Featured Post
January 21, 2021
The United States has one of the highest rates of low birthweight (LBW) among OECD countries, with significant disparities by race and ethnicity. We know that maternal “resilience”—protective factors that buffer the health effects of stress and adversity—may be associated with lower LBW rates, but the relationship among maternal resilience, race/ethnicity, and LBW is not clear. Identifying resilience and LBW patterns by race/ethnicity is important to target prevention efforts.
April 12, 2021
By delivering free naloxone and other harm reduction supplies discreetly and confidentially to people’s homes, what arrives in the mail could save a life. That’s the take-home message from an innovative approach to reducing opioid overdose deaths in Philadelphia, where the fatal overdose rate surpasses that of other large U.S. cities. Mailing is an effective yet largely underutilized strategy for increasing access to life-saving harm reduction supplies, one that policymakers should explicitly support given the urgent need.
In a recently published paper in International Journal of Drug Policy, we evaluated a partnership between NEXT Harm Reduction, the Philadelphia-based harm reduction group SOL Collective, and the Philadelphia Department of Public Health that provides free mailed naloxone to any Philadelphian who requests it. We analyzed the 422 naloxone requests received in Philadelphia from March 2020 through January 2021, throughout the pandemic.
April 8, 2021
In Health Affairs, LDI Senior Fellow Matthew Grennan, Ashley Swanson, and I present new evidence on medical device firms’ payments to physicians. Device firm relationships with physicians tend to be more involved than those between pharmaceutical reps and prescribers, but have received far less scrutiny.
April 7, 2021
[Cross-posted from CHOP PolicyLab]
In 2020, 1 in every 4 children across the United States lived in a household experiencing food insecurity, where their access to food was limited by their families’ financial resources.
The federal Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, provides nutritional support and nutrition education to food-insecure pregnant women and children under the age of 5 who are living in poverty. Since launching in 1975, WIC has clear health benefits for children who participate, including lower rates of food insecurity and improved nutrition. Unfortunately, the U.S. Department of Agriculture (USDA) estimates that only about 50% of eligible women and children across the country currently receive WIC.
April 5, 2021
Individuals involved in the criminal justice system have high rates of opioid use disorder (OUD), but frequently have limited options for treatment. The Affordable Care Act’s Medicaid expansion gave states the opportunity to increase coverage for individuals with criminal justice involvement, but whether that translated into increased access to OUD treatment in this population is an open question. In our latest study in Health Affairs, we found that the receipt of medications for OUD increased significantly more for individuals referred by criminal justice agencies in states that expanded Medicaid compared to those states that did not.
April 1, 2021
The best blogs are like good conversations. They’re engaging, enlightening, and easy to understand. As an academic blogger, your job is to get and keep your reader’s interest. Once you have that, you can give your perspective on something—a study, a news item, or a policy—and increase the chances that your work can have an impact beyond the academic sphere.
March 31, 2021
The COVID-19 pandemic has forced us to face many uncomfortable realities. As critical care physicians, my colleagues and I work in intensive care units (ICUs) that have grown to accommodate the large numbers of patients who have become seriously ill from COVID-19 during the past year. However, the specter of scarcity has been looming. We know that a day may come when there are not enough ICU beds or ventilators for all the patients who need them. In such a situation, how will hospitals fairly choose who gets access to these scarce resources, knowing that the patients who are turned away may die?
March 30, 2021
In the past few months, we have seen what can be accomplished when the federal government marshalls its resources and mobilizes a nation to address a health crisis. While there is no vaccine for the epidemic of overdoses that has claimed more than 80,000 lives in the past year alone, we already have effective treatments for opioid use disorders and proven life-saving strategies. There is an urgent need for federal leadership to address an overdose crisis that has worsened throughout the pandemic.
March 25, 2021
As the remaining non-expansion states consider expanding Medicaid eligibility, a new study offers encouraging evidence that Medicaid patients’ access to surgical care can be maintained even when enrollment surges. In the American Journal of Surgery, my co-authors and I compared patients’ use of high-quality colorectal surgeons after the Affordable Care Act’s (ACA's) Medicaid expansion in two states: New York, an expansion state, and Florida, a non-expansion state.
March 24, 2021
Can your overall diet, or specific foods, affect your risk for periodontal (gum) disease? The answer has major public health implications, since periodontal disease affects 47% of adults over the age of 30 in the United States and has an indirect economic cost of over $123 billion. In a new study in the Journal of Clinical Periodontology, my colleagues and I find that overall some categories of foods—nuts, red meat, and trans-fatty acids—may be associated with periodontal disease. In specific, nuts may be protective, while red meat and trans-fatty acids might increase your risk for periodontal disease.
March 17, 2021
Hospitals lost more than $20 billion in revenue when the pandemic led to an unprecedented nationwide shutdown in elective surgical procedures from March to May 2020. In a new Annals of Surgery study, we quantified this impact and analyzed the potential implications of a widespread interruption in elective surgeries for patients, health disparities, and the financial health of hospitals.
March 10, 2021
[Cross-posted with Penn Center for Mental Health]
Screening tools for autism spectrum disorder (ASD) often fail to identify ASD among children from low-income families and racial/ethnic minority groups, particularly when English is not the family’s primary language. A new visually-based tool may reduce these disparities at a pivotal point in children’s development.
In Pediatrics, Zuleyha Cidav, David Mandell, and colleagues found that the Developmental Check-In Tool (DCI) can accurately identify ASD risk among young children from families that have low income or speak English as a second language.
March 8, 2021
The 2016 presidential campaign saw a dramatic rise in anti-immigrant rhetoric. The sudden, high-profile change was associated with a substantial decline in utilization of health care services by undocumented adults and their children, as shown in the above chart. That’s the takeaway message from a new study in JAMA Network Open by former LDI Associate Fellow Joseph Nwadiuko and colleagues.
The authors compared primary care visits, emergency department use, and inpatient discharges from 2014 through 2017 for more than 20,000 patients in the Johns Hopkins Health System (JHHS). From the announcement of Donald Trump’s candidacy in June 2015 through May 2018, there was a 43.3% relative decrease in primary care visits for undocumented children and a 34.5% relative decline in undocumented adult primary care visits. Emergency department use increased for undocumented children, and there was a relative decrease in hospitalizations among undocumented adults.