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Big Hearts, High Tech – How Caregiving Has Changed in the U.S.

We are all caregivers now. The COVID-19 pandemic has touched and continues to re-shape our daily lives. One reality that the coronavirus era has revealed is that caregiving is a daily life-flow for everyone around the world. In the U.S., this has particularly acute impacts — physical, emotional, and financial. The 2020 AARP report on caregiving was published this month, and the survey research into caregivers uncovered fresh insights about caregivers’ demographics, financial stressors, and intensity of tasks both in volume and time. In addition, more caregivers are looking for and turning to technology to help them hack effort, time

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Stress in America – COVID-19 Takes Toll on Finances, Education, Basic Needs and Parenting

“The COVID-19 pandemic has altered every aspect of American life, from health and work to education and exercise,” the new Stress in America 2020 study from the American Psychological Association begins. The APA summarizes the impact of these mass changes on the nation: “The negative mental health effects of the coronavirus may be as serious as the physical health implications,” with COVID-19 stressors hitting all health citizens in the U.S. in different ways. Beyond the risk of contracting the virus, the Great Lockdown of the U.S. economy has stressed the U.S. worker and the national economy, with 7 in 10

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How COVID-19 Is Driving More Deaths of Despair

In the current state of the COVID-19 pandemic, we all feel like we are living in desperate times. If you are a person at-risk of dying a Death of Despair, you’re even more at-risk of doing so in the wake of the Coronavirus in America. Demonstrating this sad fact of U.S. life, the Well Being Trust and Robert Graham Center published Projected Deaths of Despair from COVID-19. The analysis quantifies the impact of isolation and loneliness combined with the dramatic economic downturn and mass unemployment with the worsening of mental illness and income inequity on the epidemic of Deaths of

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Food In-Security in a Coronavirus America

One in 10 people in the U.S. were defined as food-insecure without consistent access to nutritious food options in 2019. The COVID pandemic has quickly and negatively impacted food insecurity in America, detailed in an assessment from NIHCM on the current state of food insecurity in America. As many as 4 in 10 U.S. households reported being food-insecure as of April 2020. That includes 20% of children living in the U.S. lacking nutritious food on a daily basis. The NIHCM adopted the definition of food insecurity from the USDA Adult Food Security Survey which is a 10-question poll asking people

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TransUnion Reveals the Home Economics and Social Determinants of COVID-19

  Today, 7th May 2020, the U.S. Bureau of Labor Statistics announced that about 3.17 million jobs were lost in the nation in the last week. This calculated to an unemployment rate of 15.5%, an increase of 3.1% points from the previous week. Total jobs lost in the COVID-19 pandemic, starting from the utterance of the “P” word, has been ___ in the I.S. The virus’s global impact has led to what IMF called the Great Lockdown, resulting in economic inertia and contraction since Asia and Europe reported the first patients diagnosed with the coronavirus. The economic impact the world

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Food, Housing, Energy and Medical Care – the Material Hardships of COVID-19 in America

The Coronavirus has impacted every aspect of human life: first, the direct biological impact of COVID-19 on people, as of today the cause of over 63,000 deaths in the U.S. along with unquantifiable morbidity among millions of Americans who are surviving the virus and the toll on family caregivers. Beyond the direct physical impact of the virus, social and emotional health impacts are emerging now due to physical distancing, mandates to #StayHome, and telecommuting to jobs when possible. Mental health impacts will persist as a pandemic after the Coronavirus pandemic, I’ve previously detailed here in Health Populi. On a global

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“Everyday Life” Factors Into Our Health Risks for COVID-19, Welltok Explains

By Jane Sarasohn-Kahn on 28 April 2020 in Coronavirus, COVID-19, Social determinants of health

Everyday factors can make a big difference in a person’s current and future health risks and needs, we’re learning in the COVID-19 pandemic, detailed in a new Welltok research report, Social Determinants of Health Matter: Voice of the Consumer. “The current public health crisis underscores the importance of leveraging SDOH as a way to effectively provide timely, relevant support that is truly going to make a difference for people’s total wellbeing,” Bob Fabbio, Welltok’s CEO, explained in a press release. “It’s not only about predicting high-risk individuals, but also those that may be feeling isolated, financially insecure or emotionally unstable that

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Healthy Thinking: Inside the Mind of the COVID-19 Consumer

Stress is up, smoking increasing, drinking more alcohol….Americans are tapping into a variety of coping mechanisms in the coronavirus outbreak, with health on their collective minds. Toluna and Harris Interactive are collaborating on the COVID-19 Barometer, publishing biweekly data on consumers’ views on the coronavirus pandemic. The data here are a snapshot of consumers taken through the Toluna-Harris poll conducted among 1,047 U.S. adults between 9-20 April 2020. The first chart shows various life-flows Americans have adopted in April, all risk factors impacting peoples’ overall health status and mental well-being. There were demographic differences across these factors: more women felt

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In the U.S., the Spread of Infectious Disease Now Seen As Bigger Threat Than Terrorism – Pew

The spread of infectious disease is the new terrorism in the eyes of Americans. The most significant major threat to the U.S. is infectious disease, four in five Americans said in March 2020, closely followed by terrorism (in general), the spread of nuclear weapons, and cyberattacks from other countries. For the study, the Pew Research Center commissioned a telephone survey conducted among 1,000 U.S. adults in March 2020. Large majorities of people are also highly concerned about China’s growing power and influence, global climate change, Russia’s power and influence, the condition of the global economy, and global poverty. The percent

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The Unsurprising Surprise of Social Determinants in COVID-19 Mortality

“Covid-19 exposes America’s racial health gap,” asserts The Economist, the weekly news magazine based in London, UK, in an advanced essay dated 11 April 2020. The subtitle of the piece: “African-Americans appear more vulnerable to the virus.” The phrase, “your ZIP code is more important than your genetic code” has become the common mantra for public health people communicating the concept of the social determinants of health: those factors outside of medical services that shape peoples’ overall health and well-being. Two days ago, the Centers for Disease Control (CDC) published data that showed African-Americans were dying from complications of the

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The Grocery Store as Social, Health — and Sickness — Destination

On Monday, 6th April 2020, the Prime Minister of New Zealand, Jacinda Ardern, has determined that the Easter Bunny and the Tooth Fairy are essential workers in our age of the coronavirus pandemic. The PM has posted an Easter egg coloring project on her Facebook page to support children (and people like me who like to color) in the #StayHome era. In the U.S., the day before on Sunday 7th April, Dr. Deborah Birx advised Americans that, “The next two weeks are extraordinarily important. This is the moment to not be going to the grocery store, not going to the

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The Coronavirus Impact on American Life, Part 2 – Our Mental Health

