Although the term health equity is widely used, a common understanding of this term is lacking. Viewing health equity through the lenses of allostatic load and intersectionality could help. This blog post considers three case scenarios, all of which are composites of actual cases that have occurred within the United States, to explore ideas of… Read More »
Why do we care about unintended pregnancies? Rates of unintended pregnancy “indicate the extent to which women and couples can determine freely whether and when they have children,” as stated by Finer and Zolna. There is some evidence that women and girls who have unintended pregnancies have a higher likelihood of other risk factors, such as… Read More »
In 2019, mental health and opioid use disorders remain major public health issues. The most recent estimates suggest that 40 million adults experience mental illness in the U.S. and nearly 8 million adults experience both mental and substance use disorders at the same time. Individuals with mental illness also face higher risks of co-occurring chronic health conditions and… Read More »
President Trump wants $5 billion right now for his border wall, and another $7 billion (or maybe $13 billion) later on to finish the project. What else could we do with that kind of money? Here’s an idea: with $12 billion we could cover ALL 3.9 million uninsured children in the US today, and still have a… Read More »
There are approximately 61 million women of reproductive age (15-44 years) in the United States, and at any given time, 70% of them are at risk of unintended pregnancy—that is, they are sexually active but do not want to become pregnant. About 72% of women who currently use contraception use non-permanent methods, such as the… Read More »
The burden of homelessness on the health of those afflicted continues to be a major global public health concern. Last year, the United States recorded an increase in the number of homeless for the first time since 2010. On any given night in 2017, there were 553,742 people in the U.S. experiencing homelessness. In terms of… Read More »
APHA 2018 starts November 10! Thousands of public health practitioners, students, scholars, and activists will descend on San Diego, CA on Saturday for our annual conference. As in previous years, your faithful co-editors will be there, live-tweeting about sessions! So be sure to follow @MedCareBloggers for real-time updates. The program is looking great, and we are excited about… Read More »
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 »
Welcome to Point-Counterpoint – the BLOG Edition! In this series — as in the series by the same name in the journal — authors stake out positions on current issues, highlighting the pros and cons. In this Point-Counterpoint, we discuss the new Apple Watch’s electrocardiogram (ECG) technology, launched with the Apple Watch Series 4. The… Read More »
Over a third of all Americans are at an increased risk for chronic conditions such as heart attack, stroke, cancer, and diabetes due to their lack of sleep. Key disorders, such as obstructive sleep apnea, which now afflicts 30 million adults in the United States, are some of the primary causes of the morbidity and… Read More »
Welcome to the Bang for the Buck series! In this series, we will look at the most recent cost and cost-effectiveness research on public health methods and technology and discuss their potential for policy and implementation within the current health care system. As the costs of treating diseases continue to rise faster than inflation, prevention… Read More »
Last Tuesday I saw eight patients in my morning clinic; I felt like I did a lot. I saw Ms. S, a sixty-two-year-old lady with high blood pressure and diabetes; we chatted about her cats while I checked her feet and titrated her insulin. I treated my 9:30 am patient with some antibiotics for a… Read More »
Chlamydia and gonorrhea are among the most common sexually transmitted infections (STIs) in the United States, and research shows that 50% of sexually active individuals will contract an STI by 25 years old. Though chlamydia and gonorrhea are often asymptomatic in women, screening is important in order to prevent complications, such as pelvic inflammatory disease… Read More »
Title X, a program that provides federal dollars to be used for family planning services, is under siege. The public comment period ended July 31, 2018, and now we wait to see how funding changes for Title X unfold. Title X is a critical program that provides essential reproductive health services to women, created by… Read More »
For two years in a row, the United States has experienced a decrease in life expectancy, which researchers have largely attributed to the opioid epidemic. Life expectancy for the United States population was 78.6 years in 2016, a decrease of 0.1 year from 2015 [PDF]. Age-specific death rates between 2015 and 2016 increased for younger… Read More »
This year, we’ve seen more than 2,000 children separated from their parents, who were legally seeking asylum in the US. Most were from Central American countries in which crime and unrest place many at risk for violence. These children were taken from their families by US government employees between April 19 and May 31, 2018,… Read More »
The New York Times recently posted an article about the return on investment around public health interventions and how American life expectancy at birth increased by 30 years in the time from 1900 to 1999. The article went on to stress that these additional years of life can largely be attributed to advances in public… Read More »
Many women in the United States will be sexually assaulted during their lifetimes. And the aftermath of sexual assault impacts women health long after the assault itself. Survivors of sexual assault have been shown to have a greater increase in psychiatric disorders directly after their assaults than patients who have not been assaulted. Other research… Read More »
Readers of The Medical Care Blog know that the United States spends more money than any other country on healthcare. Currently, the US spends about 18% of its gross domestic product on health care, and it is predicted to grow to nearly 20% by 2026 [PDF]. While the growth rate in spending remains near historical… Read More »
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. I previously authored a post here at The Medical Care Blog which discussed religion-restricted healthcare and… Read More »
