More than 1 billion people are living with mental health conditions worldwide, with anxiety and depression driving the second-leading cause of long-term disability, according to two World Health Organization reports. The findings were published in  “World mental health today” and “Mental Health Atlas 2024,” and the organization underscored an urgent need for increased investment, legal reform and systemic change. [Becker's Behavioral Health ]

Here are six things to know:

1. More than 1 billion people live with mental health disorders, which are highly prevalent across all countries and income levels, according to a Sept. 2 news release from the WHO. 
2. Depression and anxiety cost the global economy an estimated $1 trillion annually, largely due to lost productivity, according to the reports.
3. Suicide remains the leading cause of death among young people. At current rates, global efforts are projected to reduce suicide mortality by 12% by 2030, short of the U.N. goal of 33%.
4. Median government spending on mental health has stagnated at 2% of total health budgets since 2017. Low-income countries spend as little as 4 cents per person, compared to $65 in high-income nations.
5. The global median number of mental health workers stands at 13 per 100,000 people, with stark shortages in low- and middle-income countries.
6. Fewer than 10% of countries have fully adopted community-based care. Inpatient psychiatric care remains common, with high rates of involuntary admission and long stays, the reports said. 

1 in 7 adolescents face a mental health disorder: WHO report

World Health Organization report underscores the urgent and growing behavioral health needs of adolescents worldwide. 

The organization’s report, published Sept. 1, found rising rates of depression and anxiety, as well as suicide, substance use and eating disorders to be the most prevalent mental health challenges among younger demographics.

Here are eight key takeaways:

1. One in seven adolescents faces a mental health condition. Globally, about 14% of 10- to 19-year-olds live with a mental health condition, making up 15% of the disease burden in this age group. 
2. Depression, anxiety and behavioral disorders are among the most common conditions. 
3. Suicide ranks as the third leading cause of death for ages 15-29. Risk factors include harmful alcohol use, childhood trauma, stigma around seeking help, limited access to care and the availability of lethal means. 
4. Risks extend far beyond adolescence. Unaddressed mental health challenges can impair physical health, limiting opportunities to lead fulfilling lives into adulthood.
5. Vulnerable groups face higher risks. Adolescents living in humanitarian and fragile settings or marginalized communities, as well as those with chronic illness or neurological conditions, experience heightened exposure to stigma, exclusion and barriers to care. 
6. Though less common than other mental health conditions, eating disorders like anorexia nervosa and bulimia nervosa often begin in adolescence and carry one of the highest mortality rates of any mental health disorder. 
7. Substance use starts young. Alcohol, tobacco and cannabis use often take root in the teenage years, with harmful patterns persisting into adulthood. WHO data shows 22% of 15- to 19-year-olds reported alcohol use in 2019. 
8. Prevention works best in schools and communities. Protective environments — such as social care settings, in classrooms and across digital platforms — play a critical role in reducing stigma, promoting resilience and deterring risk behaviors. 

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In this issue of JAMA Cardiology, Johansen and colleagues¹ report findings from a prespecified secondary analysis of the DANFLU-2 pragmatic randomized clinical trial² comparing the efficacy of standard- and high-dose (HD) inactivated influenza vaccine. Because of its enormous statistical power and the application of methods that only until recently were technically impracticable, this trial deserves consideration in a broader context than the specific comparison of the effects of 2 vaccine dosages on a specific virus. I hope this study points the way toward a future in which we have much more robust evidence to evaluate vaccines and other therapies intended for broad segments of the population. [JAMA]

The trial’s main finding is that there was no significant difference in the primary clinical outcome of hospitalization for influenza or pneumonia between the HD and standard-dose influenza vaccinations. However, a small difference was observed in rates of cardiovascular events that favored the HD vaccine. The question of how to parse these findings depends on fundamental clinical and statistical factors that frequently cause controversies in trial interpretation.

