Community Environments
A new study published in The Lancet finds that people who living within 50 meters of major highways are 12% more likely to develop dementia than those who live farther away.
City Lab reports on a new Harvard report on aging, which projects that by 2035, one in five Americans will be over age 65, an increase of more than 30 million seniors over the next 20 years. “Many of these Baby Boomers, the report notes, intend to “age in place,” or stay in their homes or communities. This is where the report sounds an alarm: In many ways, we’re just not ready. For example, only 1 percent of housing stock is currently equipped with no-step entrances, single-floor living, wide halls and doorways to allow a wheelchair, electrical controls reachable from a wheelchair, and lever-style handles on faucets and doors—“universal design” elements that help occupants age in their homes. The report highlights accessibility challenges, as well as other hurdles for an aging population: affordability, the need for in-home care, and the potential for isolation.”
The Center for Science in the Public Interest filed a lawsuit against Coca-Cola and the American Beverage Association this week, alleging that Coca-Cola and the ABA use “industry-funded reports and advertisements to shift blame for health troubles off its products and onto consumers’ exercise habits… Coca-Cola and the ABA are misleading consumers about the health risks posed by sugar drinks, and claiming that there is no science linking sugar-sweetened beverages to obesity and related diseases.
California
KPBS reports that poverty in San Diego County has risen since the recession, with approximately 14% of San Diego residents living in poverty, even though unemployment has fallen in the past few years. While poverty has increased broadly, families headed by single moms face the greatest increase in poverty, with 34.5% of families headed by single mothers living under the poverty line in 2015, up from 29.9% in 2010.
A study by Reuters, found that people in the Fruitvale area of Oakland are being exposed to potent levels of lead: 7.57% of the 500 children tested had high levels of lead in their blood — far higher than the national average (2.5%), the East Bay Times notes. The study found that poisoning rates of more than 3,000 neighborhoods across the country had surpassed the rates of Flint. In Oakland, the crisis stems from something called “legacy lead,” which comes from industrial waste, plumbing, and crumbling paint. Lead paint was legal before 1978 — and nearly all of the housing in Oakland was built before the ban.
Violence Prevention and Unintentional Injury
According to a new study in the Journal of the American Medical Association, gun violence should be treated as a public health crisis, as evidenced by the fact that every year in the U.S., more than 30,000 people die from gun-related deaths, putting gun violence ahead of many other leading causes of death, while funding for research lags far behind them. One of the authors notes, "I think a good parallel can be drawn to motor vehicle accidents. Those kill about the same number of people, but that has been decreasing substantially… All of that really starts from essential public research that determines the proximate causes of accidents — and it's only with research that you can start to develop plans and policies and initiatives." Meanwhile, a new study in the Annals of Internal Medicine found that 1 in 5 gun purchases reportedly go through without a background check. Vox makes the case that states need to take a stand to strengthen gun laws and their enforcement by moving toward universal background checks. Alternet’s “Armed for 2017” covers new state gun laws that are shrinking 'gun-free zones' and expanding access to concealed carry without training or permit. Finally, a new study published in the journal Violence and Gender found higher gun ownership dramatically increases the risk of women being murdered.
Health Equity
The selection of Tom Price as secretary of health and human services, if approved, threatens to undermine the health of American women. As the New York Times reports, Price “earned a zero rating from Planned Parenthood, an organization he’d like to defund, despite its role in providing preventive health services… In Congress, he opposed a law that would protect women in Washington, D.C., from employment discrimination based on their decision to use birth control or have an abortion. He was a co-sponsor of legislation that would have defined life as beginning at conception, inviting arguments that common forms of birth control constitute a murder weapon.”
A year after Michigan declared a state of emergency in response to lead-contaminated water in Flint; residents remain concerned about the safety of their water and many are still drink and bathe with bottled water.
According to a new study in the American Journal of Public Health, the ACA’s expansion of Medicaid coverage to people living just above the poverty line may be responsible for more people with disabilities getting jobs.
According to a recent survey reported on by NPR, approximately one-third of parents reported difficulty finding childcare. On average, parents in the US spend $9,589 a year for full-time care of children from birth to age four — more than the average cost of in-state college tuition ($9,410). Other obstacles to quality, affordable childcare are a lack of public investment and low profits combined with high liability and the need to navigate complex regulations.
