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 »
In this episode of our podcast series, Greg Stevens discusses health care provider burnout with Cooper Couch, a practicing physician assistant at an FQHC in rural Colorado. Next, he recaps the blog posts published in February and previews an article published in the April issue of Medical Care. Authored by Jae Downing, Kendall Lawley and Alex McDowell,… Read More »
In today’s healthcare system, measurement influences everything from quality improvement to payments. So it matters greatly what gets measured. Measuring what matters to patients and their family caregivers will focus healthcare on their needs, preferences, and values. In a recent measure development effort, we brought lived and professional experience together at every stage. We found… Read More »
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 »
When COVID-19 forced sudden lockdowns in 2020, Americans realized quickly that the supply of services available at home did not match growing quarantine demands. Both the public and private sectors responded with shifts to delivering contact-free services. That pandemic shift may have long-term benefits for older adults seeking services to support aging in place. Pandemic… Read More »
We’re in a new landscape, where citizens sees themselves as agents for community public health and as part of the public health infrastructure. My patient began to talk about COVID in her community. She first told me the rates of infection from the previous weeks. Then she told me what COVID strains were dominant at… Read More »
In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in February. She also previews a few of the journal articles published in this month’s issue of Medical Care. Next, Lisa Lines, co-editor, discusses an article published ahead of print on March 1. The article is available here:… Read More »
Almost 30 years ago I was working in the White House as part of a team working to win approval of President Bill Clinton’s proposal for universal health insurance. The effort was winding down. It was obvious it would fail. I was tired and depressed. One of my last appearances in support of the plan… Read More »
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 »
In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in January. Next, Jess Williams, co-editor, interviews Nien Chen Li about her recently published paper — a winner of the APHA Medical Care Section’s Student Paper Award in 2020. Dr. Li’s paper is about… Read More »
Evaluating community health worker (CHW) programs can be difficult. Many of the outcomes that we care about, such as patients’ capacity to live healthier lives, can be difficult to measure and take time to manifest. I have been fortunate to be part of a five-year research partnership with the KC Care Health Center that was… Read More »
Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »
Last week, we detailed the findings of virtual convenings we held in North Carolina to improve care for children with complex health needs (CCHN). Here, we share our takeaways about the process of planning, holding and following-up on the convenings. We also outline the specific steps other leaders, innovators, and advocates can take to engage… Read More »
Children with complex health needs (CCHN) are a unique pediatric patient population. They have chronic medical and/or behavioral conditions that need ongoing health care. They use a disproportionate share of hospital resources. And they face greater social challenges when compared to other children. In North Carolina (where we work) and across the country, CCHN fail… Read More »
In this episode of our podcast series, Greg Stevens, co-editor, recaps the blog posts we published on The Medical Care Blog in November and previews the January issue of Medical Care. Greg also interviews Dr. Ben King from the University of Houston School of Medicine about their shared interest in health care for people experiencing homeless.… Read More »
To help determine which health policy changes to the Medicare or Medicaid programs are desirable, the CMS Center for Medicare and Medicaid Innovation (CMMI) relies on formal evaluations, performed by outside contractors, of how smaller scale, typically voluntary, demonstrations and other initiatives impact outcomes of interest. However, determining causal impacts often relies on the key… Read More »
More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »
“You can’t improve what you don’t measure” is a common phrase highlighting the importance and power of data. Indeed, the importance of data was the central theme of the 2021 All In National Meeting. In case you’re unfamiliar, the host of the national meeting is All In: Data for Community Health: a learning network of… Read More »
COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and… Read More »
In our last blog post, we discussed the Biden Administration’s infrastructure package as an example of an upstream policy effort that could promote equity and help address disparities. However, as we pointed out in the first in this series of blogs, stakeholders who interact with community members are best suited to identify social risk factors… Read More »
In this episode of our new podcast series, Jess Williams, co-editor, recaps the blog posts we published on The Medical Care Blog in November and previews the December issue of Medical Care. As a bonus, Lisa Flaherty from the APHA Medical Care Section interviews two of our December contributors: Dr. Sharla Smith, founder of the… Read More »
In the United States, 700 women die every year from often preventable pregnancy or childbirth complications. An additional 60,000 more experience highly preventable birth injuries. Black women are three times more likely to die from those complications than white women. According to the CDC, the maternal mortality rate in the U.S. is roughly 17.4 maternal… Read More »
While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States, Black women are three times more likely to die from a pregnancy-related complication than white women. In Kansas, Black women are more than three times as likely to die of pregnancy-related complications compared to… Read More »
The pace of progress is never fast enough for those who stand to suffer the biggest losses. Nowhere is this more apparent than in the glaring health inequities impacting Black mothers and babies in Kansas. Among the multitude of injustices Black Kansans face today, the disproportionate rates of death and devastating health complications for Black… Read More »
Medical care is sometimes, though not on this blog, viewed as the gold standard to address inequities. However, access to medical care only accounts for an estimated 10-20% of the modifiable factors that affect population health. The other 80-90% of modifiable factors are often referred to as social determinants of health (SDOH). These are the… Read More »
The Alzheimer’s Association’s 2021 Alzheimer’s Disease Facts and Figures report [PDF] shares that currently, six million Americans are living with Alzheimer’s disease, a number that has increased 145% since the turn of the century. Around the world, there are 50 million people living with Alzheimer’s disease or related dementia. Only a quarter of would-be patients… Read More »
In Los Angeles, the nation’s homelessness epidemic is playing out in broad relief. Criticized for an inability to visibly stem the local crisis, Los Angeles is now responding. Opening villages of tiny homes for people experiencing homelessness is part of a recent package of efforts gaining traction in the city. The situation in Los Angeles… Read More »
Check out our November 2021 Podcast for a recap of recently published blogs and a preview of articles in the November 2021 issue of Medical Care.