The clinical and public health question addressed here by Johansen et al is a secondary hypothesis. According to the DANFLU-2 trial’s statistical analysis plan, a hierarchical statistical analysis was prescribed, in which secondary hypotheses could not be formally tested if the primary end point did not meet the prespecified criteria for significance.

A purist could assert that given the lack of significant difference observed for the primary end point, any further analyses would be descriptive and hypothesis generating. However, others might argue that it is reasonable to consider circumstances and prior knowledge and allocate further statistical weight to secondary outcomes of interest. All of this evokes the well-known colloquialism “to P or not to P” discussed in detail by the American Statistical Association.³ In this case, the JAMA Cardiology editorial staff and reviewers chose “not to P,” so the article reports point estimates and confidence intervals for outcomes of interest.

An additional issue is the small magnitude of the estimated benefit. Another pithy colloquialism pertains here: “A difference, to be a difference, must make a difference.” If one accepts that trial results are a good predictor of what will happen in practice, the differences are on the order of 762 people vaccinated with the HD formulation to prevent 1 cardiorespiratory hospital admission.

At the core of this argument is the minimally important clinical or public health difference: how many adverse outcomes per unit of population would need to be prevented to cause a change in practice? The authors point out that given the universal issue of influenza vaccine, use of the HD version could prevent 1 million hospitalizations per year. In a practical sense, I see this result as tipping the balance, given the prior data—influenza vaccination per se has been shown to reduce cardiopulmonary hospitalizations. The HD version confers a small but measurable benefit and yields a more robust immune response against the virus. On the other hand, the differences are small enough that they are unlikely to drive required changes in public health practice if the costs are significantly higher than the standard-dose version.

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A growing number of hospitals and health systems have expanded their C-suite ranks in the last few years to include leaders dedicated to advancing maternal and infant health, reflecting a new level of urgency as hospitals work to address longstanding disparities in outcomes and prepare for a projected rise in high-risk pregnancies. [ Beckers Health Review] 

Leaders in newly created roles are charged with developing strategies to expand access to high-quality obstetrical care and building partnerships with community providers to better coordinate care for new and expecting mothers.

This comes as the nation’s maternal death rate remains among the highest of any developed country, with more than 800 women dying each year from pregnancy-related causes, according to March of Dimes’ latest annual report card on maternal and infant health. In 2022, the U.S. recorded 22 maternal deaths per 100,000 live births, down from a peak during the pandemic though still higher than the pre-pandemic rate of 20 in 2019. Black women die from pregnancy-related causes at rates more than double those of white women, according to the data. 

Most recently on Aug. 18, NYC Health + Hospitals appointed Wendy Wilcox, MD — a prominent expert in maternal mortality — as chief of obstetrics and gynecology at Woodhull Hospital in New York City’s Brooklyn borough. She was also appointed as the system’s inaugural chief women’s health officer in 2021. In her expanded role, she will oversee the growth of labor and delivery services at Woodhull while continuing to lead systemwide initiatives, including programs that connect pregnant patients with social workers and support services, and efforts to expand postpartum and cardio-obstetric care.

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Key context: If any of your plumbing infrastructure has lead, it can flake or dissolve into your drinking water. You’re more likely to have a lead service line if your house was built before 1986, when lead pipes were banned nationwide. [Sun-Times]

City's take: Chicago’s drinking water comes from Lake Michigan. City officials say the treatment plant delivers water with no detectable levels of lead. But the most common sources of lead in drinking water are corroding lead pipes, faucets and fixtures. 

Check yourself: You can search your address on our look-up tool to see if your service line is made of lead, ask for a free test kit online, or request a free water-quality lead inspection by a trained technician from the city.

If you find lead in your water

Yes to a filter: A water filter can help — look for one with an "NSI/ANSI Standard 53" mark, which means it meets EPA standards, and a label stating it's certified to reduce lead levels. The city offers free water-filter sets to some residents and you can see if you're eligible here.

