Week of June 5–9, 2023

Week of June 5–9, 2023

General Articles

• An “unprecedented” mental health crisis is overwhelming US cities, which lack adequate resources to address growing challenges, according to a new report released today by the US Conference of Mayors. In recent years, the Covid-19 pandemic exacerbated mental health issues, particularly involving substance abuse, said a survey of mayors of 117 cities in 39 states. The report also cited “staggering increases in stress, depression, isolation, loneliness, and accompanying mental health hurdles faced by Americans of all ages.” Read more here.
• More than 55 million people globally live with dementia, and the number is expected to increase to an estimated 153 million by 2050, according to the World Health Organization. Recently, former first lady Rosalynn Carter, 95, was diagnosed with dementia. With the number of people living with dementia rising, individuals need to take steps to reduce the risk of developing it, experts say. These include sustained physical activity, making healthier lifestyle choices and staying socially connected, a 2020 article published in Lancet recommended. Read more here.
• Burnout in the health care industry is a widespread problem that long predates the covid-19 pandemic, though the chaos introduced by the coronavirus’s spread made things worse, physicians and psychologists said. Health systems across the country are trying to boost morale and keep clinicians from quitting or retiring early, but the stakes are higher than workforce shortages. Rates of physician suicide, partly fueled by burnout, have been a concern for decades. And while burnout occurs across medical specialties, some studies have shown that primary care doctors, such as pediatricians and family physicians, may run a higher risk. Read more here.
• Youth Mental Health
• More kids, teens and young adults are experiencing anxiety — but fewer are getting the appropriate treatment, according to the latest research. A new study looked at data from the National Ambulatory Medical Care Survey from 2006 to 2018 and assessed office-based physician visits to see how many included an anxiety disorder diagnosis and what treatment, if any, was given. The likelihood of a patient receiving medication alone to treat the anxiety with no therapy increased significantly in the later years of the data analyzed in this survey, which continues to be administered by the US National Center for Health Statistics. Read more here.
• A brain chemical essential to decision-making and managing stress is emerging as another indicator of why teen girls are bearing the worst of the youth mental health crisis. Why it matters: The way stress physiologically affects brain development is under-researched, leaving it unclear if there are better ways to identify and treat groups facing increased rates of suicidal behavior, sexual assault and depression. Read more here.

Impact of the Pandemic

• The United Health Foundation’s 11th America’s Health Rankings Senior Report highlights the challenges and strengths in the health of individuals 60 and over in Florida and across the country. While some statistics show growing strengths in older Americans’ lives, such as a national increase in high-speed internet access and a significant decrease in food insecurity, the report points to the negative implications of social isolation as severe. Physical inactivity, volunteerism, frequent physical distress and early deaths all worsened on a national level for America’s older adults. Read more here.

