Morning Briefing
Summaries of health policy coverage from major news organizations
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The $18,000 Breast Biopsy: When Having Insurance Costs You a Bundle
An online calculator told a young woman that a procedure to rule out cancer would cost an uninsured person about $1,400. Instead, the hospital initially charged almost $18,000 and, with her high-deductible health insurance, she owed more than $5,000.
From Book Stacks to Psychosis and Food Stamps, Librarians Confront a New Workplace
As public libraries morph into support hubs for homeless people with mental illness or addiction, librarians are struggling to reconcile their shifting roles.
'American Diagnosis' Episode 11: As Climate Crises Batter the Bayou, Houma People Are Being Displaced
Rising sea levels and severe hurricanes are displacing Indigenous people in Southern Louisiana and harming health. Episode 11 explores the United Houma Nation’s push for federal tribal recognition and the climate-change help that could come with it.
Summaries Of The News:
Administration News
Fauci Leaving Federal Government Post In December
Anthony Fauci, the nation’s top infectious disease expert who in his effort to lead the response to Covid-19 became one of the most divisive public health figures in recent memory, announced he will step down later this year. Fauci, who has led the National Institutes of Health’s National Institute of Allergy and Infectious Diseases for 38 years, told POLITICO on Monday that leaving his government post was “bittersweet” but he was also excited for what comes next. (Lim, Cancryn, Gardner and Ward, 8/22)
The announcement by Dr. Fauci, 81, was not entirely unexpected. He has hinted for some time that he was thinking of retiring, saying last month that he would “almost certainly” do so by 2025. In an interview Sunday evening, he said he was “not retiring in the classic sense” but would devote himself to traveling, writing and encouraging young people to enter government service. “So long as I’m healthy, which I am, and I’m energetic, which I am, and I’m passionate, which I am, I want to do some things outside of the realm of the federal government,” Dr. Fauci said in the interview, adding that he wanted to use his experience and insight into public health and public service to “hopefully inspire the younger generation.” (Stolberg, 8/22)
He joined the National Institutes of Health in 1968 as a 27-year-old doctor who had just finished medical residency and was quickly identified as a rising star. Most recently, Fauci has also served as President Biden’s chief medical adviser since the start of his administration. Fauci’s tenure as director of the infectious-diseases institute made him an adviser to seven presidents and put him on the front lines of every modern-day scourge, including AIDS, the 2001 anthrax scares, Ebola, Zika and the coronavirus pandemic. During the nearly four decades Fauci led the agency, it grew from a little-known institute with a $350 million annual budget to a globally recognized powerhouse with a budget exceeding $6 billion. (Abutaleb, 8/22)
“I’ve been able to call him at any hour of the day for his advice,” President Joe Biden said in a statement. “Whether you’ve met him personally or not, he has touched all Americans’ lives with his work. I extend my deepest thanks for his public service. The United States of America is stronger, more resilient, and healthier because of him.” (Neergaard and Miller, 8/22)
In addition to his role as Mr. Biden’s chief medical adviser, Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases and chief of NIAID’s Laboratory of Immunoregulation. He will step down from all three roles. ... Dr. Fauci’s departure will add to the list of empty health posts within the Biden administration. The White House is currently weighing candidates to direct ARPA-H, a new entity meant to speed health research and collaborate with the private sector, and to replace Dr. Francis Collins, the former NIH director. (Restuccia and Whyte, 8/22)
Read Fauci's own words —
It has been the honor of a lifetime to have led the NIAID, an extraordinary institution, for so many years and through so many scientific and public health challenges. I am very proud of our many accomplishments. I have worked with — and learned from — countless talented and dedicated people in my own laboratory, at NIAID, at NIH and beyond. To them I express my abiding respect and gratitude. (Anthony S. Fauci, 8/22)
Some Republicans blasted his retirement as an attempted cover-up —
Soon after Anthony Fauci announced he will be stepping down in December, White House chief of staff Ron Klain hailed the doctor: "I cannot think of a public servant who has done as much to save as many lives for as long a period as Dr. Tony Fauci. And he is a gem of a person." Just as quickly, Donald Trump Jr. tweeted that Fauci was giving up his post as President Biden’s chief medical adviser "likely to avoid being questioned by a GOP controlled house on how he got everything so wrong for so long!" The dueling narratives were under way. (Kurtz, 8/23)
"Dr. Fauci is conveniently resigning from his position in December before House Republicans have an opportunity to hold him accountable for destroying our country over these past three years," Republican Representative Andy Biggs of Arizona tweeted, adding that Fauci will be held accountable whether or not he remains in public office. "This guy is a coward." ... Republican Senator Rand Paul of Kentucky, who has had multiple public squabbles with Fauci, pledged Monday to conduct "a full-throated investigation into the origins of the pandemic" regardless of Fauci's impending departure."[Fauci] will be asked to testify under oath regarding any discussions he participated in concerning the lab leak," Paul tweeted. (Mordowanec, 8/22)