Run it: The longer water sits in your pipes, the more lead it might collect. Whenever you haven’t used your water for six hours or more, run it for at least five minutes before using it for cooking and drinking.

Aerator cleaning: Sediment, debris and lead particles can collect in that little screen that goes over your faucet opening, so clean it regularly.

Pipe replacement: The city has an online questionnaire to determine the replacement program for which you may be eligible.

Call the doctor: Talk with your pediatrician or other doctor. The Centers for Disease Control and Prevention and the Illinois Department of Public Health emphasize the importance of blood lead level testing for children younger than 6 who might have been exposed.

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• U.S. physicians say their workplaces are trying to hire more workers to help meet demand for services, but a lack of qualified talent is stymieing efforts. [Healthcare Dive]
• In a new survey of 1,001 physicians conducted by Medscape, 63% of respondents said there was a lack of qualified physicians available in their local job market, and 30% said application quality for open doctor roles had declined recently.
• Many don’t see the situation improving: Nearly 6 in 10 respondents described themselves as “very unconfident” or “unconfident” that progress could be made on the physician labor shortage over the next decade.

Dive Insight:

The Medscape report is the latest analysis to underscore that, although the healthcare labor market has improved since the COVID-19 pandemic, healthcare providers are still struggling to fill positions.

Nearly 70% of survey respondents said their workplace was actively attempting to hire doctors either full- or part-time. Hospitals and healthcare organizations were more likely to hire than office-based practices, which could be due to patients seeking out care at larger organizations, according to the report.

Most said their workplace sought to fill less than five roles. The relatively low number of open roles is somewhat “reassuring,” according to Maddi Davidson, principal and senior director of market access with Avalere Health, who was interviewed by Medscape for the report.

She said that fewer than five openings could be attributed to natural turnover. Six or more openings in smaller practices or 20-plus open roles at large care settings would signify a more systemic mismatch between labor supply and demand.

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Key Takeaways

• After the Supreme Court decision restricting the use of race in admissions, the share of medical school matriculants from groups underrepresented in medicine significantly dropped. [MedPage Today]
• Applicants from these groups were accepted at significantly lower rates than white and Asian applicants -- a break from previous years.
• The study is believed to be the first national-level analysis after the ruling, and its findings raise concerns about the future diversity of the healthcare workforce.

The number of students from historically underrepresented racial and ethnic groups matriculating at U.S. medical schools fell significantly in 2024 following the Supreme Court's decision restricting the use of race in admissions, a cross-sectional study showed.

Among nearly 292,000 applicants, the share of new matriculants from groups underrepresented in medicine (URiM) dropped from an average of 24.39% in 2019-2023 to 20.83% in 2024 (P<0.001), reported Mytien Nguyen, MS, an MD/PhD student at the Yale School of Medicine in New Haven, Connecticut, and colleagues in JAMA Network.

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On a steamy July afternoon, West Garfield Park residents lined up at the Above & Beyond Free Food Pantry on South Pulaski Road. Moms with kids, seniors and young men brought bags to fill. Inside, volunteers handed out packages of Danish pastry and cookies “rescued” from local supermarkets, along with frozen chicken and cans of tuna and beans. [Crains Forum]

Since opening during the pandemic in 2021, the pantry’s customer traffic has increased by more than 25% a year, and that’s before changes to the federal food stamp program take effect as part of the One Big Beautiful Bill Act that President Donald Trump signed into law in July. Executive Director Ken Cozzi is bracing for a surge in demand as the pantry prepares to move to a bigger space a few blocks away. “We’re a big pantry, but we only have so many refrigerators and freezers,” he says.

The Illinois Department of Human Services estimates that 360,000 people are at risk of losing eligibility for the Supplemental Nutrition Assistance Program, or SNAP, which Illinois recipients access via electronic benefit transfer cards called Link. That’s largely due to stricter work requirements that will soon be imposed. The result, food experts say, will be greater food insecurity and stress on the distribution system. SNAP, once known as food stamps, is the nation’s most effective anti-poverty program for younger people, reducing extreme poverty by more than 50%, advocates say. It’s also a powerful economic multiplier.

