Cook County Board President Toni Preckwinkle released a nearly $9.9 billion spending plan on Thursday. (Health News Illinois]

Preckwinkle said the plan does not include new taxes, fines or fees. 

“This strong fiscal foundation is because we have been consistent in setting priorities and making the tough decisions to enact them,” she said. “The result of these difficult decisions and hard votes by our Cook County Board of Commissioners over the years is a fiscally responsible and community-focused budget that fosters safe, thriving and healthy communities.”

Preckwinkle highlighted several health initiatives in the plan, like establishing 11 regional collaboratives to assist in behavioral health services and opening a clinical triage and stabilization center at Provident Hospital.

More than half the budget is dedicated to Cook County Health. 

Preckwinkle’s office said the system’s Medicaid managed care plan retained more members than expected, after the return of the Medicaid redetermination process following a hiatus during the pandemic.

The budget plan pauses a pandemic-era program that provides $500 a month in guaranteed income to low-income families. Preckwinkle told reporters the program will take a break, pending an independent review.

The county board will take up the proposal in the coming weeks.

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Infection from COVID-19 appeared to significantly increase the risk of heart attack, stroke, and death for up to three years among unvaccinated people early in the pandemic when the original SARS-CoV-2 virus strain emerged, according to a National Institutes of Health (NIH)-supported study. The findings, among people with or without heart disease, confirm previous research showing an associated higher risk of cardiovascular events after a COVID-19 infection but are the first to suggest the heightened risk might last up to three years following initial infection, at least among people infected in the first wave of the pandemic. [NIH]

Compared to people with no COVID-19 history, the study found those who developed COVID-19 early in the pandemic had double the risk for cardiovascular events, while those with severe cases had nearly four times the risk. The findings were published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

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Nearly 1 in 3 Americans — in the only wealthy country in the world to not have a developed universal health care system — lack reliable primary care access. Meanwhile, unlike JD Vance, Americans are getting shorter due in part to poor access to quality health care and nutrition. [KFF Health News}

Newsweek: Map Reveals US States Where Healthcare Is Least AccessibleAffordable healthcare is essential for public health and equality. However, access varies widely across the nation. ... Zoi Galarraga, Senior Digital PR Manager at Forbes Advisor, the group who led the study, told Newsweek. "A recent survey from Gallup and West Health found that just 55 percent of U.S. adults can access and afford quality healthcare when needed. "Additionally, over 100 million Americans—nearly one third of the nation— do not have access to a usual source of primary care, according to the National Association Of Community Health Centers." (Dewan, 10/8)

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Chicago must replace every toxic lead pipe connecting homes to water mains within two decades — an aggressive deadline imposed this week by President Joe Biden after his administration initially proposed giving city officials twice as long to complete the job. [Chicago Tribune]

The more stringent requirement is part of a broader package of changes in federal regulations intended to protect Americans from a metal so dangerous it is unsafe at any level of exposure.

More than 9 million homes nationwide get drinking water from a service line made of lead. Chicago has more than 400,000 of the toxic pipes, by far the most of any U.S. city. Illinois has more than any other state.

Biden, who will speak about the new regulations Tuesday in Wisconsin, promised during his 2020 campaign to accelerate service line replacements after decades of inaction from federal and state officials. One of the big infrastructure bills his administration brokered with Congress earmarked $15 billion toward the effort. Billions more will be needed in Chicago alone.

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Midwest communities are among the healthiest places to live, especially when it comes to achieving health equity, according to new rankings released this summer. But even the strongest communities have their weaknesses. [APHA - The Nation's Health] 

While Falls Church, Virginia, took the top spot, over half of the top 10 healthiest communities were in Indiana, Iowa, Minnesota and Wisconsin, according to U.S. News & World Report’s Healthiest Communities rankings released in August. Researchers reviewed over 90 health metrics for approximately 2,800 communities and scored them across 10 categories such as equity and the environment.

“Evaluating community health is crucial as we consider the well-being of citizens across our country,” said U.S. News data editor Julia Haines in a news release. “The Healthiest Communities rankings examine which communities offer the greatest opportunity to live a healthy, productive life. They also highlight that even the ‘healthiest’ communities struggle in certain areas.”

For the first time, this year’s rankings made health equity a key measure. The rankings assessed community health equity on metrics such as racial and ethnic disparities in premature deaths and low birthweights.

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Vaccine effectiveness was 34.5% against hospitalization, according to interim estimates from a new article published by the CDC's Morbidity and Mortality Weekly Report, among high-risk groups like young children, people with preexisting conditions and older adults. That means, vaccinated people in those groups were 34.5% less likely than unvaccinated people to get sick enough to go to the hospital. (CBC)  

Last year, the CDC's report had estimated vaccine effectiveness in South America was 51.9% against hospitalization among at-risk groups. A study by the same group looking at data from 2013 to 2017 estimated effectiveness was around 43% for fully vaccinated young children and 41% for older adults.

These data come from a research network coordinated by the Pan American Health Organization, including Argentina, Brazil, Chile, Paraguay and Uruguay. 

