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1 in 3 Americans Still Self-Rations Healthcare

People in the U.S. are much more likely to go without health care they need compared with health citizens in 10 other wealthy countries, according to the Commonwealth Fund’s 2016 international survey. One-third of Americans did not seek care due to costs, including going without recommended care, failing to fill a prescription drug, and/or not seeing a doctor when sick. While this self-rationing proportion of Americans dropped from 37% in 2013, the U.S. still ranks #1 in foregoing necessary healthcare due to cost. “In comparison to adults in the other 10 countries, adult sin the U.S. are sicker and more

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Healthcare Reform in President Trump’s America – A Preliminary Look

It’s the 9th of November, 2016, and Donald Trump has been elected the 45th President of the United States of America. On this morning after #2016Election, Health Populi looks at what we know we know about President Elect-Trump’s health policy priorities. Repeal-and-replace has been Mantra #1 for Mr. Trump’s health policy. With all three branches of the U.S. government under Republican control in 2018, this policy prescription may have a strong shot. The complication is that the Affordable Care Act (aka ObamaCare in Mr. Trump’s tweet) includes several provisions that the newly-insured and American health citizens really value, including: Extending health

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Americans Have Begun to Raid Retirement Savings for Current Healthcare Costs

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). This sober profile on healthcare consumers emerges out of survey research conducted by EBRI (the Employee Benefit Research Institute), analyzed in the report Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and

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The Drug Epidemic-Testing and Data Arm the Battle

More than 40 Americans die every day from prescribed opiate overdoses, Dr. Tom Frieden of the CDC has recognized. The harms of pain-killing drugs have been substantial: Dr. Frieden observed, “the prevalence of opioid dependence may be as high as 26% among patients in primary care receiving opioids for chronic non-cancer-related pain.” There were more deaths due to drug overdoses in 2014 than in any previous year, 61% of which involved opioid pain relieving medications such as oxycodone and hydrocodine, and heroin which has grown in use over the past few years. The CDC has recommended that healthcare providers do

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Broadband – A Social Determinant of Health

The promise of digital, connected health to engage all health citizens cannot be fully realized until people have access to the new social determinant of health: broadband connectivity. The World Health Organization considers social determinants of health inputs like education, safe drinking water, nutritious food, safe neighborhoods for walking, employment and transportation access. Together, these factors bolster personal/individual and public health. See the map of the U.S., and note whee the concentrations of aqua blue are. These are areas that lack broadband access. Telehealth and other digital health tools can get health care to under-served people in under-served geographic areas….where broadband

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Health in America: Improving, But Disparities Need Policy Prescriptions

The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable

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The Health Disparities of Being Gay

#PrayForOrlando The club Pulse, site of the biggest mass gun shooting in U.S. history, was named to honor one of the co-owner’s brothers, who succumbed to AIDS in 1991. In today’s Health Populi, I soberly ponder the lost lives in the Orlando massacre of people who joyfully convened in a safe haven to celebrate life, liberty, and their pursuits of happiness. Over fifty people ended up dead, and there will be more mortalities as the health workers at Orlando Regional Medical Center continue to fight the post-trauma battle to save gunned-down lives. We define “health” broadly in Health Populi and

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For Healthcare Costs, Geography is Destiny

Where you live in America determines what you might pay for healthcare. In this health economic scenario, as Napoleon is rumored to have said, “geography is destiny.” If you’re searching for low-cost health care, Ohio may just be your state of choice. The map illustrates these health care disparities across the U.S. in 2015, when the price of a single service could vary by more than 200% between one state and another: say, Alaska versus Arizona, or Wisconsin compared to Florida. Even within states, like Ohio, the average price of a pregnancy ultrasound in Cleveland ran nearly three times that received in

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Rural Hospitals in America – Health Disparities, Hospital Disparities

Rural hospitals operating in the U.S. have a higher risk of mortality — closure — than other hospitals in America. The U.S. health care landscape is littered with examples of health disparities among the nation’s health citizens – for example, women’s lower access to heart-health care, Latinos’ higher rates of Type 2 Diabetes, and African-Americans’ greater risks of stroke, many cancers, maternal mortality, and many other causes of mortality and diminished health. A report from iVantage, Rural Relevance – Vulnerability to Value, documents the fiscally challenging environment for rural hospitals in America. There are at least 673 facilities at-risk of closure

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Building Health Bridges — Health:Further Goes Beyond the Disruptive

Most people in the U.S. acknowledge that their richest country in the world has a broken healthcare system, especially when it comes to costs. A handful of think tanks and lawmakers offer fixes for American healthcare. Now there’s a new problem-solver in healthcare town, Health:Further, and they aim to move U.S. health forward by building bridges between stakeholders in the U.S. health ecosystem. My longtime colleague and friend, Andre Blackman of Pulse+Signal, has joined the organization as “Producer.” Here, we’ll learn more from my (JSK) interview with Andre (AB) about the organization, their mission, and plans to go beyond “disruption”

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Let’s Make a Deal: Patients Weigh Privacy Paybacks

“It depends” is the hedge-phrase that characterizes how Americans see disclosing personal information versus keeping private information private, according to the consumer survey report, Privacy and Information Sharing, published by the Pew Research Center (PRC) in January 2016. U.S. adults see a privacy trade-off, living in the convenience-context of 21st century digital economy in exchange for some form of value. The “it depends” is a factor of what kind of data is geing collected, especially by third parties, how long that data area retained, for what use — vis-à-vis what a person is trading in return which could be a hard dollar

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Retailers will morph into health destinations in 2016

