Retrospective: On Prescription Drugs

By | August 22, 2022

The Medical Care Blog is preparing for its full return later this month. Until then, we are continuing to highlight articles published by our contributors on timely topics. A federal bill is pending that would allow Medicare to begin negotiating drug prices for the very first time. Even though it would begin with only 10… Read More »

Retrospective: On Reproductive Health Care

By | August 4, 2022

The Medical Care Blog is returning from its summer break this month. We hope you are feeling recharged and ready to dig deep again into health care and public health. We’re beginning with a series of retrospective posts to highlight the work of our contributors on prominent topics. This week, we focus on a collection… Read More »

Summer Break at The Medical Care Blog

By | July 8, 2022

The Medical Care Blog is taking a short summer break from publishing new articles. In the meantime, catch up with the latest posts on the blog: Healthy Intersections Podcast, June 2022 featuring MC Governing Councilor Samy with a wrap-up and co-editor Lisa Lines interviewing noted infectious disease epidemiologist Pia MacDonald about COVID-19 – looking back and looking… Read More »

Category: All

Social Drivers of Cancer Mortality: Part 2

By | September 1, 2022

Measuring and addressing social drivers of health are important in cancer research. Part 1 of this series, published in March 2022, described three commonly used area-level SDoH indices. None are not able to explain much variation in cancer mortality rates. In this post, I share results from a new model that shows promise. Methods in… Read More »

APHA Calls for Single-Payer Health Reform

By | July 6, 2022

It is not too late to fix the US healthcare system. But every day spent in this folly, the problem gets worse. It is time to move this conversation forward. We are excited to share that in November 2021, the American Public Health Association (APHA) formally adopted a policy statement titled “Adopting a Single-Payer Health… Read More »

Ethical research using government administrative data

By | June 16, 2022

As a public health researcher, I love data, the more the better. I held this belief until I found that I myself had become the “subject” of research without my consent. This experience made me rethink ethical research. The more data, the better? In 2017, I encountered a state-level bill that required all the government… Read More »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

Healthy Intersections Podcast: June 2022

By | June 2, 2022

On this month’s episode of the Healthy Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and preview’s June’s issue of the Medical Care journal. Some great articles to check out for your summer reading list. Next, Lisa Lines, co-editor of the blog and podcast, interviews Dr. Pia MacDonald, an… Read More »

Diabetes Cure or Diabetes Management?

By | May 26, 2022

Reuter’s announced in January that diabetes deaths in the United States continue to surge well above pre-pandemic levels with over 100,000 Americans dying from diabetes in 2021. Given COVID-19’s relationship to diabetes, we may see this trend continue. Increasing deaths from diabetes is a clear call to action for new solutions. Historically, diabetes has been… Read More »

May 2022 Podcast

By | May 13, 2022

In this episode of our podcast series, Jess Williams discusses COVID-19 case and hospitalizations with Tami Gurley, an Associate Professor at the University of Kansas Medical Center. Jess also recaps the blog posts published in April and previews some articles published in the May issue of Medical Care. Listen here or wherever you get your fine audio content.… Read More »

Fixing Health Care: A Health Care Revolt Begs Five Big Questions

In a previous post, we shared highlights from an event about fixing health care featuring Dr. Michael Fine, a family medicine physician, former public health official, and the author of Health Care Revolt. The faculty of the Department of Public Health at California State University Los Angeles led the event as part of a department-wide book read.… Read More »

A Health Care Revolt Begins with Us

Readers of this blog know the problems of U.S. health care well. Principally, it is absurdly expensive, deeply inequitable, and contributes relatively little to overall public health. Yet, most people aware of these problems have been sidelined, feeling incapable of changing things and left hoping for reform to come from within. But health care providers… Read More »

Category: All

Broadband is a human right: the right to information and COVID-19 disparities

Understanding internet access through a human rights framework has been a goal of human rights advocates for years. But COVID-19 has brought the idea of “broadband as a human right” to the forefront as a necessary and urgent human need. A recent study exploring the Social Determinants of Health and COVID-19 mortality, found that individuals without… Read More »

