Continuing the trend from last year, research by our Senior Fellows has made Health Affairs’ 2018 top 10 most-read and most-shared lists.

Health Affairs tracks the most-read articles on its website. To identify the most-shared, Health Affairs uses Altmetric, which tracks and scores the social and mainstream media impact of peer-reviewed journal articles. To put the following scores in context, Altmetric reports that Health Affairs articles have a mean “attention score” (the number in the braided circle) of 45.5.

Topping the list of most-read articles is “Child Mortality In the US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis” by Ashish P. Thakrar, Alexandra D. Forrest, Mitchell G. Maltenfort, and Christopher B. Forrest.

Forrest and colleagues studied child mortality trends in the United States and 19 industrialized nations from 1961 to 2010. Childhood mortality progressively declined in all 20 countries over the study period – a tremendous public health success. However, reductions were not evenly distributed. In the US, rates have remained higher than in peer countries since the 1980s, with perinatal causes and injuries accounting for much of the disparity. Strikingly, from 2000-2010, children ages 15–19 in the US were 82 times more likely to die from gun homicide. They conclude, “The findings should motivate Americans to do everything possible to improve the medical and social conditions of children that are responsible for these preventable deaths.” The article quickly made headlines in local, national, and international outlets such as The Atlantic, CNN, and Time Magazine. It also seemed to strike a nerve amongst concerned parents, family members, and American citizens on Twitter. It holds the second-highest Altmetric score of all Health Affairs articles.

#3 on the list of most-shared articles is “Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners” by Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf.

As the title suggests, this article demonstrates the increasingly important role nurse practitioners (NPs) have in delivering primary care. From 2008-2016, more physician practices employed NPs, and there were more NPs in each practice. In that time, the presence of NPs in rural and nonrural areas increased by more than 40%.  States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice.  This article suggests that primary care practices are embracing diverse provider configurations, which may strengthen care delivery.