Social and physical isolation, along with financial hardship, are linked to lower uptake of recommended preventive health services, investigators at Cambridge Health Alliance and Harvard Medical School report this week in the Annals of Family Medicine. [CIDRAP- Center for Infectious Disease Research & Policy, Research and Innovation Office, University of Minnesota, Minneapolis, MN][ C

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The team mined data from the 2022 Behavioral Risk Factor Surveillance System phone survey to assess the association between self-reported social and physical isolation (using transportation barriers as a proxy for the latter), material deprivation (financial strain, inadequate health care access), and uptake of COVID-19, influenza, and pneumococcal vaccinations and cervical, colorectal, and breast cancer screening among US adults. 

A lack of social connections has been linked to higher all-cause death rates, adverse cardiovascular outcomes, high blood pressure, complications of diabetes, depression, suicide, and other adverse effects. “The mechanism of these associations may involve different aspects of isolation that limit meaningful social connections, including social, physical, and emotional dimensions,” the authors wrote.

Isolation declined as income rose

Of 281,592 adult respondents who responded to questions about isolation and transportation difficulties, 31.9% reported social isolation, and 8.2% said they were physically isolated.

Average rates of physical isolation were higher among participants from southern and southwestern states, Alaska, and territories. States with higher rates of physical isolation tended to also have more social isolation.

For social isolation, isolated adults were younger than their non-isolated counterparts (average age, 44.8 vs 50.9 years, respectively), and for physical isolation, the average age was 42.8 versus 49.6 years, respectively. Relative to non-isolated participants, isolated respondents were more likely to be Black, American Indian, or Hispanic; single; and less educated. But rates of living in an urban versus rural county were comparable across groups. 

In total, 63.9% of physically isolated adults were socially isolated, compared with 29.0% of those who were not physically isolated. Both isolation types were more common among low-income adults and steadily declined as income rose. 

Physical and social isolation were both tied to material deprivation. For example, 82.1% of physically isolated respondents and 30.9% of those who didn’t cite physical isolation experienced financial difficulty, including food insecurity and problems paying housing or utility bills, sometimes facing utility shutoff.

Policy efforts may be needed in multiple areas 

Before adjustment, both physical and social isolation were associated with a lower likelihood of receiving most preventive health services. 

"The complexity of possible causal pathways suggest that policy efforts may be needed on multiple fronts to mitigate the health harms of isolation."

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One day at an Idaho hospital, half the newborns Tom Patterson, MD, saw didn't get the vitamin K shots that have been given to babies for decades to prevent potentially deadly bleeding. On another recent day, more than a quarter didn't get the shot. Their parents wouldn't allow it. [MEDPAGE TODAY]

"When you look at a child who's innocent and vulnerable -- and a simple intervention that's been done since 1961 is refused -- knowing that baby's going out into the world is super worrisome to me," said Patterson, who's been a pediatrician for nearly three decades.

Doctors across the nation are alarmed that skepticism fueled by rising anti-science sentiment and medical mistrust is increasingly reaching beyond vaccines to other proven, routine preventive care for babies.

A recent study in JAMA, which analyzed more than 5 million births nationwide, found that refusals of vitamin K shots nearly doubled between 2017 and 2024, from 2.9% to 5.2%. Other research suggests that parents who decline vitamin K shots are much more likely to refuse getting their newborns the hepatitis B vaccine and an eye ointment to prevent potentially blinding infections. Rates for hepatitis B vaccination at birth dropped in recent years, and doctors confirm that more parents are refusing the eye medication.

"I do think these families care deeply about their infants," said Kelly Wade, MD, PhD, a Philadelphia neonatologist. "But I hear from families that it's hard to make decisions right now because they're hearing conflicting information."

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Four U.S. states that mandated more frequent syphilis screening during pregnancy and at delivery had increased case detection rates, but the effect waned in the year after those laws took effect, according to an observational study of more than 16 million live births. [MEDPAGE TODAY]

As congenital syphilis cases surge, state mandates may not be enough to keep detection rates up.

In the first quarter after enacting expanded prenatal syphilis screening mandates, Arizona, Georgia, Louisiana, and Michigan together saw the incidence of maternal syphilis case detection increase by 26% (P=0.02), reported Jessica Cohen, PhD, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues.

