Our data says a lot about us – where we go, who we see, and what we do. And since our smartphones come with us everywhere, they are almost always collecting our data. To improve my understanding of how our data and devices can be used to fight the COVID-19 pandemic, I sat down with (over… Read More »
Health care and public health loom large today, on the eve of the presidential election. From COVID-19 to the Affordable Care Act (ACA), this is now clearly a public health election. Let’s review what’s on people’s minds and what’s at stake. Where are voters on health issues? In February of this year, health care was… Read More »
As I scrolled through Ms. Jones’ chart, I jotted down her chronic problems: hypertension, depression, and urinary incontinence. She was taking lisinopril and sertraline. She had seen gynecology back in February for surgical management of the incontinence. The chart said she wanted a hysterectomy as “definitive management.” It seemed the surgery was canceled due to… Read More »
Millions are losing sleep due to anxiety, fear, and the difficulty of maintaining a schedule during this pandemic. Research suggests that those who get insufficient sleep may be at risk for health conditions such as obesity and heart disease. Yet, too much sleep may increase the risk of other health conditions such as diabetes and… Read More »
It’s that time again! The annual meeting for the American Public Health Association starts on October 24th with a twist–this year, the meeting is being held virtually. Everything from social events to scientific sessions will take place online. While I will miss seeing old and new friends in person, I am excited about the meeting.… Read More »
Historically, women are disproportionately impacted by pandemic illness and COVID-19 is no exception. Addressing domestic violence (DV) and access to reproductive healthcare may reduce the gendered impact of COVID-19. Before the COVID-19 pandemic, we piloted a program to enhance reproductive health literacy, Sexual Health Empowerment for Birth Control (SHE-BC). This program may offer insights to… Read More »
Earlier this fall the American Public Health Association (APHA) released a remarkable report on the relationship between Housing Equity and Health, “Creating The Healthiest Nation: Health and Housing Equity.” APHA’s Caucus on Homelessness is deeply appreciative of the report’s focus on US housing inequalities and the shortcomings of our current affordable housing programs to address… Read More »
The Veterans Health Administration (VA) has expanded research and education on complementary and integrative health (CIH) programs, focusing on pain, mental health, and chronic illness. CIH programs are a part of “Whole Health,” an approach to support veterans’ health and well-being. A recent Medical Care supplement contains several articles on the effectiveness and implementation of… Read More »
In March, CMS and other Federal agencies announced temporary telehealth policy changes in response to the COVID-19 public health emergency. These changes promoted continued access to care while allowing for physical distancing. Virtual care encounters have increased since March. However, as the public health emergency has continued, there are questions about the future of virtual… Read More »
Preserving access to care is a high priority, even in a pandemic. We need to strengthen the existing coordinated regional treatment network for better preparedness. One consequence of the COVID-19 pandemic has been that people are scared to seek health care because they fear getting infected in clinics and hospitals. Although in many cases it… Read More »
COVID-19 has exposed the cracks in the foundation of America’s rural community health system. These cracks include increased risk of facility closures, loss of services, low investment in public health, maldistribution of health professionals, and payment policies ill-suited to low-volume rural providers. As a result, short-term relief to stabilize rural health systems and long-term strategies… Read More »
Health equity and the disparities within our health care system were the predominant themes at AcademyHealth’s 2020 Annual Research Meeting (ARM), which concluded on August 6th. As usual, health services researchers gathered to disseminate the latest evidence across a broad range of health care topics and discuss the most pressing issues in health services research… Read More »
What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »
Note from the Editors: Last week capped two jam-packed weeks of political nominating convention activities. COVID-19 was discussed at both conventions. The Washington Post fact-checked some of the health care claims at the Democratic convention. Here, with the permission of Kaiser Health News and Politifact, we are republishing their recent fact-checking of the COVID-19 content from the Republican… Read More »
Climate change is a contributory factor to wildfires in California this year that have engulfed 1.4 million acres of land. Most recently, lightning strikes sparked new fires in Northern California, including the L.N.U. Lightning Complex (currently the third largest fire in California history). Wildfires contribute to poor health outcomes and disrupt care delivery. In addition, the… Read More »
Provider contracting may sound dull, but it can have big impact on patients. Contracting may not be the first thing you think of when choosing a provider or facility. It may also not be something you have a lot of control over. But because of surprise billing, provider contracting can have a big effect on… Read More »