As the coronavirus pandemic’s curve of infected Americans ratchets up in the U.S., people are seeking comfort from listening to Dolly Parton’s bedtime stories, crushing on Dr. Anthony Fauci’s science-wrapped-with-empathy, and streaming the Tiger King on Netflix. These and other self-care tactics are taking hold in the U.S. as most people are “social distancing” or sheltering in place, based on numbers from the early April 2020 Kaiser Family Foundation health tracking poll on the impact of the coronavirus on American life. While the collective practice of #StayHome to #FlattenTheCurve is the best-practice advice from the science leaders at CDC, the NIAID

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West Virginia Was the Last State to ID a COVID-19 Positive Patient; The States’ Residents Are At Highest Risk for Severe Reaction to C19

Gallup has estimated 11 Million in U.S. at Severe Risk If Infected With COVID-19 in research published today. And the health citizens of West Virginia would be at greatest risk for having a severe reaction to the coronavirus. A “severe reaction” here means being critically ill or dying. The forecast doesn’t focus on the whole number of people in the US. who would be at-risk of contracting the coronavirus; the 11 million is the total number of Americans who have a “very high chance of becoming critically ill or dying” if 100% of the country were infected with C19. This

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Shaky Trust in the Age of the Coronavirus – Who Do Americans Trust for COVID-19 Facts?

One in two Americans trust the Centers for Disease Control for the facts on the coronavirus pandemic, and 43% trust the World Health Organization. But there’s a huge trust deficit when it comes to trusting President Donald Trump on the facts about COVID-19, a poll from Morning Consult and The Hollywood Reporter found. 2,200 U.S. adults were surveyed between 12 and 15 March 2020 on the coronavirus pandemic and their perspectives on the media and political leaders’ information credibility. For news on the pandemic, only one in five Americans believed the President and 18%, the Vice President, Mike Pence, followed

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Estimates of COVID-19 Medical Costs in the US: $20K for inpatient stay, $1300 OOP costs

In the midst of growing inpatient admissions and test results for COVID-19, Congress is working as I write this post to finalize a round of legislation to help Americans with the costs-of-living and (hopefully) health care in a national, mandated, clarifying way. Right now in the real world, real patients are already being treated for COVID-19 in American hospitals. Patients are facing health care costs that may result in multi-thousand dollar bills at discharge (or death) that will decimate households’ financial health, particularly among people who don’t have health insurance coverage, covered by skinny or under-benefited plans, and/or lack banked

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Lockdown Economics for U.S. Health Consumers

The hashtag #StayHome was ushered onto Twitter by 15 U.S. national healthcare leaders in a USA Today editorial yesterday. The op-ed co-authors included Dr. Eric Topol, Dr. Leana Wen, Dr. Zeke Emanuel, Dr. Jordan Shlain, Dr. Vivek Murthy, Andy Slavitt, and other key healthcare opinion leaders. Some states and regions have already mandated that people stay home; at midnight last night, counties in the Bay Area in California instituted this, and there are tightening rules in my area of greater Philadelphia. UBS economist Paul Donovan talked about “Lockdown Economics” in his audio commentary today. Paul’s observations resonated with me as

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The Book on Deaths of Despair – Deaton & Case On Education, Pain, Work and the Future of Capitalism

Anne Case and Angus Deaton were working in a cabin in Montana the summer of 2014. Upon analyzing mortality data from the U.S. Centers for Disease Control, they noticed that death rates were rising among middle-aged white people. “We must have hit a wrong key,” they note in the introduction of their book, Deaths of Despair and the Future of Capitalism. This reversal of life span in America ran counter to a decades-long trend of lower mortality in the U.S., a 20th century accomplishment, Case and Deaton recount. In the 300 pages that follow, the researchers deeply dive into and

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How Coronavirus Is Re-Shaping Consumer Behavior, From the Amusement Park to the Voting Booth

The coronavirus has shaken U.S. consumer confidence, both in terms of financial markets and personal health risks. COVID-19 is re-shaping peoples’ behavior and daily choices, from using public transit to choosing where to shop, based on Morning Consult’s National Tracking Poll #200276 conducted February 28-March 1, 2020. Morning Consult surveyed 2,200 U.S. adults, finding that 3 in 4 Americans were concerned about the coronavirus outbreak. The first chart from the survey shows various consumer activities by peoples’ likelihood of choosing to do them. Clearly, our daily life-flows outside of our homes have been impacted by our perceived risks of the coronavirus:

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The High Cost-of-Thriving and the Evolving Social Contract for Health Care

Millions of Americans have to work 53 weeks to cover a year’s worth of household expenses. Most Americans haven’t saved much for their retirement. Furthermore, the bullish macroeconomic outlook for the U.S. in early 2020 hasn’t translated into individual American’s optimism for their own family budgets. (Sidebar and caveat: yesterday was the fourth day in a row of the U.S. financial markets losing as much as 10% of market cap, so the global economic outlook is being revised downward by the likes of Goldman Sachs, Vanguard, and Morningstar, among other financial market prognosticators. MarketWatch called this week the worst market

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Why CTA’s Shepherding AI Is Important for Re-Imagining Healthcare

The Consumer Technology Association (CTA), collaborating with industry stakeholders, has ushered in a standard for artificial intelligence in health care.   CTA is the membership organization for companies that innovate, manufacture and market consumer-facing tech like big-screen TVs, slick new autos, video games and voice assistants. So what’s an organization like CTA doing with AI and health care? Let me connect the dots. Check out this graphic taken from my book, HealthConsuming: From Health Consumer to Health Citizen. This shows the ten categories of tech I revisit each year at CES, CTA’s annual mega-conference of new-new things in consumer electronics

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Will Trade Data for (Cheaper) Health Care – USC’s View of the Future

Patients are now front-line payors in the U.S. health care system. As such, American health consumers are wrestling with sticker shock from surgical procedures, surprise medical bills weeks after leaving the hospital, and the cost of prescription drugs — whether six-figure oncology therapies or essential medicines like insulin and EpiPens. To manage personal health finances, patients-as-payors are increasingly willing to face trade-offs and change personal behaviors to lower health care costs, based on research in The Future of Health Care Study from USC’s Center for the Digital Future. The Center analyzed the perspectives of 1,000 U.S. adults in August 2019 regarding

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The Ill Health of Rural Hospitals in Four Charts

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

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What Health Plans, Hospitals and Health Systems Can Learn from CES 2020

