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Broadband As Social Determinant of Health – Microsoft’s Plan to Bolster Rural Access

In the U.S., the highest levels of unemployment are in places that often have the lowest access to broadband connectivity. And, “without a proper broadband connection, these communities can’t start or run a modern business, access telemedicine, take an online class, digitally transform their farm, or research a school project online,” Microsoft President Brad Smith said yesterday as the company announced their continued commitment to expanding broadband in rural America. Microsoft is expanding a program the company launched last year to address the rural broadband gap in the U.S. The Airband Initiative is working from Northwest Georgia to South Africa to bolster

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Loneliness, Public Policy and AI – Lessons From the UK For the US

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

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The Importance of Broadband and Net Neutrality for Health, to the Last Person and the Last Mile

California’s Governor Jerry Brown signed into law a net neutrality bill this weekend. Gov. Brown’s proverbial swipe of the pen accomplished two things: he went back to the Obama-era approach to ensure that internet service providers treat all users of the internet equally; and, he prompted the Department of Justice, representing the Trump Administration’s Federal Communications Commission (FCC), to launch a lawsuit. California, home to start-ups, mature tech platform companies (like Apple, Facebook and Google), and countless digital health developers, is in a particularly strategic place to fight the FCC and, now, the Department of Justice. Nearly two dozen other states

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Slow Food, Slow Medicine: What Italy Can Teach America About Health

Obesity, diabesity, food deserts and food swamps co-exist across America, factors that cost the U.S. economy over $327 billion a year just in the costs of diagnosed diabetes. In addition, America’s overweight and obesity epidemic results in lost worker productivity, mental health and sleep challenges, and lower quality of life for millions of Americans. Food — healthy, accessible, fairly-priced — is a key social determinant of individual health, wellness, and a public’s ability to pursue happiness. There’s a lot the U.S. can learn from the food culture, policy and economy of Italy when it comes to health. This week, I have the

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Value Comes to Healthcare: But Whose Value Is It?

The Search for Value is the prevailing journey to a Holy Grail in healthcare these days. On that, most stakeholders working on the ground, globally. can agree. But whose value is it, anyway? Three reports published in the past few weeks give us some useful perspective on that question, woven together in today’s Health Populi blog. Let’s start with the Philips Future Health Index, which assesses value to 16 national health systems through three lenses: access, satisfaction, and efficiency. The results are shown in the map. “Value-based healthcare is contextual, geared towards providing the right care in the right place, at

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Shinola Welcomes Immigrants on the 4th of July: A Love Letter from Detroit to the World Via NYC

Lady Liberty beckons to welcome the tired, the weary, and the ambitious to America in this Shinola video, made in my hometown Detroit. May this bring you joy and positive vibes on Independence Day 2018.  

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It Could Take Five Generations for a Low-Income US Family to Reach Average Income in America

Social mobility in America has a lot of friction: children of wealthier people tend to grow into affluence, and children of low-income parents tend to struggle to move up the income and education ladder, according to A Broken Social Elevator: How to Promote Social Mobility, a new report from the OECD. The Organization for Economic Cooperation and Development studied member nations’ economies, demographics, income and opportunities to gauge each country’s social mobility. Social mobility, the OECD explains, is multi-faceted. It can refer to inter-generational mobility between parents, children, and grandchildren. Alternatively, social mobility can look at intra-generational mobility, over the course

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Pope Francis is a Public Health Advocate

“The world today is mostly deaf,” the Pontiff observes in Pope Francis: A Man of His Word, Wim Wenders’ documentary on this religious leader who likes to quote Dostoevsky, joke about mothers-in-law, and advocate for the sick, the poor, the disenfranchised, and Planet Earth. He is, I realized while watching this film and hearing this man of words, a public health advocate. Throughout the film, we see clips of Pope Francis washing the feet of prisoners in Philadelphia, comforting dying children in a pediatric clinic in central Africa, and speaking out to the U.S. Congress about the dangers of climate

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Re-Tweeting Sanofi’s Tweet: Inclusion Matters for Health, Wellness, and the Body Politic

