Category Archives: Access to Health Care
Recession Saw Parents Cut Back on Care for Kids with Special Health Needs
The financial struggles of the recent recession led many families to cut back on health care treatments for children with chronic physical or emotional problems, according to the journal Health Affairs. About one in every five U.S. kids fits these criteria. "Those are children who require health or related services beyond those required by children generally," said researcher Pinar Karaca-Mandic, an assistant professor of public health at the University of Minnesota. "A child with asthma would fit in this category, for example. A child with depression, ADHD or a physical limitation would also fit this definition." Researchers analyzed government data on out-of-pocket costs for families with private insurance from 2001 to 2009, finding expenses climbed steadily until 2007, when spending for generally healthy children jumped but spending for kids with special health needs dropped. Dental care and prescription medications were the services most likely to see cut backs. Christina Bethell, professor of pediatrics at Oregon Health and Science University, in Portland, said the findings demonstrate that "We're not putting a system of care together for kids that appears to be optimal, and families are struggling.” Read more on access to health care.
CDC: Older Americans, Pregnant Women at Greatest Risk for Listeria
Older Americans, pregnant women, newborns and people with weakened immune systems account for approximately 90 percent of all Listeria food poisoning cases each year, according to the a new Vital Signs report from the U.S. Centers for Disease Control and Prevention. The report outlines safety measures to help prevent the bacterial infection, including knowing which foods are highest risk and how to prepare them properly. About 1,600 people contract Listeria annually and it is the third leading cause of food poisoning deaths. Read more on food safety.
Health of Black, Hispanic Teens Most Affected by Fast Food Near Schools
Fast food restaurants near schools have the greatest negative impact on the health of black and Hispanic teens in lower-income neighborhoods, according to a new study in the Journal of Public Policy & Marketing. Those teens were more likely than white of Hispanic kids to be overweight or obese. For all students, fast food one mile closer to school basically offset the benefits of one day of exercise per week; for black and Hispanic teens it offset up to three days of exercise. "The findings imply that it is important to examine the behaviors and contexts associated with low-income and ethnic minority status in urban areas," study co-author Sonya Grier, associate professor of marketing at American University, noted in the release. "These populations not only are the fastest growing but also have the highest rates of obesity, and research is relatively limited." Read more on obesity.
Special Family Court Systems Limit Kids' Time in Foster Care, Improve School Performance
With families who went through a special unified family court system that deals with divorce, child custody, juvenile delinquency, drug abuse and alcohol abuse, children spent less time in foster care and performed better in school (also an indicator of better emotional health), according to a new study in Evaluation Review. Kids whose families went through these courts were more likely to be reunited with their parents or other primary caregivers. Researchers found that children spent an average of 29 days fewer in foster care placements in counties with unified family courts, and kids were 11 percent more likely to be reunited with their parents or other caregivers. “The shortened time in foster care seen in this study can be attributed to the efficiency of unified family courts, which translates into savings for the court system and benefits to children seen through improved educational outcomes,” said Frank Sloan, PhD, of Duke University. The study was funded by the Robert Wood Johnson Foundation’s Public Health Law Research Program. Read more on education.
Diets High in Vegetables and Low in Meats Lead to Fewer Chronic Diseases, Longer Lives
Vegetarians and people with diets low in meat and high in vegetables are less likely to die from heart disease or any other chronic conditions over any particular period of time, according to a new study in JAMA Internal Medicine. In a study of more than 73,000 people from 2002 to 2007, researchers found that by December 31, 2009 about seven in 1,000 meat eaters and about five to six in 1,000 vegetarians died each year. However, researchers noted that there were a variety of contributions to this result. "It's important to note that the vegetarians in this study were more highly educated, less likely to smoke, exercised more and were thinner," said Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University in Boston, who was not involved with the new study, to Reuters Health. About 5 percent of Americans are vegetarian. Read more on nutrition.
