Author Archives: Lisa M. Lines

About Lisa M. Lines

Lisa M. Lines, PhD, MPH is a senior health services researcher at RTI International, an independent, non-profit research institute. She is also an Assistant Professor in Population and Quantitative Health Sciences at the University of Massachusetts Chan Medical School. Her research focuses on social drivers of health, quality of care, care experiences, and health outcomes, particularly among people with chronic or serious illnesses. She is co-editor of TheMedicalCareBlog.com and serves on the Medical Care Editorial Board. She has served as chair of the APHA Medical Care Section's Health Equity Committee from 2014 to date. Views expressed are the author's and do not necessarily reflect those of RTI or UMass Chan Medical School.

Healthy Intersections Podcast: Healthcare’s Carbon Footprint

By | February 28, 2024

If the US healthcare industry were its own country, it would be in the top 10% of all countries in greenhouse gas emissions. Welcome to the February, 2024 edition of the Healthy Intersections Podcast! This month, we sit down with David Introcaso, PhD, to discuss the healthcare industry’s carbon footprint. Dr. Introcaso is the host… Read More »

Healthy Intersections Podcast: Talking About Plastics

By | January 26, 2024

January 2024 Edition Hello, and welcome to the Healthy Intersections Podcast, hosted here at The Medical Care Blog. We’re kicking off a year of climate action here on the podcast and blog. For our first episode of 2024, we interview Dr. Imari Walker-Franklin, a research chemist at RTI International, science communicator, and the co-author of… Read More »

Healthy Intersections Podcast: November 2023

By | February 17, 2024

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 »

Meet the Blog’s Newest Addition to the Editorial Team: Ben King

By | November 9, 2023

Ben King is joining our editorial team at The Medical Care Blog! Dr. King (he/him) is currently an Assistant Professor of Population Health at the new Tilman J Fertitta Family College of Medicine at the University of Houston. He has additional appointments in the Department of Behavioral and Social Sciences, with the UH-Humana Integrated Health… Read More »

Healthy Intersections Podcast: October 2023

By | February 17, 2024

This month’s topic focuses on suicide and social determinants of health (SDoH) Welcome to the Healthy Intersections podcast for October, 2023. Today’s podcast focuses on the links between suicide and social determinants of health in the United States. Suicide is one of the causes of deaths of despair, along with deaths from drugs and alcohol.… Read More »

Healthy Intersections Podcast: September 2023

By | February 17, 2024

Happy fall! This month’s Healthy Intersections Podcast focuses on food and climate — a timely topic during the fall harvest months. Food insecurity and food quality are known as important social determinants of health. For example, the percent of residents receiving food assistance (eg, SNAP) is associated with neighborhood life expectancy. On the other hand,… Read More »

Healthy Intersections Podcast: August 2023

By | February 17, 2024

Hi everyone! We’re excited to share the August edition of our Healthy Intersections Podcast with you. This month, we hosted Dr. Amanda Onwuka, a social epidemiologist and health services researcher at RTI International, as well as Jeremy Ney, author of American Inequality. We talk about the epidemic of drug overdose deaths in the US, mental… Read More »

Health equity: mistakes to avoid when conducting research

By | August 3, 2023

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 »

Healthy Intersections Podcast: July 2023

By | July 21, 2023

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 »

Healthy Intersections Podcast: June 2023

By | June 19, 2023

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 »

Healthy Intersections podcast: May, 2023

By | May 19, 2023

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 »

Racial and ethnic segregation in primary care

By | April 20, 2023

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 »

Healthy Intersections Podcast: April 2023

By | April 24, 2023

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 »

Pain: no longer a vital sign?

By | April 7, 2023

Pain was widely under-treated in the 1980s. Two decades ago, pain was recognized as an important problem that needed to be managed by healthcare providers. Today, the opioid crisis has led to under-treatment once again. Professional recognition of pain as a symptom that needs managing was the eventual outcome of several decades of research. Again… Read More »

Healthy Intersections Podcast: January 2023

By | January 26, 2023

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 »

Long-acting reversible contraception in the era of abortion bans

It is more important than ever to expand access to a broad range of safe and effective contraceptives that includes long-acting reversible contraception (LARC) methods. We are living in a new era in the US. As of early November, 2022, abortions are banned from the point of conception in 12 states and severely restricted in… Read More »

October 2022 Healthy Intersections Podcast

By | November 9, 2022

In this month’s podcast, Dr. Samy Anand gives an overview of the Medical Care Blog posts published in September and a preview of the journal articles in the October issue of Medical Care. Then, co-editor of the blog, Dr. Lisa Lines, discusses an article in the October issue in more detail. Below is a transcript… Read More »