Covid-19
Pfizer Asks FDA For Updated Covid Booster OK Ahead Of Clinical Trials
Pfizer and BioNTech said Monday that they have asked the Food and Drug Administration to authorize a new booster shot targeted at the Omicron BA.4/BA.5 strain of the coronavirus that causes Covid-19, the first step in a process that could lead to more effective booster shots. (Herper, 8/22)
Following the FDA's guidance, the data the drugmakers are submitting represents a departure from what's been used in earlier vaccine authorizations. Instead of waiting for results from human trials, the FDA asked the drug companies to initially submit only the results of tests on mice, as NPR reported last week. Regulators will rely on those results — along with the human neutralizing antibody data from earlier BA.1 bivalent booster studies — to decide whether to authorize the boosters. (Huang and Stone, 8/22)
In a statement, Pfizer said its EUA would clear the booster for use in people ages 12 and older. The company said the clinical trial is expected to begin later this month, but it has already scaled up production and will be ready to ship the vaccine in September, as soon as the FDA approves the emergency use authorization (EUA) application. To speed the consideration of the EUA, the FDA told Pfizer it could submit clinical data for its bivalent BA.1 vaccine alongside preclinical and manufacturing data on its BA.4/BA.5 vaccine. Preclinical data in animals suggest that the BA.4/BA.5 bivalent booster prompts a strong neutralization antibody response against Omicron BA.1, BA.2, and BA.4/BA.5 variants, as well as to the original SARS-CoV-2 virus. (Schnirring, 8/22)
“The agility of the mRNA platform, together with extensive clinical experience with the Pfizer-BioNTech COVID-19 Vaccine, has allowed us to develop, test and manufacture updated, high-quality vaccines that align to circulating strains with unprecedented speed,” Albert Bourla, Pfizer’s CEO, said in a statement. (Sullivan, 8/22)
Moderna is expected to file a similar application soon for updated boosters for adults. The U.S. has a contract to buy 105 million of the Pfizer doses and 66 million Moderna ones, assuming FDA gives the green light. (Neergaard, 8/22)
Another Reason To Exercise? It May Help Lower Covid Risks
Regular physical activity could lower the likelihood of adverse COVID-19 outcomes, according to a study published Monday in the British Journal of Sports Medicine. In the peer-reviewed analysis of data from 16 global studies that included more than 1.8 million adults, the researchers found that those who engaged in regular physical activity had a lower risk of infection, hospitalization, severe COVID-19 illness and COVID-19-related death as compared with their inactive peers. (Fracassa and Vaziri, 8/22)
What is the magic amount of exercise? The combined data used the Metabolic Equivalent of Task (MET) which calculates the amount of calories burned per minute of activity. The most effective amount, according to the researchers, is 500 METs which equates to 150 minutes of moderate exercise or 75 minutes of vigorous activity per week. This is in line with the U.S. Centers for Disease Control and Prevention’s (CDC) recommendation that adults should get 150 minutes a week of moderate-intensity exercise along with two days of strength training. (Mikhail, 8/22)
Covid's incubation period appears to have fallen from 5 days to 3 days —
As the dominant circulating strain of SARS-CoV-2 evolved from Alpha to Omicron, the incubation period from infection to symptoms or first positive COVID-19 test result gradually decreased, from 5 to 3.4 days, according to a systematic review and meta-analysis published today in JAMA Network Open. (Van Beusekom, 8/22)
More on the spread of covid —
As the world continues to learn how to live with Covid-19 in the long run, scientists are testing ways to quickly tell people how well-protected they are against the virus, and whether they need another booster. (Chen, 8/23)
The lawsuit was filed Aug. 8 in Alameda County Superior Court on behalf of a Sacramento woman, Faye Getubig, a Kaiser Foundation Health Plan member who went to the HMO in June for a test after feeling COVID-19 symptoms. She got the nasal swab, and after she received her results, she got a bill. For $310. (Woolfolk, 8/22)
“We all want this pandemic to be over, but wishing it won’t make it so,” said Katie Murphy, president of the Massachusetts Nurses Association, at a virtual news conference. “Pretending that we’re doing all that needs to be done for the fall and winter seasons and what they may portend, isn’t acceptable on any level.” (Bartlett, 8/22)
The new year marks the first time since early 2020 where social distancing, mask mandates and other precautionary measures in response to the pandemic won’t be implemented across Billings Public Schools. Last month, the district’s board of trustees voted to end the emergency declaration for COVID and rescind its mask mandate. (Young, 8/22)
Experts in California are closely tracking two newer subvariants, BA.4.6 and BA.2.75 — themselves members of the Omicron family. It isn’t clear whether they will eventually spread to worrisome extents in the state, but there’s reason to pay attention as they’ve caused concern elsewhere in the world. (Lin II and Money, 8/22)
And covid precautions helped prevent the spread of norovirus —