At this year’s CES — that’s the annual meta-meet-up of tech-loving folks from around the world who meet in Las Vegas to see the latest in all forms of consumer electronics and technology, from smart refrigerators and sexy sleek cars to videogames and personal emergency systems — there was a lot for the health care industry to soak up. I explain what was not only hot, but impactful, for health care providers and plans in the Medecision Liberation Blog published today. This year’s #CES2020 wasn’t as much about the shiny new things in the Internet of Things as it was

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Health@Retail Update: Kroger and Hy-Vee Morph Grocery into Health, Walmart’s Health Center, CVS/housing and More

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

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USA Today Finds Hidden Common Ground Among Americans For Health Care

“We need to demand our health citizenship. That means our nation must approach medical treatment and data privacy as civil rights that protect everyone.” This is the start of my column, Americans, let’s claim our health care rights, published by USA Today today. USA Today is publishing a 10-part series called “Hidden Common Ground” addressing key issues where Americans can come together. Thus far, the series has covered climate change, and this month health care. Going forward, we’ll see analyses on jobs, gun rights and violence, and immigration through May’s publishing schedule. In their study conducted in December 2020, USA Today

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Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

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What’s Causing Fewer Primary Care Visits in the US?

Americans who have commercial health insurance (say, through an employer or union) are rarely thought to face barriers to receiving health care — in particular, primary care, that front line provider and on-ramp to the health care system. But in a new study published in the Annals of Internal Medicine, commercially-insured adults were found to have visited primary care providers (PCPs) less often, and 1 in 2 had no PCP visits in one year. In Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008-2016, the researchers analyzed data from a national sample of adult health

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Most Americans Are Curious and Hopeful About Genetics Research, But Privacy-Concerned

Most Americans associate more optimistic words with human genetics research than they do darker implications: “curious,” “hopeful,” “amazed.” and indeed “optimistic” ranked the top four impressions in peoples’ minds, based on a survey form the American Society of Human Genetics (ASHG). Below these perceptions are a few concerning concepts such as “cautious,” “concerned,” “hesitant, and “skeptical,” the poll found. Based on the relatively positive views on genetics research, most Americans support increasing Federal funding for that research: 74% said it was somewhat or very important to do so, compared with 15% saying it was not important. People value genetics research

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Consumers Seek Benefits From Food, a Personal Social Determinant of Health

As consumers in the U.S. wrestle with accessing and paying for medical benefits, there’s another sort of health benefit people increasingly understand, embrace, and consume: food-as-medicine. More people are taking on the role of health consumers as they spend more out-of-pocket on medical care and insurance, and seeking food to bolster their health is part of this behavior change. One in four Americans seek health benefits from food, those who don’t still seek the opportunity to use food for weight loss goals, heart health and energy boosting, according to the 2019 Food & Health Survey from the International Food Information

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Calling Out Health Equity on Martin Luther King Day 2020

Today as we appreciate 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 is

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Home Is Where the Health Is, CareMore Health (And Most People) Believe

Most people dealing with chronic conditions, and those who care for them, believe that “home is where the health is,” according to a survey about the “21st century house call” from CareMore Health. To gain peoples’ perspectives on health care at home and chronic disease management, CareMore Health and Aspire Health commissioned a survey among 2,009 U.S. adults 23 years of age and over in September and October 2019. The survey sample included people dealing with chronic disease themselves, as well as caregivers attending to people with chronic illnesses. The definition of that “modern house call” is largely based on the

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Living in Digital Healthcare Times – Kicking off #DigitalHealthCES & #CES2020

Today is Day 1 of two Media Days at #CES2020 in Las Vegas, kicking off this manic week of the Consumer Electronics Show at the Mandalay Bay convention center. For several years, I’ve convened with journalists and industry analysts from around the world for these two days before the “official” opening of CES to hear the latest news from some of the largest tech-focused companies on Earth. Announcements come from across industry sector — from automotive and transportation, telecoms, consumer goods, entertainment, social media, travel, and retail…with platform technologies playing a role including but not limited to AI, AR/VR/XR (the

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The 2020 Social Determinants of Health: Connectivity, Art, Air and Love

Across the U.S., the health/care ecosystem warmly embraced social determinants of health as a concept in 2019. A few of the mainstreaming-of-SDoH signposts in 2019 were: Cigna studying and focusing in on loneliness as a health and wellness risk factor Humana’s Bold Goal initiative targeting Medicare Advantage enrollees CVS building out an SDOH platform, collaborating with Unite US for the effort UPMC launching a social impact program focusing on SDoH, among other projects investing in social factors that bolster public health. As I pointed out in my 2020 Health Populi trendcast, the private sector is taking on more public health

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Medicare Members Are Health Consumers, Too – Our AHIP Talk About Aging, Digital Immigrants, and Personalizing Health/Care

As Boomers age, they’re adopting mobile and smart technology platforms that enable people to communicate with loved ones, manage retirement investment portfolios, ask Alexa to play Frank Sinatra’s greatest hits, and manage prescription refills from the local grocery store pharmacy. Last week, the Giant Eagle grocery chain was the first pharmacy retailer to offer a new medication management skill via Alexa. That program has the potential to change our Medicare members manage meds at home to ensure better adherence, supporting better health outcomes and personal feelings of efficacy and control. [As an aside, consumers really value pharmacies embedded in grocery

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Food As Medicine: Grocery Stores Expand as Health Destinations While the Federal Government Cuts Food Stamps

There’s something like cognitive dissonance as I prepare my 2020 Health Populi TrendCast of what to expect in the health/care ecosystem in the new year. One of my key pillars for health-making is food-as-medicine, and that opportunity in this moment resonates in this holiday season with Dickens’ “Best of Times, Worst of Times” context-setting that kicks off Great Expectations. In the “best of times” part of the food+health equation, we recognize the growing role of grocery stores, food-tech and food manufacturers in the health/care landscape. A current example comes from Kroger, partnering with Ascension’s health system in Tennessee, enhancing the organization’s

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Longevity Stalls Around the World And Wealth, More Concentrated

Two separate and new OECD reports, updating health and the global economic outlook, raise two issues that are inter-related: that gains in longevity are stalling, with chronic illnesses and mental ill health affecting more people; and, as wealth grows more concentrated among the wealthy, the economic outlook around most of the world is also slowing. First, we’ll mine the Health at a Glance 2019 annual report covering data on population health, health system performance, and medical spending across OECD countries. The first chart arrays the x-y data points of life expectancy versus health spending for each of the OECD countries

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Social Determinants of Health – My Early Childhood Education and Recent Learnings, Shared at the HealthXL Global Gathering

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. When Daddy drove us back out to our suburban home about 30 minutes from the fancy hotel, the car radio was tuned to WWJ Newsradio 950, all news all the time. As soon as Daddy switched on the radio, we were shocked by the news of a riot breaking out in the city, fires and looting and gunshots and chaos in the Motor City. Two days later, my father, who did business with Mom-and-Pop retail store owners in the