The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »
To be at the intersection of technology and product development in a field as ripe for disruption as healthcare couldn’t be more opportune. But how can we use technology to improve community health, especially after COVID-19? Technology and Health: A Budding Relationship On April 10th 2020 the Apple-Google partnership announced a notification tool for contact tracing to support… Read More »
The U.S. government is reportedly harming people held in immigration detention centers with its excessive use of a common disinfectant. According to reports by immigrant advocacy groups, HDQ Neutral disinfectant is being sprayed dozens of times per day in enclosed environments. This is resulting in concerning health symptoms among detained people. This potentially egregious practice further… Read More »
Postpartum depression is common, preventable, and treatable. The Agency for Healthcare Research and Quality (AHRQ) challenge competition, “Cross-Sectional Innovation to Improve Rural Postpartum Mental Health,” identifies what communities are doing to improve access to mental healthcare for rural women. Furthermore, the challenge seeks new solutions to ensure that more women and families receive the help… Read More »
As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for… Read More »
A new study out this month in Medical Care by Yongkang Zhang and colleagues finds that people in struggling neighborhoods have considerably higher spending on potentially preventable health care. While overall health care spending was similar between the most deprived areas and average communities, the finding about spending on potentially preventable health care tells an… Read More »
In this series on options for universal coverage, we explore elements of various reform proposals and evaluate their potential impact. Rather than examining complete proposals, we highlight specific policy elements that appear in one or more such proposals. The three we focus on in this series are: Part 1 – Eliminating Medicare Advantage (May 14,… Read More »
We don’t always think of health insurers as communicators. However, when insurers set reimbursement rates, they provide information that directly influences service delivery. When payors reimburse for certain services, they are informing providers these services are valued and providing these services is encouraged. When payors do not reimburse for services, or reimburse at lower rates,… Read More »
Nursing facilities have been in the center of the COVID-19 pandemic and experienced sweeping policy changes. The pace of change has made it difficult to keep track of each new policy, so this post summarizes the key shifts from January through May. Nursing facilities are attempting to protect residents by ramping up existing infection control… Read More »
In this post we reflect on the definition of success in a study measuring the value of peer support services administered through the HUD VASH program and discuss client-centered definitions of value. We propose designing and understanding programmatic success goals tailored to unique need categories within veteran participant groups. With stay-at-home orders lifting all across… Read More »
Over the past two decades, research has helped identify ways to reduce complications among people with diabetes and laid the foundation for primary prevention. However, prevention and treatments are still unequally applied, and social, economic, and age-related disparities persist. The June 2020 supplement issue of Medical Care argues for and presents the results of natural… Read More »
Like the rest of society, the US health insurance system is going to change in the wake of the COVID-19 pandemic. The question is whether changes will be made deliberately, through policy actions, or reactively, through the markets. The American health care system has been at the forefront of the COVID-19 crisis in more ways… Read More »
We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »
May 6 heralded another grim milestone in the United States: the first COVID-19-related death of an Immigration and Customs Enforcement (ICE) detainee, a 57-year-old man from El Salvador. Despite having high blood pressure and possibly diabetes, he had been denied release on bond by a judge. He continued to be held in Otay Mesa Detention… Read More »
Every night at 8pm, my neighborhood in Los Angeles, like many, cheers for the front-line health care providers who care for our communities. My family joins in the nightly raucous thanks. But a few nights ago, we paused. Where were the cheers for the public health professionals? Medical professionals have been in the spotlight, doing the… Read More »
We are in the midst of two global public health catastrophes: the rapid spread of COVID-19 and the more insidious, chronic effects of climate change. The swift spread of COVID-19 has devastated many countries and their economies. But global changes in environmental conditions have been harming communities for decades. The World Health Organization estimates that… Read More »
With the 2020 US presidential election drawing near, debate about the options for universal coverage will ramp up. At the heart of this debate is the estimated 45% of US adults who are either uninsured or under-insured. They are at risk of experiencing financial hardship or going without needed care in a time when access to… Read More »