One apparent result of the measures cruise lines have taken against covid-19: Outbreaks of gastrointestinal illness have been far lower than in pre-pandemic years. So far this year, cruise lines have reported two outbreaks of vomiting and diarrhea to the Centers for Disease Control and Prevention that affected 3 percent or more of passengers or crew. ... The two outbreaks, affecting a total of 113 people, took place on a Carnival Cruise Line ship in late May and a luxury Seabourn voyage from late April through May. (Sampson, 8/22)
Reproductive Health
Key Votes Will Help Shape Abortion Landscape In Florida, NY, Oklahoma
On this, the Democratic candidates for Florida governor agree: New restrictions on abortion in the Sunshine State and uncertainty about the future of women’s health across America have reinvigorated their voters and elevated the urgency to their effort to knock off Gov. Ron DeSantis this fall. ... Democratic voters in Florida will be the final arbiters on Tuesday when the state holds its primary, one of the last of the 2022 midterm cycle. (Contorno, 8/22)
In the aftermath of its June 28 primary, the Sooner Oklahoma has two notable GOP runoffs. Republican Rep. Markwayne Mullin and former state House Speaker T.W. Shannon will meet in a runoff in the special election for Senate to succeed Republican Sen. Jim Inhofe, who announced earlier this year that he would resign. ... Shannon has struggled to outflank Mullin on the right, as their lone debate showed they largely agree on most issues, including support for abortion bans and Trump’s false claim that the 2020 election was rigged. (Skelley, 8/23)
As leaders from both parties search for clues about what lies ahead in November, the vote here on Tuesday – to replace Antonio Delgado, a Democrat who left to become lieutenant governor – has emerged as a national barometer of the political energy unleashed by the high court’s decision to end the nationwide right to abortion. It’s a test of whether Democrats, even in a politically unpredictable congressional district like New York’s 19th, can translate the anger of their base, and concerns over the implications of the ruling that cut across party lines, into a potent midterm message. (Krieg, 8/22)
Roe v. Wade weighs heavily on the race in Pennsylvania —
The voter registration envelope had been sitting in Kiera Coyle’s bedroom for months when her cell phone started blowing up that Friday in June. Had she seen the news about the Supreme Court? Coyle, an 18-year-old from Willow Grove, had been interested in voting but just hadn’t gotten around to it, busy preparing to leave for college, babysitting for a local family, and making trips to the Jersey Shore. (Terruso and Lai, 8/22)
Many suburban Republicans say they are having a hard time bringing themselves to vote for their party’s nominee for governor, Doug Mastriano. And several voters and political operatives doing on-the-ground outreach say his stance on abortion is a big reason why. In this race to lead purple Pennsylvania, the difference between the candidates is stark. (Meyer, 8/22)
In other news about reproductive rights —
Yelp is adding a prominent consumer notice to crisis pregnancy center listings to more clearly distinguish them from clinics that provide abortion services, in a policy change shared first with Axios. The big picture: Yelp's move is the latest tech-company response to a post-Roe world in which abortion information has become a significant online battleground, with both sides of the debate applying intense pressure. (Fried, 8/23)
Red state lawmakers rushing to pass new abortion restrictions are being stymied by an unexpected political force — OB-GYNs. These physicians — many of whom have never before mobilized politically — are banding together in the wake of the Supreme Court overturning Roe v. Wade, lobbying state lawmakers, testifying before committees, forming PACs, and launching online campaigns against proposed abortion restrictions. Legislators who are themselves physicians are using their medical backgrounds to persuade colleagues to scale back some of the more restrictive and punitive portions of anti-abortion laws being considered. (Ollstein and Messerly, 8/22)
Students returning to college are confronting a new reality in states such as Texas, Ohio and Indiana: Abortion, an option for an unplanned pregnancy when they were last on campus, has since been banned, often with few exceptions. Students said they’ve made changes both public and intimate since the U.S. Supreme Court decision this summer that overturned the landmark Roe v. Wade ruling. Students said they’re using more birth control, and some have made a plan to leave the state for an abortion if they become pregnant. They’re also taking public stances, with increased activism by both opponents and supporters of abortion rights. (Rodgers and Franko, 8/22)
On the eve of the anniversary of her daughter's death Tuesday night, Rosa Hernández was having trouble falling asleep. She said she could still feel the presence of her 16-year-old child Rosaura "Esperancita" Almonte Hernández, who died a decade ago when she had leukemia. Doctors had delayed giving Rosaura chemotherapy because she was pregnant, and they didn't want to harm the fetus. (Acevedo, 8/19)
Abortion 'Trigger' Bans Set To Take Effect In Tennessee, Idaho, Texas
A number of states have codified abortion bans without the use of a trigger law. So far, a total of 14 states have near-total abortion bans or bans after six weeks of pregnancy. Barring any last-minute court intervention, three of those states are expected to implement even more draconian laws starting Aug. 25. (Kim, 8/22)