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Art As Medicine – WHO Weaves the Evidence for Arts’ Role in Improving Health

“What’s the evidence on the role of the arts in improving health and well-being?” asks a report from the World Health Organization‘s Europe region team (WHO-Europe). There’s a lot of proof supporting arts-as-medicine, WHO details in this paper, which synthesizes research published in over 3,000 studies. The first chart illustrates the logic model that bridges arts to health in three segments: “Components” of arts programs, including but not limited to cognitive stimulation (e.g., learning a new arts skill such as painting, drawing or journaling), social interaction (e.g., participating in theatre), physical activity (e.g., dance), and evocation of emotion (e.g., listening

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Will Technology Cure Americans’ Health Care System Ills? Considering Google and Ascension Health’s Data Deal

“Google’s ‘Project Nightingale’ Gathers Personal Health Data on Millions of Americans,” the Wall Street Journal reported in today’s paper and on the WSJ.com website. The story started with the scenario that, “Search giant is amassing health records from Ascension facilities in 21 states; patients not yet informed.” Here’s Ascension’s press release on the collaboration, described in the title as “healthcare transformation.” Note: this release was written after the Wall Street Journal published this story. And, according to the WSJ reporting, “Neither patients nor doctors have been notified. At least 150 Google employees already have access to much of the data

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A Tale of Two Americas as Told by the 2019 OECD Report on Health

It was the best of times, It was the worst of times, It was the age of wisdom, it was the age of foolishness, It was the epoch of belief, it was the epoch of incredulity, … starts Dickens’ Tale of Two Cities.  That’s what came to my mind when reading the latest global health report from the OECD, Health at a Glance 2019, which compares the United States to other nations’ health care outcomes, risk factors, access metrics, and spending. Some trends are consistent across the wealthiest countries of the world, many sobering, such as: Life expectancy rates fell in 19 of the

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Will Consumers Cross the Cost-and-Trust Chasm Between Prescription Drugs and Hospitals?

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

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While Costs Are A Top Concern Among Most U.S. Patients, So Are Challenges of Poverty, Food, and Housing

Rising health care costs continue to concern most Americans, with one in two people believing they’re one sickness away from getting into financial trouble, according to the 2019 Survey of America’s Patients conducted for The Physicians Foundation. In addition to paying for “my” medical bills, most people in the U.S. also say that income inequality and inadequate social services significantly contribute to high medical spending for every health citizen in the nation. The Physicians Foundation conducts this study into Americans’ views on the U.S. health care system every other year. This year’s poll was conducted in September 2019 and included input

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Making Health Care Better, from the N of 1 to the Public’s Health – Trend-Weaving Medecision Liberation 2019

Health and our health information are deeply personal. Changing health care and inspiring positive health behaviors is hard to do. But we must and we will, a group of inspiring and inspired people who work across the health/care ecosystem affirmed this week in Dallas at the conference of Medecision Liberation 2019. I was engaged at this conference to wear several hats — as a keynote speaker, a sort of “emcee,” and, finally, to trend-weave the many talks and discussions happening throughout the meeting. This post is my synthesis of the summary I delivered live at the end of the conference,

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How a Razor Bolsters Health, Wellness and Love for Caregiving

The market for caregiving is growing and the business community has, finally, begun to pay attention. The Washington Post referred to this market as a “gold rush” to design smart shoes, custom razors and technology for the “over-65 crowd.” Caregiving in the U.S., the seminal report from AARP, estimated that 43,5 million adults in the U.S. had provided unpaid care to an adult or child in the past year, about one in five people being caregivers. Over half of caregivers are women, and are about 49 years of age on average. Caregivers spent over 24 hours a week providing care go

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What the 2019 Nobel Prize Winners in Economics Teach Us About Health

The three winners of the 2019 Nobel Prize for Economics — Banerjee and Duflo (both of MIT) and Kremer (working at Harvard) — were recognized for their work on alleviating global poverty.” “Over 700 million people still subsist on extremely low incomes. Every year, five million children still die before their fifth birthday, often from diseases that could be prevented or cured with relatively cheap and simple treatments,” The Nobel Prize website notes. To respond to this audaciously huge challenge, Banerjee, Duflo and Kremer asked quite specific, granular questions that have since shaped the field of development economics — now

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The New Health/Care is Patient-Led, Retail-Enabled – The GMDC Self-Care Summit

SelfCare is health/care, particularly as patients, everyday people, take on greater responsibility for clinical decisions and paying for medical services. We’re convening today through Sunday in Indianapolis with GMDC, the Global Market Development Center and Retail Tomorrow to brainstorm the current and future prospects for SelfCare, health and wellness in the hands, hearts, and homes of consumers. To bolster the message and engage with industry stakeholders, GMDC collaborated with the Hamacher Resource Group to develop a SelfCare Roadmap, an interactive tool that provides insights into twelve conditions where consumers typically looking to DIY their health using over-the-counter medicines, supplies and

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The Promise of Telehealth for Older People – the U-M National Poll on Healthy Aging

Older people are re-framing their personal images and definitions of aging, from continuing to work past typical retirement age, Skyping and texting with grandchildren, and traveling to destinations well beyond the “snowbird” locales of Florida and Arizona to more active and often charitable/volunteer situations in developing economies. And so, too, are older folks re-imagining how and where their health care services could be delivered and consumed. Most people over 50 years of age are cautious but open to receiving health care virtually via telehealth platforms, according to the National Poll on Healthy Aging from my alma mater, the University of Michigan. U-M’s

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The Rise of Social Determinants of Health in Healthcare is Just Real Life Stuff for People, Patients, Consumers

Based on the influx of research studies and position papers on social determinants of health flowing into my email box and Google Alerts, I can say we’re past the inflection point where SDoH is embraced by hospitals, professional societies, health plans and even a couple of pioneering pharma companies. PwC published a well-researched global-reaching report this week appropriately titled, Action required: The urgency of addressing social determinants of health. The “wheel of determinants” illustrates potential partners for collaborating in communities to address SDoH factors. The collaborators include governments, health care providers, payors, life science and pharma, tech and telecomms, policy

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Thinking About Isaiah, User-Centered Design, and Healthcare – Heard at Health 2.0

Turning 13, “we’re an unruly teenager on our hands now,” Matthew Holt invoked the start of the annual Health 2.0 Conference, convening this week in Santa Clara for its 13th year in existence. Started with Co-Founder Indu Subaiya, Health 2.0 was conceived as a “movement,” Matthew explained. “When (we were) younger, we broke some things.” Indu continued on that riff, “we’re breaking barriers now (that) we are older, and it’s time to raise the bar.” In the yin-and-yang riffing style that is the brand of this duo, Matthew continued in that vein of “breaking things,” invoking a metaphor of storming

