As the Senate works on its version of the AHCA, and a bipartisan group works separately to repair the ACA (Politico), several new studies in Health Affairs shed light on the effects of the ACA. One study found that Medicaid expansion under the Affordable Care Act led to lower rates of severe psychological distress among low-income parents. The authors suggested that the parents’ improved mental health status may be linked to having health insurance coverage, and as a result, experiencing less stress related to finances. Another study found that the Medicaid expansion improved access to and affordability of health insurance among low-income patients over the last three years, in addition to increasing coverage rates. Low-income adults also reported better quality of care.
Trump is expected to release his budget proposal on Tuesday. The Atlantic reports that two NIH sources say it includes a “10% cap on the NIH’s indirect costs, which researchers say will be a huge blow to their budget. Meanwhile, according to Politico, Republicans are looking to cut $400 billion, largely from safety-net programs, to balance the FY18 budget. “The proposal won't specify which programs would get the ax; instead it will instruct committees to figure out what to cut to reach the savings. But among the programs most likely on the chopping block, the sources say, are food stamps, welfare, income assistance for the disabled and perhaps even veterans’ benefits.”
Almost 700 positions are vacant at the Centers for Disease Control and Prevention because of the Trump administration's freeze on hiring, the Washington Post reports.
“Officials and researchers say the freeze affects programs supporting local and state public health emergency readiness, infectious disease control and chronic disease prevention.The same restriction remains in place throughout the Health and Human Services Department…At the National Institutes of Health, staff say clinical work, patient care, and recruitment are suffering.”
Researchers are finding that depression may be helping to drive the opioid epidemic, Olga Khazan writes in the Atlantic. Depression can increase susceptibility to pain and recovery times, researchers have found. And some people experience opioids as soothing or mood elevating, like anti-depressants. Studies have shown that people with depression are more likely to misuse pain killers, and that prescription opioids can make depression worse.
Writing in Vox, German Lopez details how the Trump Administration’s actions may be making the opioid crisis worse rather than eliminating it, as candidate Trump had promised. Among the concerns: potentially cutting the Office of National Drug Control Policy’s budget by 95%, expressing skepticism about the value of medication-assisted treatment, and focusing on pursuing low-level drug dealers instead of on addressing underlying factors driving the epidemic. Meanwhile, the “rising US drug threat,” including “soaring US drug deaths, foreign drug production, and drug seizures” made the list of concerns detailed in the Senate Select Committee on Intelligence Worldwide Threat Assessment. The assessment reported that deaths from synthetic opioids increased 73% from 2014 to 2015.
KQED reports on the concerns of undocumented families in California relating to last year’s “Health for All Kids” law expanding Medi-Cal coverage to undocumented children. Approximately 190,000 undocumented children have subsequently enrolled, but some families now worry that the information they provided to Medi-Cal will be shared with immigration enforcement. Immigrants are also increasingly skipping doctor appointments because of similar concerns, according to the survey, conducted in March by the advocacy group Children Now. Kelly Hardy, Children Now’s managing director of health policy, said some families even have sought to withdraw their children from the Medi-Cal program because they fear that their immigration status might be shared with immigration officials. ‘Holding on to the kids who have recently enrolled is going to become critically important,’ Hardy said.
Physical violence is the second leading cause of death among male adolescents worldwide, QZ reports on WHO data. In 2015, 42,277 young men ages 10-19 died from interpersonal violence, second only to traffic crashes. “The report doesn’t definitively say that young men are fighting one another; such deaths could be occurring due to domestic violence with older men in households. Either way, physical fights are turning fatal for teenaged boys.”
The FDA will be delaying parts of the implementation of a rule to regulate e-cigarettes like other tobacco products. Additionally, FDA head Scott Gottlieb indicated a willingness to reconsider e-cigarette restrictions introduced under the Obama administration: "We need to have the science base to explore the potential to move current smokers — unable or unwilling to quit — to less harmful products, if they can't quit altogether.” Meanwhile, new research finds that e-cigarettes, like traditional cigarettes, are linked to an elevated risk of bladder cancer.
More than 60 percent (57,141 of the 91,764) of military service members discharged for misconduct had previous diagnoses for post-traumatic stress disorder or other conditions that could be associated with misconduct, according to a recent report from the US Government Accountability Office. The GAO’s analysis of discharges from 2011-2015 also found that nearly 25% of those 57,141 discharges were classified as “other than honorable, potentially disqualifying the veterans for health benefits through the Department of Veterans Affairs. The GAO found that the different military services branches did not always follow Department of Defense policies designed to consider conditions such as brain injury and PTSD as potential mitigating factors in discharges for misconduct. STAT reports the defense department disputed the findings, contending the report underestimated the number of screenings for mental health problems in the discharge process.
Philadelphians elected a district attorney, Larry Krasner, who campaigned on a platform promising not to incarcerate nonviolent offenders, and to end mass incarceration and cash bail, Think Progress reports.
Just one month after the Trump administration rejected a proposed ban on chlorpyrifos, a dangerous insecticide, more than 50 California farmworkers were sickened by exposure to the pesticide.
An op-ed in the Philadelphia Tribune draws attention to the environmental injustices faced by African-American communities that will be exacerbated by the presidential administration’s approach to environmental protection. “We must understand that diseases like asthma and heart disease don’t just happen. When decisions are made about where polluting industries should be placed, our communities too often end up in the cross hairs. We must be vigilant about the need to stand up for environmental protections: Our lives are at stake.”
The presidential administration plans to “vastly expand” the global gag rule, a policy that withholds US aid from health organizations across the developing world that provide abortions. In effect, this has muzzled health organizations who fear discussing abortion and risking funding; the Trump administration formally extends the global gag rule to bar US aid from organizations that even discuss abortion as an option. The New York Times warns that this expanded gag rule has the potential to “disrupt hundreds of clinics in Africa and around the world that fight AIDS and malaria…
Michael Bloomberg, the WHO global ambassador for non-communicable diseases, has pledged to fund $5 million in public health projects in 40 cities around the globe. The cities must pick from 10 issues, which include cutting sugary drink consumption, smoking bans, and promoting exercise, the Guardian reports.
A new PHI analysis find that food sector revenue has risen by 15%, and over 450 new jobs in the food industry were created--an increase of 7.2%--in the two years since the Berkeley soda tax took effect.
Media reports from Ohio highlight rising concerns and efforts to address opioid misuse in the state:
- Police in East Liverpool, Ohio are calling for stronger penalties for drug trafficking after a police officer died of an overdose after brushing a substance suspected to be fentanyl from his shirt in a “field test” during a search and seizure, STAT reported. The officer died after repeated applications of the anti-opiate Narcan. The consequences of incidental contact with the deadly drug have heightened concerns in the town, which has been flooded with cases of opioid misuse.
- State lawmakers have introduced the Opioid PACE (Preventing Addiction through Continuing Education) Act to help doctors identify and address opioid misuse.
- The Cleveland Jewish News looks at opioid misuse among the Jewish community. One rabbi said: “We like to see ourselves as moving positively through society without carrying the burdens of addiction.”
- The student council at Spencerville High School organized a Mental Health Awareness day to educate students about topics ranging from depression to human trafficking to opiate misuse, according to LimaOhio.com.