The communications team at Sanofi, the France-based global pharmaceutical company, quickly responded to a tweet by Roseanne Barr issued this morning about how her use of Ambien was related to her offensive tweet lobbed yesterday on Twitter about Valerie Jarrett, President Obama’s senior advisor. Barr’s comment on Twitter late last night was that, “I was ambien tweeting.” Ambien is Sanofi’s prescription drug used by patients to deal with insomnia and sleeplessness. Data provided to the FDA from patients who have used the product demonstrate a variety of side effects including but not limited to nausea, headache, slowed breathing, and amnesia

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The Healthiest Communities Are Built on Education, Good Food, Mindfulness, and the Power of Love

Be the change you wish to see in the world, Gandhi has been attributed as saying. This sentiment was echoed by Lauren Singer as we brainstormed the social determinants of health and the factors that underpin healthy communities. Our Facebook Live session was convened by the Aetna Foundation, which sponsored research on the Healthiest Communities in 2018.  In addition to Lauren, founder of Trash Is For Tossers, Dr. Garth Graham, President of the Aetna Foundation, Dr. Pedro Noguera, Distinguished Professor of Education at UCLA, and I joined the quartet, moderated with panache and sensitivity by Mark J. Ellwood, journalist. Each

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A Tale of Two America’s for Health

  Disparities in Americans’ health vary among people living in each of the 50 states. These differences in health status generally fall into two regions: north and south, found in the Commonwealth Fund’s 2018 Scorecard on State Health System Performance. The map shows this stark geography-is-health-destiny reality: the worse-than-average states, the Fund found, run from Nevada southeast to Arizona, through New Mexico and Texas all the way to Atlantic Ocean and the Carolinas, then north west all the way up through the industrial Midwest states through Michigan to the north. Wyoming is the only non-contiguous state in the worse-performing U.S. state

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The Health of A Nation – Being Healthy In America Depends on Where You Live

In the US, when it comes to life and death, it’s good to live in Hawaii, Utah, Minnesota, North Dakota, and Iowa — the top five states with the greatest life expectancy and healthy life expectancy at birth in 2016. For health and longevity, sorry to see the lowest five ranked states are Washington DC which ranks last, along with Mississippi, Louisiana, South Carolina, and Alabama. This sober geography-is-health-destiny update was published this week in JAMA, The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. The first chart illustrates states down the left

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Sounds Like A John Denver Song: Virginia and Colorado Towns Rank High As Healthy Communities

If it’s true that “your ZIP code is more important than your genetic code,” you’d look for a job in 22046, buy a house there, and plant your roots. You’d find yourself in Falls Church, Virginia, named number one in the Healthiest Communities rankings of 500 U.S. towns. You can see a list of all of the communities here. The project is a collaboration between the Aetna Foundation and U.S. News & World Report, with help from the University of Missouri Center for Applied Research and Engagement Systems (CARES) and a team from the National Committee on Vital and Health

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How We Spend Versus What We Get: America’s Healthcare Spending Makes for Poor Health

The U.S. spent nearly twice as much as other wealthy countries on healthcare, mostly due to higher prices for both labor and products (especially prescription drugs). And, America spends more on administrative costs compared to other high-income countries. What do U.S. taxpayers get in return for that spending? Lower life spans, higher maternal and infant mortality, and the highest level of obesity and overweight among our OECD peer nations. These sobering statistics were published in Health Care Spending in the United States and Other High-Income Countries this week in JAMA, the Journal of the American Medical Association. The study analyzes

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Getting Real About Social Determinants of Health

New research points out that real people live real lives, and our assumptions about social determinants of health (SDOH) may need to be better informed by those real lives. I read three reports in the past week sobering up my bullish #SDOH ethos dealing with food deserts, transportation, and health service access — three key social determinants of health. To remind you about the social determinants, here’s a graphic from Kaiser Family Foundation that summarizes the key pillars of SDOH. Assumption 1: Food deserts in and of themselves diminish peoples’ healthy nutrition lifestyles. Low-income households who are exposed to the same food-buying