This translated to an overall difference-in-difference estimate of 19.5% more cases detected per quarter -- or 32.2 additional cases per 100,000 live births -- with the mandate than without it (P=0.04), the research team detailed in JAMA Health Forum.

That positive detection bump faded in the year after the mandates' enactment, however. After the first quarter's significant increase, the next three quarters trended toward an 11% increase without reaching statistical significance (P=0.48).

"Our study suggests that mandates can generate a meaningful boost in case detection after they are enacted, but that it may be short-lived," co-author Sara Baum, also of Harvard T.H. Chan School of Public Health, told MedPage Today. "Mandates alone may not come with the complementary supports needed for clinicians and patients to generate sustained impact."

Congenital syphilis transmitted during pregnancy from mothers to babies can increase the risk of stillbirth, neonatal death, and low birth weight. After reaching historic lows in the early 2000s, U.S. congenital syphilis rates have spiked -- climbing from 8.7 cases per 100,000 live births in 2013 to 105.8 cases per 100,000 in 2023.

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As part of the U.S. Food and Drug Administration's continuous quality improvement efforts, the agency today published a Federal Register Notice seeking public comment on the Commissioner's National Priority Voucher pilot program. The agency also announced a public hearing on June 12, to allow stakeholders to present information and views about the program. [US Food & Drug Administration]

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The public hearing, consistent with 21 CFR § 15.1 et seq., will seek feedback about the program's eligibility criteria, the voucher selection processes, sponsor responsibilities, pre-submission requirements, FDA review procedures, the role of the CNPV Review Council, and other aspects of program implementation.

The CNPV pilot program was established in June 2025 to address critical public health needs by providing an ultra-fast review pathway for drugs and biological products of strategic national importance while maintaining the FDA's rigorous scientific and regulatory standards. So far, the agency has awarded vouchers for 18 products and granted four approvals, including two approvals for oncology drugs delivered 44 and 55 days after filing.

"National priority vouchers are a game changer for patients waiting for life-changing therapies," said FDA Commissioner Marty Makary, M.D., M.P.H. "As a clinician who has been frustrated at the bedside by a lack of available treatment options, I'm excited about the potential of this program's future following a very successful first year. As with all of our new initiatives, we are seeking input on how we can better meet the needs of the American people."

Companies that are awarded a national priority voucher have a product that aligns with one or more national health priorities, including bringing innovative therapies to the American people, addressing large unmet medical needs, promoting domestic manufacturing, and increasing affordability. Recipients are issued a nontransferable "voucher" entitling them to expedited FDA review of a single application with enhanced regulatory engagement. The program radically increases efficiency by reducing idle time, while maintaining safety as the top priority.  

Key features includes:

• Expedited pre-filing period.
• Target of 1-2 months from filing to action (compared to nearly a year).
• Enhanced pre-submission engagement, which facilitates earlier correction of issues (e.g., chemistry, manufacturing, and controls (CMC) and inspection) that can lead to review cycle extensions.
• Multidisciplinary review approach culminating with a CNPV Review Council meeting with senior leadership and lead review staff.

The June 12 public hearing will be held at the FDA's White Oak Headquarters with both an in-person and virtual option for participation. The FDA panelists will include subject matter experts from the Office of the Commissioner, the Center for Drug Evaluation and Research, the Center for Biologics Evaluation and Research, and the Oncology Center of Excellence, as well as a presiding officer. Requests to speak are due by May 1. The FDA is also soliciting written comments until June 27. For more information about the hearing: https://www.fda.gov/news-events/commissioners-national-priority-voucher-cnpv-pilot-program-public-hearing-06122026.

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The June 12 public hearing will be held at the FDA's White Oak Headquarters with both an in-person and virtual option for participation. The FDA panelists will include subject matter experts from the Office of the Commissioner, the Center for Drug Evaluation and Research, the Center for Biologics Evaluation and Research, and the Oncology Center of Excellence, as well as a presiding officer. Requests to speak are due by May 1. The FDA is also soliciting written comments until June 27. For more information about the hearing: https://www.fda.gov/news-events/commissioners-national-priority-voucher-cnpv-pilot-program-public-hearing-06122026.