Two months after the Supreme Court overturned Roe v. Wade, about 20.9 million women have lost access to nearly all elective abortions in their home states, and a slate of strict new trigger laws expected to take effect in the coming days will shut out even more. Texas, Tennessee and Idaho all have existing restrictions on abortion, but the laws slated to begin Thursday will either outlaw the procedure entirely or heighten penalties for doctors who perform an abortion, contributing to a seismic shift in who can access abortion in their home states. (Shepherd, Rachel Roubein and Kitchener, 8/22)
More on the court fight in Idaho —
A federal judge in Idaho will rule by Wednesday on whether a near-total ban on abortion can take effect in the state, following a Justice Department lawsuit that says the statute violates a federal requirement to provide medical care when a pregnant person’s life or health is at stake. The case marks the Justice Department’s first attempt to fight a strict abortion ban in court following the Supreme Court decision in June that overturned Roe v. Wade, upending the right to terminate a pregnancy that had been enshrined in federal law for nearly 50 years. (Stein, 8/22)
Idaho lawmakers offered to revise a plan to prosecute doctors for performing abortions to allow emergency health exceptions after a judge said the state’s strict enforcement may run afoul of federal law. (Rosenblatt, 8/22)
Abortion updates from Kansas and Indiana —
After five days, multiple credit cards, $119,000 and no shortage of confusion, a hand recount of the Kansas abortion amendment vote in nine counties changed the ultimate margin of the outcome by only 63 votes, after its sound defeat on Aug. 2. The recount, requested by Melissa Leavitt, a Colby resident who has trafficked in election conspiracy theories, and Mark Gietzen, a Wichita anti-abortion activist, wasn't expected to meaningfully change the results. The "no" vote side lost 57 votes overall, while the "yes" votes gained only six votes. That's a small fraction of the over 922,000 Kansans who voted on the amendment. (Bahl, 8/22)
Now that Indiana has banned nearly all abortions, crisis pregnancy centers in Indiana are looking to expand. Employees told IndyStar that they have seen upticks in requests for their services and anticipate this need to increase once the ban takes effect Sept. 15. They and other advocates say the centers want to give pregnant people more information before they make their decision on abortion and point to a wide range of other services provided, including therapy and life skills classes. (Kane, 8/22)
Outbreaks and Health Threats
Every State Has Reported At Least One Monkeypox Case
Monkeypox has now been detected in all 50 states, health officials revealed. Wyoming became the final state to report a case of the disease on Monday. The Wyoming Department of Health announced the case in an adult male in Laramie County, which includes the capital of Cheyenne. (Kekatos, 8/22)
Roughly half of men who have sex with men have reported reducing their number of sexual partners and encounters in response to the monkeypox outbreak, according to a survey released on Monday by the Centers for Disease Control and Prevention (CDC). Forty-eight percent of the poll’s participants said they reduced their number of sexual partners, 50 percent reduced their number of one-time sexual encounters, and 49 percent reduced how much sex they had with partners they met through dating apps or sexual venues. (Choi, 8/22)
Monkeypox is spreading primarily through close physical contact, mostly during sex. So far, the CDC says, the vast majority of cases in the United States are among gay and bisexual men. Owners of queer bars, who serve this community, feel uniquely positioned to share information about the virus — without adding to rising stigma against LGBTQ people. (Petersen, 8/23)
California has changed how it is referring to the virus —
California health officials Friday confirmed they are avoiding using the term "monkeypox" and will now refer to it as "mpox" or “MPX.” ... The change comes as the World Health Organization has called for a new term for the virus to make it less stigmatizing and discriminatory. (Zavala, 8/20)
More on the monkeypox vaccine rollout —
The Biden administration’s plan to stretch supplies of monkeypox vaccine by giving people fractional doses of the product is running into problems, with some local health officials saying they are unable to extract the targeted number of doses from vials. (Branswell and Gaffney, 8/23)
As the Biden administration scrambles to get a handle on the rapidly spreading monkeypox outbreak, its latest focus is getting vaccines to high-risk events, such as pride parades. (Cohen, 8/22)
Several countries, including the United States, Britain and Spain, are stretching out the available doses, with unknown outcomes. Indeed, the Bavarian Nordic shot has not undergone clinical trials to evaluate the vaccine's ability to prevent monkeypox in humans, though initial studies suggest it will provide some protection. "The whole vaccination strategy for monkeypox is associated with a lot of uncertainties," said Dr Dimie Ogoina, a professor of medicine at Niger Delta University in Nigeria and member of the WHO's monkeypox emergency committee. (Rigby and Grover, 8/23)
“Rapidly increasing the supply and safe delivery of monkeypox vaccine to Americans at the highest risk of contracting the virus is a top priority for President Biden,” said Bob Fenton, coordinator of the White House National Monkeypox Response. “This partnership between Bavarian Nordic and GRAM will significantly increase the capacity to fill and finish government-owned doses – for the first time in the US – and allow us to deliver our current and future supply more quickly to locations nationwide.” (Nelson, 8/22)
