Category Archives: Health behaviors

The Social Determinants of Addiction

By | February 15, 2018

Opioid use is a serious concern that the executive branch of the United States government recently declared a public health emergency. Based on data from the Department of Health and Human Services, in 2016, 2.1 million people misused prescription opioids for the first time, and 42,249 people died from overdosing on opioids. Also in 2016, 170,000… Read More »

In the fight against the opioid epidemic, states should update their needle and syringe access laws

By | February 8, 2018

During my time as a community pharmacist in Maryland, I often encountered individuals who would approach the pharmacy in search of syringes. Although they would try to disguise their intentions by stating that they needed it for someone else or for an animal, it was apparent why they were there; they were going to use… Read More »

Why Aren’t We Expanding Medicaid to Address the Opioid Epidemic?

By | February 7, 2018

Now more than ever, we need a sensible, unified, national response to the opioid epidemic; a response that recognizes the gravity of the situation and the reality that opioid use disorder (OUD) is a chronic – and treatable – condition. While there are many preventive measures that could pay dividends down the line, such as… Read More »

Abuse-Deterrent Formulations: A Solution to the Problem

By | January 25, 2018

Despite continuous efforts to address the problem, high rates of prescription opioid use and abuse continue to plague our country.  According to the CDC, deaths involving prescription opioids in the United States have quadrupled since 1999, and so have the sales of these prescription drugs.  In 2015, the American Public Health Association published a policy… Read More »

Five principles for developing digital clinic-based, behavior-change health interventions

 In this post, we describe five principles that guided the development of Positive Health Check, a clinic-based digital health intervention for HIV-positive patients, aimed at making it acceptable and feasible in a clinic setting.

Is your activity tracker a medical device?

Activity tracker technology has come a long way.  The first Fitbit released in 2009 only measured movement, sleep, and calories burned.  In contrast, the Fitbit Ionic smartwatch released in 2017 has a much broader range of functions, including heart rate monitoring, personal coaching, and built-in GPS. Consequently, with this change in functionality comes a change in potential uses for… Read More »

Hitching our Wagon to the Stars: Making the Most of Quality Reporting

By | December 7, 2017

The Centers for Medicare and Medicaid Services (CMS) has a set of “Compare” websites – Hospital Compare, Nursing Home Compare, Home Health Compare, etc.; consumers and policymakers can compare physicians, long-term care hospitals, inpatient rehabilitation facilities, hospice care, and dialysis facilities today, and other settings may follow. Together with their associated health care quality measurement… Read More »

Smoking in America: Medicaid, Quitting, and Income

Over the last few decades, cigarette smoking has become a health burden concentrated primarily among low-income individuals in the U.S. In our recently published research study, Medicaid coverage expansions and cigarette smoking cessation among low-income adults, we sought to determine the relationship between recent expansions of Medicaid coverage and smoking cessation for low-income adults. Demographics… Read More »

Promoting Primary Prevention of Neonatal Abstinence Syndrome

By | October 19, 2017

“Neonatal abstinence syndrome” (NAS) sounds deceptively innocuous, given that it is literally infant drug withdrawal. It is usually caused by prenatal exposure to opiates but can also result from maternal consumption of other substances, like alcohol and antianxiety medications. Common symptoms include excessive high-pitched crying, fever, sweating, irritability, vomiting, diarrhea, rapid breathing, sleep disturbances, and poor… Read More »

What happens to veterans’ health after leaving the military?

By | October 12, 2017

Veterans leaving military service face many challenges transitioning back to civilian life. More than a quarter of veterans report struggling with the return to civilian life, according a Pew Research Poll. Some challenges are psychological; a considerable body of research has linked veteran status with mental health concerns. Other challenges, however, can be physical. Civilian… Read More »

Survey says: Most women don’t know about breast cancer overdiagnosis and overtreatment

By | October 5, 2017

October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »

What’s the difference between opioid use, misuse, and addiction?

By | September 30, 2017

Opioid addiction seems to be in the news every day. But what’s the difference between an opioid user and an opioid addict? First, let’s define our terms. Opioids are drugs derived from the opium poppy, including heroin and morphine. The class also includes synthetic opium-derived prescription painkillers including oxycontin and fentanyl, as well as drugs… Read More »

Mobile Apps to Improve Medication Adherence

What do you use your cell phone for on a daily basis? Many people would say using social media, texting, and placing phone calls– but have you ever considered your smartphone as a tool to improve medication adherence?  Our phones are an integral part of our lives, and consequently, researchers, clinicians, and patients have all… Read More »

Patterns of Opioid Use and Risk of Opioid Overdose

By | July 6, 2017

Opiate overdose is now the leading cause of accidental death in the United States, killing more than 50,000 people in 2015. About 20,000 of those deaths were attributed to the use of prescription opiate medications. As a physician, I want to alleviate my patients’ pain, but I have also taken an oath to do my… Read More »

The Intersection of Religion, Female Empowerment, and Access to Reproductive Healthcare

By | June 22, 2017

Reproductive rights have been a topic for policy making and legal jurisprudence throughout much of the past century. As the healthcare system of the United States continues to evolve, women’s health and reproductive rights remain central to the debate. A recent policy update by Aishwarya Rajagopalan and Lisa Lines here at The Medical Care Blog discusses… Read More »

How Accurate is Your Activity Tracker?