Social Drivers of Cancer Mortality: Part 2

By | September 1, 2022

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 »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

Social drivers of cancer mortality

By | March 28, 2022

In 1981, Doll and Peto published a well-known paper estimating that roughly 75-80% of cancer mortality was preventable. Forty years later, cancer mortality has declined some overall – but we still see vast disparities. Some of these disparities have gotten worse over time. With the Biden administration’s reignited Cancer Moonshot initiative, combined with a renewed… Read More »

To Address Synthetic Opioids, These Public Health Strategies Must Play a Vital Role

By | February 14, 2022

The opioid epidemic and substance use disorders have garnered national attention as overdose deaths continue at an alarming rate. Synthetic opioids – chiefly fentanyl – are the culprit in many of those deaths. The Commission’s report Earlier this month, the bipartisan Congressional Commission on Combating Synthetic Opioid Trafficking, with representatives from many Federal agencies and… Read More »

Imputing Race & Ethnicity: Part 2

By | August 26, 2021

Part 1 of this two-part series laid out arguments for and shortcomings of imputing race/ethnicity from the perspective of health equity. In this post, we’ll talk about gaps in the evidence and a few alternatives to imputation, including approaches involving population-level and neighborhood-level data. Imputation is a common solution to deal with “the missing-data problem.”… Read More »

Imputing Race & Ethnicity: Part 1

In Part 1 of this two-part series (originally published Aug. 19, 2021), we lay out arguments for and shortcomings of imputing race/ethnicity from the perspective of health equity. In Part 2, we’ll talk about evidence gaps and research needed, as well as a few alternative approaches. The Biden administration is focusing on health equity and… Read More »

Monitoring EMS data for substance use

The United States is currently experiencing multiple, simultaneous epidemics that claim thousands of lives every week. According to the CDC, over 81,000 drug overdose deaths occurred between June 2019 and May 2020. That’s the highest number of overdose deaths ever recorded in a 12-month period. An estimated 93,000 Americans die annually from alcohol-related causes. Many… Read More »

Artificially intelligent social risk adjustment

By | December 10, 2021

What accounts for large differences in life expectancy from one neighborhood to another? This post explains what our team has discovered so far using an “artificially intelligent” approach to understanding social risk at the local level. Where you live affects how long you live In 2018, when the National Center for Health Statistics released the… Read More »

End-of-year post: 2020 edition

By | December 28, 2020

This past year at The Medical Care Blog has been quite an adventure. Like the rest of humanity, we were thrown into a whole new reality with the COVID-19 pandemic. Our first posts about SARS-CoV-2 (the novel coronavirus) and COVID-19 (the disease it causes) began in mid-March and haven’t stopped since. All told — across… Read More »

Are DRG-based Reimbursements Appropriate for COVID-19?

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 »

The myth of female hysteria and women’s health disparities

By | March 5, 2020

What role might the myth of “female hysteria” play in women’s health disparities? For thousands of years, women’s health complaints were often diagnosed as “female hysteria” – a catch-all term that basically implied “it’s all in her head.” The condition was sometimes believed to be caused by a wandering uterus and/or sexual frustration. Doctors treated… Read More »

Adjusting publicly reported performance measures for social risk factors

By | March 18, 2020

With the current focus on social risk factors (SRFs) affecting health care, it is not surprising that methods for comparing hospital performance might do well to account for such factors in their assessment. If up to 70 percent of health outcomes are driven by factors beyond medical care, and measures used to compare hospitals focus… Read More »

Care experiences among Medicare beneficiaries with cancer: A cross-study overview of published results to date from SEER-CAHPS

Medicare beneficiaries who have cancer are a growing population with unique care needs. Population-based research examining relationships between cancer patient experiences, health care utilization, and subsequent patient health outcomes is lacking. A recently updated data resource called SEER-CAHPS links cancer registry data with Medicare information and patient surveys. It provides a comprehensive, nationally representative source… Read More »

Stroke risk has declined in the US — for some groups more than others

By | April 18, 2019

The risk of having a stroke has gone down over the past 25 years among older people in the US, according to new research by Yao and colleagues published this month in Medical Care. The study combined data from several different nationally representative data sources, including Medicare claims and survey data from NHANES and MCBS.… Read More »

In Massachusetts, primary care sensitive emergency department use persists 5 years after health reform

Primary care sensitive (PCS) emergency department (ED) use is a measure that highlights the connection between primary and emergency care. The right care, for the right person, in the right place, at the right time is a reasonable goal of a high-quality health system. In the US, however, many people go to the emergency department… Read More »