Retailers in the U.S. are morphing into health destinations in 2016. Members of Target’s management team attended the 2016 Consumer Electronics Show (CES) and shared their perspectives in the company blog. Among the Target teams observations came from the Chief Marketing Officer, Jeff Jones, who observed, “A tidal wave of newness is coming to fitness technology and many companies are on the cusp of changing the game. From nutrition and sleep to how you exercise, it’s all going to be measured, linked and tracked. Wearables are here to stay and getting smarter every year.” The Senior Vice President for Hardlines,

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Talking Infant Mortality At the 2016 Consumer Electronics Show

The rate of infant mortality — that is, babies dying in their first year of life — in the United States ranks lowest among the world’s developed countries, and below some less wealthy nations, as well. Shiny new things for digital health will be launching at the 2016 CES, the Consumer Electronics Show, in Las Vegas this week. And in the midst of virtual reality devices, connected cars, drones, and 4K TVs, I’ll be moderating a panel to kick off the Digital Health Summit at CES on Thursday focusing on The Wizards of Maternal Health — and how digital +

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The 2016 THINK-Health Health/Care Forecast

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

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The Internet of Healthy Things According to Dr. Kvedar

By 2020, according to the World Economic Forum, more than 5 billion people and 30 billion “things” will be connected to the Internet — cars, refrigerators, TVs, washing machines and coffeemakers, among those 5 bn folks’ electronic stuff. But so will medical devices, activity trackers, and a host of sensor-enabled “things” to help people and clinicians optimize health and manage illness. The Internet of Things (IoT) phenomenon, which is already penetrating households with energy management and security applications, is reaching health care. One of the pioneers in this connected health market is Dr. Joseph Kvedar, who leads the Center for

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Getting to Connected Health Is A Marathon, Not A Sprint

Consumers may demand connected experiences in daily living, but there have been many barriers to health care industry stakeholders delivering on that expectation: among them, privacy and security concerns, and provider resistance. This demand-and-supply chasm is noted in Deloitte’s Center for Health Solutions’ latest look into the healthcare landscape, Accelerating the adoption of connected health. The objectives of connected health, or cHealth, are: To improve digital connectivity among consumers, providers, health plans and life sciences companies To facilitate self-managed care in a secure environment that protects privacy To deliver care outside of traditional institutional settings To enable chronic care management

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U.S. Health At A Glance – Not So Healthy

People in the U.S. have lower life expectancy, a growing alcohol drinking problem, and relatively high hospital inpatient rates for chronic conditions compared with other OECD countries. And, the U.S. spends more on health care as a percent of GDP than any other country in the world. This isn’t new-news, but it confirms that U.S. health citizens aren’t getting a decent ROI on health spending compared with health citizens around the developed world. In the OECD’s latest global look at member countries’ health care performance, Health at a Glance 2015, released today, the U.S. comes out not-so-healthy in the context

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The rise and rise of noncommunicable diseases

Noncommunicable diseases (NCDs) are the #1 cause of death in the world. NCDs are the yin to the yang of infectious diseases. Mortality from infectious disease has fallen as national economies have developed, while NCDs such as heart disease, respiratory disease, cancer, diabetes, and other NCDs are a growing burden. Health Affairs devotes its September 2015 issue to The Growing Burden of Noncommunicable Diseases, featuring research focusing both on global trends and U.S.-specific challenges. In their look into the relationships between NCDs, unhealthy lifestyles and country wealth, Thomas Bollyky et. al. note that NCDs aren’t only the “diseases of affluence,”

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How Growing Income Inequality Hurts Everyone, and Especially Our Health

Income inequality has increased in most developed countries, and especially in the U.S., according to the OECD’s report, In It Together: Why Less Inequality Benefits All, published in May 2015. The red arrow in the first chart shows where the U.S. ranks versus other developed nations in income inequality, which is defined as the wealth gap between rich and poor people. The U.S. has the greatest income inequality in the developed world. The second chart shows data for the U.S. on benefits provided to low-wage workers (the bottom 25% of wage earners) versus high-wage workers (the top 25% of earners).

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What Mavis Staples taught us about health at SXSW

While I am all health, all-the-time when I’m at the annual South-by-Southwest meet-up in Austin, I had the opportunity to attend the premiere of the documentary, Mavis! (exclamation point included and appropriate, given the energy and joy in the title’s subject). “Mavis” is Mavis Staples, who you should know for her music, as singer with her family’s group, The Staple Singers; and, for as a positive force for good. In fact, she’s a lesson in whole health, which is why I’m writing about here on Health Populi which is dedicated to health where we live, work, play, pray…and sing. For

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A health agenda comes to the 2015 Oscars

The 87th annual 2015 Oscars show (#Oscars15) feted more than the movie industry: the event celebrated health in both explicit and subtle ways. Julianne Moore took the golden statuette for Best Actress, playing the title role in Still Alice, the story a woman diagnosed with early-onset Alzheimer’s Disease. In accepting her award, Moore spoke of the need to recognize and “see” people with Alzheimer’s – so many people feel isolated and marginalized, Moore explained. Movies help us feel seen and not alone – and people with Alzheimer’s need to be seen so we can find a cure, she asserted. See Moore’s lovely

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Telehealth is in demand, driven by consumer convenience and cost – American Well speaks

Evidence of the rise of retail health grows, with the data point that on-demand health care is in-demand by 2 in 3 U.S. adults. American Well released the Telehealth Index: 2015 Consumer Survey, revealing an American health public keen on video visits with doctors as a viable alternative to visiting the emergency room. Virtual visits are especially attractive to people who have children living at home. [For context, this survey defines “telehealth” as a remote consultation between doctor and patient]. Convenience drives most peoples’ interest in telehealth: saving time and money, not leaving home if feeling unwell, and “avoiding germs

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Thinking about health disparities on Martin Luther King Day 2015

On this day celebrating Martin Luther King, Jr., I post a photo of him in my hometown of Detroit in 1963, giving a preliminary version of the “I Have a Dream” speech he would give two months later in Washington, DC. As I meditate on MLK, I think about health equity. By now, most rational Americans know the score on the nation’s collective health status compared to other developed countries: suffice it to say, We’re Still Not #1. But underneath that statistic is a further sad state of health affairs: that people of color in the U.S. have lower quality of

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Who is perfect? Advocacy ads for real people.