For decades, peer-reviewed journals have been a critical pathway for disseminating and advancing scientific knowledge. However, curbing the spread of misinformation requires evidence translation by experts into plain English. The rapidly evolving knowledge base on COVID-19 shines a spotlight on the issue. For example, a recent article in the New England Journal of Medicine offered… Read More »
While working as a nurse, I remember one instance of caring for two patients who were twins. Along with the same birthday and the same last name, they both had very similar first names. The twins were roughly around the same height, the same weight, and also had the same hair color. At first glance… Read More »
COVID-19 has revealed many vulnerabilities in our societal structure. One particular vulnerability is the risk inherent in our use of congregate institutions to house and treat people. This includes the risks of inpatient psychiatric facilities. Inadvertently, the pandemic has surfaced critical questions that we should seek to answer even when the virus is under control: What is the right… Read More »
Who is essential to the basic functioning of society? Who has to work to enable millions of us to stay safe in our homes during the COVID-19 pandemic? At some level, we all want to think that our jobs are “essential,” and in many senses, they are. They allow us to put food on the… Read More »
As of April 17, 2020, the novel coronavirus has infected more than 2.4 million people globally and led to 170,000 deaths. The global response to the COVID-19 pandemic largely emphasizes social distancing and shelter-in-place ordinances. These policies impact everyone, also upending the lives of those not directly affected by the virus COVID-19 pandemic. Like other… Read More »
Women do not stop needing access to abortions in a pandemic. They should not need to place themselves and others at risk of COVID-19 to access one. But that is exactly what is happening — due in part to new bans, but mostly as a result of years of dwindling access across the country. The current… Read More »
In early April, President Trump, in his daily press briefing, told Americans to take the drug hydroxychloroquine, calling it a “game changer” for people with COVID-19: “I really think they should take it. But it’s their choice. And it’s their doctor’s choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you’d like.”… Read More »
There is a lot of attention being paid to the proportions of severe and fatal cases in discussions of COVID-19. Unless you’ve been living under a rock since January, you know that there are groups who are more likely to get very sick or die during this pandemic. In this post, we explore the evidence… Read More »
We have seen hospitals filled, high daily death tolls, and exhausted healthcare workers in large cities, like New York and Seattle. How will COVID-19 affect rural America? While initially many rural Americans felt protected by nature of their location, they are now feeling the effects of COVID-19 close to home. Small towns may serve as… Read More »
The current requirements for social distancing affect support groups for people with substance use disorders, but online support groups may provide the perfect solution. This post is the first in a series of planned posts on telehealth for addiction. COVID-19, the disease caused by the novel coronavirus called SARS-CoV2, is putting tremendous strain on all… Read More »
The COVID-19 pandemic is placing healthcare professionals in the untenable position of rationing personal protective equipment (PPE) and working with suboptimal protection. This post explores which materials may be best suited for crafting homemade masks and considers how to use homemade masks productively. Personal protective equipment is critical when caring for patients with respiratory infection.… Read More »
The rapid emergence of COVID-19 reminds us of the importance of the public health system. Local health departments (LHDs) play a central role in emergency preparedness and response. Effective epidemic response rests on the performance of the essential public health activities— assessment, policy development, and assurance—by LHDs. Evidence suggests that LHDs can improve population health… Read More »
This post summarizes what we know right now about the SARS-CoV-2 virus and the disease it causes, COVID-19. The information contained in this post may change as the situation changes, or may become obsolete. We will attempt to update if any of this changes substantively. News and social media outlets have fallen short of useful… Read More »
COVID-19, the disease caused by the novel coronavirus, is spreading across the US and around the world. Can providers use telehealth to help identify and manage the novel coronavirus while helping organizations manage capacity and prevent the spread of COVID-19? Read on to find out more. Because of its airborne person-to-person transmission, coronavirus and related… Read More »
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 »
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 »
Patients are sometimes referred to as “frequent flyers” when they visit an emergency department multiple times for the same issue. Often this is because discharged patients miss necessary follow-up care. This results in further worsening health, and may contribute to the frequent flying. To address this cycle, patients may be referred to a community health… Read More »