WORLD POPULATION: 8,015,936,000*
YEAR 2050 PROJECTION: 9,800,000,000**
YEAR 2100 PROJECTION: 11,200,000,000**
U.S. POPULATION: 333,287,557***
POLITICS & POLICIES
April 7, 2023: The Health Policy Institute of Ohio has released an action guide that highlights policy options for improving housing, one of the social drivers of infant mortality in Ohio. HPIO recently produced the Social Drivers of Infant Mortality: Recommendations for Action and Accountability in Ohio report as an update to the 2017 A New Approach to Reduce Infant Mortality and Achieve Equity report. The action guide takes a closer look at the housing recommendations in the Action and Accountability report and provides state and local health stakeholders with additional information and tools to support next steps. Despite the efforts of many in both the public and private sectors, progress in reducing infant mortality since 2011 has been minimal and uneven (as illustrated in the graphic above), and Ohio’s infant mortality rate remains higher than most other states. Infant mortality prevention efforts have largely focused on public health and healthcare interventions for pregnant women, such as safe sleep education and prenatal care access. While these efforts have likely contributed to the overall reduction in infant mortality, healthcare services alone are not enough to close gaps in birth outcomes in Ohio.
April 22, 2023: The man bringing artificial intelligence to the masses through the viral chatbot ChatGPT wants to revolutionize mental health care and addiction treatment with psychedelic drugs. Sam Altman, chief executive of OpenAI, is chairman of a start-up that aims to tap into the promise that psychedelic drugs have shown in clinical trials — and make them broadly available for people who suffer from mental health and drug-use disorders. The firm, Journey Colab, is partnering with a luxury rehab clinic, All Points North, to shepherd drugs like MDMA and psilocybin through late-stage trials and design a model for administering them to patients. Jeeshan Chowdhury, Journey’s CEO, says such drugs are powerful tools, comparing them to performing complex surgeries. “Surgery is done in a safe environment in specialized facilities by highly experienced teams,” he said. “We aim to demonstrate that rehab centers … are the safest place for these interventions.”
PROGRAMS, PROJECTS, CONFERENCES, GRANTS, AWARDS & EVENTS
Welcome to Healthcare IT News’ coverage of the 2023 HIMSS Global Health Conference & Exhibition, scheduled for April 17-21 in Chicago. Our editors, reporters and video producers will be reporting on everything you need to know from the event – bringing you news, features, podcasts and more about information and technology, healthcare trends, policy announcements, education sessions, keynote speeches and much more. Be sure to refresh this page often for our pre-conference, onsite and post-conference coverage of HIMSS23!
The European Public Health Association (EUPHA) and the European Public health Conference (EPH) are pleased to invite you to the 16th EPH conference. Chair of the Conference is Anthony Staines.
The National Network of Public Health Institutes (NNPHI) is proud to announce its Annual Conference is headed to Washington, DC, May 9-11, 2023. Since 2001, the NNPHI Annual Conference is the only national meeting that supports and highlights the work of the nation’s public health institutes. NNPHI members lead conference programming that explores fresh concepts and strategies for supporting healthy communities at the local, state, and federal levels. We invite you to join the diverse array of conference participants for the 2023 conference, which will include representatives from established and emerging public health institutes; public health training centers; federal, state and local health agencies; national partners and trade organizations; local, state, and national foundations; and community organizations.
HISTORICAL, REPORTS, DOCUMENTS, DATA & INDEXES
February 6, 2023: Cancer figures provide stark evidence of the gap between the health of Aboriginal and Torres Strait Islander people and non-Indigenous people in Australia. The difference is confronting – and it’s increasing over time. Cancer is the leading broad cause of death for Aboriginal and Torres Strait Islander people, accounting for 3,612 deaths (23% of deaths). Indigenous Australians are 14% more likely to be diagnosed with cancer. They are 20% less likely to survive at least five years beyond diagnosis. While the likelihood of dying from cancer in the general population declined by 10% from 2010 to 2019, it increased by 12% for Aboriginal and Torres Strait Islander people. These figures highlight major challenges for the federal government’s stated aim to close the life expectancy gap in a generation. But data will also be critical to meeting this goal.