What is the nature of disability? What is the nature of beauty? What is perfection? Who among us is perfect? These questions are at the heart (literally and figuratively) of a project undertaken by Pro Infirmis, a Switzerland-based advocacy organization raising awareness of people with disabilities, promoting the International Day of Persons with Disabilities in December 2013. Mannequins in fashionable shops on Zurich’s tony street the Bahnhofstrasse were replaced by new ones, artfully, painstakingly and lovingly created, as shown in the video. Pro Infirmis’s website tells us “who” we are looking at in human and 3-D life-size mannequin form: Miss Handicap 2010,

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The Internet of Healthy Me – putting digital health in context for #CES2015

Men are from Mars and Women, Venus, when it comes to managing health and using digital tools and apps, based on a poll conducted by A&D Medical, who will be one of several hundred healthcare companies exhibiting at the 2015 Consumer Electronics Show this week in Las Vegas. Digital health, connected homes and cars, and the Internet of Things (IoT) will prominently feature at the 2015 Consumer Electronics Show in Las Vegas this week. I’ll be attending this mega-conference, meeting up with digital health companies and platform providers that will enable the Internet of Healthy “Me” — consumers’ ability to self-track,

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Women-centered design and mobile health: heads-up, 2014 mHealth Summit

This post is written as part of the Disruptive Women on Health’s blog-fest celebrating the 2014 mHealth Summit taking place 7-11 December 2014 in greater Washington, DC. Women and mobile health: let’s unpack the intersection. On the supply side of the equation, Good Housekeeping covered health tracking-meets-fashion bling in the magazine a few weeks ago in article tucked between how to cook healthy Thanksgiving side dishes and tips on getting red wine stains out of tablecloths. This ad appeared in a major sporting goods chain’s 2014 Black Friday pre-print in my city’s newspaper last week. And along with consumer electronics brand faves like

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Health info disconnect: most people view accessing online records important, but don’t perceive the need to do so

There’s a health information disconnect among U.S. adults: most people believe online access to their personal health information is important, but three-quarters of people who were offered access to their health data and didn’t do so didn’t perceive the need to. The first two graphs illustrate each of these points. When people do access their online health records, they use their information for a variety of reasons, including monitoring their health (73%), sharing their information with family or care providers (44%), or downloading the data to a mobile device or computer (39%). In this context, note that 1 in 3

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NephCure – a rare disease community that’s patient-powered

The burden of chronic kidney disease (CKD) is growing, with one in 10 U.S. adults having some level of CKD.  End-stage renal disease (ESRD) is the last phase of CKD, when dialysis or an organ transplant are required. Nephrotic syndrome is one of the most common forms of CKD, and focal segmental glomerulosclerosis — FSGS — is the fastest-growing cause of nephrotic syndrome in children, and the second-leading cause of kidney failure in children. I spoke with Gigi Peterkin, a longtime colleague of mine who has helped guide my own digital footprint in health. Gigi is Global Director of Marketing at

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Stress Is US

“Reality is the leading cause of stress among those in touch with it,” Lily Tomlin once quipped. Perhaps in 2014, America is the land of stress because we’re all so in touch with reality. THINK: reality TV, social networks as the new confessional, news channeling 24×7, and a world of too much TMI. So no surprise, then, that one-half of the people in the U.S. have had a major stressful event or experience in the last year. And health tops the list of stressful events in This American Life in the forms of illness and disease (among 27% of people)

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In pursuit of healthiness – Lancet talks US public health

It’s Independence Day week in America, and our British friends at The Lancet, the UK’s grand peer reviewed medical journal, dedicate this week’s issue to the Health of Americans – exploring life, death (mortality), health costs, chronic disease, and the Pursuit of Healthiness. This project is a joint venture between The Lancet and the U.S. Centers for Disease Control (CDC) which took 18 months to foster, called The Health of Americans Series. Americans mostly die from chronic diseases, aka non-communicable diseases, which are largely amenable to lifestyle changes like eating right, quitting smoking, drinking alcohol in moderation, and moving around more. 1 in

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Affordable medicine: a preferred future

The price of medicines is a barrier for about one billion people on the planet, for citizens in developing countries as well as middle-class families in the richest country in the world, the United States.  Today is World Health Day, when for 24 hours public health advocates (including me) are calling out key issues preventing people from fully living life. One obstacle for too many people is the cost of drugs and supplies that save lives and help people add life to years. For example, bug bites can be deadly if you’re talking about the 50% of the world’s population

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U.S. families face medical financial burdens; health care in the SOTU

  A growing proportion of American families are facing money problems related to health care, according to the report, Financial Burden of Medical Care: A Family Perspective, No. 142 in the NCHS Data Brief series from the CDC, published January 2014 and based on 2012 data. 1 in 4 families are dealing with some financial burden due to medical care. “Financial burdens” in health include problems paying medical bills in the past 12 months, shared by 16.5% of families; and medical bills being paid over time, faced by 21.4% of families. 1 in 10 families (9%) have medical bills they are

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Food and money matter for health – more hospital admissions at the end of the month

