Week of Feb. 20–24, 2023

Week of Feb. 13–17, 2023

General Articles

• Watching news reports of the heroic relief efforts underway in Turkey and Syria following the devastating earthquake there, I can imagine the terrible weight of emotional trauma that so many people are experiencing right now because I’ve experienced it myself. A dozen years ago, as a young doctor with a background in emergency medicine, I felt prepared to handle disaster response situations. But I was totally unprepared for the constant exposure to widespread suffering and death that I experienced while providing emergency medical relief after the 2010 earthquake that killed 220,000 people in Haiti. Read more here.
• To uncover the happiest places in America, SmartAsset analyzed the 200 largest cities, 164 of which had available data. This analysis looked at 13 different metrics across three categories: personal finance, well-being and quality of life. California cities dominated the top 10. However, not all places can offer the same level of happiness, as some cities offer more economic opportunities and a better quality of life than others. Read more here. 
• Many Black Americans are at increased risk for depression, stress and anxiety. However, the idea of seeking behavioral health services like therapy and medication may not receive a warm reception in some African-American families. This is especially true for many people raised in communities who for many reasons have historically “toughed it out” or only sought solace in religion, regardless of their health struggles. And we can’t overstate the effect that racial injustice has had and continues to have on behavioral health. Read more here.
• New York City Mayor Eric Adams is poised to roll out a wide-ranging mental health plan that would triple the capacity of so-called clubhouses for people with severe mental illness, launch a virtual mental health care platform for teens and bolster harm reduction services in neighborhoods like the South Bronx and upper Manhattan. Health Commissioner Ashwin Vasan shared details of the plan during a briefing Wednesday for city and state lawmakers. The agenda will consist of three plans: one to reduce overdose deaths and help people with substance use disorders, another for people with severe mental illness and a third to address the mental health needs of children and families. Read more here. 

Youth Mental Health

• Researchers from the Brown School at Washington University in St. Louis found that college-educated Black Americans are suffering racial discrimination that leads to depression. For “Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans”, researchers conducted a nationwide online survey of 528 college graduates over 24 years old to determine if there is a health cost to being a college-educated Black American. Read more here. 

Impact of the Pandemic

• People who have long COVID and experience anxiety and depression following a mild infection may have brain changes that affect its structure and function, Brazilian researchers reported yesterday at the American Academy of Neurology (AAN) annual meeting in Boston. The team, from the University of Campinas in Sao Paulo, assessed 254 people who had mild COVID 3 months earlier. Read more here. 

Gun Violence

• Mass shootings in America invariably raise questions of fault. That finger of blame, however, rarely lands on the manufacturer of the guns used in the massacres. Lawmakers in Colorado and at least five other states are considering changing that, proposing bills to roll back legal protections for gun manufacturers and dealers that have kept the industry at arm’s length from questions of blame. California, New York, Delaware and New Jersey have passed similar legislation in the last three years. Read more here. 

Workforce Issues

• In 2016, the warnings about the future of the Texas mental health care workforce were clear. “More than 80 percent of Texas counties are designated as Mental Health Professional Shortage Areas, which are defined as more than 30,000 residents per clinician,” the Texas Statewide Behavioral Health Strategic Plan stated seven years ago. “Many of the most experienced and skilled practitioners are approaching retirement. … Texas higher education institutions have been unable to produce enough graduates to meet the predicted demand.” Read more here.
• More states are working out differences over what medical services non-doctors can provide in order to ease stubborn workforce shortages plaguing health systems. But the compact model is catching on to address other health care workforce challenges, evidenced by a 17-state compact allowing mental health counselors to practice in other participating states without the need for multiple licenses. Read more here.
• Medical students aren't flocking to primary care, despite an uptick in applicants to schools and congressional efforts to boost residency slots, data show. Why it matters: While the pandemic drove home the importance of preventive care, many residents continue to flock to higher-paying specialties, potentially leaving gaps in care and big holes in the medical workforce. Read more here. 