January 22, 2023: Health data can include information about health-care services, health status and behaviours, medications and genetic data, in addition to demographic information like age, education and neighbourhood. These facts and statistics are valuable because they offer insights and information about population health and well-being. However, they can also be sensitive, and there are legitimate public concerns about how these data are used, and by whom. The term “social licence” describes uses of health data that have public support. Studies performed in Canada, the United Kingdom and internationally have all found public support and social licence for uses of health data that produce public benefits. However, this support is conditional. Public concerns related to privacy, commercial motives, equity and fairness must be addressed.
April 20, 2023: Universal Influenza Candidate Vaccine Performs Well in Phase 1 Trial
mRNA Version of NIAID Vaccine Begins Similar Testing. Scientists at NIAID’s Vaccine Research Center (VRC) report in two new studies that an experimental influenza vaccine, designed to elicit immunity against a broad range of influenza viruses, performed well in a small trial of volunteers. In fact, the vaccine has advanced to a second trial led by scientists at Duke University through NIAID’s Collaborative Influenza Vaccine Innovation Centers (CIVICs). In a phase 1 clinical trial of 52 volunteers, the vaccine developed by the VRC – known as H1ssF (influenza H1 hemagglutinin stabilized stem ferritin nanoparticle vaccine) – was safe, well-tolerated, and induced broad antibody responses that target the hemagglutinin stem. The two new studies assessing the nanoparticle vaccine published April 19 in Science Translational Medicine.
April 20, 2023: Over 200 international participants working with the mRNA Technology Transfer Programme met in Cape Town this week for their first face-to-face meeting. Joined by World Health Organization (WHO) Director General, Dr. Tedros Adhanom Ghebreyesus and Dr. Joe Phaahla, Minister of Health and Minister of Trade and Industry, Mr. Ebrahim Patel of South Africa together with high-level officials from funding countries, this unique meeting reviewed the progress since WHO and Medicines Patent Pool (MPP) launched it in June 2021. “I am delighted to be here in Cape Town with our partners to support a sustainable model for mRNA technology transfer to give low- and middle-income countries equitable access to vaccines and other lifesaving health products,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I am immensely proud of the achievement of all those involved in this project; in less than two years we have shown that when we work collaboratively, we succeed collectively.” The meeting participants include biomanufacturing partners from 15 countries in the Programme, leading experts, industry, civil society representatives, and funders. During the five-day meeting, participants will share progress and discuss critical enablers for the sustainability of the Programme such as intellectual property issues and regulatory aspects, as well as the science of mRNA technologies and key applications relevant to LMICs in other disease areas such as HIV and tuberculosis.
DISEASES & DISASTERS
February 15, 2023: Authorities lifted evacuation orders about a week after a train derailment that resulted in a toxic chemical spill, giving residents of East Palestine, Ohio, the green light to return to their homes and telling them that the air was safe to breathe and the water supply untainted. But for the nearly 5,000 inhabitants of this small village on the border with Pennsylvania, those assurances have done little to allay their fears of a long-term environmental and health disaster after 38 cars of a Norfolk Southern Railroad train, some carrying hazardous chemicals, derailed Feb. 3 near their city, sending flames high into the night sky. Five of the derailed cars carried vinyl chloride, a highly volatile, colorless gas used to make polyvinyl chloride, or PVC, a type of plastic. The gas is a known human carcinogen and has been linked to an increased risk of a rare form of liver cancer called hepatic angiosarcoma. Fearing a major explosion, crews performed a controlled release of the toxic chemicals from those five cars. As a result, East Palestine residents are concerned about hazardous gases that may be lingering in the air. “I would be concerned about its immediate effects more than its long-term effects,” said Carl D. Hoff, a professor of chemistry in the University of Miami College of Arts and Sciences. “Almost all organochlorine compounds are toxic. Even after decomposition, it may leave residues that are longer lasting but less dramatic in their danger. The monomeric compound is a real hazard but should diminish with time in my view.” He cited a published Environmental Protection Agency report that indicates that vinyl chloride will rapidly exchange with soil and water and air and be destroyed by sunlight with a half-life of a day and a half. Still, monitoring of the water and soil in the area will be critical, according to Naresh Kumar, a professor of environmental health at the Miller School of Medicine. “And I am sure that is something they will do for weeks and potentially months in the future,” he said. For some animals in the area, the derailment, which is under investigation by the National Transportation Safety Board, might have already had a deadly impact. The Ohio Department of Natural Resources, for example, has reported that the chemical spill has killed about 3,500 small fish across seven and a half miles of streams. What’s more, a resident who lives 10 miles from East Palestine reported to a local TV station that her five hens and rooster had perished.