If your wallets are lighter at the end of the month, you’re likely to have less access to quality food, and more likely to be admitted to the hospital if you have diabetes. The hypothesis that people with low incomes whose household budgets are spent before the end of the month have greater health inequities was tested in the article, Exhaustion of Food Budgets At Month’s End And Hospital Admissions For Hypoglycemia, published in the January 2014 issue of Health Affairs. Researchers from the University of California – San Francisco found that, indeed, the health in households with low-income suffer from

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Mobile health apps – opportunity for patients and doctors to co-create the evidence

There are thousands of downloadable apps that people can use that touch on health. But among the 40,000+ mobile health apps available in iTunes, which most effectively drive health and efficient care? To answer that question, the IMS Institute for Healthcare Informatics analyzed 43,689 health, fitness and medical apps in the Apple iTunes store as of June 2013. These split into what IMS categorized as 23,682 “genuine” health care apps, and 20,007 falling into miscellaneous categories such as product-specific apps, fashion and beauty, fertility, veterinary, and apps with “gimmicks” (IMS’s word) with no obvious health benefit. Among the 23,682 so-called

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7 Women and 1 Man Talking About Life, Health and Sex – Health 2.0 keeping it real

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

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Chief Health Officers, Women, Are In Pain

Women are the Chief Health Officers of their families and in their communities. But stress is on the rise for women. Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress, and over-drinking. Overdosing on opioids. Opioids are strong drugs prescribed for pain management such as hydrocodone, morphine, and oxycodone. The number of opioid prescriptions grew in the U.S. by over 300% between 1999 and 2010. Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.

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Americans’ health insurance illiteracy epidemic – simpler is better

Consumers misunderstand health insurance, according to new research published in the Journal of Health Economics this week. The study was done by a multidisciplinary, diverse team of researchers led by one of my favorite health economists, George Loewenstein from Carnegie Mellon, complemented by colleagues from Humana, University of Pennsylvania, Stanford, and Yale, among other research institutions. Most people do not understand how traditional health plans work: the kind that have been available on the market for over a decade. See the chart, which summarizes top-line findings: nearly all consumers believe they understand what maximum out-of-pocket costs are, but only one-half do.

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Healthways buys into Dr. Ornish’s approach: will “Ornish-inside” scale wellness in America?

People who live in U.S. cities with low levels of well-being have twice the rate of heart attacks as people who live in healthier America. That’s 5.5% of the population in sicker America versus 2.8% of the population living in healthy America. The first chart illustrates this disparity, taken from the Gallup-Healthways index that examined 190 metropolitan areas in 2012. Based on this study, it’s good to live in parts of Utah, Nebraska and Colorado, but not so healthy to be a resident in West Virginia, Alabama, and parts of Kentucky and Ohio. Heart disease and diabetes are killing a plurality

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Americans’ health not keeping up with the world: why to spend more on social determinants of health

The American health infrastructure is not First World or First Rate, based on the outcomes. This, despite spending more on health care per-person than any country on the planet. Two seminal reports are out this week reminding Americans that our return-on-investment in health spending is poor. The first research comes from JAMA titled  The State of US Health, 1990-2010:  Burden of Diseases, Injuries, and Risk Factors. There is some good news in this report at the top line: that life expectancy for Americans increased in the two decades from 75.2 years to 78.2 years. But this positive quantitative outcome comes with

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The health and wellness gap between insured and uninsured people

If you have health insurance, chances are you take several actions to bolster your health such as take vitamins and supplements (which 2 in 3 American adults do), take medications as prescribed (done by 58% of insured people), and tried to improve your eating habits in the past two years (56%). Most people with insurance also say they exercise at least 3 times a week. Fewer people who are uninsured undertake these kinds of health behaviors: across-the-board, uninsured people tend toward healthy behaviors less than those with insurance. This is The Prevention Problem, gleaned from a survey conducted by TeleVox

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A physical activity shortage: Let’s Move!

Only 1 in 5 Americans got the minimum recommended amount of physical activity in 2011, based on guidelines offered by the U.S. Centers for Disease Control. More men than women met the standard: 23.4% of men versus 17.9% of women. There are wide variations across the 50 states, as the map shows, with the healthiest folks exercise-wise living in the west, Alaska, upper midwest, and New England. The range runs from a 12.7% low in West Virginia and Tennessee to 27.3 at the high end in Colorado. That bar is set at 150 minutes a week (that’s 2.5 hours) of

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Dietitians provide a health bridge between food and pharmacy

The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a

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The value of big data in health care = $450 billion

  Exploiting Big Data in industry is Big News these days, and nowhere is the potential for leveraging the concept greater than in health care. McKinsey & Company estimates that harnessing big data across five dimensions of health care could yield nearly one-half trillion dollars’ worth of value in The ‘big data’ revolution in healthcare. The chart summarizes McKinsey’s calculations on the value of Big Data in health care at its maximum. Before digging into the value potential, just what is Big Data in health care? Statistics and information are generated in the health care system about patients: say, during visits

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The Not-So-Affordable Care Act? Cost-squeezed Americans still confused and need to know more

While health care cost growth has slowed nationally, most Americans feel they’re going up faster than usual. 1 in 3 people believe their own health costs have gone up faster than usual, and 1 in 4 feel they’re going out about “the same amount” as usual. For only one-third, health costs feel like they’re staying even. As the second quarter of 2013 begins and the implementation of the Affordable Care Act (ACA, aka “health reform” and “Obamacare”) looms nearer, most Americans still don’t understand how the ACA will impact them. Most Americans (57%) believe the law will create a government-run health plan,

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An American Nanny State? Most Americans support government tactics addressing lifestyle impacts on chronic disease