Polio Spread Reminds Us The Oral Vaccine Has Rare Risks
In a surprising twist in the decades-long effort to eradicate the virus, authorities in Jerusalem, New York and London have discovered evidence that polio is spreading there. The original source of the virus? The oral vaccine itself. Scientists have long known about this extremely rare phenomenon. That is why some countries have switched to other polio vaccines. But these incidental infections from the oral formula are becoming more glaring as the world inches closer to eradication of the disease and the number of polio cases caused by the wild, or naturally circulating, virus plummets. (Cheng, 8/21)
Wild poliovirus circulates in only two countries — Afghanistan and Pakistan — where this year nine cases had been reported by June.But vaccine-derived poliovirus appears periodically elsewhere, particularly in Africa and Asia. These cases come from a widely used oral vaccine that contains live, weakened virus that sometimes mutates to a dangerous form capable of infecting the nervous system. (Ledford, 8/22)
More on the spread of polio —
New York state confirmed the first U.S. polio case in nearly a decade on July 21 in an unvaccinated man in Rockland County. Health experts have been urging immunizations among the unvaccinated, as some states have rates below 90 percent. Below is a timeline of the initial wastewater sample collections to its present ongoing investigation of the case. (Gleeson, 8/22)
Officials in New York are urging pediatricians and parents to bring patients up to date on polio shots, as evidence suggests the infectious and potentially debilitating poliovirus was present in the state as early as April. (Abbott, 8/22)
A local polio survivor is urging everyone to get vaccinated after the nation detected its first case of the virus in nearly a decade last month. "It was painful and I couldn't do a lot of things," said Patricia Hughes. The Melrose resident was just five years old when she was diagnosed with polio in 1955. The virus, which can cause paralysis, weakened her muscles – making it difficult to walk. (Chan, 8/22)
Since polio was found in wastewater samples in New York last month, health officials have tracked the virus from sewage systems in two southeastern counties, Rockland and Orange, to New York City. But detecting viruses like polio won't be as easy in Philly. (D'Onofrio, 8/22)
Poliovirus has at no point been renamed Guillain-Barré syndrome (GBS) and it is not a side effect of COVID-19 vaccines. Poliovirus infection can cause GBS but incidents are rare, one expert told Reuters, while another two went further and said it does not cause GBS. (8/22)
Health Industry
Amid Spate Of Closures, One Hospital In Rural Tennessee Reopens Its Doors
Despite many rural hospitals closing for good nationwide for financial reasons, Haywood County Memorial Hospital in Tennessee recently reopened, radio station WPLN reported Aug. 21. The hospital was previously owned by Franklin, Tenn.-based Community Health Systems, which has been shedding its ownership of rural facilities, according to WPLN. (DeSilva, 8/223)
More about health care staffing —
Grand Marais, Minn.-based North Shore Health may have to close its nursing facility for older adults and end ambulance services due to a staffing shortage, radio station WTIP reported Aug. 22. "If [hiring] efforts are not successful, we may not be able to continue to provide services such as the ambulance and care center as we are very dependent on people to allow us to provide these needed services," Kimber Wraalstad, a hospital administrator, said in a report shared with the North Shore Health Hospital Board during a meeting Aug. 18. (DeSilva, 8/22)
Cleveland Clinic said it is well on its way to hitting its goal of hiring 1,200 Cleveland residents in 2022. As part of the partnership, the health system said it has knocked on doors with City Council members to raise awareness about Cleveland Clinic career opportunities, according to the news station. (Gooch, 8/22)
In his first weeks as CEO of CommonSpirit Health, Wright Lassiter is focusing on a few key priorities he says will help the largest not-for-profit system in the country navigate a post-COVID world. ... CommonSpirit, which has 150,000 employees across 21 states, is forming an internal staffing agency and nursing residency program to bolster its workforce. (Kacik, 8/22)
On health insurance —
This time last year, a gaggle of buzzy health insurance startups justified big investments as key to their aggressive growth plans. Now, these same companies are pulling back and instead pursing a novel business strategy: earning profits. (Tepper, 8/22)
KHN: The $18,000 Breast Biopsy: When Having Insurance Costs You A Bundle
When Dani Yuengling felt a lump in her right breast last summer, she tried to ignore it. She was 35, the same age her mother had been when she received a breast cancer diagnosis in 1997. The disease eventually killed Yuengling’s mom in 2017. (Sausser, 8/23)
From The States
California Governor Blocks Safe Injection Site Bill
California Gov. Gavin Newsom on Monday vetoed a controversial bill that would have allowed supervised injection site pilot programs in Los Angeles, San Francisco and Oakland, in efforts to prevent drug overdose deaths and connect people to treatment for addiction. The number of safe injection sites that would have been authorized by the bill could have induced a “world of unintended consequences,” Newsom wrote in his veto message. (Wiley, 8/22)