April 19, 2023: People who use home- and community-based services (HCBS) are at heightened risk of serious illness or death from exposure to COVID-19 and disproportionately likely to need hospital or nursing facility care if HCBS are unavailable. However, during the pandemic, there were fewer workers available and willing to provide services and extra safety precautions were required to prevent COVID-19 infection. Recognizing those challenges, the federal government provided states with new authorities to maintain access to HCBS during the public health emergency (PHE). The PHE has been in place since 2020 and will end on May 11, 2023. This policy watch explores the potential implications of ending the PHE for Medicaid HCBS programs, including new or continued workforce challenges and potential reductions in patients’ access to care. In 2020, an estimated 6 million people used HCBS according to CBO estimates. HCBS are provided in peoples’ homes and other non-institutional settings. They include medical and supportive services that assist people with the activities of daily living (such as eating, bathing, and dressing) and instrumental activities of daily living (such as preparing meals, managing medications, and housekeeping). They are provided to people who need such services because of aging, chronic illness, or disability and may include personal care, adult daycare, home health aide services, transportation, and supported employment. Medicare generally does not cover HCBS and in 2020, Medicaid spent $162 billion on HCBS—a majority of the $245 billion in total HCBS spending. Although all states offer some HCBS through Medicaid, most services are optional for states, and states may cover different services for different types of Medicaid enrollees. To be eligible for Medicaid HCBS, individuals must have limited financial resources and significant functional impairments. https://www.kff.org/policy-watch/ending-the-public-health-emergency-for-medicaid-home-and-community-based-services/
April 19, 2023: Intuitive Surgical, the market leader in robotic surgery, reported double-digit sales growth and a 26% increase in da Vinci procedures in the first quarter as hospital backlogs eased. The company had 312 da Vinci system placements in the period, about the same number as a year earlier. While Intuitive hasn’t accelerated growth, it has boosted its install base. With 12% more systems in place than the year-earlier quarter, Intuitive posted growth across multiple measures, CEO Gary Guthart told investors on a conference call on Tuesday. “Use of our products grew strongly in the first quarter versus a year ago, helped by positive surgical trends and strong execution by our team,” he said. “New capital installs were likewise strong as customers built their da Vinci and Ion system capacity to meet demand. Some manufacturing and supply challenges this quarter negatively impacted our product margins. This is an opportunity for sharper execution going forward.”
April 18, 2023: High-risk medical devices that undergo post-approval modifications are more likely to be recalled from the U.S. market, according to an analysis published in JAMA Network Open. The study linked the use of supplements to modify devices with premarket approval (PMA) to a 28% increased risk of any recall and a 32% increased risk of Class I recall. While the retrospective study cannot show supplements cause recalls, the authors of the paper see the findings as evidence that improved post-marketing surveillance systems may be needed to mitigate risks to patient safety.
CLIMATE CHANGE & ENVIRONMENTAL HEALTH
April 14, 2023: China and Brazil announced this Friday a new collaborative effort to eliminate deforestation and control illegal trade causing forest loss. In a joint statement, the countries said they “intend to engage collaboratively in support of eliminating global illegal logging and deforestation through effectively enforcing their respective laws on banning illegal imports and exports”. Brazilian President Lula da Silva met with his Chinese counterpart Xi Jinping during a visit to China, in a bid to strengthen ties. China is Brazil’s largest trading partner and a major importer of commodities such as soy and crude petroleum. Both countries added they will cooperate with satellite information, “which will enable enhanced monitoring”. China and Brazil share the CBERS satellite program, which made its first launch back in 2001.
April 17, 2023: The G7 group of big, wealthy countries has failed to agree a date by which they will stop making electricity with coal. At the G7 environment ministers meeting in the Japanese city of Sapporo, the United Kingdom and Canada wanted to “set a 2030 date for completing the goal of an accelerated phase out of domestic unabated coal power generation”. France accepted this but they were opposed by Japan, the United States and the European Union, according to an annotated draft seen by Climate Home. In the final 36-page communique, environment ministers said they would prioritise “concrete and timely steps towards the goal of accelerating the phase-out of domestic unabated coal power generation”. But they stopped short of setting a specific deadline. At the end of the summit, Canada’s environment minister Steven Guilbeault said that “phasing out coal-fired electricity generation by 2030 has never been more urgent”.