  Most people like government policies targeting reducing tobacco use, requiring food manufacturers and restaurants to reduce salt content, and mandating schools to require 45 minutes of daily activity for students. A large majority of Americans (at least 8 in 10 people) support government actions to promote public health that stem chronic disease, from preventing cancer (89%) and heart disease (86%) to helping people control their diabetes (84%) and preventing childhood obesity (81%). A Survey Finds Public Support For Legal Interventions Directed At Health Behavior To Fight Noncommunicable Disease (NCD). This poll, published in the March 2013 issue of Health Affairs, profiles the

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Gettin’ higi with it: Lupe Fiasco’s foray into public health

The latest in SoLoMo (Social, Local, Mobile) Health is a gamified tool coupled with a hardware kiosk, known as higi. The brainchild of Michael Ferro, a successful dotcom entrepreneur who now owns the Chicago Sun-Times, higi’s mission is to help people – particularly younger peeps – to take better care of themselves by scoring points and, as a result, social connections. Higi’s an African word for origin, so the health tool has some aspects relating to being in a tribe — a kind of health tribe. It also has a fun sound to it, Ferro noted, which sets the vibe

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Bill Clinton’s public health, cost-bending message thrills health IT folks at HIMSS

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

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Health is wealth and wealth, health

It’s America Saves Week (February 25-March 2, 2013). Do you know what your savings rate is? If you’re in the center of the American savings bell curve, you probably don’t have a savings plan with specific goals and don’t know your net worth. Two-thirds of U.S. adults say they have sufficient emergency savings for unexpected expenses like a visit to a doctor. However, only one-half of non-retired people believe they’re saving enough for a retirement where they’ll have a “desirable standard of living.” This six annual survey by the Consumer Federation of America, the American Savings Education Council, and the

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Health consumers don’t understand overtreatment, and their role in driving health costs

Overuse of health care is defined as the delivery of health care services for which the risks outweigh the benefits, according to a study into the utilization of ambulatory care health services published in the January 28, 2013, issue of JAMA Internal Medicine (the new title for the Archives of Internal Medicine). “Trends in the Overuse of Ambulatory Health Care Services in the United States” found that, of the estimated $700 billion that is wasted annually in U.S. health care, overuse comprises about $280 billion – over one-third of waste — equal to over 10% of total health spending in

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Lower calories are good business

The restaurant chain business employs 10% of U.S. workers and accounts for $660 bn worth of the national economy. Where restaurant chains are growing fastest is in serving up lower-calorie meals, and it’s been a boon to the bottom-line. The case for lower calories leading to better business is made in Lower-Calorie Foods: It’s Just Good Business from the Hudson Institute‘s Obesity Solutions Initiative, published February 2013. In the report, researchers analyzed nitty-gritty restaurant chain data on servings and traffic from 2006-2011 to sort out whether sales of so-called lower-calorie menu items in 21 chains led to improved business. The chains

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Americans are first in un-health: the US health disadvantage

In the U.S., we’ll be the #1 oil producer by 2020. We’re the largest national economy in the world (to be surpassed by China before 2030). And, we’re #1 in terms of the lowest taxes paid as a percentage of national GDP. That’s all heartening news for the time being. But we’re also #1 in what I’ll call “un-health:” in auto accident mortality for adolescents, obesity rates, infant mortality, prevalence of sexually transmitted diseases, and among other public health metrics. A report from the National Research Council and Institute of Medicine (NRC/IOM) calls out what JAMA terms The US Health Disadvantage:

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People want more control over health care in the midst of rising costs: a tale of two surveys

Two surveys of American consumers point to their growing concern over (1) rising costs and (2) wanting control over their care. More than 1 in 3 U.S. adults put off health care due to costs in the past year, a Gallup poll found. As shown in the graph, this is the highest proportion of people forgoing care due to cost since Gallup began asking the question in 2012. This survey was conducted in November 2012. There are differences between people without insurance and those with commercial or public sector plans such as Medicare and Medicaid. Over one-half of uninsured people

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Americans #1 health care priority for the President: reduce costs

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

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Food and health: information is not doing the job as the U.S. continues its obesity march

Notwithstanding the fact that most phones on U.S. streets are “smart” ones, most adults surf the net for health information, and most people try to change a health habit each year, Americans haven’t adopted healthier long-term relationships with food. The International Food Information Council has conducted the Food & Health Survey: Consumer Attitudes Toward Food, Safety, Nutrition & Health poll since 2006, thus enabling us to track peoples’ attitudes and behaviors over the past several years. The latest polling results appear in Is it Time to Rethink Nutrition Communications? A 5-Year Retrospective of Americans’ Attitude toward Food, Nutrition, and Health online in

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Consumers blame insurance and pharma for health costs, but love their primary care doctors

The 78% of U.S. adults with primary care physicians (think: medical homes) are very satisfied with their doctors’ visits. The main reasons for this high level of satisfaction include communication (listening, talking), customer service (caring, personable), and clinical (good diagnosis and treatment). More women than men have a primary care physician relationship, more college grads do, and more people with incomes of $75,000 a year or more do, as well. 90% of those 55 and over have a primary care doctor – a stat heavily influenced by the fact that Medicare coverage kicks in for older people. This consumer profile

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Patients want to see the notes their doctors write about them: the power of transparency in health care

Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians. There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week. The objective of the study was to measure the impact on doctors and patients of extending

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Not goin’ mobile (yet): health search still mostly done on computers

As the Web Goes Mobile, Healthcare Stands Still, sums up a survey from Makovsky Health and Kelton. Their research finds that, while consumers have beloved relationships with their mobile devices (phones and tablets) and use them regularly for aspects of daily living, healthcare information search is still largely managed via desktop and laptop computers. The infographic organizes some of Makovsky-Kelton’s findings. Of note is that parents are more likely to seek health answers online, Wikipedia has gained in health use since 2011, women are more likely than men to research before filling a prescription, and recommendations from friends and family are