Newsom’s decision against Senate Bill 57, announced just hours ahead of the legal deadline for a veto, will almost certainly be seen by supporters as a retreat from his commitment to progressive California policies. It is also likely to heighten speculation that his possible aspirations as a Democratic presidential candidate might have compelled him to row back support for an idea he was “very, very open” to when he ran for governor in 2018. (Hatch and Holden, 8/22)
In his veto letter, Newsom said the unlimited number of sites the legislation would have allowed could induce “unintended consequences,” mentioning “worsening drug consumption challenges.” He directed his Health and Human Services secretary and local officials to come back to the Legislature with detailed plans for a “truly limited pilot program.” (Moench, 8/22)
In other health news from California —
About 40,000 low-income adults living in the country illegally won’t lose their government-funded health insurance over the next year under a new policy announced Monday by California Gov. Gavin Newsom’s administration. California already pays for the health care expenses of low-income adults 25 and younger, regardless of their immigration status. A new law scheduled to take effect in January 2024 would extend those benefits to cover all adults who, but for their immigration status, would qualify for the state’s Medicaid program. (Beam, 8/23)
“Nothing in this bill says that workers are able to use cannabis and come to the workplace high,” said California Employment Lawyers Association Legislative Counsel Mariko Yoshihara. “It simply allows a person to use cannabis off the job, like any other legal substance, without facing discrimination.” (Pak, 8/22)
Data Show Hawaii Is State With Longest Life Expectancy
Where should you live to have the longest life expectancy? New data suggests heading out West is a good bet. Hawaii has the highest life expectancy of any U.S. state, according to new federal figures released on Tuesday by the Centers for Disease Control and Prevention. The combined average life expectancy for men and women in the state was 80.7 years old, the only U.S. state with an average expectancy rate above 80 years. Washington state has the second-highest life expectancy, at 79.2 years. California was also high on the list, at 79.0 years. (Ansari, 8/23)
The average life expectancy in the U.S. dropped by nearly two years in 2020, down to 77 years from 78.8 in 2019. It was the country’s lowest average in nearly two decades. A new report from the National Center for Health Statistics looks at how that decline varied from state to state. ... (Bendix and Chiwaya, 8/23)
In other health news from across the U.S. —
Proposals to legalize medical marijuana in Nebraska will not appear on the November general election ballot after the efforts failed to collect enough signatures, the state’s top elections official said Monday. (8/22)
If you are in Colorado and you need treatment for, say, cancer, there are dozens of hospitals and clinics that can provide it for you. But those places are not equal. (Ingold, 8/22)
Missouri was the only state that did not allow a grab-and-go option for its Summer Food Service Program operators, according to an exclusive NBC News analysis based on responses from all 50 states. The result was a dramatic drop in the number of meals that Missouri kids received: up to 97% fewer than last summer at some sites, community operators across the state told NBC News. (Chuck, 8/23)
Teachers will not be forced to address students by the pronouns that match their gender identity even if a parent asks them to and transgender students will be barred from playing sports if two new policies targeting gender identity are approved Monday night by the Grapevine-Colleyville Independent School District board. (Lopez, 8/22)
KHN: ‘American Diagnosis’: As Climate Crises Batter The Bayou, Houma People Are Being Displaced
Lanor Curole is a member of the United Houma Nation. She grew up in Golden Meadow, a small bayou town in Southern Louisiana. The impacts of repetitive flooding in the area forced her to move farther north. Louisiana’s coastal wetlands lose about 16 square miles of land each year. This land loss, pollution from the 2010 BP oil spill, and lingering devastation from Hurricanes Katrina and Ida are pushing many Houma people out of their homes. (8/23)
Gun Violence
Mental Illness A Poor Red Flag For Predicting Mass Shootings: Experts
America’s mass killers fit no single profile and certainly no pattern of insanity — many, if not most, had never been diagnosed with a serious psychiatric disorder. Background checks can prevent someone with a diagnosis of mental illness from acquiring a gun, but psychologists say there is a wide divide between a clinical diagnosis and the type of emotional disturbance that precedes many mass killings. (Dewan, 8/22)
The Parkland shooter was born to an addicted mother, his defense says —
The troubled life of Nikolas Cruz, who killed 17 people at his former Florida high school four years ago, began long before he was born, his lead defense lawyer told jurors on Monday, arguing that his biological mother’s heavy consumption of alcohol and drugs while pregnant irreparably harmed his developing brain. At birth, he was deprived of oxygen by an umbilical cord wrapped three times around his neck, and doctors spent the first minute after his delivery resuscitating him. (Mazzei, 8/22)
Danielle Woodard hadn’t seen her baby biological brother in person since Sept. 24, 1998, when he was born at the hospital. They reunited, in a way, almost 24 years later. Woodard, who herself is in jail in Miami awaiting trial in a carjacking case, took the witness stand on Monday, testifying on behalf of younger brother Nikolas Cruz, who is facing the death penalty as he’s being sentenced for the February 2018 massacre at Marjory Stoneman Douglas High in Parkland. (Ovalle, 8/22)