The Opioid Crisis and Addiction Issues

• As the nation confronts an ongoing overdose crisis, families continue to lose loved ones every day. As such, reducing overdose deaths will require targeted and long-needed investment of resources that can effectively reach our most marginalized communities and address their health and social needs. At the same time, US communities are at an unprecedented moment in which proceeds from lawsuits against opioid manufacturers, distributors, and pharmacies for their role in propagating the overdose crisis have led to billions of dollars becoming available to distribute across states, local jurisdictions, and tribal communities. Read more here.
• Republicans listed fentanyl and opioids as the top public health threat plaguing the U.S. in a new Axios-Ipsos survey, as both parties in Congress seek to spotlight the country’s overdose crisis. The new poll found that 37 percent of Republican respondents list fentanyl and other opioid drugs as the top public health threat, compared to 17 percent of Democrats. Democrats listed gun or firearm access as the nation’s top public health threat, at 35 percent of respondents. Just 4 percent of Republicans agreed. Read more here.
• Despite an overdose epidemic that killed 107,000 people last year, nearly 9 in 10 Americans who need medication to treat their addiction to deadly opioids aren’t receiving it. Surprising new results from a first-of-its-kind study in Rhode Island could hold a key to getting addiction medication to more people who need it: allowing patients to get prescriptions at their local pharmacy rather than a doctor’s office. Read more here.
• In 2021, a total of 4,041 people died from drug overdoses, the highest figure reported in The Tar Heel State in a single year. It's also a 22% increase from the 3,304 fatal overdoses recorded in 2020. "North Carolina's communities and families are meeting the tragedy of overdose deaths and the opioid crisis head on, every day," NCDHHS Secretary Kody Kinsley said in a statement. Read more here.
• Nevada Attorney General Aaron Ford has announced the state’s inclusion in a settlement with opioid manufacturer Allergan. The multi-state settlement will bring in $29 million for Nevada. “Settlement recoveries, including these funds, are a vital component to combatting the opioid epidemic in our state,” said Ford. “The recoveries will fund programs and services throughout the state to help eradicate this epidemic and help Nevadans affected by the opioid epidemic.” Read more here.
• Ever since fentanyl entered the U.S. drug supply, many Americans seeking treatment for opioid addiction have found that only a single medication is effective at easing cravings and withdrawal: methadone. But even though the drug is widely considered to be safe and effective, there’s not much data about how methadone stacks up against its main alternative, buprenorphine. Now, amid calls to dramatically expand methadone access, a team of addiction researchers is looking for answers. Read more here.
• Since it was created more than 50 years ago, naloxone has done one thing exceptionally well: save lives from an opioid overdose. Naloxone is safe. It is easy to administer. It is readily available. And thanks to overwhelming support from an advisory panel to the FDA, it may soon be available over-the-counter to all who need it. Read more here. (A free account is required to read this article.) 

Health Insurance and Health Care Spending

• Americans say they're worried about opioids and gun violence, but what they really want the government to tackle is rising drug costs and health bills, according to the new Axios-Ipsos American Health Index. The big picture: Pocketbook health issues still resonate the most with voters, who are increasingly convinced businesses and politicians don't have their backs. What they found: The national survey of 1,213 U.S. adults found almost 8 in 10 want insurers to cover weight-loss drugs, and almost 9 in 10 back a monthly cap on out-of-pocket costs for insulin. Read more here.
• Healthcare systems have found themselves in precarious financial standing due to a dramatic increase in the number of inpatient claims being denied by health insurers based on the lack of medical necessity, according to data collected by accounting and technology firm Crowe. These level-of-care reimbursement disputes are especially rising in frequency among Medicare Advantage plans. One of the most straightforward payer categories when it comes to assigning the appropriate level of care is traditional Medicare, found Crowe. Read more here. 

Social Determinants 

• The food pantry, one of a few in this city of about 20,000 people, serves more families now than at any point in King’s 20 years of working there, she said. In January, FISH provided food boxes to nearly 790 people. But King and other food bank managers fear that demand will spike further in March, when officials roll back pandemic-era increases to SNAP benefits. The program, administered by the Department of Agriculture, provides monthly stipends to people with low incomes to spend on food. Read more here. 

Federal and State Policy

• A group of senators is urging the Biden administration to rethink its restrictive coverage determination for emerging Alzheimer's disease treatments. The letter to Department of Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure is signed by 20 senators comprising 18 Republicans and two Democrats. In it, the legislators said they're echoing calls from patient advocates as well as the Alzheimer's Association to make it easier for people with the disease to access monoclonal antibody drugs that target amyloid. Read more here.
• A recent survey of adults found more than 60% are not aware their eligibility for Medicaid could be in danger, underscoring the massive task states and managed care plans face ahead of an April 1 deadline. The analysis, published Thursday by the Robert Wood Johnson Foundation, looks at the awareness of the looming Medicaid eligibility redeterminations at the end of 2022. The survey, conducted by the think tank Urban Institute, showed awareness was lacking across the country regardless of the area. Read more here.
• A bipartisan group of Maryland lawmakers on Friday gathered to express their support for a package of legislation to modernize and improve access to mental health services in the state. The measures focus on getting people help earlier, preferably in community and primary care settings, before they experience a mental health crisis requiring costly trips to the emergency room or in-patient care. Read more here.