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Consumerism growing in health care, says Altarum

Patients are morphing into health care consumers with growing use of technology for medical shopping and health engagement, according to a survey conducted by Altarum, the health services research organization. Virtually all (99%) of U.S. health citizens want to play a role in medical decisions about their care. However, consumers vary in just how much of that responsibility they want to assume: – 35% want to make the final decision with some input from doctors and other experts – 29% want to be completely in charge of their decisions – 28% want to make a joint decision with equal input

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The gender gap in U.S. health economics

50% more women than men are worried about health care affordability and access in the U.S., revealed in a new Kaiser Opinion Poll, the Health Security Watch, based on interviews from May 2012. Overall, about the same proportion of men and women had problems paying medical bills in the past year — 26% vs. 27%, respectively. However, when it comes to self-rationing health care — delaying or skipping treatment due to cost — gender gap shows, with 52% of men and 64% of women delaying or skipping health care. Underneath these numbers are even greater gaps between men and women.

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Patient engagement and medical homes – core drivers of a high-performing health system

It was Dr. Charles Safran who said, “Patients are the most under-utilized resource in the U.S. health system,” which he testified to Congress in 2004. Seven years later, patients are still under-utilized, not just in the U.S. but around the world. Yet, “when patients have an active role in their own health care, the quality of their care, and of their care experience improves,” assert researchers from The Commonwealth Fund in their analysis of 2011 global health consumer survey data published in the April/June 2010 issue of the Journal of Ambulatory Care Management. This analysis is summarized in International Perspectives on

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Wellness Ignited! Edelman panel talks about how to build a health culture in the U.S.

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

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Wellness and the global health citizen – carrying our own doctors, inside

Every patient carries her or his doctor inside, said the great Renaissance man, Albert Schweitzer. Based on Euro RSCG Worldwide’s Prosumer Report – My Body, Myself, Our Problem: Health and Wellness in Modern Times, health citizens globally have begun to take on Dr. Schweitzer’s vision. Clement Boisseau of Euro RSCG points out that people, globally, are fairly schizophrenic when it comes to thinking about empowerment over illness: check out the chart for perceptions by condition and disease state. Boisseau says that people perceive health today both in modern terms (such as feeling empowered to control some conditions), and archaic or “magically

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We are all health illiterates: navigating the health system in a sea of paper and financial haze

“Older patients, caregivers, and family members face growing challenges in understanding and navigating the nation’s increasingly complex healthcare system,” begins a well-articulated column called Why Consumers Struggle to Understand Health Care, in U.S. News & World Report dated January 27, 2012. Health literacy isn’t just about understanding clinical directions for self-care, such as how to take medications prescribed by a doctor, or how to change a bandage and clean an infected area. Health literacy is also about how to effectively navigate one’s health system. The first graphic is a schematic published in the New Republic in 2009 which illustrates the arcane Trip-Tik

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Hey, Big Spender: 1% of US health citizens consume 20% of costs

Cue up the song “Hey Big Spender” from the Broadway hit, Sweet Charity, when you read the January 2012 AHRQ report with the long-winded title, The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.” The report’s headline is that 1% of the U.S. population consumed 20% of all health costs spent in the U.S. in 2008 and 2009, illustrated by the chart. These Big Health Spenders tend to be in poor or fair health, older, female, non-Hispanic whites and people with only publicly-provided health insurance. Their mean expenditure was $90,061. The top 10%

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Health spending in America – self-rationing slows cost increases

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.   Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which

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The social determinants of health – U.S. doctors feel unable to close the gap and deliver quality care

Most U.S. primary care physicians realize the health of their patients is largely out of their hands — with their social needs ranking as important as addressing their medical conditions, according to the 2011 Physicians’ Daily Life Report, conducted on behalf of the Robert Wood Johnson Foundation by Harris Interactive in September-October 2011, results published in November 2011. In fact, unmet social needs are directly leading to worse health for Americans, say 9 in 10 doctors. With that recognition, most physicians feel they’re unable to address patients’ health concerns caused by unmet social needs. This has led to most doctors confessing

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Peoples’ decline in health information seeking related to the fall of print and educational attainment

The percentage of U.S. adults seeking health information declined from 2007 to 2010, according to the Health Tracking Household Study conducted by the Center for Studying Health System Change (HSC), published in November 2011. In 2007, 57% of consumers sought health information, falling to 50% in 2010, HSC found. The chart illustrates where the big drop in health information seeking occurred: in print media including books, magazines and newspapers, falling by one-half from 33% of consumers to 18%. The Internet (with 33% of consumers searching health information online) and friends and family (attracting 29% of consumers) remained relatively flat as information sources. TV/radio dropped 5.6 percentage

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Sustainable health care: patients, doctors and hospital execs see different futures

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value. While these 3 segments – physicians, people-patient-consumers, and hospital execs, agree on this topline assessment, what they see about the future of health delivery in America varies, according to a new survey from the new Optum Institute for Sustainable Health, Sustainable health communities: A manifesto for improvement. This is the kick-off of the Optum Institute, a member of the

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Workplace wellness: the cost of unhealthy behaviors in the American workforce is $623 per worker

The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs. Thomson Reuters and NPR polled over 3,000 Americans on their health behaviors, utilization and costs of health care, publishing their results in a summary, Paying for Unhealthy Behaviors in October 2011. 4 in 5 overall — and 9 in 10 of those with over $50,000 annual income — believe that people with healthy behaviors should receive a

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Why a Foundation and the Federal Reserve are working together to improve health in the U.S.