CDC: Fewer Americans Struggling with Medical Bills, But Many Skipping Care Altogether
While overall fewer Americans are having difficulty paying their medical bills, the uninsured and other people who would have difficulty paying are increasingly skipping medical care completely, according to the U.S. Centers for Disease Control and Prevention (CDC). According to CDC's National Center for Health Statistics, the percentage of people under age 65 in families struggling to pay bills dropped from 21.7 to 20.3 percent from the first half of 2011 to the first half of 2012. For families with children up to 17 years old, the share dropped from 23.7 percent to 21.8 percent. Still, families of more than 54 million people are unable to pay their medical bills. "During this time period, those who were uninsured or who had public coverage were about twice as likely as those with private coverage to have problems paying medical bills," said study author Robin Cohen, a CDC health statistician. Read more on access to health care.
Regular Aerobic Exercise Best for Treating Depression
Researchers have pinpointed which types of exercise are best for combating major depressive disorders, according to a new study in the Journal of Psychiatric Practice. By reviewing and analyzing data from nine trials, they discerned that aerobic exercise is best, three to five sessions a week are necessary, each session should last 45 minutes to one hour, at least 10 weeks of training are needed, and other details. Karen Cassiday, PhD, board member and secretary of the Anxiety and Depression Association of America, said physicians should help patients identify barriers to proper exercise. “Discuss with them how you can pair exercise with something fun—audio books, podcasts, music,” she said. “Suggest that they exercise with other people. If you are meeting someone, you are more likely to do it.” Read more on mental health.
Survey: Doctors Seeing Shortage of Critical Cancer Drugs
Shortages of cancer-fighting drugs are affecting patient care and increasing treatment costs across the country, according to new findings to be presented at the annual meeting of the American Society of Clinical Oncology in Chicago. "These drug shortages are persistent and pervasive," said Keerthi Gogineni, MD, an oncologist in the Abramson Cancer Center and the Perelman School of Medicine at the University of Pennsylvania. "They are affecting the treatment of curable cancers, forcing physicians to improvise." About 94 percent of physicians say their treatments were impacted, 83 percent said they couldn’t even offer standard chemotherapy and 13 percent said the shortage caused trouble with clinical trials. Leucovorin, liposomal doxorubicin, 5-fluorouracil, bleomycin and cytarabine are the most common drugs to see shortages. "Clearly, it impacts the treatments patients receive," said Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society, in reference to cytarabine, which is used to treat leukemia. "It takes a long time to develop an understanding of effective drug regimens. When you can't use a proven effective drug and you have to go to an alternative plan, you certainly become concerned about the effect of that switch on the health of your patient." Read more on cancer.
CMS: Estimates for Average Charges of 30 Hospital Procedures
Building on the release last month of the average charges for the 100 most common inpatient procedures, the Centers for Medicare and Medicaid Services (CMS) today released selected hospital outpatient data that includes estimates for average charges for 30 types of hospital outpatient procedures from hospitals across the country, such as clinic visits, echocardiograms and endoscopies. Read more on access to health care.
To what lengths will hospitals go to make sure their employees are washing their hands? The answer for North Shore University Hospital on Long Island, N.Y., is thousands of miles to India where far-flung employees check their monitors, trained on the hospital floors, to find workers who skip the sinks on their way to the hospital’s intensive care units. According to a recent article in the New York Times, that is just one of many ways hospitals are working to increase hand washing and stop the spread of germs that can kill hospitalized patients. Other methods include free pizza and coffee incentives for frequent hand-washers and embedded chips on hospital employees that emit an alarm when a doctor bypasses a sink outside a patient room.
A March report from the Centers for Disease Control and Prevention (CDC) easily explains the increasing emphasis on hospital hand washing. According to the report, a family of bacteria called Carbapenem-Resistant Enterobacteriaceae, which includes e.coli, have become increasingly resistant to last-resort antibiotics during the past decade, and more hospitalized patients are developing incurable infections. CDC researchers found that during the first half of 2012, 4 percent of hospitals and 18 percent of long-term care facilities treated a patient with this type of infection.