The Maternal & Child Health Workgroup is actively developing new initiatives, updating its strategic action plan, and preparing for the 2nd Maternal & Child Health Symposium this fall. We are grateful to Dr. Anita Stewart, MD, MPH, JD, MBA, Billings Fellow, for her dedicated contributions over the past two years, as well as to the entire workgroup for their commitment.

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Maternal health remains one of the most pressing challenges in healthcare and public health. The Institute is deeply committed to this area and collaborates closely with community partners to make a meaningful difference.

The Maternal & Child Health Workgroup is dedicated to supporting the health of women and infants before, during, and after pregnancy through compassionate clinical care and effective leadership. Composed of IOMC Fellows, the Workgroup strives to improve maternal and child health, reduce mortality and morbidity, and advance health equity by addressing healthcare disparities in Chicago and throughout Illinois.

PURPOSE

The purpose of the Maternal & Child Health Workgroup is to identify and address key healthcare disparities affecting maternal and child health, mortality, and morbidity. The group also aims to define specific actions and timelines to promote maternal justice through thoughtful clinical practices.

Visit the Maternal & Child Health Workgroup webpage for more information>

We warmly invite you to consider joining our workgroup if you are passionate about maternal and child health, have expertise in this area, or are interested in making a meaningful impact.

Contact the Institute for more information by sending an email to info@iomc.org or call the office at 312.709.2685. 

Sincerely, 

Beena Peters, DNP, RN, FACHE, FABC, FAAN 

Chair, Maternal & Child Health Workgroup, IOMC   

Fellow, IOMC 

Secretary, IOMC 

The respiratory illness RSV is still going strong in Chicago — an unusually late showing for the virus, which can strike infants especially hard. [Chicago Tribune]

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RSV activity has moved from moderate to high in Chicago, according to the Chicago Department of Public Health. Though it’s typical for RSV to spread more widely in the winter — along with illnesses like the flu and COVID-19 — it’s often more prevalent earlier in the season.

RSV activity in Chicago is still not as high as it was at its peaks in recent years, but it’s stubbornly elevated for this time of year. 

“This is not the typical pattern we see,” said Dr. Larry Kociolek, an attending physician of pediatric infectious disease at Lurie Children’s Hospital. “We’re not seeing a ton of it, we just keep seeing it for a prolonged period, and now that we’re heading into spring, it seems a bit more unusual.”

RSV, which stands for respiratory syncytial virus, can cause a runny nose, coughing and fever, and in most people is mild and resolves within a week or two. But the illness can be more severe in babies and young children, causing pneumonia and inflammation of the small airways in the lung. 

Each year, about 2% to 3% of babies younger than 3 months old are hospitalized with RSV, according to the Centers for Disease Control and Prevention. 

So far, two children with RSV have died this season in Chicago, according to the city health department. 

For the week that ended March 7, emergency department visits by babies and children up to 4 years old for RSV in Chicago were more than three times higher than during the same week last year, according to the city health department.

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NIH Director -- and CDC Acting Director -- Jay Bhattacharya, MD, PhD, had little trouble Tuesday responding to questions from House members during an oversight hearing. [MEDPAGE TODAY]

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"While the promise of the NIH is strong, we must reflect upon policies and evolve with changing technology," Bhattacharya told members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. "And reform is already underway. A new office within the [Office of the Director] will support rigorous analysis of the NIH portfolio to strengthen performance management, accountability, and promote reproducibility of our research, because ... it's vital that the research that we do is reproducible, that an independent team looking at the same result find the same answer."

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IDPH FAST PHACT

Trials and Tribulations: Implications of Public Health Regulations on Clinical Practice Webinar

March 19, 2026 

Summary and Action Items:

Join us for a series of clinician-directed interactive info sessions in an office hours format targeted towards raising timely awareness of emerging and high-impact public health issues that directly involve clinical care or health system considerations. All health care professionals are invited to participate.