During the pandemic, telemedicine demonstrated it’s power. As we begin to make the shift back to in-person clinical care in a post-pandemic world, it’s important to look at the lessons learned during the pandemic. This will help guide us in how to move forward and improve telemedicine delivery. The History The use of telemedicine is… Read More »
The annual meeting of the American Public Health Association starts this weekend! This year the meeting is being held in person in Denver with lots of virtual options as well. I know everyone is excited about getting back together and connecting as a community. I can’t wait to connect with friends and colleagues and meet… Read More »
The COVID-19 pandemic has strained healthcare and public health. Many workers in these industries have felt growing frustration with leadership. They face a barrage of medical misinformation, ethical strains, and burnout. Now more than ever, authentic leadership is critical in supporting healthcare workers and advancing public health. This post will describe authentic leadership and examine… Read More »
COVID-19 has uncovered and multiplied health workforce equity challenges across the US. In the early days of the pandemic, healthcare workers faced incredible personal risk from an unknown, highly contagious, deadly disease. Insufficient personal protective equipment (PPE) and reprimand and dismissal by employers for speaking out worsened this risk. As waves of COVID-19 swept across… Read More »
In March 2020, the Centers for Disease Control and Prevention (CDC) confirmed COVID-19 as a pandemic. More than 18 months later, the nation has yet to return to ‘normal’. Hope for normalcy increased with the rollout of COVID-19 vaccines in the months that followed. Reluctance and resistance to vaccination, however, have made it difficult to… Read More »
Front-line workers are always at risk. It’s in the name. The COVID-19 pandemic has made this reality more salient for everyone. Risks of sickness from COVID-19 include death and morbidity. Front-line workers may also have lost more friends and co-workers than the average person. Healthcare workers have also been subject to violence and see the… Read More »
Homelessness persists in the US, and across the world, despite decades of recognition and longstanding efforts to end the condition. There have been major successes in our understanding of what policies and programs work to prevent and end homelessness. However, the work must and will find new ways to adapt and improve if we are… Read More »
Nonprofit hospitals make up the majority of hospitals in the US. In exchange for their tax-exempt status, the federal government requires these hospitals to provide support in the form of community benefits. Tracking community benefit spending and its impact is important to ensure that such spending aligns with community needs. Community benefit activities can include… Read More »
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 »
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 »
How is research on patient-centered transitional care going? A supplement on this topic funded by the Patient-Centered Outcomes Research Institute (PCORI) was recently published in Medical Care. Care transitions are “ripe with hazard,” as discussed in an editorial from Amy Berman. As pointed out by Berman, figuring out what works and what doesn’t is critical to… Read More »
It’s hard to turn down a free lunch. It’s perhaps a little harder still if you’re paying for the free lunches of others. Yet, a decade after the passage of the Affordable Care Act (ACA), that’s what is happening in some states. Legislatures opposed to the ACA are refusing federal dollars for Medicaid expansion; dollars that other… Read More »
Until a few years ago Veterans generally had to visit a Veterans Affairs (VA) facility to receive care. Long wait times and long travel times caused problems for Veterans who needed healthcare. In response, the VA MISSION Act (2018) expanded access to community providers and increased benefits for caregivers. A recent supplement in Medical Care explores some… Read More »
Efforts to achieve herd immunity to COVID-19 in the U.S. have stalled out. Currently, just about 68% of all U.S. adults have received at least one dose, despite vaccines being widely available. This is due, in great part, to a “misinformation pandemic” that now threatens public health. With many people still spending considerable time working from… Read More »
The pandemic has highlighted the challenge health care providers face in translating new scientific findings to actual patient care. The integration of COVID-19 monoclonal antibody treatment is a good example of this challenge. Frustration at a Local Hospital In a year of difficult days, my mom came home from work one evening in March especially… Read More »
The US maternal mortality rate is higher than it was a quarter of a century ago. For every one person that dies, another 65 almost die. We do not adequately care for mothers and mothers-to-be. Not only that, but as providers, we inadvertently (and at times overtly) inflict obstetric violence, through both individual actions and our… Read More »
The global Covid-19 pandemic came with financial, emotional, and physical health implications for just about everyone worldwide. Along with those burdens, a significant strain was placed on resources, people, and systems. Issues that were lingering just beneath the surface bubbled up, inequities became highlighted, and urgent outcries and demands for swift solutions became harder to… Read More »
The pandemic has familiarized us all with the phrase “medical mistrust,” often framing those who have it as being irrational or uninformed. Oft ignored is the biomedical community’s long legacy of broken trust. Addressing cancer-related inequities will require health professionals to make concerted efforts to repair that broken trust. Cancer and Broken Trust People of… Read More »
The Biden Administration’s proposed infrastructure investments are an example of an upstream effort to address disparities related to social determinants of health (SDOH). As mentioned in our previous blog post, SDOH are the conditions or circumstances within which people live, and these differ based on the distribution of power, money, and resources. The systems and… Read More »
Long-term services and supports (LTSS) for older adults and persons with disabilities have become a policy priority. The American Rescue Plan and the proposed American Jobs Act aim to increase LTSS spending through the Medicaid program, particularly for Home- and Community-Based Services (HCBS). These measures would address the need for wider service availability, while presenting… Read More »
During its recent mid-year meeting, the American Public Health Association’s Medical Care Section was honored to hear from two physician leaders serving at the heart of the fight against COVID-19. Hailing from opposite ends of the country, Drs. Atul Nakhasi (California) and Ayne Amjad (West Virginia) shared their insight about teamwork in a public health… Read More »