Some hospitals have incentive ideas that employers and families can adopt including buttons that say, “Ask me if I’ve washed my hands?”
>>Read the article.
Federal Agencies Issue Final Rules on Workplace Wellness Programs Under the Affordable Care Act
The U.S. Departments of Health and Human Services, Labor and the Treasury have issued final rules on employment-based wellness programs under the Affordable Care Act. Starting in 2014, the rules will allow companies to reward employees who participate in the programs by reducing their health insurance premiums up to 30 percent—up ten percent from current rules. Incentives for smoking cessation can be even higher. And employers can increase premiums for employees who don’t participate in workplace programs or don’t meet certain benchmarks. However, the rules require companies to provide "reasonable alternatives" to employees who can’t meet health benchmarks but still want the discounts. They also allow workers to involve their physicians to help tailor programs with their employers. "These rules will help ensure that wellness programs are designed to actually promote wellness, and that they are not just used as a back-door way to shift health-care costs to those struggling with health problems," said Ron Pollack, executive director of Families USA, a health advocacy group. Read more on prevention.
CDC: 20 Percent of U.S. Adults Visited ERs in a Year
Approximately one in five U.S. adults took at least one trip to an emergency department over the past year, according to a new comprehensive government report based on a survey conducted in 2011. Health, United States, 2012 compiled health data from federal health agencies, state health agencies and the private sector and includes a wide array of U.S. health data. Among the other findings are the fact that 7 percent of people reported at least two emergency department visits, cold symptoms were the most common reason for emergency visits by children and people up to age 64 with Medicaid coverage were the most likely to visit emergency department. The full U.S. Centers for Disease Control and Prevention report is available here. Read more on access to health care.
Study: ADHD Drugs Don’t Increase the Risk of Adulthood Addiction
Taking medication for attention-deficit/hyperactivity disorder (ADHD) during youth does not increase the risk of adulthood addiction to substances such as alcohol, cocaine, marijuana and nicotine, according to a new study in JAMA Psychiatry. There has been debate over the issue for years in the medical community, with studies reaching different conclusions. "Our study provides an important update to clinicians," said study author Kathryn Humphreys, a doctoral student in psychology at University of California, Los Angeles. "Particularly for those who are concerned that stimulant medication is a 'gateway' drug or increases the risk for later substance use, there is no evidence at the group level for this hypothesis." Stimulants such as Ritalin and Adderall are commonly used to treat ADHD. Read more on prescription drugs.
Devastation in Oklahoma, More Storms Possible
Following tornadoes in Oklahoma yesterday that killed and injured scores of people and leveled whole communities, the National Weather Service is warning that that severe weather could move eastward as far as the Gulf Coast and Northeast on Tuesday and Wednesday. “These are dangerous storms and we urge people to monitor the situation closely and be alert for severe weather warnings in their community,” said Trevor Riggen, vice president of Disaster Operations and Logistics for the Red Cross. The Red Cross has created a free tornado app, available in English or Spanish, whose features include a high-pitched siren tornado warning alert that signals when an alert from a National Oceanic and Atmospheric Agency (NOAA) tornado warning has been issued. The app, found in the Apple App Store and the Google Play Store for Android by searching for American Red Cross, also includes an all-clear alert that lets users know when a tornado warning has expired or has been cancelled. The app also includes one-touch “I’m safe” messaging to alert family and friends through social media outlets. Read more on preparedness.
Cost, Other Factors May Keep African-Americans from Calling 911 when they have Stroke Symptoms
African-Americans often know the signs of stroke, but concerns about medical cost, ambulance response time and lack of familiarity with the need for prompt hospital care impacted whether they called 9-1-1 immediately, according to a new study of 77 African American community members in Flint, Michigan by researchers at the University of Michigan. The study was published in Circulation: Cardiovascular Quality and Outcomes. To encourage 9-1-1 calls even if a stroke victim is concerned about cost, the study authors recommended highlighting the reduction in post-stroke disability if treatment is given quickly. Read more on access to health care.