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Prelude to Health 2.0 2019: Thinking Consumers At the Center of Digital Health Transformation

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

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Phone Calls, Social Plans, and Entertainment As Prescriptions for Older Peoples’ Loneliness

Loneliness is a killer, a health risk factor that’s been equated to smoking 15 cigarettes a day. There’s a Loneliness Epidemic in America, according to the Health Resources & Services Administration, part of the U.S. Department of Health and Human Services. HRSA’s infographic here tells us that there’s a 45% greater risk of mortality among older people who feel lonely. Given that millions of seniors in the U.S. feel lonely on a regular basis, that translates into a huge risk of death for so many older people who feel disconnected from others. “As a force in shaping our health, medical

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Why Humana Joined CTA – The Pivot from “Health Insurance” to Behaving as a Health-Tech Start-Up

“Every company is a tech company,” Christopher Mimms asserted in the Wall Street Journal in December 2018. Connectivity, artificial intelligence, and automation are now competencies every company must master, Mimms explains. This ethos underpins Humana’s decision to join CTA, the Consumer Technology Association which hosts CES every January in Las Vegas. If you read this blog, you know one of the fastest-growing “aisles” at the annual conference is digital health. Humana joined up with CTA’s Health and Fitness Technology Division this month. Last year, Humana hired Heather Cox in the new post of Chief Digital Health and Analytics Officer, reporting directly

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How Whirlpool’s #CareCounts Campaign Bolsters a Key Social Determinant of Health

Did you know that September is Attendance Awareness month? Me, neither. But reading one of last Sunday’s national newspapers, I noticed a full-page ad that read, “Whirlpool is helping keep kids in schools with washers and dryers.” Reading further on, the copy called out two data points making the point about laundry and education: One in five students don’t have access to clean clothes, making them more likely to miss school; and Students who miss school are 7 times more likely to drop out of educational system. The full ad’s theme in the words of Whirlpool is that, “Education has a

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Walmart’s Growing Footprint in Healthcare and Public Health, from Guns to Mental Health and Gardens

Over the past couple of weeks, Walmart is demonstrating its growing commitment to and leadership in healthcare and public health. The company’s announcement this week of pulling products that can be used in military-style weapons from its Outdoor Sports/Shooting department is a major move for public health that is something of a watershed that will impact well beyond the company’s inventory and stock price. This announcement will continue a trend among some thoughtful business leaders, like CEO Edward Stack of Dick’s Sporting Goods, banning gun sales from the retailer’s 125 stores in March 2019, who have begun to listen to

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A Profile of People in Medicare Advantage Plans – HealthMine’s Survey of “Digital Immigrants”

There are over 60 million enrollees in Medicare in 2019, and fully one-third are in Medicare Advantage plans. Medicare is adding 10,000 new beneficiaries every day in the U.S. Medicare Advantage enrollment is fast-growing, shown in the first chart where over 22 million people were in MA plans in January 2019. Better understanding this group of people will be critical to helping manage a fast-growing health care bill, and growing burden of chronic disease, for America. To that end, HealthMine conducted a survey among 800 people enrolled in Medicare Advantage plans ag 65 and over with at least one diagnosed

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Getting More Personal, Virtual and Excellent – the 2020 NBGH Employer Report

In 2020, large employers will be “doubling down” efforts to control health care costs. Key strategies will include deploying more telehealth and virtual health care services, Centers of Excellence for high-cost conditions, and getting more personal in communicating and engaging through platforms. This is the annual forecast for 2020 brought to us by the National Business Group of Health (NBGH), the Large Employers’ Health Care Strategy and Plan Design Survey. The 42-page report is packed with strategic and tactical data looking at the 2020 tea leaves for large employers, representing over 15 million covered lives. Nearly 150 companies were surveyed

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Talking “HealthConsuming” on the MM&M Podcast

Marc Iskowitz, Executive Editor of MM&M, warmly welcomed me to the Haymarket Media soundproof studio in New York City yesterday. We’d been trying to schedule meeting up to do a live podcast since February, and we finally got our mutual acts together on 6th August 2019. Here’s a link to the 30-minute conversation, where Marc combed through the over 500 endnotes from HealthConsuming‘s appendix to explore the patient as the new health care payor, the Amazon prime-ing of people, and prospects for social determinants of health to bolster medicines “beyond the pill.” https://www.pscp.tv/MMMnews/1eaJbvgovBYJX Thanks for listening — and if you

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What the Pew Report on Trust and Distrust in America Means for Health/Care, El Paso and Dayton — Pogo Rears His Head Again

Two in three Americans believe their trust in each other has been shrinking. And most people connect the dots between that low level of trust and America’s ability to solve problems. It’s been well-documented that Americans’ trust in institutions, and especially government and media, has eroded over the past decade. I’ve tracked that social trend here in Health Populi each year since covering the Edelman Trust Barometer, which has traced the downward sloping curve on trust globally and certainly in the U.S. The precipitous decline in trust in America among fellow Americans is described in Pew Research Gr0up’s report, Trust

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100 Million People in America Lack Broadband — an On-Ramp to Health and Safety

One in three Americans does not have a broadband connection, according to a new report from the NPD Group. This means that about 100 million people in the U.S. can’t benefit from telehealth and other digital health connections that can bolster self-care, home care, and lower cost care. Most of these folks in the broadband-digital divide live in rural America/ “The so-called digital divide, between those that can or cannot make the best use of the Internet, can be clearly felt in rural markets where the lack of broadband impacts everything from entertainment to the educational system,” Eddie Hold, President

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The Monetary, Clinical and Ethical Value of Patient Data – A View from the UK and NHS

There are about 55 million patient records held by the United Kingdom’s National Health Service (NHS). Their monetary value to private sector companies would be £5 billion and nearly that much in patient benefits. Add in value for patient outcomes, and the total approaches £10 billion. In today’s UK:US currency exchange rate, 10 billion British pound sterling is worth roughly $12 billion. Realising the Value of Healthcare Data from EY explores how patient data can, in the words of the report, “unlock significant operational savings, enhanced patient outcomes, and wider economic benefits” for the NHS and patients through using artificial

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The Number of Unintended Deaths From Car Accidents, Falls and Overdoses in America Grew 40% Between 1999 and 2017

The rate of deaths due to unintentional injuries in the U.S. grew by 40% between 1999 and 2017, according to the Centers for Disease Control (CDC). Three mortality line items make up this overall statistic: Deaths from motor vehicle traffic injuries Deaths from unintentional drug overdoses (that is, not including suicides which are defined as “intentional”), and Deaths due to unintentional falls. The line graph illustrates the macro trend on the top-line, with the three specific causes underneath. You see deaths due to falls, motor vehicle accidents, and drug overdoses increased over the eighteen years. Drug overdose death rates began

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Gaps in Health Equity in America Are Growing

There’s been a “clear lack of progress on health equity during the past 25 years in the United States,” asserts a data-rich analysis of trends conducted by two professors/researchers from UCLA’s School of Public Health. The study was published this week in JAMA Network Open. The research mashed up several measures of health equity covering the 25 years from 1993 through 2017. The data came out of the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System looking at trends by race/ethnicity, sex and income across three categories for U.S. adults between 18 and 64 years of age.