By | June 8, 2017

The functionality and popularity of consumer-grade activity trackers (such as Fitbit) appear to be ever-increasing.  If you don’t personally own one, you probably know at least one or two people who do.  In an online survey of 1,000 respondents [PDF], conducted in 2016 by PwC, 45% owned a fitness band, with “Health” being the primary… Read More »

Smoking cessation treatment among newly covered individuals under the ACA

By | April 13, 2017

Smoking cessation is not innovative or trendy or even particularly exciting, but as a primary care doctor, in most cases helping a patient quit smoking is the best thing that I can do to help that patient over their lifetime. Without question. And for that reason, I always make it a priority to talk about it… Read More »

Intimate Partner Violence: The Under-Addressed Pandemic

By | March 23, 2017

Violence against women and girls is an international concern that cuts across all sectors of society. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary… Read More »

The childhood roots of health inequity: Part 3 – Dr. Kerith Conron

By | March 13, 2017

This post is the third in our series focusing on presentations that were delivered at a special panel session at APHA16 on the childhood roots of health inequity [part 1, part 2]. Our third presenter, Kerith Conron, ScD, MPH, is currently the Blachford-Cooper Distinguished Scholar and Research Director at The Williams Institute of UCLA’s School… Read More »

Discrimination in Trans Healthcare and the Call for Further Provider Education

By | January 26, 2017

Adequacy of healthcare for transgender patients has recently come to light, particularly with the increased discussion of trans persons in the media. Trans individuals identify their gender differently from their assigned sex at birth. Trans healthcare is an emerging field of research, and this increased focus continues to uncover the lack of knowledge amongst providers… Read More »

Childhood roots of health inequity: Part 2 – Dr. Donald Barr

By | January 19, 2017

Exposure to toxic stress in childhood is associated with adult health inequities. Last fall, the Medical Care Health Equity Committee organized a special panel presentation on the topic at the 2016 APHA Annual Meeting. This post is the second of a series of posts.

The childhood roots of health inequity: Part 1 – Dr. Paula Braveman

By | November 28, 2016

Children who grow up in stressful environments, without adequate adult support, are at much greater risk of developing heart disease, cancer, and many other diseases as adults. This is partly because of the coping behaviors that people use to deal with stress, but also because of the cumulative effects of toxic stress. Thus, many of… Read More »

The Person-Centered Wellness Home: Reflections on a Conversation with Dr. Thelma Mielenz

By | October 31, 2016

With the mania of the presidential election in full tilt and the election just days away, it’s hard to have a rational public discussion about health care.  Supporters of the two presidential candidates have drawn a deep and divisive line (or rather a tectonic fissure) in the sand about health care reform.  This is due, in great part, to the bombastic, and ultimately… Read More »

Economic Burden of the Opioid Epidemic

By | September 29, 2016

According to the U.S. Department of Health & Human Services, in 2014, more than 240 million prescriptions were written for opioids, which is more than sufficient for each American adult to have one full bottle of opioids. Prescription drugs are second only to marijuana as the most abused category of drug in the United States. A recent article… Read More »

Could Pokémon Go be your new fitness tracker?

By | September 22, 2016

Do you play Pokémon Go? Well if you don’t, I’m sure you know at least 2-3 other people who do.  Although I hadn’t ever played the game before writing this post, I can safely think of about 4 friends who have invested a significant amount of time and energy into their Pokémon collection thus far. If… Read More »

Seeking Clarity on Opioid Prescribing

By | July 8, 2016

According to the National Institutes of Health (NIH), more than 18,000 people died from overdoses of prescription opioids in 2014. This is more than the number of overdose deaths attributed to heroin (10,854) and cocaine (5,415) combined. Opioids are pain relievers that are chemically similar to morphine. Existing clinical guidelines recommend against exceeding a threshold… Read More »

Why aren’t you wearing your Fitbit?

By | May 26, 2016

Nobody can deny that the market for consumer wearable devices (such as Fitbit and Jawbone) is booming.  In 2015, a research firm estimated the number of activity trackers sold in the US to be over 13 million. Personally, I followed the fitness tracker trend and bought a Fitbit for both my husband and father as… Read More »