A federal judge in Texas issued an order Saturday halting enforcement of the ACA provision that protects transgender patients from healthcare discrimination and ensures entities receiving federal dollars provide comprehensive reproductive health-care services, including abortion care. As BMSG notes, that in spite of the ruling, coverage from Reuters features a hopeful quote from White House spokesperson Katie Hill, who highlights the shared value of equity: "Today's decision is a setback, but hopefully a temporary one, since all Americans -- regardless of their sex, gender identity or sexual orientation -- should have access to quality, affordable health care free from discrimination."
Mental Health
Single fathers are twice as likely to report poor physical and mental health as fathers with partners, according to a study published in the Journal of Epidemiology and Community Health. The study found that 12% of single fathers and mothers rated their heath as poor or fair. Lead author Maria Chiu of the University of Toronto said, "We need to pay attention to the physical health and mental health of single dads in the same way we do with single moms." Fathers who reported poor or fair health were more likely to have lower income and educational attainment and to be unemployed.
The New York Times Magazine examines the case of Marine Corps veteran Sam Siatta, who was sent to prison for forcing his way into a house and assaulting a man who turned out to be a fellow serviceman. Siatta, who had been drinking heavily to cope with PTSD in the wake of his return from service in Afghanistan, said he had no memory of the event. “The Marine Corps taught Sam Siatta how to shoot. The war in Afghanistan taught him how to kill. Nobody taught him how to come home.”
NPR explores the use of lay counselors to treat people with mental health struggles in India who cannot access professional help. It’s an approach that has been tried in the past in the US and found to be successful. “Most of the old research showed that lay counselors were just as effective for depression as counselors with lots more education — sometimes even more effective.” The report suggests that the use of paraprofessionals didn’t get traction in the US in part because professionals were both threatened by the competition and concerned about substandard care.
A study published in JAMA concludes that increasingly limited access to psychiatric inpatient treatment is contributing to the rising suicide rate. The study says most state-funded psychiatric beds are allotted to people in the criminal justice system.
Better Georgia profiles the work of CHRIS 180, which is addressing trauma by focusing on root causes, including access to food, health care, shelter, skills and education.
A Health Affairs blog looks at some of the obstacles that are preventing people from accessing cost-effective, evidence-based mental health services, despite parity laws. The authors make the case for the Collaborative Care Model, in which mental health is integrated in the primary care setting.
Health Systems Transformation
This article details how meaningful change will only be brought about by ’balancing health care with social determinant strategies.’ The piece asserts that there is an increasing consensus that social determinants – such as the conditions in which people are born, grow, live, work and age - affect health outcomes, noting “Being denied disability benefits, food stamps and health insurance directly bars families from obtaining needed medications or food. Tenants facing utility shut-offs can no longer refrigerate medications. Living in housing infested with insects, rodents, or mold can cause asthma, allergies or migraines. Sustaining injuries from domestic violence can require repeated visits to emergency rooms.” The piece concludes by highlighting how doctors and lawyers in Iowa are working together to improve children’s health.
The Washington Post reports on a new study in the Journal of the American Medical Association showing that chronic, largely preventable conditions are a primary driver of personal health spending in the US. The article notes, “Most of the discussion of health care in America has focused on access to insurance, but the spending breakdown shows that the biggest opportunities may come in preventing disease.”
In ACA news, Reuters reports on Republican U.S. Senator Mike Enzi’s resolution – introduced on Tuesday - allowing for the repeal of the ACA. The Republicans are using a budget resolution to enable repeal, allowing them to act without any Democratic votes. A Senate vote on the resolution could come next week, with action in the House of Representatives expected to follow. The Washington Post reports on those who stand to lose the most if the ACA is repealed: middle and low-income people, noting, “The risks to essential benefits for tens of millions of low- and moderate-income Americans include losing coverage extended to them by the ACA, threats to the fundamental structure of the Medicaid health-insurance program for the poor and further reduction of already squeezed funding for scores of other important programs serving the most vulnerable Americans.” A new Urban Institute study found that areas with the largest premium increases "reflect needed corrections" to low prices in the ACA's early years, sicker people may be more likely to enroll, premiums may be higher where there's less competition, and the risk adjustment program is inadequate for some areas. The group's recommended fixes: boosting subsidies and the penalty for not having coverage (which won't happen in a GOP-controlled Washington), and letting the Obama administration's tweaks to the risk adjustment program take effect. According to the Committee for a Responsible Federal Budget (CRFB), repealing the ACA would increase the budget deficit by $350 billion over 10 years. Finally, The American Medical Association and The American College of Physicians called on lawmakers to outline plans to replace the ACA before they repeal it.