Centering measurement on patients and family caregivers while developing two novel quality measures

In healthcare, what gets measured gets done. This is particularly true as the use of value-based purchasing, alternative payment models, and consumer tools to compare quality expand in the U.S. Centering measurement on patients, and focusing on their needs, preferences, and values, ensures that what we measure really matters, not only to patients and their… Read More »

Whole Person Health: A Path to Health Equity (Part 2)

In our first blog post of this series, we discussed how the current medical approach misses so much of what influences health, and how it perpetuates health inequities in our society. In this post, we go in-depth on the elements of Whole Person Health (WPH) that are necessary components of a just and equitable approach… Read More »

Whole Person Health: A Path to Health Equity (Part 1)

Our current U.S. medical system doesn’t work. It is not able to adequately care for the sickest, most vulnerable, and least resourced people. It often excludes those seen as “other” in our society. To become a just system, we need a new focus on Whole Person Health (WPH). Very briefly, WPH cares for the whole person and… Read More »

April 2022 Podcast

By | April 7, 2022

In this episode of our podcast series, Greg Stevens discusses health care provider burnout with Cooper Couch, a practicing physician assistant at an FQHC in rural Colorado. Next, he recaps the blog posts published in February and previews an article published in the April issue of Medical Care. Authored by Jae Downing, Kendall Lawley and Alex McDowell,… Read More »

Measuring what matters to patients and their family caregivers: Measure development isn’t just for measure developers

In today’s healthcare system, measurement influences everything from quality improvement to payments. So it matters greatly what gets measured. Measuring what matters to patients and their family caregivers will focus healthcare on their needs, preferences, and values. In a recent measure development effort, we brought lived and professional experience together at every stage. We found… Read More »

Social drivers of cancer mortality

By | March 28, 2022

In 1981, Doll and Peto published a well-known paper estimating that roughly 75-80% of cancer mortality was preventable. Forty years later, cancer mortality has declined some overall – but we still see vast disparities. Some of these disparities have gotten worse over time. With the Biden administration’s reignited Cancer Moonshot initiative, combined with a renewed… Read More »

Pandemic Aging in Place Services: A Silver Lining for the Silver Economy

By | March 16, 2022

When COVID-19 forced sudden lockdowns in 2020, Americans realized quickly that the supply of services available at home did not match growing quarantine demands. Both the public and private sectors responded with shifts to delivering contact-free services. That pandemic shift may have long-term benefits for older adults seeking services to support aging in place. Pandemic… Read More »

The new landscape for community public health

By | March 10, 2022

We’re in a new landscape, where citizens sees themselves as agents for community public health and as part of the public health infrastructure. My patient began to talk about COVID in her community. She first told me the rates of infection from the previous weeks. Then she told me what COVID strains were dominant at… Read More »

March 2022 Podcast

By | March 2, 2022

In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in February. She also previews a few of the journal articles published in this month’s issue of Medical Care. Next, Lisa Lines, co-editor, discusses an article published ahead of print on March 1. The article is available here:… Read More »

Vaccination Choice: The Strongest Link in the Weakest Case

By | February 24, 2022

Almost 30 years ago I was working in the White House as part of a team working to win approval of President Bill Clinton’s proposal for universal health insurance. The effort was winding down. It was obvious it would fail. I was tired and depressed. One of my last appearances in support of the plan… Read More »

To Address Synthetic Opioids, These Public Health Strategies Must Play a Vital Role

By | February 14, 2022

The opioid epidemic and substance use disorders have garnered national attention as overdose deaths continue at an alarming rate. Synthetic opioids – chiefly fentanyl – are the culprit in many of those deaths. The Commission’s report Earlier this month, the bipartisan Congressional Commission on Combating Synthetic Opioid Trafficking, with representatives from many Federal agencies and… Read More »

February 2022 Podcast

By | February 10, 2022

In this episode of our podcast series, Samyuktha Anand, secretary-elect for the Medical Care section, recaps the blog posts we published in January. Next, Jess Williams, co-editor, interviews Nien Chen Li about her recently published paper — a winner of the APHA Medical Care Section’s Student Paper Award in 2020. Dr. Li’s paper is about… Read More »

Evaluating Community Health Worker Programs

By | February 3, 2022

Evaluating community health worker (CHW) programs can be difficult. Many of the outcomes that we care about, such as patients’ capacity to live healthier lives, can be difficult to measure and take time to manifest. I have been fortunate to be part of a five-year research partnership with the KC Care Health Center that was… Read More »

Is Something Going Wrong With the Patient Centered Medical Home?