The Opioid Crisis and Addiction Issues

• The opioid crisis could get a lot worse. Rahul Gupta, the director of the White House Office of National Drug Control Policy, said that the number of fatal drug overdoses could climb to 165,000 a year by 2025, about 55,000 more than last year. At the same time, he said that if President Joe Biden’s policies to address the crisis are implemented — such as funding treatment for incarcerated individuals and expanding telehealth treatment — the number of people dying each year could be cut in half. Read more here.
• As the number of overdose deaths from fentanyl continues to soar across the state, health officials are launching a campaign to make the anti-overdose medication Narcan easily available to the people who need it most. Over the next few months, the Oklahoma State Department of Mental Health and Substance Abuse Services officials will install vending machines across the state with Naloxone and fentanyl testing strips as part of its Harm Reduction campaign, which seeks to stop the stigma associated with asking for help regarding substance abuse. Already, billboards have gone up across the city warning of fentanyl contaminating controlled substances. Read more here.
• Teva Pharmaceutical Industries (TEVA.TA) on Wednesday agreed to pay Nevada $193 million to settle claims that its marketing practices fueled opioid addiction, the state announced.
• Nevada was one of two states, along with New Mexico, that did not join a $4.35 billion nationwide settlement with the Israel-based drugmaker last year. New Mexico has also since settled. "The money coming into Nevada from these settlements will help our state recover and will help resources flow to the Nevadans impacted by this epidemic," Nevada Attorney General Aaron Ford said in a statement. Read more here.
• The atmosphere inside the Allen House is easygoing as residents circulate freely through the hallways, meet in group sessions, or gather on a large outdoor patio that features a dirt volleyball court with an oversize net. The 60-bed safety-net residential treatment center in Santa Fe Springs, run by Los Angeles Centers for Alcohol and Drug Abuse, has a dedicated detox room, on-site physicians and nurses, substance abuse counselors, licensed therapists, and other practitioners. It offers group counseling as well as individual and family therapy, and it endorses the use of medications for addiction treatment, such as buprenorphine and naltrexone, which are increasingly considered the gold standard. Read more here.
• President Joe Biden's administration on Tuesday pledged an improved effort to combat drug overdoses that claimed the lives of about 100,000 Americans last year, using a White House summit to tout a multifaceted approach to tackle synthetic and illicit drugs such as the powerful opioid fentanyl. "Today's summit is needed because the global and regional drug environment has changed dramatically from just even a few years ago," Rahul Gupta, director of the White House Office of National Drug Control Policy, told the summit, being held jointly with public health officials from Mexico and Canada. Read more here.
• The study highlighted the impact of gun deaths on children and teens. Gun violence is the leading cause of death for people ages 1-19, accounting for 20 percent of deaths in that age group — 4,733 deaths in 2021. Gun deaths among young people are more likely to be homicides than suicides, with homicides making up 64 percent of gun deaths in that age group and suicides accounting for 30 percent. Homicides are more likely to affect young people, while suicides are more likely to affect older people, in general, according to the study. Read more here.
• Programs like Youth Alive meet survivors of gunshot or stab wounds in the hospital, and fast – when the need is greatest. It’s at this moment that survivors are at their most vulnerable. They’re recovering from wounds, questioning their safety and facing a higher risk of re-injury and perpetuation of violence through retaliation. Read more here.

Climate Change

• Wildfires are increasingly causing destruction and illness around the world, but the smoke drifting southward from eastern Canada this week is a new experience for the tens of millions who live in the U.S. Northeast. Many in those states are wondering what they need to know about a first-time wildfire smoke event. Any amount of inhaled particles will trigger inflammatory responses in the body. Children, the elderly and people with chronic cardiac, respiratory and other illnesses are most vulnerable. Read more here.

 Medicaid Redetermination

• Although hundreds of thousands have been knocked off state Medicaid rolls this spring, worries about dropped coverage for Medicaid-dependent nursing home residents have so far not proven reality in large numbers. McKnight’s Long-Term Care News surveyed a dozen sector associations about the impact the end of the COVID-19 public health emergency and a Medicaid continuous coverage requirement have had on facilities. Several were unable to provide detailed insight, noting that they had not heard from members that they were experiencing widespread disenrollment issues. Read more here.  