Report: High SPF Sunscreens Not Any More Effective
Just in time for the Memorial Day Weekend, the Environmental Working Group has released its 7th annual Sunscreen Guide, which rates the safety and efficacy of more than 1,400 sunscreens, lotions, lip products and makeups that advertise sun protection. EWG researchers found that only 25 percent of products on the market in 2013 offer strong and broad protection and pose few safety concerns. “The vast majority of sunscreens available to the consumer aren’t as good as most people think they are, but there are a handful of products that rise above the rest,” said Sonya Lunder, senior research analyst at EWG and lead author of the report. Lunder says that’s important because “despite an increasing awareness of the sun’s risks, rates of melanoma have tripled over the past 35 years, with an annual increase of 1.9 percent per year since 2000.” EWG says it thinks the U.S. Food and Drug Administration (FDA) should push companies to stop selling high-SPF sunscreens (above 50+), which account for 1 in 7 products on the market. The FDA has said that it cannot vouch for any sunscreen above 30. According to Lunder, as a result of misleading and confusing marketing claims, consumers frequently misuse sunscreens and spend more time in the sun than they should, putting them at greater risk. Read more on cancer.
WHO Reports First Patient-to-Nurse Transmission of SARS-like Virus
The World Health Organization (WHO) is reporting that two health care workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients, which represents the first case of the virus spreading this way within a hospital. Novel coronavirus, or nCoV, is thought to be spread through close contact, but, "scientists are on the alert for any sign that nCoV is mutating to become easily transmissible to multiple recipients, like SARS -- a scenario that could trigger a pandemic," according to Reuters. Read more on infectious disease.
Repeated Head Injuries Raise Soldiers' Suicide Risk
Soldiers who sustain multiple traumatic brain injuries, even if they are mild, are at greater risk for suicide, according to a study published in the journal JAMA Psychiatry. Researchers found that the risk for suicidal thoughts or behaviors increased for soldiers with such injuries over the course of a lifetime -- not just in the short term after the injuries occur. Suicide is the second-leading cause of death among U.S. military personnel, and researchers say this study provides further guidance on assessing risks and supporting wounded soldiers. Read more on military health.
HHS Announces $1 Billion to Fuel Health Care Innovation
The U.S. Department of Health and Human Services (HHS) launched a nearly $1 billion initiative -- the Health Care Innovation Awards -- that will fund work to transform the health care system by demonstrating better care and lower costs. This is the second round of the award. In the first round, the Centers for Medicare & Medicaid Services awarded 107 Awards out of nearly 3,000 applications. Round one awardees included a medical home for people with disabilities that showed a 71 percent reduction in hospitalization rates. Read more on access to health care.
A recent Opinionator column in The New York Times by Nancy DiTomaso, vice dean for faculty and research at Rutgers Business School in New Jersey, suggests that some of the reason for the 13 percent unemployment rate among African-Americans—double the rate for whites—may stem from the fact that whites are more able to rely on their social networks for an edge when finding out about and applying for higher-wage jobs.
“Getting an inside edge by using help from family and friends is a powerful, hidden force driving inequality in the United States,” says DiTomaso, who adds that whites helping other whites is not the same as discrimination, and it is not illegal, “yet it may have a powerful effect on the access that African-Americans and other minorities have to good jobs, or even to the job market itself.”
Income—and lack of it—impact every aspect of health, from being able to afford safe housing to being able to purchase nutritious food to accessing high-quality healthcare. A study published in the British Medical Journal earlier this year found that there were nearly 40,000 extra hospital readmissions over a three-year period in states with the greatest income inequality.
NewPublicHealth illustrated the link between jobs and health in a recent infographic.