By | January 27, 2022

Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »

Lessons From Conducting the Path-4CNC Virtual Convenings

Last week, we detailed the findings of virtual convenings we held in North Carolina to improve care for children with complex health needs (CCHN). Here, we share our takeaways about the process of planning, holding and following-up on the convenings. We also outline the specific steps other leaders, innovators, and advocates can take to engage… Read More »

Engaging Communities to Improve Systems of Care for Children with Complex Health Needs

Children with complex health needs (CCHN) are a unique pediatric patient population. They have chronic medical and/or behavioral conditions that need ongoing health care. They use a disproportionate share of hospital resources. And they face greater social challenges when compared to other children. In North Carolina (where we work) and across the country, CCHN fail… Read More »

January 2022 Podcast

By | February 10, 2022

In this episode of our podcast series, Greg Stevens, co-editor, recaps the blog posts we published on The Medical Care Blog in November and previews the January issue of Medical Care. Greg also interviews Dr. Ben King from the University of Houston School of Medicine about their shared interest in health care for people experiencing homeless.… Read More »

How are CMMI health policy evaluations addressing non-parallel trends?

To help determine which health policy changes to the Medicare or Medicaid programs are desirable, the CMS Center for Medicare and Medicaid Innovation (CMMI) relies on formal evaluations, performed by outside contractors, of how smaller scale, typically voluntary, demonstrations and other initiatives impact outcomes of interest. However, determining causal impacts often relies on the key… Read More »

Category: All

“Carve In” Mental Health and Substance Use Treatment

By | December 21, 2021

More than 150,000 avoidable deaths occur each year due to mental, emotional, and behavioral health problems. This includes nearly 50,000 suicide deaths and 100,000 overdose deaths. People with chronic persistent mental illness suffer a 20-year shorter life expectancy. This country urgently needs to address how we pay for mental health services. Medicaid is a major… Read More »

The Power of Data – Takeaways from the 2021 All In National Meeting

By | December 10, 2021

“You can’t improve what you don’t measure” is a common phrase highlighting the importance and power of data. Indeed, the importance of data was the central theme of the 2021 All In National Meeting. In case you’re unfamiliar, the host of the national meeting is All In: Data for Community Health: a learning network of… Read More »

Nursing Home Characteristics and COVID-19 Outcomes: The Evidence is Mixed

By | December 17, 2021

COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and… Read More »

Downstream Efforts to Address Social Determinants in the CMS Financial Alignment Initiative

In our last blog post, we discussed the Biden Administration’s infrastructure package as an example of an upstream policy effort that could promote equity and help address disparities. However, as we pointed out in the first in this series of blogs, stakeholders who interact with community members are best suited to identify social risk factors… Read More »

December 2021 Podcast

By | December 7, 2021

In this episode of our new podcast series, Jess Williams, co-editor, recaps the blog posts we published on The Medical Care Blog in November and previews the December issue of Medical Care. As a bonus, Lisa Flaherty from the APHA Medical Care Section interviews two of our December contributors: Dr. Sharla Smith, founder of the… Read More »

Parent Perspectives on Birth Equity – Birth Equity Series Part 3

In the United States, 700 women die every year from often preventable pregnancy or childbirth complications. An additional 60,000 more experience highly preventable birth injuries. Black women are three times more likely to die from those complications than white women. According to the CDC, the maternal mortality rate in the U.S. is roughly 17.4 maternal… Read More »