Cruz had developmental delays early in his childhood, including his difficulty communicating with others. He would bite others, lash out emotionally and was impaired intellectually, public defender Melisa McNeill said. Cruz first received special education services at age 6, struggling in school socially and academically throughout his young life, she said. (Levenson, Royal and Weisfeldt, 8/23)
In other news about mental health —
In June, Dr. Kevin Simon became Boston’s chief behavioral health officer — a role new to the city and possibly unique to Boston. Mayor Michelle Wu and Dr. Bisola Ojikutu, executive director of the Boston Public Health Commission, appointed Simon, a child psychiatrist with Boston Children’s Hospital, to develop a city-wide strategy to address behavioral health issues, especially among youth. (Freyer, 8/22)
Decades ago, North Carolina legislators sought to change the way mental health care is delivered. They closed psychiatric hospitals arguing that patients would be better treated in the community, in less restrictive settings. (Knopf, 8/23)
In Oakland Schools, where the mental health repercussions of November's fatal school shooting at Oxford High School remain reverberant, Benson said mental health resources for students are an “ever-changing participatory resource collection.” Oakland Schools teams are making sure students find these resources to be accessible, by making them available via QR codes and phone apps, for example. (Brookland, 8/22)
What science increasingly shows is that virtual interactions can have a powerful impact, positive or negative, depending on a person’s underlying emotional state. “The internet is a volume knob, an amplifier and accelerant,” Byron Reeves, a professor of communication at Stanford University, said. But there is a lack of reliable research into how technology affects the brain, and a shortage of funding to help ailing teens cope. From 2005 to 2015, funding from the National Institute of Mental Health to study innovative ways to understand and help adolescents with mental health issues fell 42 percent. (Richtel, 8/22)
KHN: From Book Stacks To Psychosis And Food Stamps, Librarians Confront A New Workplace
For nearly two decades, Lisa Dunseth loved her job at San Francisco’s main public library, particularly her final seven years in the rare books department. But like many librarians, she saw plenty of chaos. Patrons racked by untreated mental illness or high on drugs sometimes spit on library staffers or overdosed in the bathrooms. She remembers a co-worker being punched in the face on his way back from a lunch break. One afternoon in 2017, a man jumped to his death from the library’s fifth-floor balcony. Dunseth retired the following year at age 61, making an early exit from a nearly 40-year career. (Scheier, 8/23)
Science And Innovations
Researchers Use AI To Spot Early Parkinson's Signs In Breath Patterns
James Parkinson first flagged a link between changes in breathing patterns and the debilitating disease that now bears his name. But since his work in the early 19th century, only minimal progress has been made in treating a condition that has become alarmingly prevalent. (Ross, 8/22)
It was a shot in the dark — or at best, a dimly lit room: injecting a mouse with a little bit of spinal cord fluid from someone with the most common form of amyotrophic lateral sclerosis, or ALS. (Cueto, 8/22)
In research on memory loss —
Sending weak electrical current into the brain for 20 minutes a day for four days in a row reversed declines in working and long-term memory that come with aging, scientists reported Monday in Nature Neuroscience. (Molteni, 8/22)
For four consecutive days, 150 senior citizens pulled on a swim-like cap and allowed parts of their brain to be bathed with low-dose electrical pulses. During 20-minute sessions, they were given five lists of 20 words each and asked to recall them. In some, the oscillations were directed to an area of the brain known to be involved in short-term memory, where a just-learned phone number would be stored. They were tested to see how many recently-mentioned words they remembered. (Weintraub, 8/22)
In research on kidney diseases —
Recent years have seen a surge of research into rarer forms of kidney disease, with drug companies, regulators, and researchers alike hunting for ways to help patients who have few options. (Cueto, 8/23)
After having her son, Judy Akin got sick much more often than before, and her blood pressure was on the rise, but she led a busy, active life. The ailments were a consequence of stress, she imagined. Doctors told her she just had to shed some pounds to feel better. (Cueto, 8/23)
Study Hints Heart Health Issues Linked To Early Brain Aging
By estimating people's brain age from scans, researchers have identified multiple risk factors for a prematurely ageing brain. They found that worse heart - or cardiovascular - health at age 36 predicted a higher brain age later in life. (Massey, 8/22)
On heart disease and heart failure —
Symptoms of heart disease — the country's No. 1 killer — may be more subtle and varied in women than in men, according to a review published Thursday in the American Heart Association journal Circulation. (Edwards, 8/21)