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The United States of Care Launches to Promote Healthcare for All of US

Let’s change the conversation and put healthcare over  politics.  Sounds just right, doesn’t it? If you’re reading Health Populi, then you’re keen on health policy, health economics, most of all, patients: now playing starring roles as consumers, caregivers, and payors in their own care. Andy Slavitt, former Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), has assembled a diverse group of health care leaders who care about those patients/people, too, appropriately named the United States of Care. Founders include Dr. Bill Frist, former Republican U.S. Senator from Tennessee, Dave Durenberger, former Republican U.S. Senator from Minnesota, and

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What Healthcare Can Learn from A Pig and Piggy Bank via Santander Bank

When patients feel disrespected in a medical exam room, they will be less likely to follow instructions they receive from a doctor. Research from the Altarum Institute revealed this fundamental finding. The chart shows that feeling respected reduces  a patient’s diabetes medication adherence by a factor of nearly 2x, and is a risk factor for poorly managed diabetes. Furthermore, consumers who feel disrespected by providers are three times more likely to not believe doctors are accurate sources of information than consumers who do feel respected. And, patients with diabetes who do not feel respected are one-third more likely to have poorly

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Calling Out Health Disparities on Martin Luther King Day 2018

On this day appreciating the legacy of 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 deliver two months later in Washington, DC. Wisdom from the speech: “But now more than ever before, America is forced to grapple with this problem, for the shape of the world today does not afford us the luxury of an anemic democracy. The price that this nation must pay for the continued oppression and exploitation of the Negro or any other minority group

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In the Post-Weinstein Era, How to Market Health to Women: Philips, Kalenji, and Libresse Getting It Right

“With Mad Men still in charge, ad campaigns miss the mark,” an editorial published this week in the Financial Times asserts. Leave it to a fiscally conservative British publication to be spot-on about a particularly, but not uniquely, American challenge, in this post-Weinstein (Miramax), -Price (Amazon), and today, -Halperin (MSNBC) moment of sexual harassment revelations. In health/care, women are key consumers, buyers and influencers, yet under-represented in the Mad Men demographic of senior advertising executives, as the data-driven FT essay points out. So it’s especially heartening to find this month a few examples of empowering, inspiring ad campaigns getting health/care marketing

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Income Inequality For Older Americans Among Highest in the World – What This Means for Healthcare

Old-age inequality among current retirees in the U.S. is already greater than in ever OECD country except Chile and Mexico, revealed in Preventing Ageing Unequally from the OECD. Key findings from the report are that: Inequalities in education, health, employment and income start building up from early ages At all ages, people in bad health work less and earn less. Over a career, bad health reduces lifetime earnings of low-educated men by 33%, while the loss is only 17% for highly-educated men Gender inequality in old age, however, is likely to remain substantial: annual pension payments to the over-65s today are

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Women’s Access to Health Care Improved Under the Affordable Care Act

    The Affordable Care Act (ACT) was implemented in 2010. Since the inception of the ACA, the proportion of uninsured women in the U.S. fell by nearly one-half, from 19 million in 2010 to 11 million in 2016. The Commonwealth Fund has documented the healthcare gains that American women made since the ACA launch in their issue brief, How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care, published earlier this month. The first chart talks about insurance: health care plan coverage, which is the prime raison d’être of the ACA. It’s

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Healthcare Quality and Access Disparities Persist in the U.S.

  In 2015, poor and low-income people in America had worse health care than high-income households; care for nearly half of the middle-class was also worse than for wealthier families.   Welcome to the 2016 National Healthcare Quality and Disparities Report from the Agency for Healthcare Research and Quality (AHRQ). The report assesses many measures quantifying peoples’ access to health care, such as uninsurance rates (which improved between 2010 and 2016), and quality of health care — including person-centered care, patient safety, healthy living, effective treatment, care coordination, and care affordability. While some disparities lessened between 2000 and 2015, disparities

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Most Americans, Including Republicans, Want President Trump’s Administration to Make the ACA Work – Not Fail