Words Matter in Creating Birth Equity – Birth Equity Series Part 2

While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States, Black women are three times more likely to die from a pregnancy-related complication than white women. In Kansas, Black women are more than three times as likely to die of pregnancy-related complications compared to… Read More »

Defining Birth Equity in Kansas – Birth Equity Series Part 1

The pace of progress is never fast enough for those who stand to suffer the biggest losses. Nowhere is this more apparent than in the glaring health inequities impacting Black mothers and babies in Kansas. Among the multitude of injustices Black Kansans face today, the disproportionate rates of death and devastating health complications for Black… Read More »

The Long Arm of Redlining: Health Inequities in the Digital Divide

Medical care is sometimes, though not on this blog, viewed as the gold standard to address inequities. However, access to medical care only accounts for an estimated 10-20% of the modifiable factors that affect population health. The other 80-90% of modifiable factors are often referred to as social determinants of health (SDOH). These are the… Read More »

Blood-Based Biomarker Tests Address Unmet Need in Alzheimer’s Disease Care

By | September 1, 2022

The Alzheimer’s Association’s 2021 Alzheimer’s Disease Facts and Figures report [PDF] shares that currently, six million Americans are living with Alzheimer’s disease, a number that has increased 145% since the turn of the century.  Around the world, there are 50 million people living with Alzheimer’s disease or related dementia. Only a quarter of would-be patients… Read More »

Wrapped in Services and Art, Los Angeles Opens Tiny Homes for People Experiencing Homelessness

In Los Angeles, the nation’s homelessness epidemic is playing out in broad relief. Criticized for an inability to visibly stem the local crisis, Los Angeles is now responding. Opening villages of tiny homes for people experiencing homelessness is part of a recent package of efforts gaining traction in the city. The situation in Los Angeles… Read More »

Category: All

The Future of Telemedicine Depends on Applying Lessons From The Pandemic

By | October 28, 2021

During the pandemic, telemedicine demonstrated it’s power. As we begin to make the shift back to in-person clinical care in a post-pandemic world, it’s important to look at the lessons learned during the pandemic. This will help guide us in how to move forward and improve telemedicine delivery. The History The use of telemedicine is… Read More »

APHA Annual Meeting 2021 Preview

By | October 23, 2021

The annual meeting of the American Public Health Association starts this weekend!  This year the meeting is being held in person in Denver with lots of virtual options as well. I know everyone is excited about getting back together and connecting as a community. I can’t wait to connect with friends and colleagues and meet… Read More »

Authentic Leadership in Healthcare And Public Health: What Is It And Why Should We Care?

The COVID-19 pandemic has strained healthcare and public health. Many workers in these industries have felt growing frustration with leadership. They face a barrage of medical misinformation, ethical strains, and burnout. Now more than ever, authentic leadership is critical in supporting healthcare workers and advancing public health. This post will describe authentic leadership and examine… Read More »

COVID-19 and Health Workforce Equity

COVID-19 has uncovered and multiplied health workforce equity challenges across the US. In the early days of the pandemic, healthcare workers faced incredible personal risk from an unknown, highly contagious, deadly disease. Insufficient personal protective equipment (PPE) and reprimand and dismissal by employers for speaking out worsened this risk. As waves of COVID-19 swept across… Read More »

The Uncertainty of Black Pregnant Women and COVID-19 Vaccines

In March 2020, the Centers for Disease Control and Prevention (CDC) confirmed COVID-19 as a pandemic. More than 18 months later, the nation has yet to return to ‘normal’. Hope for normalcy increased with the rollout of COVID-19 vaccines in the months that followed. Reluctance and resistance to vaccination, however, have made it difficult to… Read More »

Supporting Front-line Workers with Resiliency Training

By | September 15, 2021

Front-line workers are always at risk. It’s in the name. The COVID-19 pandemic has made this reality more salient for everyone. Risks of sickness from COVID-19 include death and morbidity. Front-line workers may also have lost more friends and co-workers than the average person. Healthcare workers have also been subject to violence and see the… Read More »