Heart failure can cause early, subtle symptoms that can be "harbingers" of the disease worsening and impending death, according to a report from the American Heart Association. The report, published on Thursday in the medical journal Circulation, outlines the most recent knowledge on the symptoms of heart failure, as well as other cardiovascular diseases, including stroke. (Schuster-Bruce, 8/22)
More on heart research —
Energy drinks have known health risks, particularly when consumed in large quantities or combined with alcohol. They’ve been linked to heart and blood vessel problems, like heart rhythm disturbances and increased heart rate and blood pressure. It's less clear whether the drinks are linked to problems like coronary artery disease, which is generally due to a combination of genes and long-term lifestyle habits. Because a lot of things can contribute to heart disease, it’s difficult to say energy drinks are the reason for someone’s diagnosis or medical event, according to Dr. Sanket Borgaonkar, a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center. But they could be a contributor, he said. (Camero, 8/22)
A pioneering cardiovascular researcher and one-time co-executive director of Cincinnati Children's Hospital Medical Center's Heart Institute was killed in a cycling crash Saturday, officials confirmed. Jeff Robbins, Ph.D., was cycling in Indian Hill around 8:30 a.m. Saturday when there was a collision with a vehicle, according to reports from the Indian Hill Rangers. He was 71, according to the Hamilton County Coroner's Office. (Knight, 8/22)
Editorials And Opinions
Different Takes: The Consequences Of Overturning Roe Are Here, And They Are Terrifying
In the middle of July, three big blue billboards went up in and around Jackson, Mississippi. PREGNANT? YOU STILL HAVE A CHOICE, they informed passing motorists, inviting them to VISIT MAYDAY.HEALTH to learn more. Anybody who did landed on a website that provides information about at-home abortion pills and ways to get them delivered anywhere in the United States—including parts of the country, such as Mississippi, where abortions are now illegal under most circumstances. (Yascha Mounk, 8/22)
With federal protections for reproductive rights rolled back, data privacy protections are more important than ever for healthcare and abortion access. Facebook and other tech companies routinely cooperate with police demands for information they collect, including messages and keyword searches. For the Nebraska case, Facebook claimed it wasn’t aware that the police were seeking information relevant to a person’s abortion. That raises the question: What would Facebook have done if the warrant included the word “abortion”? (Cynthia Conti-Cook and Kate Bertash, 8/23)
Eight years ago, my husband and I received unimaginable news regarding our first pregnancy. Five and a half months in, due to medical complications, we were forced to decide whether to continue a pregnancy with almost no chance of infant survival. (Laurel Marlantes, 8/22)
For the rest of our lives, we’ll remember where we were or what we were doing when the Roe decision was announced. (Sana Shaikh, 8/22)
One school morning, after a sleepover with my best friend, I'd woken to intense waves of nausea. Her mom ran to fetch a bottle of coke syrup out of her medicine cabinet to settle my stomach. It didn't help, but I didn't think anything of it. (Jennifer Grey, 8/22)
Viewpoints: OTC Hearing Aids Will Have Unexpected Benefits; Who Is At Risk For Monkeypox?
The Food and Drug Administration is finally giving millions of adults with mild to moderate hearing loss what they want and need — access to hearing aids without having to get a pricey, often uncomfortable medical exam. Eliminating this requirement will enable people across the U.S. to purchase these lifesaving devices online or at their local drugstore. (Helene Rosenthal, 8/22)
No sweat, we’ve got this. That’s what we thought when the monkeypox outbreak emerged in May. After all, as an orthopoxvirus, it’s similar to smallpox and so we already have a vaccine — two, in fact. There is also a treatment, it’s generally not deadly, and, as a DNA virus (as opposed to an RNA one like SARS-CoV-2), it’s unlikely to mutate much. (Therese Raphael and Sam Fazeli, 8/23)
Last week, the Centers for Disease Control and Prevention announced it will overhaul itself in response to pandemic mistakes. The first thing the CDC should do is to clarify what those mistakes were. (Faye Flam, 8/22)
One in five Americans will experience a mental health illness episode in any given year. It should also be noted that one in five children — either currently or at some point during their life — have had a seriously debilitating mental illness experience. (Spencer Wiggins, 8/22)
We in psychiatry have known, without exception and for decades, how to promote the recovery of our patients with serious mental illness. (Steven Madonick, MD, 8/23)
I contracted polio 25 years after the world already had Dr. Jonas Salk’s vaccine. I was living in poverty in India in 1980 in the Southern state of Tamil Nadu, and my birth mother hadn’t heard anything about the polio vaccine. (Ramesh Ferris and Hannah Docter-Loeb, 8/21)
I think Fauci will be remembered for the twin infectious disease outbreaks that have, in a sense, served as bookends to his public-service career: AIDS and the coronavirus pandemic. Both times, he became controversial. But they turned out very differently for him. During the early days of the AIDS epidemic, as so many gay men were dying, they were also protesting Fauci, calling him a murderer and a killer. He brought them into his fold and befriended many of them. He would be the first to tell you that it changed him; it made him more sensitive to the patient’s point of view. (Blake Hounshell and Sheryl Gay Stolberg, 8/22)