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 »
Randomized control trials are the commonly held gold standard clinical trial design. The randomized controlled trial (RCT) is the gold standard of clinical research. However, researchers are increasingly asking: must they be? Webster-Clark, Jonsson Funk, and Stürmer discussed single-arm trials: administering a drug to an experimental group and using real-world data (RWD) to select an… Read More »
White paper, grey literature, black box warning. The nature of our medical research, presentation, reporting, and publication has defined the values associated with colors. A white paper is defined as an “authoritative” report on a subject. Grey literature is described as being “non-conventional, fugitive, and sometimes ephemeral.” And a “black box” warning alerts physicians and… Read More »
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 »
The inequitable distribution of COVID-19’s terrible burden has been well documented. There are notable disparities by race and ethnicity. COVID-19 rates, including incidence and fatality rates, are higher among Black, Indigenous, and other Persons of Color (BIPOC). This is structural racism at its worst, in which BIPOC individuals are disproportionately represented among essential workers and… Read More »
Barriers to immigration into the United States are a common topic of political debates. Less frequently publicized are the numerous barriers to healthcare that undocumented immigrants (UIs) face even after their arrival. These obstacles can have profoundly negative effects: not just on the individual immigrants’ health, but on their local communities as a whole. Medical… Read More »
The Medicare Part D program, which was launched in 2006, is in the middle of its second decade of providing prescription drug coverage to Medicare beneficiaries. The Part D program has improved beneficiaries’ access to prescription drugs but at increasing cost. Federal spending for Part D has more than doubled from $44.3 billion in 2006… Read More »
In military medicine, exercises, such as a mass vaccination points-of-dispensing (POD) scenario, test preparedness capacity, and drill for potential real-world public health emergency scenarios. Exercises are designed to challenge medical teams to work under pressure and problem solve according to conditions presented in the exercise scenario. A benefit of medical exercises in the military is… Read More »
What is telehealth? Telehealth involves using technology to facilitate healthcare interactions but has not been used extensively in Medicare in the past. The use of telehealth may be particularly relevant where there are geographic barriers such as a lack of local providers or a public health emergency such as the coronavirus pandemic. There are a… Read More »
The World Health Organization (WHO) defines social determinants of health (SDOH) as the non-medical factors that influence health outcomes. They are the “conditions in which people are born, grow, work, live, and age.” Currently, SDOH is a hot topic as stakeholders try new ways to improve individual and population health, achieve health equity, and reduce… Read More »
COVID-19-related scams are spreading nearly as fast as COVID-19 and threatening the health and safety of our communities. Since January 2020, people across the country have filed over 426,000 COVID-19-related complaints to the Federal Trade Commission (FTC) about fraud, identify theft, and other consumer protection. They have reported losses totaling over $397 million. As trusted… Read More »
A growing trend in health care, accelerated by the COVID-19 pandemic, is the implementation of telemedicine. Telemedicine is the delivery of health-related information and services among patients and providers via telecommunication technologies. An example is the use of video technology by doctors to evaluate, diagnose, or treat a patient instead of having a face-to-face encounter. … Read More »
As we are overcoming the COVID-19 pandemic, the obesity pandemic is worsening. The United States is the most obese country in the world. Is it time to admit defeat in this 30-year battle against obesity? Only 1 in 122 mildly obese people with a primary care physician will achieve a normal weight, according to a… Read More »
Over 30% of Black, Latinx, and Indigenous populations in the US are enrolled in Medicaid programs; more than half of all Medicaid enrollees are people of color. As such, Medicaid policies disproportionately affect populations of color. As more institutions reckon with historical and current injustices due to centuries of racism and racist policies, understanding how… Read More »
In an earlier post, we showed how rural prisons and census methods create distortions in county demographic and health statistics. In this post, we add further evidence and discuss the economic, political, and research implications of these potentially misleading data. National survey methodology may contribute to inaccurate data Census policy coupled with national survey methodology… Read More »
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. We have just wrapped up our student blog competition that was co-sponsored by the Medical Care Section of APHA! The posts submitted by students ranged broadly, from administrative to political… Read More »
Health insurers often pay health plans to manage the care of their members. Good care can help prevent emergencies, such as avoidable trips to a hospital emergency department (ED). Medically complex patients, such as those with behavioral health problems or substance use disorders, tend to have a lot of ED visits. Social determinants of health… Read More »