Health Wonk Review – November 2018

By | November 15, 2018

Greetings from San Diego, where we’re just wrapping up the 2018 meeting of the American Public Health Association. It’s been a whirlwind stretch of great presentations, engaging conversations, and electric scooters! Have you seen these things? I was surprised at how many of my public health colleagues were willing to ride without a helmet… But… Read More »

Insurance-Based Discrimination: Evidence and Consequences

A relatively undiscussed and unconsidered form of discrimination continues to plague our health care institutions. It’s about time we talk about it. Insurance-based discrimination is the prejudicial treatment of a patient based on his/her insurance status. This type of discrimination mostly affects the 28.9 million Americans who have no health insurance coverage, although there is… Read More »

BRIEF: Out-of-pocket costs for Alzheimer’s disease

By | July 26, 2018

Alzheimer’s disease and related dementias (ADRD) affect about 5.7 million people in the US. Although most of those affected are covered by Medicare, many of the medical costs are not covered by insurance and must be borne by patients and their families. Total costs of care for ADRD have been estimated at more than $277… Read More »

An exercise in frustration: Barriers to obtaining healthcare information online

In a graduate course this semester (at the Temple University College of Public Health) on Healthcare Quality and Safety, one of the assignments is to explore the internet to learn about how consumers/patients without specific healthcare knowledge might get information on quality of care.  When students enter “consumer healthcare information” in Google, the first result… Read More »

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

By | September 29, 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 »

Universal Health Coverage? A Response

In a recent Health Affairs blog post, Universal Health Coverage? Why?, Walter McClure, Alain Enthoven, and Tim McDonald make a convincing case for expanding health insurance coverage in the United States. They argue that universal coverage is a “wise public investment” that “expands the workforce and makes it more productive,” similar to universal public education.… Read More »

Getting recommended preventive care: costs aren’t the only barrier

By | August 3, 2017

Annual routine check-ups, flu shots, and mammograms are among the basic preventive services for which the Patient Protection and Affordable Care Act of 2010 established a mandate for insurance plans: full coverage, with no out-of-pocket costs. In making it a little easier for some parts of the US population to access basic services, did the… Read More »

New methods in risk modeling: does adding EHR data improve predictions?

By | July 20, 2017

One of the challenges in delivering efficient medical care is identifying people who are at risk of a negative outcome, so we can focus our efforts on screening and treating those at elevated risk. We do this in individual face-to-face encounters through clinical, diagnostic processes: taking a patient’s history, performing a physical examination, recording signs… Read More »

Cancer care: sometimes less is more

By | July 13, 2017

Cancer is a dreaded disease – and in the US, a typical response to a cancer diagnosis is to try every treatment available in hopes that something might work. Understandable! But cancer overtreatment is a serious problem that drives up costs, causes avoidable morbidity and mortality, and reduces the quality of care. What is overtreatment?… Read More »

The Past, Present, and Future of Risk Adjustment: An Interview with Arlene Ash

By | June 14, 2018

Recently, I sat down to talk with Arlene Ash, PhD about risk adjustment. Dr. Ash is Professor and Chief of the Division of Biostatistics and Health Services Research, Department of Quantitative Health Sciences at the University of Massachusetts Medical School. As a methods expert on risk adjustment in health services research, she has pioneered tools… Read More »

POLICY UPDATE: Contraception Coverage

The burden of contraception falls primarily on women. In the United States, women need prescriptions for the majority of contraceptive methods, and so are vulnerable to changes in the healthcare system affecting access to care. Recently, President Trump has issued executive orders on religious liberty and related subjects that have paved the way for a rule… Read More »

The Childhood Roots of Health Inequity: Part 4 – Dr. Jennifer Manly

By | April 27, 2017

This post is the final one in our 4-part 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, part 3]. Our fourth presenter, Dr. Jennifer Manly, is Associate Professor of Neuropsychology in Neurology at the Gertrude H. Sergievsky Center and the… 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 »

How did Part D affect mortality among women with breast cancer?

By | February 27, 2017

Ten years ago, Medicare began publicly financing and subsidizing the prescription drug program for seniors known as Part D. Individuals over age 65 with incomes below poverty are dually eligible for both Medicaid and Medicare, and full-benefit dual enrollees are automatically enrolled in a subsidized prescription drug plan with minimal co-payments. Turns out, this policy intervention may have played… Read More »

Chronic pain, opioids, and medical marijuana

By | February 4, 2017

High-quality evidence supports the use of medical marijuana for chronic pain, neuropathic pain, and other conditions. Yet, patients who live in some states can’t legally use it — and are threatened with loss of access to their prescribed pain medications if they do. I know this because a close family member of mine has chronic pain.… Read More »