In the new US consumer marketplace, doing good for society is powerful. Choices that people are making about how their food is grown, how companies test household products and reduce their impact on the environment, and how companies make their profits are driving new business models. Farmers are changing their pest and weed-control methods, manufacturers are… Read More »
Growing up we were encouraged to learn how to manage our time. Many of us were told that time management was the key to successful careers, personal lives, and finding the balance between the two. A cursory search online of time management brings you to a world of articles, blog posts, and books on time… Read More »
It was my first interview of the season, and I was interviewing for Obstetrics & Gynecology residency at a university-affiliated Catholic hospital. Because Catholic institutions do not allow abortion, patients are generally referred to other clinics and hospitals for termination needs. As the daughter of a religion scholar and professor, I was already very familiar… Read More »
Ironically, many healthcare providers–doctors, nurses, physician and medical assistants–are not trained in “health” at all but in “medicine” instead. Often, as providers, our instinct is to first reach for a pill bottle or a procedure and forget about lifestyle changes that could be safer and more financially feasible for our patients. As the burden of… Read More »
The name doesn’t exactly help. But before we discuss rebranding, a brief introduction to the concept . . . Salpingectomy refers to surgical removal of one (unilateral) or both (bilateral) fallopian tubes. It is thus a surgical option for female sterilization—but also drastically reduces a woman’s risk of ovarian cancer. This is huge. Ovarian cancer… Read More »
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 »
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 »
[Editors’ note: This post was originally published on Feb. 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… Read More »
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 »
One hundred and sixty-one Americans died of an opioid overdose each day in 2016, and early 2017 data suggest this trend is continuing. The medical and public health community knows from decades of research that providing individuals suffering from opioid use disorder with specific medications can save lives. Our public policies governing opioid use disorder,… Read More »
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.
Prisoners have a fundamental right to receive health care while incarcerated, a right that is mandated by the US Supreme Court. However, negligent care in prisons persists and is often an issue of limited access due to cost mitigating policies. Since the 1990’s, prison systems have integrated managed care strategies, like co-payments, to mitigate increasing… Read More »
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 »
Each year, millions of people around the world are victims of human trafficking. In the US, the National Human Trafficking Hotline, which maintains one of the most extensive data sets, received 13,897 calls in 2017, with 4,460 human trafficking cases reported. Of the 4,460 cases reported, 3,186 cases were of sex trafficking and 689 cases were… Read More »
Improving the overall patient care experience is an essential focus for organizations as healthcare delivery continues to evolve. The US Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ) notes patient experience as an integral component of healthcare quality, which includes “several aspects of healthcare delivery that patients value highly when… Read More »
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 »
American Indians (AIs) typically have poorer health outcomes than any other racial or ethnic minority group in the United States. This includes an increased risk for cancer, diabetes, injury related mortality, and infant mortality. AIs tend to have the highest rates of poverty and low rates of insurance coverage. Much of the AI population uses the Indian… Read More »
“Neonatal abstinence syndrome” (NAS) sounds deceptively innocuous, given that it is literally infant drug withdrawal. It is usually caused by prenatal exposure to opioids 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 »
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 »
Medicine, alongside achievements in sanitation and public health, remains one of the major achievements of modern society. The reduction (or eradication) of many infectious diseases from the developed world, breakthroughs in anesthesiology and surgery, and advances in the care of chronic diseases (including HIV) are just a few of the multitudes of achievements. But these… Read More »
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 »
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 »
The pursuit of health equity – ensuring equal access to opportunities that enable all communities to lead healthy lives – is a critical task for the U.S. The direct and indirect medical costs associated with sickness and premature death resulting from health care inequities are enormous (estimated to be $230 billion and $1.24 trillion, respectively,… Read More »
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 »
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 »
Despite a rapid expansion in the use of buprenorphine-naloxone (bup-nx) as a treatment for opioid use disorder, there is little understanding of the patterns of treatment. In a newly published-ahead-of-print Medical Care article, Brendan Saloner and colleagues from Johns Hopkins used an all-payer claims database to investigate what factors predict the duration of treatment, dosage, and continuity of treatment for… Read More »
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 »
I’ll never forget the time Granddaddy tried to eat my hand. At least that’s how it seemed to me at age six. In reality, he’d simply confused my hand with the straw sticking out of the milkshake we’d brought to him at the nursing home. By that point in his early-onset Alzheimer’s disease, the Granddaddy… Read More »
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 »
Republican Congressional leaders are currently debating how to repeal the Affordable Care Act (ACA) as part of the budget reconciliation process. Much of the debate over the ACA has focused on the individual mandate (and here) and the affordability (here and here) of coverage in the state-based marketplaces. The House version of the legislation, however,… Read More »