EQUITY & DISPARITIES
Patients in the US belonging to racial or ethnic minority groups often receive medical care in different hospitals than White patients, which contributes to health care disparities. We explored whether ambulance transport destinations contribute to this phenomenon. Using a national emergency medical services research data set for calendar year 2020, we made within–ZIP code comparisons of the transport destinations for White patients and non-White patients transported by ambulance from emergency scenes. We used the dissimilarity index to measure transport destination discordances and decided a priori that a more than 5 percent difference in transport destinations (that is, dissimilarity index >0.05) would be practically meaningful. We found meaningful differences in the destination hospitals for White and non-White patients transported by ambulance from locations in the same ZIP code. The median ZIP code dissimilarity index was 0.08, 64 percent of ZIP codes had a dissimilarity index above 0.05, and 61 percent of patients were transported from ZIP codes with a dissimilarity index above 0.05. Forty-one percent of ZIP codes had a dissimilarity index above 0.10, and one-third of the patients were transported from those ZIP codes. These data indicate that ambulance transport destinations contribute to discordances in where White and non-White patients receive medical care.
Algorithms are currently used to assist in a wide array of health care decisions. Despite the general utility of these health care algorithms, there is growing recognition that they may lead to unintended racially discriminatory practices, raising concerns about the potential for algorithmic bias. An intuitive precaution against such bias is to remove race and ethnicity information as an input to health care algorithms, mimicking the idea of “race-blind” decisions. However, we argue that this approach is misguided. Knowledge, not ignorance, of race and ethnicity is necessary to combat algorithmic bias. When race and ethnicity are observed, many methodological approaches can be used to enforce equitable algorithmic performance. When race and ethnicity information is unavailable, which is often the case, imputing them can expand opportunities to not only identify and assess algorithmic bias but also combat it in both clinical and nonclinical settings. A valid imputation method, such as Bayesian Improved Surname Geocoding, can be applied to standard data collected by public and private payers and provider entities. We describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.
WOMEN, MATERNAL, NEONATAL & CHILDREN’S HEALTH
April 19, 2023: Exercise during pregnancy has been associated with a reduced risk of gestational diabetes and preeclampsia. According to recommendations from the American College of Obstetricians and Gynecologists, a healthy pregnant woman should exercise at moderate intensity for at least 150 minutes a week. In the United States, about 1% of pregnancies result in complications due to cardiovascular disease (CVD), which could lead to maternal mortality and morbidity. Thus, it is important to understand the effect of moderate-intensity exercise in pregnant women with underlying cardiac conditions. https://www.news-medical.net/news/20230419/The-effect-of-moderate-intensity-exercise-in-pregnant-women-with-cardiovascular-disease.aspx
April 19, 2023: In a recent study published in the Particle and Fibre Toxicology Journal, researchers explored the impact of exposure to ultrafine particles during pregnancy on the risk of influenza infection. Identifying interactions between infectious agents and air pollution is crucial, particularly for safeguarding vulnerable populations. The susceptibility of pregnant women to influenza and air pollution exposure is a matter of concern, but the relationship between the two is not fully understood. Exposure to ultrafine particles (UFPs) in mothers can cause distinct immune responses in the lungs. In the present study, researchers hypothesized that exposure to UFP during pregnancy could result in abnormal immune responses to influenza, which could increase the severity of the infection. In the study, pregnant mice were exposed to either UFPs or filtered air (FA) equivalent to a 24-hour average of 25 µg/m3 during gestational days (GD) 0.5 to 13.5. The study involved inoculating dams with either heat-inactivated (HI) control virus or live Influenza A/Puerto Rico/8/1934 (PR8) virus and evaluating them three days after infection. The viral titer of PR8 was measured in the lung using a 50% tissue culture infectious dose (TCID50) assay and quantitative polymerase chain reaction (qPCR) to determine its infectivity. A semi-quantitative scoring system was used to evaluate pulmonary histopathology three days after infection. The study examined T cell responses in maternal lung samples from different exposure groups, specifically T1, T2, T17, and CD8+cytotoxic T lymphocyte (CTL) lineages.
