Category Archives: All

Is Medicaid expansion enough to encourage people to get Mental Health care?

By | January 7, 2021
0 Comment

Low-income households across the US are more likely to be uninsured or under-insured.  Medicaid Expansion paves a path for low-income Americans to obtain access to care.  Working-aged underinsured individuals tend to get later medical care and too little care–resulting in poorer health outcomes. Even insured individuals may delay necessary care because of cost. A 2018… Read More: Is Medicaid expansion enough to encourage people to get Mental… »

Telehealth in Jails and Prisons: Part 2

By | December 18, 2020
0 Comment

This is Part 2 of my interview with Saira Haque, PhD a telehealth expert and the Director of RTI’s Data Interoperability and Clinical Informatics program, and Nick Richardson, PhD a research analyst in RTI’s Applied Justice Research division. Part 1 is here. What are the benefits to using telehealth? Dr. Haque: As mentioned earlier, it… Read More: Telehealth in Jails and Prisons: Part 2 »

Telehealth in Jails and Prisons: Part 1

By | December 21, 2020
0 Comment

As the COVID-19 pandemic continues, telehealth is becoming increasingly ingrained within our healthcare system. This includes environments beyond the traditional office or hospital setting. With 2.3 million people currently residing in US jails or prisons, healthcare delivery to justice-involved individuals (JIIs) is an important component to consider. (Note: the term “justice-involved individual (JII)” refers to those… Read More: Telehealth in Jails and Prisons: Part 1 »

Student Voices at The Medical Care Blog

By | December 14, 2020
0 Comment

The Medical Care Blog regularly welcomes and features the voices of students from public health, medicine and other health professional fields. Most of our student contributors are earlier in their careers than the health care providers, public health professionals, and academic researchers who contribute to our dialogue most often. But they are frequently experts in… Read More: Student Voices at The Medical Care Blog »

Pediatric Payment Models for Child Health Services

By | December 11, 2020
0 Comment

How could alternative pediatric payment models help to address children’s broad health, social, and developmental needs? This post delves into funding and financing challenges and potential solutions. I recently collaborated on a report on alternative payment models for child health with colleagues from the Duke Margolis Center for Health Policy and Mental Health America. The… Read More: Pediatric Payment Models for Child Health Services »

Student Blog Contest!

By | March 25, 2021
0 Comment

Now more than ever, we need students engaged in improving healthcare access, delivery, and quality. The Medical Care Blog is committed to elevating student voices on these and other public health topics. To encourage excellent student blog posts, we are sponsoring a blogging competition with the Medical Care Section of the American Public Health Association.… Read More: Student Blog Contest! »

Pandemic Reminds Us to Pay Attention to Lack of Supplement Regulation in the U.S.

By | November 21, 2020
0 Comment

During the COVID-19 pandemic, health misinformation has been soaring across the internet and social media platforms. Despite a lack of supplement regulation, vitamin and supplement use have seen a sudden 28% increase in the US and a 25% increase globally during COVID-19. Vitamin C supplements have gained particular attention because of studies finding it might reduce… Read More: Pandemic Reminds Us to Pay Attention to Lack of Supplement… »

Becoming dementia friendly: Less stigma, more inclusion, better care

By | November 11, 2020
0 Comment
Older man

With a growing recognition of the toll that dementia takes on individuals, families, and communities, there is a movement to prepare our society to better meet the needs of people living with dementia. This movement is referred to as becoming “dementia friendly,” and it can reduce stigma, increase inclusiveness, and improve care. A family example… Read More: Becoming dementia friendly: Less stigma, more inclusion, better care »

Using Digital Technologies for COVID-19 Exposure Notification and Tracking

By | November 8, 2020
0 Comment

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: Using Digital Technologies for COVID-19 Exposure Notification and Tracking »

On the Eve of a Public Health Election

By | November 2, 2020
0 Comment

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: On the Eve of a Public Health Election »

Racism in Reproductive Care and Beyond

By | October 29, 2020
0 Comment

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: Racism in Reproductive Care and Beyond »

Is Sleep Driving Up Your Medical Costs?

By | October 22, 2020
0 Comment

  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: Is Sleep Driving Up Your Medical Costs? »

APHA 2020 Annual Meeting Preview

By | October 21, 2020
0 Comment

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: APHA 2020 Annual Meeting Preview »

Addressing reproductive coercion during the COVID-19 pandemic

By | October 16, 2020
0 Comment

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: Addressing reproductive coercion during the COVID-19 pandemic »

Health and Housing Equity: a new report released by the American Public Health Association

By | October 12, 2020
0 Comment
Row of stone buildings with boarded up windows, with new tall buildings all around.

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: Health and Housing Equity: a new report released by the… »

Complementary and integrative health in the VA

By | October 8, 2020
0 Comment

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: Complementary and integrative health in the VA »

What’s next for virtual care after the pandemic?