Bans on Gender-Affirming Care and LGBTQ Issues

• Debate in a Senate committee hearing about the youth mental health crisis grew tense when Sen. Ted Budd (R-N.C.) brought up concerns about hormone treatment for transgender youth. The Committee on Health, Education, Labor and Pensions met Thursday to evaluate the current mental health infrastructure and legislation. Nine mental health programs will lose their funding unless the committee re-approves their budget before the programs’ expiration date in September. A portion of the hearing focused on recent research regarding mental health in LGBTQ+ adolescents, specifically transgender youth. Read more here.
• For the first time in its history, the largest LGBTQ+ rights organization in the U.S. has declared a state of emergency for the country’s LGBTQ+ people. Statehouses across the U.S. have increasingly introduced bills and passed laws targeting the LGBTQ+ community, creating an imminent threat to health and safety, according to the Human Rights Campaign, which was founded in 1980. At least 525 bills that the HRC characterized as anti-LGBTQ+ have been introduced across 41 state legislatures during this legislative session, and 76 have been signed into law — more than double the record reached last year, according to the organization. More than 220 of the introduced bills targeted the transgender community, the group found. Read more here.
• This week, the LGBTQ rights group Human Rights Campaign (HRC) declared a state of emergency for LGBTQ Americans, the first time the organization has ever done so. And they’re right: Despite immense progress on rights for gay, lesbian, trans and other minority groups in the United States, we are in the midst of an expansive and ugly right-wing backlash to those rights, and it’s imperiling transgender and other gender-diverse Americans and their families. And frankly, given the state of women’s rights in many of the same states attacking LGBTQ people, women’s groups should do the same. Read more here.
• In much of the country, there are deep divides by partisanship and news consumption on using gender-neutral pronouns, being comfortable with a friend coming out as LGBTQ+, and feeling that it’s appropriate to discuss gender identity in schools. A new survey from the nonpartisan Public Religion Research Institute (PRRI) provides more insight into these splits — and finds that some Americans seem to be moving further away from certain acceptance of LGBTQ+ people. Read more here.
• Missouri Gov. Mike Parson (R) signed legislation Wednesday that will prevent transgender minors from accessing gender-affirming medical care and bar transgender women and girls from competing on female sports teams. Both laws will take effect in August. Missouri's Senate Bill 49, the ban on gender-affirming care, will prohibit health care providers in the state from administering medications including puberty blockers and hormone replacement therapy to treat gender dysphoria in minors, with an exception carved out for transgender youths who began treatment before the law's effective date of Aug. 28. Read more here.
• Gov. Greg Abbott signed into law Friday a bill that bars transgender kids from getting puberty blockers and hormone therapies, though the new law could face legal challenges before it takes effect on Sept. 1. Senate Bill 14’s passage brings to the finish line a legislative priority for the Republican Party of Texas, which opposes any efforts to validate transgender identities. Trans kids, their parents and LGBTQ advocacy groups fiercely oppose the law, and some have vowed to stop it from going into effect. Texas — home to one of the largest trans communities in the U.S. — is now one of 18 states that restrict transition-related care for trans minors. Read more here.
• Debate surrounding Florida’s new restrictions on gender-affirming care focused largely on transgender children. But a new law that Republican presidential candidate and Gov. Ron DeSantis signed last month also made it difficult – even impossible – for many transgender adults to get treatment. Like many transgender adults in Florida, he and Lucas are now facing tough choices, including whether to uproot their lives so that they can continue to access gender-confirming care. Clinics are also trying to figure out how to operate under regulations that have made Florida a test case for restrictions on adults. Read more here.
• The Louisiana Senate voted Monday to pass a controversial bill to ban gender-affirming health care for transgender minors, advancing the measure even after it was defeated by a GOP-controlled state Senate committee last month. The measure, House Bill 648, seeks to bar health care providers from administering gender-affirming medical care to patients younger than 18 under the threat of having their professional licenses revoked. The bill died late last month in a state Senate committee, with Sen. Fred Mills (R) casting the deciding vote. Read more here.
•  A federal judge temporarily blocked portions of a new Florida law championed by Republican Gov. Ron DeSantis that bans transgender minors from receiving puberty blockers, saying in a Tuesday ruling that gender identity is real and the state has no rational basis for denying patients treatment. Judge Robert Hinkle issued a preliminary injunction, saying three transgender children can continue receiving treatment. The lawsuit challenges the law DeSantis signed shortly before he announced a run for president. “Gender identity is real. The record makes this clear,” Hinkle said, adding that even a witness for the state agreed. Read more here.
•  Health insurers responded to the 2015 Supreme Court decision recognizing same-sex marriage with more equitable coverage for LGBTQ couples, including spousal benefits, according to a new study published in Health Affairs. What they found: The percentage of all LGBTQ adults with a usual source of health care access increased from 64% to 75% from 2013 to 2019. Disparities in coverage began to decline in 2014, when the main coverage provisions of the Affordable Care Act went into effect. By 2017–2019, coverage rates for LGBTQ adults were comparable to those of non-LGBTQ adults, although significant disparities in access remained. Read more here.

Federal and State Policy

• A federal appeals court will hear arguments today on whether to lift a freeze on a decision halting the Affordable Care Act's requirement that employers fully cover the cost of specified preventive health care services. Driving the news: If the New Orleans-based U.S. 5th Circuit Court of Appeals affirms the ruling, it could eliminate cost-free coverage for certain cancer screenings, behavioral counseling, HIV prevention and other services recommended by the U.S. Preventive Services Task Force. Legal experts say a ruling could come as soon as this week. Read more here.
• People concerned about the safety of patients often compare health care to aviation. Why, they ask, can’t hospitals learn from medical errors the way airlines learn from plane crashes? That’s the rationale behind calls to create a “National Patient Safety Board,” an independent federal agency that would be loosely modeled after the National Transportation Safety Board, which is credited with increasing the safety of skies, railways, and highways by investigating why accidents occur and recommending steps to avoid future mishaps. Two measures are underway to create a safety board. Read more here.