POVERTY ALLEVIATION & ERADICATION
In its resolution 72/233, the General Assembly proclaimed the Third United Nations Decade for the Eradication of Poverty (2018–2027). It also considered that the theme of the Third Decade, to be reviewed at its seventy-third sessions, should be “Accelerating global actions for a world without poverty”, in line with the 2030 Agenda for Sustainable Development. The core of the present report consists of an inter-agency, system-wide plan of action for poverty eradication to coordinate the efforts of the United Nations system, as well as recommendations concerning how to make the Third Decade effective. As the international community embarks on the Third Decade for the Eradication of Poverty, an estimated 783 million people lived on less than $1.90 a day in 2013, compared with 1.867 billion people in 1990. Economic growth across developing countries has been remarkable since 2000, with faster growth in gross domestic product (GDP) per capita than advanced countries. This economic growth has fuelled poverty reduction and improvements in living standards. Achievements have also been recorded in such areas as job creation, gender equality, education and health care, social protection measures, agriculture and rural development, and climate change adaptation and mitigation. To eradicate poverty by 2030, given current rates of population growth, it will be necessary to reduce by about 110 million every year the number of people living on less than $1.90 a day. The United Nations system plays an important role in meeting that global challenge. The present section highlights priority areas of the response of the United Nations system as an integral component of global action for the effective implementation of the 2030 Agenda. While the support of the United Nations system is necessary, it will have the most impact when countries put in place the right integrated policies to fight poverty at the local, national and regional levels, supported by an enabling international environment, as recognized in relevant
resolutions adopted by Member States.
October 5, 2022—The world is unlikely to meet the goal of ending extreme poverty by 2030 absent history-defying rates of economic growth over the remainder of this decade, according to a new World Bank study. The study finds that COVID-19 dealt the biggest setback to global poverty-reduction efforts since 1990 and the war in Ukraine threatens to make matters worse. The Bank’s latest Poverty and Shared Prosperity Report provides the first comprehensive look at the global landscape of poverty in the aftermath of the extraordinary series of shocks to the global economy over the past few years. It estimates that the pandemic pushed about 70 million people into extreme poverty in 2020, the largest one-year increase since global poverty monitoring began in 1990. As a result, an estimated 719 million people subsisted on less than $2.15 a day by the end of 2020.
HUMANITARIAN, NONPROFITS, FOUNDATIONS & NGOS
February 27, 2023; More than half of U.S. hospitals are nonprofit, meaning they receive generous tax exemptions in exchange for benefiting their communities. Many aren’t fulfilling that mission. Some nonprofits have billed patients who should have qualified for charity care, racking up billions of dollars in charges. Some have aggressively collected on medical debt through legal action or reports to credit agencies. Others have exploited poor communities by maintaining a token presence there to qualify for federal subsidies that benefit the needy, only to expand in rich communities. At least one institution has explicitly set up care pathways that prioritize the elite at the expense of the general public. At the same time, many hospitals — both nonprofit and for-profit — have failed to meet their workers’ expectations. Throughout the pandemic, staff members had to proactively organize for key protections — tests, masks, and vaccines — while flooded with patients. Nurses nationwide have accused hospitals of placing financial interests before safety in adopting imbalanced staffing ratios. All this while many institutions fail to pay their employees a living wage.
December 21, 2022: Nikiesha Barnett had knee surgery in 2006 and took unpaid leave from her job as a Georgia hospital coordinator while she was recovering. When Barnett wasn’t able to keep up with the payments for the surgery, she ended up owing about $4,500. That debt lingered for almost 14 years until one day in 2020, she received a letter from a nonprofit telling her the debt had been relieved. RIP Medical Debt, a national nonprofit, had bought her debt and forgiven it. Barrett says when she was in debt, she felt too guilty about what she owed to go to the doctor. Now that concern has been wiped away. Barnett is one of the millions of Americans who’ve had medical debt paid by nonprofits that receive increased support from a wide variety of grantmakers and donors, including MacKenzie Scott. Scott gave RIP Medical Debt $30 million in November after awarding the organization $50 million in 2020. That support has fueled RIP Medical Debt’s far-reaching debt relief. The nonprofit has cleared more than $7 billion of debt since it was founded in 2014 and helped more than 4 million families.