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Health Care and the Democratic Debates – Round 2 – Battle Royale for M4All vs Medicare for All Who Want It – What It Means for Industry

Looking at this photo of the 2020 Democratic Party Presidential candidate debater line-up might give you a déjà vu feeling, a repeat of the night-before debate. But this was Round 2 of the debate, with ten more White House aspirants sharing views — sometimes sparring — on issues of immigration, economic justice, climate change, and once again health care playing a starring role from the start of the two-hour event. The line-up from left to write included: Marianne Williamson. author and spiritual advisor John Hickenlooper, former Governor of Colorado Andrew Yang. tech company executive Pete Buttigieg, Mayor of South Bend,

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Health Care and the Democratic Debates – Part 1 – Medicare For All, Rx Prices, Guns and Mental Health

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

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Talk to Me About My Health, Medicare Advantage Beneficiaries Tell J.D. Power

Cost is the major reason why Medicare Advantage plan beneficiaries switch plans, but people who switch also tend to have lower satisfaction scores based on non-cost factors. Those ratings have a lot to do with information and communication, according to J.D. Power’s 2019 Medicare Advantage Plan Study. The Study explores MA beneficiaries’ views on six factors: Coverage and benefits Provider choice Cost Customer service Information and communication, and Billing and payment. Kaiser Foundation Health Plan garnered the top spot for the fifth year in-a-row. By feature, Kaiser achieved 5 “Power Circles” for all factors except for cost and provider choice,

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Kroger Health Thinks Food is Medicine – Nutrition at the Grocery Store Via FMI’s Insights

In reading the July/August issue of Eating Well magazine this week, I came across this ad which I scanned for you to see yourself: “We believe in food as medicine.” Signed, Kroger Health. Here’s the introductory text in the full-page ad: “As Kroger Health, our vision is to help people live healthier lives. And now, more than ever, through our experts, innovation, and technology, we’re uniquely positioned to bring that vision to life,” the copy read. “We know food,” the text continued, as part of The Kroger Co. which is the largest grocery chain in the U.S. celebrating 135 years

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The Most Important Trends For Health in Mary Meeker’s 2019 Internet Report Aren’t About Health Care

The health care section of Mary Meeker’s 334-page annual report, Internet Trends 2019, comprises 24 of those pages (270 through 293). These two dozen exhibits detail growing adoption of digital tech in health care, the growth of genomics and EHR adoption, examples of these tools from “A” (Apple) to “Z” (Zocdoc), and on the last page of that chapter, medical spending in the U.S., the highest in raw and per capita numbers versus the rest of the world. But the most important implications for American health care aren’t found in those pages: they’re in other parts of the report addressing

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The Grocery Store As Health Destination: Publix Produce for Kids and the Social Determinants of Health

Food insecurity ranks high on Americans’ greatest social health risks. In local communities, grocery stores are playing key roles in bolstering neighborhood wellness. Publix and other food chains, collaborating with the Produce for Kids program, are walking the talk on nutrition for local health citizens. Produce for Kids is associated with Feeding America, which works with local food banks and non-profits to help channel healthy food to children and families. Feeding America is a national network of over 200 food banks fighting hunger in America, serving over 46 million people and 60,000 food pantries, and advocating for legislation that addresses

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Intent, Insiders/Outsiders and Insights — Disney Institute’s Women’s Leadership Summit

There are many forms of magic inspired by Disney, the company. There’s the obvious attraction, the Magic Kingdom, that was Walt’s original destination vision, “imagineered” in 1932. Then there are other kinds of magic. The one I’m deep into in the moment is inspiration, ideation, and “reimagineering” my own thinking about work, legacy, and social justice. I’m grateful to have had the opportunity to spend much of this week at the inaugural Disney Institute Women’s Leadership Summit. The Institute convened about 300 women (and a handful of brave “He-for-She” men keen on diversity) in Orlando to learn about and brainstorm

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People Want to Flourish, Not Just Live – Speaking Health Politics to Real People

“How should we define ‘health?'” a 2011 BMJ article asked. The context for the question was that the 1948 World Health Organization definition of health — that health is, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”– was not so useful in the 21st century. The authors, a global, multidisciplinary team from Europe, Canada and the U.S., asserted that by 2011, human health was marked less by infectious disease and more by non-communicable conditions that could be highly influenced, reversed and prevented through self-care by the individual and public health policy

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How Consumers’ Belt-Tightening Could Impact Health/Care – Insights from Deloitte’s Retail Team

Over the ten years between 2007 and 2017, U.S. consumer spending for education, food and health care substantially grew, crowding out spending for other categories like transportation and housing. Furthermore, income disparity between wealthy Americans and people earning lower-incomes dramatically widened: between 2007-2017, income for high-income earners grew 1,305 percent more than lower-incomes. These two statistics set the kitchen table for spending in and beyond 2019, particularly for younger people living in America, considered in  Deloitte’s report, The consumer is changing, but perhaps not how you think. The authors are part of Deloitte Consulting’s Retail team. The retail spending data

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How Consumers Look At Social Determinants of Health for Cancer, Diabetes and Mental Health

Enlightened health/care industry and public policy stakeholders have begun to embrace and address social determinants of health. These are the inputs that bolster health beyond health care services: they include economic stability like job security and income level (and equity), education, and access to healthy food, food security, safe neighborhoods, social support, clean environments (water and air), and in my own update on SDoH factors, access to broadband connectivity. As physician leaders in the AMA, technology advocates from AMIA, and numerous health plans focus efforts on strengthening social determinants, what do people – consumers, patients, caregivers — think about these

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When Will Self-Service Come to Health Care?