The 2020 Census is complete and the results will be released soon. Because of how we count people in prison, there may be inaccurate demographics and a virtual overestimate of people living and accessing services in rural communities. In this two-part series, we look at how rural prisons can skew county-level analyses of rural demographics… Read More »
For older adults in the United States, obtaining and paying for prescriptions can be a challenge. Although most Americans over age 65 are eligible for prescription drug coverage under the Medicare Part D, understanding and navigating the benefit can be difficult. The Center for Medicare and Medicaid Innovation (CMMI) recently launched a new payment model… Read More »
The pandemic has consistently exposed the underlying inequities and effects of systemic racism on American Indian (AI) and other marginalized communities. The health equity challenge of 2021 is around COVID-19 vaccine equity. Over the first months since the vaccine has become available, communities of color are not getting shots in the arm at the same… Read More »
President Biden released the National Strategy for the COVID-19 Response and Pandemic Preparedness on January 21, 2020. It is an ambitious attempt to decrease the spread of the novel coronavirus and get hundreds of millions of Americans immunized. This COVID-19 vaccine plan, however, is missing a key element. Namely, primary care. An incomplete national strategy for… Read More »
Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »
Throughout the past decade, the U.S. has seen a dramatic shift in addiction medicine research, clinical practice, and related stigma in seeking care. In a pair of blog posts, we will explore the top six trends related to treating the opioid crisis. And we’ll consider what may be next. The Opioid Epidemic Opioid addiction has… Read More »
We have reached a 30-year high in the rate of suicide in the United States. Suicide risk and prevention efforts among women are the focus of a recent Medical Care supplemental issue. Efforts at prevention and recovery have been especially important for the Departments of Defense and Veterans Affairs. As mentioned in the introduction to… Read More »
To help you prepare your APHA and other meeting abstracts for submission, the APHA MC Health Equity Committee presented a webinar on the topic of Making Your Abstract Awesome + Getting It Accepted. We had limited spots available for the live event, but we recorded it and are happy to share that recording and the… Read More »
This fall, CMS launched two new websites: Care Compare and the Provider Data Catalog (PDC). Both tools replaced the eight existing Compare tools and data.medicare.gov, which were sunset last year. The data included on Care Compare is intended to help Medicare beneficiaries make informed decisions about their care. While there have been articles and press releases… Read More »
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 »
During the past year, the COVID-19 pandemic has highlighted health inequality created by social determinants of health (SDoH) in the United States. SDoH include all aspects of the living environment, social support, safety, well-being, and resource availability, directly or indirectly influencing physical health outcomes. Consideration of SDoH is critical for successful comprehensive COVID-19 vaccine rollout.… Read More »
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 »
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 »
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 »
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 »
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 »
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 »
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 »
Historically, public health has served the nation through sanitation, immunization, and other disease-prevention activities (e.g., disease tracking and quarantine). For example, public health developed wastewater treatment programs to help fight typhoid fever during the industrial revolution. It also helped educate the public (and the food industry) on safely preparing and preserving foods. As a result,… Read More »
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 »
National Rural Health Day provides an opportunity to reflect on the quality of medical care in rural and medically underserved communities. This year has posed additional challenges to fragile healthcare systems and vulnerable populations. Faced with new barriers, rural communities are adapting and innovating through telehealth. COVID-19 caught the entire country off balance, highlighting structural… Read More »
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 »
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 »
John bowled in a Friday night league for 20 years. It was often the highlight of his week – a chance to spend time with friends, blow off some steam, and enjoy some friendly competition. Now 75 and living with dementia, John has tried more than once to walk to a bowling alley that no… 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 »
The COVID-19 pandemic caused large reductions in in-person office visits, costing primary care practices billions and exposing many of the risks associated with the fee-for-service (FFS) payment system. Capitation arrangements, in which providers are paid a per-member per-month payment, may offer a more attractive, less risky arrangement in the post-COVID-19 world. Almost all US health… 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 »