The biggest drop in effectiveness this year may be the result of fewer cases from "A(H1N1)pdm09," a strain that has spread since the H1N1 swine flu pandemic in 2009.

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Chicago and Cook County are on pace to see a drastic decline in opioid-related fatalities in 2024, keeping with a nationwide downturn in fatal drug overdoses since the peak of the COVID-19 pandemic. [Chicago Tribune]

Public health and law enforcement officials point to a variety of factors that could be responsible. Increased community outreach, addiction treatment efforts and less available fentanyl all likely play a role, they said.

Through Sept. 20, Cook County had recorded 806 opioid-related deaths this year, according to data from the medical examiner’s office. Of those, 580 occurred in Chicago. In that same time frame in 2023, the county saw 1,363 opioid-related deaths with 1,022 in Chicago.

The number of opioid-related deaths so far this year is likely higher than medical examiner data suggests — it often takes several weeks for the results of post-mortem toxicological screenings to return — but there are signs of progress. Year-to-date, opioid deaths in Chicago are down more than 40%.

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Sen. Tammy Duckworth, D-Ill., joined colleagues this week to unveil a plan to boost Medicaid funding for labor and delivery units at hospitals in rural and underserved communities. [Health News Illinois]

“It is absolutely unconscionable that hundreds of expectant and new moms in maternity deserts are left without access to the care they need,” Duckworth said in a statement. “Every mother, no matter their zip code, deserves access to high-quality maternal healthcare.”

Supporters say the proposal, co-signed with 17 other Democratic senators, would address the “root causes of labor and delivery unit closures.”

It would enhance federal financing for eligible rural and high-need urban hospitals and set a Medicaid labor and delivery revenue floor to cover the costs of staffing and maintaining obstetric services at low-volume hospitals.

And supporters say it will expand Medicaid flexibilities to fuel “innovative care delivery, including through maternal health homes.”

The bill would also require states to provide coverage for postpartum women in Medicaid for 12 months, a move Illinois and 46 other states have already taken.

From 2011 to 2021, nearly a quarter of the country's rural hospital obstetrics units closed, according to a report cited by lawmakers. In 2022, over 2.3 million women of childbearing age lived in counties without an obstetric facility or clinician.

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Cook County needs to double its mental health workforce to meet the demand for services expected in the coming years. [Health News Illinois]

A report released Monday found the county needed 16,000 more behavioral health professionals to provide for the 420,000 residents who needed — but did not receive — care last year. 

An estimated 30,763 behavioral health professionals worked in core, nursing and adjacent occupations in 2023. Roughly 40 percent of current behavioral health workers are expected to retire, leave Cook County or leave their occupation in the next five years.

“By 2028, Cook County needs to attract, retain and/or upskill 30,000 workers to address the (behavioral health) worker shortage and replace professionals expected to leave the field over the next five years,” noted the report from Cook County Health and the Cook County Public Health Department.

About 1.2 million residents, or 23 percent of the county's population, needed behavioral health services last year.

Challenges in the sector, including underfunding and higher rates of attrition and burnout, have lasted for years. However, the report said the COVID-19 pandemic “turned a workforce shortage into an emergency, increasing the need for mental health and substance use treatment across the state.”

The problem stretches across Illinois, with over a quarter of adults in the state reporting significant symptoms of anxiety or depressive disorder in 2023, compared with just 11 percent in 2019. In 2021, the American Association of Medical Colleges said that Illinois could meet 24 percent of the mental health needs of the state with its current workforce.

It will take local and state policymakers and community leaders to tackle the issue, the report noted. Potential solutions could include a $50 million public/private fund to expand scholarship, apprenticeship and fellowship programs to bring individuals into the workforce. 

The report acknowledged recent efforts by Gov. JB Pritzker and the General Assembly to raise Medicaid rates, but said they “remain inadequate to address the problem.”

A symposium hosted by Cook County Health is set for Tuesday to discuss the report’s findings.

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When I lived in the Sonoran Desert, I came to know it as a place of majesty and tragedy. The pink sand desert has incredible biodiversity and a vibrant border culture. But it can be an unforgiving place with coyotes, scorpions, rattlesnakes and, yes, temperatures in the 120s. In fact, temperatures in Phoenix surpassed 110 degrees 55 times this summer — tying last year’s record and causing at least 177 deaths. [Chicago Tribune]

The U.S. government has long wielded Arizona’s hostile environment as a weapon to control immigration. Those who know the land observe that over time, immigration enforcement patterns shifted border crossing points to increasingly desolate and dangerous areas with the notion that migrants would be deterred from making the trip. In desperation, they came anyway. The effort to save lives and count the lives lost in the desert is a serious undertaking by organizations such as Humane Borders and No More Deaths.

Now, I live in Illinois where I am a political science professor studying American politics and immigration. The underlying philosophy of the federal government’s immigration control tactics is deterrence through attrition — essentially making it so difficult to immigrate that people simply give up. Immigrant rights activists and scholars call this the “misery strategy” because these policies make it hard to survive, much less claim asylum rights or ask for help. Despite the fact that there are now more people fleeing conflict, famine and persecution than ever in history, Latin Americans were told: “Do not come.”

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