This FAST PHACT session will be on March 19, 2026, from 12:00 - 1:00 p.m. (CST) and will focus on: Trials and Tribulations: Implications of Public Health Regulations on Clinical Practice

Register: https://illinois.webex.com/webappng/sites/illinois/webinar/webinarSeries/register/0804e2093f6249ebbe88b5130f6f2566

Up to one credit hour of Continuing Medical Education credit is Available. Live webinar attendance with completion of post-webinar survey and quiz is required.

Learning objectives:

• Increase awareness of IDPH regulatory oversight of healthcare facilities including hospitals, ASCTs and nursing homes.
• Explore impact of various types of healthcare facility citations with focus on “immediate jeopardy” situations.
• Enhance knowledge of clinician role in regulatory requirements at facilities.

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Statement from Dr. Michael Warren, Chief Medical and Health Officer, March of Dimes

The latest maternal mortality data released by the CDC shows a slight decline in deaths in 2024 from causes related to pregnancy or childbirth in the United States. While any reduction in maternal deaths is encouraging, this decrease to 17.9 deaths per 100,000 live births from 18.6 in 2023 is not statistically significant and reminds us that progress remains fragile. [March of Dimes]

These findings also demonstrate persistent health disparities experienced by Black moms and babies in America. In fact, the data show that the maternal mortality rate among Black moms was 44.8 per 100,000 live births compared to 14.2 among white moms.

The 2025 March of Dimes Report Card also shows that American Indian/Alaska Native and Pacific Islander women are substantially more likely to die compared to women of other racial and ethnic groups.

These deaths are tragic, unacceptable, and a stark reminder that the U.S. remains among the most dangerous developed nations for childbirth. A system failing moms and babies is a system failing everyone.

March of Dimes remains committed to addressing the maternal and infant health crisis in America by advancing evidence-based solutions that improve maternal health outcomes, including expanding access to high-quality maternity care, supporting the maternal health workforce, and investing in innovations that help prevent complications and save lives. Every mom deserves the safest possible start to motherhood, and every baby deserves a healthy beginning.

Download Illinois Report> 

Download USA Report>

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Intro: From the JAMA Network, this is the JAMA Medical News Podcast, discussing timely topics in clinical medicine, biomedical sciences. Public Health and Health Policy featured in the Medical News section of JAMA. [JAMA Network and JN Learning]

Abbasi: On today's show, we're discussing the state of one of the most powerful tools in HIV prevention. pre-exposure prophylaxis, or PrEP, including how the landscape has changed in light of both scientific advances and access challenges I'm Jennifer Abbasi, Director of JAMA Medical News. Associate Managing Editor Kate Schweitzer is here to tell us about the news. Kate, thanks for joining. Thanks, Jen. So how transformative has PrEP really been in the goal to end the HIV epidemic?

Schweitzer: It's hard to overstate. To the experts I spoke with, it's one of the most important breakthroughs in medical history. When taken as prescribed, PrEP can reduce the risk of acquiring HIV by more than 99%. A bit of background, the first form of PrEP, a daily oral pill, was approved in the US in 2012. Since then, we've seen a rapid evolution in options. There's now also long-acting injectable medications that can be given every two months or even every six months. There's on-demand PrEP, and trials are testing a once-a-month pill. This menu of options is important. It gives patients choice and studies suggest that substantially increases uptake. And we're already seeing that impact. PrEP use among eligible individuals has grown dramatically. By 2024, nearly 600,000 people in the U. S. were using it. At the same time, HIV diagnoses have been declining. Experts acknowledge that it's difficult to attribute that trend to any single factor, but regions with higher PrEP coverage have seen the largest reductions in new infections. In states with the highest uptake, new infections drop by nearly forty percent. According to doctor Anna Person, an infectious disease physician at Vanderbilt University, we now have the tools we need to end this epidemic in the US.

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Webinar: April 21, 2026 12:00 PM CT. From Awareness to Action: Increasing HPV Vaccine Referrals in Dental Settings. Jennifer Sukalski, PhD, MS, RDH, Assistant Professor, Preventive and Community Dentistry, University of Iowa. More details and to register>

Additional Information:  Direct-to-Consumer Telemedicine for HIV Preexposure Prophylaxis—Profit Meets Public Health, JAMA Network, 12.1.2025.  

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