worse. It is time to move this conversation forward. We are excited to share that in November 2021, the American Public Health Association (APHA) formally adopted a policy statement titled “Adopting a Single-Payer Health… Read More »
As a public health researcher, I love data, the more the better. I held this belief until I found that I myself had become the “subject” of research without my consent. This experience made me rethink ethical research. The more data, the better? In 2017, I encountered a state-level bill that required all the government… 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 »
In our first blog post of this series, we discussed how the current medical approach misses so much of what influences health, and how it perpetuates health inequities in our society. In this post, we go in-depth on the elements of Whole Person Health (WPH) that are necessary components of a just and equitable approach… Read More »
Our current U.S. medical system doesn’t work. It is not able to adequately care for the sickest, most vulnerable, and least resourced people. It often excludes those seen as “other” in our society. To become a just system, we need a new focus on Whole Person Health (WPH). Very briefly, WPH cares for the whole person and… Read More »