At least one in three people who have tried out virtual health care have done so because they use technology in all aspects of life and want to do the same with their healthcare. This data point has informed my vision for self-care and the home as our health hub, bolstered in part through the research of Accenture from which this first graphic comes. A common theme at health care meetings these days is how and when health care will meet its Amazon, Apple, or Uber moment? Lately, one of my speaking topics is the “Amazon Prime-ing” of health consumers,

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Scaling the Social Determinants of Health – McKinsey and Kaiser’s Bold Move

People who are in poor health or use more health care services are more likely to report multiple unmet social needs, such as food insecurity, unsafe neighborhoods, lack of good housing, social isolation, and poor transportation access, found through a survey conducted by McKinsey. The results are summarized in Addressing the Social Determinants of Health. The growing recognition of the influence of social determinants reached a tipping point last week with the news that Kaiser-Permanente would work with Unite US to scale services to people who need them. The mainstreaming of SDoH speaks to the awareness that health is made

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Prescription Drug Costs In America Through the Patient Lens, via IQVIA, GoodRx and a New $2 Million Therapy

Americans consumed 17.6 prescriptions per person in 2018, two in three of which treated chronic conditions. Welcome to Medicine Use and Spending in the U.S. , the annual review of prescription drug supply, demand and Rx pricing dynamics from the IQVIA Institute for Human Data Science. In a call with analysts this week in which I participated, the Institute’s Executive Director Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. prescription drug market might look like five years from now. The report is organized into four sections: medical use

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Assessing the GAO’s Report on Single-Payer Healthcare in America: Let’s Re-Imagine Workflow

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. As a response, the Chairman of the House Budget Committee in the U.S. Congress, Rep. John Yarmuth (D-Ky.), asked the Congressional Budget Office (CBO) to develop a report outlining definitions and concepts for a single-payer health care system in the U.S.         The result of this ask is the report, Key Design Components and Considerations for Establishing a Single-Payer Health Care System, published on 1st May by the CBO. The report provides

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The Convergence of Health/Care and Real Estate

There’s no denying the growth of telehealth, virtual visits, remote health monitoring and mHealth apps in the healthcare landscape. But these growing technologies don’t replace the role of real estate in health, wellness and medical care. Health care is a growing force in retail real estate, according to the ICSC, the acronym for the International Council of Shopping Centers, which has been spending time analyzing, in their words, “what landlords should know in eyeing tenants from a $3.5 trillion industry.” Beyond the obvious retail clinic segment, the ICSC points out a key driving growth lever for its stakeholders, recognizing that,

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Will Health Consumers Morph Into Health Citizens? HealthConsuming Explains, Part 5

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

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What We Know We Know About ZIP Codes, Food, and Deaths of Despair – HealthConsuming Explains, Part 3

“There’s a 15-year difference in the life expectancy between the richest and poorest Americans.” That’s the first sentence of Chapter 7 in my book, HealthConsuming: From Health Consumer to Health Citizen. This data point comes from research published in JAMA in April 2016 on the association between income and life expectancy in the U.S. (That’s endnote #399 in the back of the book, one of 519 notes I use to support the plotline). Today, the Brookings Institution convened a meeting on the funding for social determinants of health to address disparities, costs, and quality of healthcare in America. The overall

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Health Consumers Are Now Amazon-Primed for Healthcare – HealthConsuming Explains, Part 2

As patients now assume the role of health consumer, they rationally expect retail-level experiences with greater first-dollar payment for health insurance, health care services and medical products like prescription drugs. Consumers know what good retail looks and feels like, and are focusing that experiential lens on health care, Aflac found when their Workforces Survey polled Americans on their desirable health insurance shopping experience. One in two people said it should feel, “like Amazon,” and another 20% of folks said, “like retail.” Chapter 3 of HealthConsuming is titled, “How Amazon Has Primed Health Consumers,” and explains this re-shaping of patient expectations.

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Health/Care Everywhere – Re-Imagining Healthcare at ATA 2019

“ATA” is the new three-letter acronym for the American Telemedicine Association, meeting today through Tuesday at the Convention Center in New Orleans.  Ann Mond Johnson assumed the helm of CEO of ATA in 2018, and she’s issued a call-to-action across the health/care ecosystem for a delivery system upgrade. Her interview here in HealthLeaders speaks to her vision, recognizing, “It’s just stunning that there’s such a lag between what is possible in telehealth and what is actually happening.” I’m so keen on telehealth, I’m personally participating in three sessions at #ATA19. On Monday 15th April (US Tax Day, which is relevant

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Digital Health As A Basic Human Need – the Dentsu Digital Society Index 2019

We are all Homo informaticus these days, multi-channel, multi-platform beings using digital platforms. “Computing is not about computers anymore. It is about living,” Nicholas Negroponte wrote in Being Digital. He said that in 1995. In that quarter-century since Negroponte made that prescient observation, we come to better understand that being a Digital Society has its upsides and downfalls, alike. We need a “new needs model” for the digital age, asserts a new report, Human Needs in a Digital World, the 2019 Digital Society Index report from the Dentsu Aegis network. Taking Maslow’s Hierarchy of Needs as a basic construct, the Index

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World Health Day 2019: Let’s Celebrate Food, Climate, Insurance Coverage and Connectivity

Today, 7 April, is World Health Day. With that in mind, I devote this post to three key social determinants of health (SDOH) that are top-of-mind for me these days: food for health, climate change, and universal health coverage. UHC happens to be WHO’s focus for World Health Day 2019. [As a bonus, I’ll add in a fourth SDOH in the Hot Points for good measure and health-making]. Why a World Health Day? you may be asking. WHO says it’s, “a chance to celebrate health and remind world leaders that everyone should be able to access the health care they need,

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Our Mobile Health Data: Shared, Identifiable, and Privacy-Deprived

As more mobile app users — consumers, patients, and caregivers — use these handy digital health tools, much of the data we share can be re-identified and monetized by third parties well beyond those we believe we’re sharing with. This compromised health data privacy scenario comes out of research published this month in the BMJ, Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis. The researchers, faculty from the University of Toronto (Canada) and the University of Sydney (Australia), come from nursing, pharmacy, and computer science expertise — a sound combination of disciplines

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Having Health Insurance Is A Social Determinant of Health

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs. These were the two top health care issues among voters in late 2018, a Kaiser Family Foundation poll at the time assessed. Yesterday, President Trump verbally re-branded the Republican Party as “the party of healthcare.” That Presidential pronouncement was tied to a letter written on U.S. Department of Justice

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Medical Issues Are Still The #1 Contributor to Bankruptcy in the U.S., An AJPH Study Asserts

Medical costs in America are still the top contributor to personal bankruptcy in the U.S., a risk factor in two-thirds of bankruptcies filed between 2013 and 2016. That’s a sad fiscal fact, especially as more Americans gained access to health insurance under the Affordable Care Act, according to a study published this month in the American Journal of Public Health (AJPA). Between 2013 and 2016, about 530,000 bankruptcies were filed among U.S. families each year associated with medical reasons, illustrated in Table 1 from the study. The report, Medical Bankruptcy: Still Common Despite the Affordable Care Act, updates research from 2007 which

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Patients, Health Consumers, People, Citizens: Who Are We In America?