Health philanthropies are about more than making grants. The Robert Wood Johnson Association, among the largest health philanthropic organizations in the world, is partnering with the Federal Reserve Bank (the Fed) on how community development impacts health — and vice versa. You cannot have a healthy community without focusing on housing, schools, and other neighborhood stakeholders, Dr. Risa Lavizzo-Mourey told the conference on Healthy Communities: Building Systems to Integrate Community Development and Health. In this context, Dr. Lavizzo-Mourey quoted Robert Kennedy who said, “The gross national product does not allow for the health of our children, the quality of their education, or

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Consumer electronics comes to health care — but don’t overestimate consumer demand just yet

More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in

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Every picture tells a story, and nowhere more important than in health

A picture’s not only worth the proverbial thousand words, but can save a life. So can a t-shirt…er, TeachShirt. At the Unniched meeting held on 25 October 2011 in NYC, I spent a few minutes talking with two members of Zemoga‘s brain trust: Sven Larsen, Chief Marketing Office, and the firm’s Principal Design guru, Dan Licht. We discussed how design is so critical a factor in health, and in life — particularly, in DIY health, where we are all taking on more responsibility for our own health care — clinical, financial, mental, social. Among Zemoga’s colorful and uber-creative portfolio is its concept, the

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Tech fast forward families are ripe for health care self-care

Kids lead their parents in the adoption of  digital technologies; that’s why the youngers are called Digital Natives. An intriguing survey of adults’ use of technologies finds that those who do so like “childlike play,” and at the same time, for kids, make them feel more grown up. The trend, Ogilvy says, is blurring generational lines: market to adults as kids, and kids as adults. This convergence is leading families to become more “units” — parents and kids increasingly on the same page in purchase decisions. In Tech Fast Forward: Plug in to see the brighter side of life, from

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The economy’s impact on personal health: shopping and social

The recessionary, sluggish U.S. economy has had an impact on Americans’ mental and physical health. The least healthy citizens have experienced a disproportionately hard hit on their health and health care. But necessity being the mother of invention, some people are re-inventing their personal workflows in health care — and many of these tactics may well benefit their health in the long run. The Economy and Health: 10 Observations is the analysis from Euro RSCG‘s survey of U.S. adults’ views on their personal health in light of the continued economic downturn. The first chart shows the economy’s impact on the overall mood of

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Health information gumbo: peoples’ health searches are mashed-up and increasingly mobile

Health professionals are go-to sources for medical diagnoses, information about prescription drugs and alternative treatments, and recommendations for doctors and hospitals. On the other hand, health information seekers turn to fellow patients, friends and family for emotional support in dealing with health issues, and quick remedies for everyday issues. And increasingly, those health information searches are going mobile, with 17% of U.S. adults having ever used their cell phone to look up health or medical information. This proportion nearly doubles for 18-29 year olds, and is also higher for wealthier people, Latino’s, college graduates, and urbanites. 1 in 10 people with a

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Welcome Migraine.com to the health care community

  About 1 in 10 people in the U.S. suffer from migraine headaches. The direct cost to business for medical care and wage replacement is over $1 bn, but this underestimates the total economic impact of lost productivity to the economy and personal lives (for more on  whole-health costs, read yesterday’s Health Populi, Lost Costs: Lost Productivity Represents One-Half of Health Costs for U.S. Employers). There are actually 14 kinds of headaches, as classified by the International Headache Society (IHS). Among these, there are four primary headache types: migraine, tension-type headaches, cluster headaches and trigeminal autonomic cephalagias, and a fourth

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The people who seek health information online aren’t always the ones who should

While 8 in 10 U.S. adult internet users seek health information online, they’re not the people you might assume would take advantage of the opportunity to do so. This lightbulb moment is brought to you by the Pew Internet & American Life Project’s latest survey analysis,  Health Topics: 80% of internet users look for health information online. For example, while 2 in 3 U.S. adults with one or more chronic condition go online, only one-half of them are looking online for health information. Among the 54% of online adults with disabilities, only 42% of them seek health information online. Among the 88%

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Kids in America have unequal health compared to most of the world’s rich nations

By Jane Sarasohn-Kahn on 3 December 2010 in Global Health, Health disparities, Health Economics, Public health

In a nation where ‘no child left behind’ has been a mantra, it’s clear that in the U.S., many children are left behind when it comes to health. UNICEF’s Report Card #9 is out from the Innocenti Research Centre, providing the league table for child well-being in the world’s 24 richest countries. In health inequality — that is, the gap between kids who have ‘average’ well-being in the U.S. and those who fall below — the U.S. ranks #22 among the 24 wealthiest nations in the world. While an educated guess might put U.S. kids’ health inequality below Switzerland, Norway, and Denmark,

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Mobile health search is on the rise – but not yet at the tipping point

The oracle (and I use the word here in the classic sense) of health internet statistics, Susannah Fox (@susannahfox on Twitter), along with the Pew Internet & American Life Project and the California HealthCare Foundation, find that 17% of mobile phone users look up health information online — and nearly 1 in 3 young adults 18-29 do so, while between 5-6% of people 50 and seek health information via mobile. The Mobile Health 2010 report tells the story. Beneath these macro statistics are the ones shown in the chart: people who have used cell phones to look up health information, which is a larger base

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Broadband@home: one antidote to addressing health disparities

2 in 3 American adults use a broadband connection at home. Among those who don’t have high-speed access at home, most don’t go on the internet at home, and the others who do use dial-up connections (only 5% of adults). The Pew Internet & American Life Project knows more about Americans’ use of the internet than probably any other research organization, and their report, Home Broadband 2010, presents a comprehensive snapshot of how people in the U.S. are using the internet as of May 2010. The most striking statistic in Pew’s survey is that growth of broadband among African-Americans grew in double-digits

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Bienvenido, HolaDoctor!