By | October 6, 2020
0 Comment

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: What’s next for virtual care after the pandemic? »

Maintaining healthcare access during outbreaks

By | October 6, 2020
0 Comment

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: Maintaining healthcare access during outbreaks »

Rebuilding the Foundation of Rural Community Health after COVID-19

By | September 17, 2020
0 Comment

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: Rebuilding the Foundation of Rural Community Health after COVID-19 »

Health Equity: Lessons from AcademyHealth 2020

By | September 21, 2020
0 Comment

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: Health Equity: Lessons from AcademyHealth 2020 »

Potential effects of COVID-19 on health care utilization and quality measures

By | September 17, 2020
0 Comment

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: Potential effects of COVID-19 on health care utilization and quality… »

A Revisionist History of COVID-19

By | August 31, 2020
0 Comment

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: A Revisionist History of COVID-19 »

Wildfires: Effects on Health and Care Delivery

By | August 27, 2020
0 Comment

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: Wildfires: Effects on Health and Care Delivery »

Surprise Billing: Why Provider Contracting May Matter to You

By | August 27, 2020
0 Comment

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: Surprise Billing: Why Provider Contracting May Matter to You »

After COVID-19, We Must Build Back Better

By | August 17, 2020
0 Comment

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: After COVID-19, We Must Build Back Better »

Using Technology to Improve Community Health After COVID-19

By | August 12, 2020
0 Comment

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: Using Technology to Improve Community Health After COVID-19 »

In COVID-19 Response, ICE May Be Misusing a Common Disinfectant in Detention Facilities

By | August 6, 2020
0 Comment

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: In COVID-19 Response, ICE May Be Misusing a Common Disinfectant… »

Rural Postpartum Mental Health: the Challenge to Improve

By | July 17, 2020
0 Comment
Depressed mother with baby

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: Rural Postpartum Mental Health: the Challenge to Improve »

COVID-19 & Violence Against Healthcare Workers

By | July 13, 2020
0 Comment

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: COVID-19 & Violence Against Healthcare Workers »

A story of primary care: neighborhood deprivation and health spending

By | July 2, 2020
0 Comment
this image shows a blighted area of a downtown city, which is used to represent a neighborhood likely to be among the most deprived.

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: A story of primary care: neighborhood deprivation and health spending »

Options for Universal Coverage: Part 2 – Eligibility and Enrollment

By | June 25, 2020
0 Comment

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: Options for Universal Coverage: Part 2 – Eligibility and Enrollment »

Medicare Advantage and Reimbursement to Address Social Risk Factors

By | June 22, 2020
0 Comment

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: Medicare Advantage and Reimbursement to Address Social Risk Factors »

The Challenge of Change: Tracking COVID-19 Policy Updates for Nursing Facilities

By | June 15, 2020
0 Comment

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: The Challenge of Change: Tracking COVID-19 Policy Updates for Nursing… »

Framing Success for Supportive Housing Services

By | June 11, 2020
0 Comment

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: Framing Success for Supportive Housing Services »

Natural Experiments for Diabetes

By | June 7, 2020
0 Comment

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: Natural Experiments for Diabetes »

Born in a Crisis: How COVID-19 May Change the US Health Insurance System

By | June 4, 2020
0 Comment

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: Born in a Crisis: How COVID-19 May Change the US… »

#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020
0 Comment

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: #SexEdForAll: What We Need to Prevent Intimate Partner Violence »

Spain, Belgium, and Others Are Releasing Immigrant Detainees During COVID-19. Why the United States Should, Too

By | May 29, 2020
0 Comment

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: Spain, Belgium, and Others Are Releasing Immigrant Detainees During COVID-19.… »

For pennies on the dollar, public health is succeeding out of the spotlight

By | May 26, 2020
0 Comment

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: For pennies on the dollar, public health is succeeding out… »

COVID-19: Lessons for Climate Change Strategy

By | May 13, 2020
0 Comment

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: COVID-19: Lessons for Climate Change Strategy »

Options for Universal Coverage: Part 1 – Public vs. Private Provision

By | June 12, 2020
0 Comment

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: Options for Universal Coverage: Part 1 – Public vs. Private… »

Beyond Evidence Reporting: Evidence Translation in an Era of Uncertainty

By | June 12, 2020
0 Comment
illustration of audience for evidence translation

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: Beyond Evidence Reporting: Evidence Translation in an Era of Uncertainty »

Patient Matching: Fixing An Identity Problem in Our Medical Data

By | May 8, 2020
0 Comment

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: Patient Matching: Fixing An Identity Problem in Our Medical Data »

Risks of inpatient psychiatry during COVID-19 and beyond

By | May 3, 2020
0 Comment
Two patients sitting in a common area of a psychiatric ward, watching television

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: Risks of inpatient psychiatry during COVID-19 and beyond »

Protecting essential workers

By | April 27, 2020
0 Comment

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: Protecting essential workers »

Telehealth for Addiction, Part 2 – Confidentiality: Real Concerns in Virtual Settings

By | April 22, 2020
0 Comment

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: Telehealth for Addiction, Part 2 – Confidentiality: Real Concerns in… »

Access to Abortion during COVID-19 and Beyond

By | April 19, 2020
0 Comment

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: Access to Abortion during COVID-19 and Beyond »

Is hydroxychloroquine ready for prime time for COVID-19? Not just yet.

By | April 17, 2020
0 Comment

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: Is hydroxychloroquine ready for prime time for COVID-19? Not just… »

COVID-19: High risk of severe illness

By | April 13, 2020
0 Comment

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: COVID-19: High risk of severe illness »