“Patients as Consumers” is the theme of the Health Affairs issue for March 2019. Research published in this trustworthy health policy publication covers a wide range of perspectives, including the promise of patients’ engagement with data to drive health outcomes, citizen science and participatory research where patients crowdsource cures, the results of financial incentives in value-based plans to drive health care “shopping” and decision making, and ultimately, whether the concept of patients-as-consumers is useful or even appropriate. Health care consumerism is a central focus in my work, and so it’s no surprise that I’ve consumed every bit of this publication. [In

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Can AI Make Healthcare Human Again? Dr. Topol Says “Yes”

“The Fourth Industrial Age,” Dr. Abraham Verghese writes, “has great potential to help, but also to harm, to exaggerate the profound gap that already exists between those who have much and those who have less each passing year.” Dr. Verghese asserts this in his forward to Deep Medicine, Dr. Eric Topol’s latest work which explores the promise of artificial intelligence (AI), Big Data, and robotics — three legs of the Fourth Industrial Age stool. [If you don’t know the work of Dr. Verghese, and since you’re reading the Health Populi blog, you must get to know Dr. V now. Your

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Digital Transformation Is The New Mantra But Can’t Happen Without Access To Connectivity

As more of our “things” get digitally connected, there’s an unanswered question about how our connected lives impact human life and health. A new report from the OECD asks and answers: How’s Life in the Digital Age? Opportunities and Risks of the Digital Transformation for People’s Well-being. This research is part of OECD’s ongoing series asking the Big Question, “How’s Life?” A prevailing current mantra in work and daily living is “digital transformation.” The OECD broadly defined the phrase in their 2017 paper on the topic as follows: Mobility, cloud computing, the Internet of things (IoT), artificial intelligence (AI) and big

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Loneliness Is A Health Risk, Especially Among Older People

In America, one in three people over 50 years of age feels a lack of companionship, and one-fourth feel isolated from other people, according to a new poll on loneliness and aging from the University of Michigan, sponsored by AARP. The University of Michigan National Poll on Healthy Aging surveyed some 2,000 U.S. adults age 50–80 in October 2018, assessing older peoples’ health, health behaviors, experiences and feelings related to companionship and social isolation. While three in four people have frequent social contact with family, friends and neighbors outside of their home, the remaining one in four have social contact once a

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Time To Travel And Wait In Health Care: The Opportunity For Self-Care At Home

What industry compels its “consumers” to wait longer and travel further for services more than any other in a person’s daily life? That would be health care, a report from Altarum notes. People travel further and wait longer for medical services than for veterinary care (second in this line-up), auto repair, banking, and household services. The annual opportunity cost for travel and wait time in health care is $89 billion, Altarum estimated. For the average person, that translates to 34 minutes of travel time and 11 minutes waiting time at the provider’s office. In terms of personal opportunity costs, Altarum gauged the

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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

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Health Is Social – The Social Determinants of Health at HIMSS19

In the health care world, it is now commonly accepted that genes contribute less than half of the influence on peoples’ health status. Other issues play starring roles in overall well-being, including environmental factors, health care services, and social determinants of health (SDOH). These inputs include education, personal economics (like job security and financial stability), physical built environments (think: transportation access, safe and healthy housing), food and nutrition, and access to health care. At HIMSS17, I gave a talk in a big room about how technology can scale SDOH; we had standing room only, which is not a brag —

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Consumers Expand Their Definition of Well-Being to Include Food-As-Medicine

Consumers put food front-and-center when thinking about their health. Viewing food-as-medicine is going mainstream for health consumers, who look beyond the “medicine” in that phrase toward a broader concept of personal well-being. This is the theme of a new report from the FMI Foundation called The Power of Health and Well-Being in Food Retail. The report’s insights are based on surveys FMI has conducted over the past two years, as the Foundation has observed that consumers broadening their definition of health to include emotional health, energy levels, and sleep quality. The consumer-as-medical-bill-payor is now looking at foods with health benefits, first

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Care Gets Personal at Philips for Parents and Babies

Our homes should nurture our health. In addition to nutrition and good food, positive relationships, clean air and water, and the basic needs that bolster whole health, technology is playing a growing role to help us manage health at home. At CES 2019, I spent time with Roy Jakobs, Chief Business Leader of Personal Health with Philips, to discuss the company’s evolving portfolio of products that help fulfill the mission to support people across their own continuum of health. Following CES, I wanted to further dive into one part of the portfolio very important to family health at home: the

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The Consumer and the Payor, Bingo and Trust: My Day At Medecision Liberator Bootcamp

To succeed in the business of health information technology (HIT), a company has to be very clear on the problems it’s trying to address. Now that EHRs are well-adopted in physicians’ practices and hospitals, patient data have gone digital, and can be aggregated and mined for better diagnosis, treatment, and intelligent decision making. There’s surely lots of data to mine. And there are also lots of opportunities to design tools that aren’t very useful for the core problems we need to solve, for the clinicians on the front-lines trying to solve them, and for the patients and people  whom we

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Calling Out Health Equity on Martin Luther King Day 2019

On this weekend as we appreciate 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

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A Smarter Home for Healthy Living at CES 2019….and a nod to Microsoft

Health begins at home. I found evidence for that, beyond my own N of 1 understanding, in a research article published in the UK in 2000 by Lyn Harrison and Frances Heywood. Lyn and Frances tested three assumptions that they believed linked housing and health: that housing contributes to health; that housing is not routinely included in health or social planning;’ and that the potential contribution of primary care is wasted. Their conclusion: that the housing-health link was not receiving the recognition that connection needs. Nearly two decades later, that housing-health link still isn’t universally embraced by health care stakeholders. But

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The Consumer as Payor – Retail Health at CES 2019

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

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What #CES2019 5 Tech Trends to Watch Mean for Health/Care

As #CES2019 kicks off in Las Vegas with today’s first Media Day, the Consumer Technology Association presented its forecast on the 5 Technology Trends to Watch in 2019 — and they all play into health, wellness, and medical care. The five trends are: Artificial Intelligence on the Rise Envisioning the Smart Home of the Future Digital Health Tech Empowers Patients Esports and Sports Technology, and Smart Cities Promote Resilience. Here are how these five mega-trends can bolster our health and healthcare products and services over the next decade. AI is indeed on-the-rise in healthcare: as I have begun planning my agenda for

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