8 in 10 Americans want President Trump and his administration to do what they can to make the Affordable Care Act work, according to the latest August 2017 health tracking poll from Kaiser Family Foundation (KFF). By political party affiliation, this includes 95% of Democrats, 80% of Independents, and 52% of Republicans (that is, to emphasize the point, just over half, a majority, of Republicans). More Americans are also relieved and happy, versus disappointed and angry, that the ACA repeal did not occur (thus far), the second chart illustrates. To be sure, a majority of Republicans register anger and disappointment,

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Health Equity Lessons from July 23, 1967, Detroit

On July 23, 1967, I was a little girl wearing a pretty dress, attending my cousin’s wedding at a swanky hotel in mid-town Detroit. Driving home with my parents and sisters after the wedding, the radio news channel warned us of the blazing fires that were burning in a part of the city not far from where we were on a highway leading out to the suburbs. Fifty years and five days later, I am addressing the subject of health equity at a speech over breakfast at the American Hospital Association 25th Annual Health Leadership Summit today. In my talk,

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Fix the ACA, Most Americans Say

  61% of Americans hold negative views of repealing-and-replacing the Affordable Care Act, according to the July 2017 Health Tracking Poll from the Kaiser Family Foundation. This month’s survey focused on Americans’ views on Republican legislative efforts to repeal and replace the Affordable Care Act (ACA). As of the writing of this post, the majority of the Senate rejected the full repeal of the ACA, but the situation is very fluid. Note that this poll was conducted by phone between July 5-10, 2017, among 1,183 U.S. adults ages 18 and older. The column chart here illustrates that the proportion of people

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Shopping Food for Health: the 2017 U.S. Grocery Shopper Trends

Wellness is at the grocery store, the vast majority of U.S. health citizens say. 8 in 10 U.S. shoppers are concerned about the nutritional content in the food they eat. As grocery shoppers look for more fresh and less processed foods, grocery stores are seen as trusted allies for meeting wellness needs. Grocers are coupling the growth of more healthy packaged foods in the middle of the store with more fresh and prepared food options that consumers see as healthier than restaurant meals, according to U.S. Grocery Shopper Trends 2017 from FMI (the Food Marketing Institute) and Hartman Group. While

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Americans Say Healthcare is the Nation’s #1 Problem – Tied with Dissatisfaction with Government

Healthcare tops the list of Americans’ concerns, tied with a dissatisfaction for government, this month (May 2017). According to a Gallup poll published 12 May, poor government leadership and healthcare are together the most important problem currently facing the U.S. Immigration, the economy, jobs, and race relations are distance 3rd places in this survey, which was conducted during the first week of May 2017 among 1,011 U.S. adults 18 years and older. The highest percent of Americans citing healthcare as America’s most important problem was 26%, found in August/September 2008 when town hall meetings round the country were protesting healthcare

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So Far, Food and Nutrition Aren’t Baked Into President Trump’s Health Policies

The FDA is delaying the public posting of calorie counts, a policy that President Obama’s administration had pioneered for public health and wellness. Menu labeling has applied to grocery stores, gas stations, convenience stores, movie theaters and sports stadiums that sell prepared food. “Health and Human Services Secretary Tom Price said the menu labeling requirements would be ‘unwise and unhelpful’ as currently written, and added that the FDA is looking for ways to make the rules ‘more flexible and less burdensome.'” Former FLOTUS Michelle Obama took on the issue of healthy food and fitness for America’s children. Except for keeping her White

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Women and Children First? What the AHCA Holds for Vulnerable Populations

In accounting, there’s a rule with acronym “LIFO;” this stands for “last in, first out,” which requires taking account of the most recent cost of products being the first ones to be expensed on the ledger. I’m thinking about LIFO when it comes to the American Health Care Act (AHCA) which narrowly passed through Congress yesterday by 4 votes, with a final tally of 217 to 213. Why “LIFO?” Because long-uninsured folks who just recently received access to health insurance as an on-ramp to health care services could lose this benefit, just months after joining the ranks of the insured. Among

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