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Human–computer interactions have been occurring for decades, but recent technological developments in medical artificial intelligence (AI) have resulted in more effective and potentially more dangerous interactions. Although the hype around AI resonates with previous technological revolutions, such as the development of the Internet and the electronic health record,1 the appearance of large language models (LLMs) seems different. LLMs can simulate knowledge generation and clinical reasoning with humanlike fluency, which gives them the appearance of agency and independent information processing.2 Therefore, AI has the capacity to fundamentally alter medical learning and practice.3,4 As in other professions,5 the use of AI in medical training could result in professionals who are highly efficient yet less capable of independent problem solving and critical evaluation than their pre-AI counterparts. [New England Journal of Medicine]

Such a challenge presents educational opportunities and risks. AI can enhance simulation-based learning,6 knowledge recall, and just-in-time feedback7 and can be used for cognitive off-loading of rote tasks. With cognitive off-loading, learners rely on AI to reduce the load on their working memory, a strategy that facilitates mental engagement with more-demanding tasks.8 However, off-loading of complex tasks, such as clinical reasoning and decision making, can potentially lead to automation bias (overreliance on automated systems and risk of error), “deskilling” (loss of previously acquired skills), “never-skilling” (failure to develop essential competencies), and “mis-skilling” (reinforcement of incorrect behavior due to AI errors or bias).9 These risks are especially troubling because LLMs operate as unpredictable black boxes10; they generate probabilistic responses with low reasoning transparency, which limits assessment of their reliability. For example, in one study, more than a third of advanced medical students missed erroneous LLM answers to clinical scenarios.11

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The Chicago Department of Public Health will collaborate with the University of Illinois Chicago on a new network to monitor the city’s air quality. [Health News Illinois]

The network will place sensors that measure levels of particulate matter and nitrogen dioxide around the city, with a focus on areas historically vulnerable to environmental impacts.

“Installing air sensors across our city is imperative in assessing what risks there are and protecting our community members, especially those who are most vulnerable, such as children, older folks and people with respiratory illnesses,” said health Commissioner Dr. Olusimbo “Simbo” Ige. “CDPH continues to gather the best available data for all Chicagoans to guide the development of interventions to improve the health of Chicagoans.”

Chicago air quality data is currently available and tracked by eight federal-grade monitoring systems that are run by the Illinois Environmental Protection Agency, in partnership with Cook County.

CDPH said the new network will supplement the existing work and will provide neighborhood-level air quality data to the public.

The network will set 280 sensors around the city by the end of summer, which officials said will give Chicago the “largest community air monitoring network in the world.”

The release of a dashboard with publicly available data is expected in early 2026.

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The American Fluoridation Society opposed recent actions taken by federal officials to move away from community water fluoridation in the U.S. [Becker's Dental & DSO Review]

In April, the Environmental Protection Agency said it will “expeditiously review” new information on the potential health risks of fluoride. The move came as HHS Secretary Robert F. Kennedy Jr. announced that he would advise the CDC to stop recommending the addition of fluoride to public water supplies. Additionally, the FDA said it would begin removing ingestible fluoride prescription drug products for children. 

The American Fluoridation Society questioned EPA’s ability to conduct an impartial review due to RFK Jr.’s viewpoints, and said Aug. 12 that the attacks on fluoride are based on a “misrepresentation of the evidence.”

The organization pointed to a recent Make America Healthy Again report that cited “74 high-quality studies” reviewed by the National Toxicology Program as a basis for its concerns about fluoride. However, the AFS highlighted that 70% of the studies reviewed by the NTP were rated as low quality. The NTP report also found no link between low IQ scores and the level of fluoride in U.S. water supplies.

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