Welcome, HolaDoctor, to the growing roster of consumer-facing health portals. La differencia, this time, is that HolaDoctor is an entirely Spanish-speaking website of comprehensive health information. The site focuses on health content and tools highly targeted to Hispanics and health issues of most concern. Known previously as DrTango, founded in 1999, HolaDoctor has at least 1.3 million Hispanic consumers who have registered on its site, and operates over 500 multilingual health websites under its corporate umbrella. The morphing from DrTango to HolaDoctor has to do with the organization’s launch of its consumer-focused health and wellness portal reaching out to Spanish speakers in the

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Risky Business: the state of U.S. high schoolers' health

From bad driving behaviors to binge drinking and unprotected sex, the health-state of America’s high school population gets a grade of “R” for “risky.” The 2009 National Youth Risk Behavior Survey is out from the Centers for Disease Control from the good people at the Division of Adolescent and School Health, based on survey data among 16,410 young people grades 9-12 who live in all 50 states and the District of Columbia.  As you read the statistics, keep in mind these are self-reported among kids who are 14-18 years of age. Among the most high-risk health behaviors are the findings that: 1

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ER update: people with health coverage more likely to visit, and health reform could worsen overcrowding

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A picture tells a thousand words and health cost disparities in the State of Maine

By Jane Sarasohn-Kahn on 17 May 2010 in Health disparities, Health Economics, Health Quality

The Dartmouth Atlas and other health cost analysts have exposed the phenomenon of varying health costs, from the state of Florida to California, Oregon to McAllen, Texas. Now we have evidence of big cost disparities within a relatively small state – the State of Maine. Details on this story appear in the May 16th 2010 Portland Press Herald, which created the illustration shown here based on pricing data collected throughout the state. Health citizens in Maine are fortunate to have a state-funded resource that aggregates and analyzes data on health care cost and quality from health care providers in the state,

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Being Digital Doesn’t Always Mean You’re Young, Demographically Speaking

Being younger demographically doesn’t mean you’re younger, digitally-speaking. Your Real Age isn’t your Digital Age, according to Wells Fargo‘s survey into Americans’ use of advanced tools for daily tasks. The categories of peoples’ digital maturity include: – Digital teens, who are people who are online but don’t use all tools at a ‘high level’ – Digital novices are those people who manage basic tasks online but aren’t yet connecting with others online or managing more complex tasks – Digital adults have the highest digital age, as demonstrated by their using online tools for daily tasks, interacting with others online, and

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Health is contagious: the nature of connected-ness

  The book Connected was recommended by my colleague, intellectual beacon and friend, Susannah Fox of the Pew Internet & American Life Project. In the midst of late nights analyzing health reform scenarios and medical microeconomics, I’ve made the time to read this book in its entirety. It’s been a worthwhile investment.    Previously, the authors of Connected, Nicholas Christakis and James Fowler, found evidence on connectedness in health in the areas of obesity,    This week, another team of innovative thinkers led by John Caccioppo from the University of Chicago published their latest findings on the contagiousness of loneliness

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Poverty is a major health risk

Poverty is a problem for all of us…and it reaches across the generations. The health effects of poverty begin in early childhood and persist through a person’s lifetime. Poor children have a higher rate of asthma and lower rates of cognitive development. By middle age, diabetes and heart disease hit the poor harder than more affluent Americans. Among older Americans, those living below the poverty line are far more likely to have three or more chronic conditions than those whose incomes are four times greater than the poverty line. Poverty costs not only the poor, but the overall U.S. economy

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Geography is health insurance destiny

By Jane Sarasohn-Kahn on 12 October 2009 in Health disparities, Health Plans, Health reform, Public health

Where you live is a determining factor in whether you have health insurance. The darker green on the map illustrates states with the highest percentage penetration of people with private health insurance among people under 65. Note the concentration in the Upper Midwest, scattered Midwest, and bits of the northeast. It’s also helpful to live in Utah when it comes to health insurance coverage. The lowest proportions of privately insured Americans are in much of the south, from Florida west to Texas and into southern New Mexico, Arizona and much of California. The Urban Institute has studied health insurance coverage

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Health disparities: options for getting even

By Jane Sarasohn-Kahn on 19 January 2009 in Health disparities, Health literacy, Health reform, Public health

“A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom.” So spoke Martin Luther King, Jr. on April 4, 1967 — one year before his assassination.   In this week that’s sure to be inspirational and aspirational, I ponder Dr. King and the state of health care in America.   Health disparities continue to mar the State of American Health Care. “Race remains a significant factor in determining whether an individual receives care, whether an individual receives high quality care, and in determining health outcomes,” according

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Health Plan Illiteracy, or how not to benefit from the Benefit

Health plan illiteracy is alive and well, according to J.D. Power and Associates. The consumer market research firm’s 2008 National Health Insurance Plan Study finds that 1 in two plan members don’t understand their plan. In this second year of the survey, J.D. Power notes that, as consumers understand the benefits of their Benefit, their satisfaction with the plan increases. Thus, there is a virtuous cycle that happens between a plan and an enrollee when communication is clear and understood.   J.D. Power looked at member satisfaction in 107 health plans throughout the U.S. in terms of 7 key metrics:

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The cost of health illiteracy = 47 million uninsured

The annual financial burden of health illiteracy costs between $106 and $238 billion. This is enough money to cover the 47 million uninsured people in America.   That metric, and many other insights, were published this week in an important new report called, Low Health Literacy: Implications for National Health Policy. The report was written by Dr. John Vernon, a professor of finance at the University of Connecticut, and three colleagues from the University of Central Florida, George Washington University, and an executive from Pfizer. This research was sponsored by Pfizer, which has been promoting health literacy as part of

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