>> Read the post from The New York Times.
Business Coalitions to Receive Funds to Improve Community Health
The Robert Wood Johnson Foundation and United Health Foundation will award $700,000 in grants to nine National Business Coalition on Health member coalitions. The community health grants will fund resources to help the communities assess their health problems and come up with solutions. The issues include obesity rates, tobacco use, healthy living efforts and pre-term births. “Supporting and nurturing businesses to engage with their communities to identify and address priority local health issues is the first step in solving them,” said Reed Tuckson, MD, senior advisor of the United Health Foundation. Read more on community health.
AHA: Dog Owners at Reduced Risk of Heart Disease
Owning a pet—especially a dog—may help cut a person’s chance of heart disease, according to a new scientific statement from the American Heart Association (AHA). A study of more than 5,200 U.S. adults found a link between owning a dog and being more physically fit, because of the need to talk dogs on frequent walks. There are also calming effects to consider when looking at the lower levels of obesity, blood pressure and cholesterol. Glenn N. Levine, a professor at Baylor College of Medicine in Houston, said more research is needed to determine whether adopting a pet can help improve pre-existing cardiovascular conditions. Read more on heart health.
HHS: $150M to Help Uninsured Enroll in New Health Insurance Options
Approximately $150 million in funding from the U.S. Department of Health and Human Services (HHS) will go toward community health centers to help uninsured Americans understand and enroll in new health insurance coverage options. The improvements will include hiring new staff, staff training and community outreach. There are about 1,200 health centers serving 21 million people annually. “Health centers have extensive experience providing eligibility assistance to patients, are providing care in communities across the nation, and are well-positioned to support enrollment efforts,” said HHS Secretary Kathleen Sebelius. Read more on access to health care.
HHS Makes Hospital Cost Information Available to Consumers
The U.S. Department of Health and Human Services (HHS) has announced a new initiative that, for the first time, gives consumers information on what hospitals charge for many procedures and services. The information will be posted on the website of the Centers for Medicare and Medicaid Services and will show comparative charges for services that may be provided during the 100 most common Medicare inpatient stays, such as knee replacements. The new data shows significant variation across the country and within communities in what hospitals charge for common inpatient services. The agency is also providing close to $90 million to states to collect, analyze, and publish health pricing and medical claims reimbursement data. To help show how the data can be used the Robert Wood Johnson Foundation has announced a data visualization challenge. Read more on access to health care.
CDC Issues Updated Hepatitis C Screening Guidelines
The U.S. Centers for Disease Control and Prevention (CDC) has issued new screening guidelines for Hepatitis C that recommend anyone born between 1945 and 1965 be screened for the infection, as well as anyone who received a blood transfusion or organ donation before 1992 when screening of the blood supply was improved, and anyone who has ever injected drugs. The CDC is making the new recommendations because only half of Americans identified as ever having had hepatitis C received follow-up testing to see if they were still infected, according to a new Vital Signs issued by the agency. CDC researchers looked at data from eight areas across the country and found that of the hepatitis C cases reported in those areas, follow-up testing was only done in 51 percent of the cases. “Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences,” says said CDC Director Tom Frieden, MD, MPH. According to the CDC, about 3 million Americans are infected with hepatitis C and up to 3 out of 4 do not know they are infected. Read more on infectious disease.
Researchers Call for Independent Review Process for DSM-5 Updates
Arguing that that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) missed “crucial population-level and social determinants of mental health disorders,” a group of researchers at the Columbia University Mailman School of Public Health and Columbia University Medical School are calling for an independent review for any future revisions of the American Psychiatric Association’s guidelines. The article appears in the journal Health Affairs. “As the DSM evolves, we must ensure the accuracy of psychiatric diagnoses and their equitable use in health care by systematically reviewing and applying the lessons in the population health and social science literature,” wrote the authors. The factors include various environmental factors, cultural perceptions and institutional pressures. Read more on mental health.