For nearly two decades, the Commonwealth Fund has tracked health and health care in each state, seeking both to understand how the policy choices we make affect people’s health outcomes and to motivate the change needed to improve the health of all communities across the United States. But assessing how well a state performs on average can mask the profound inequities that many people experience. [The Commonwealth Fund]

The Commonwealth Fund 2024 State Health Disparities Report

This report evaluates disparities in health and health care across racial and ethnic groups, both within states and between U.S. states. We collected data for 25 indicators of health system performance, specifically focusing on health outcomes, access to health care, and quality and use of health care services for Black, white, Hispanic, American Indian and Alaska Native (AIAN), and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations. We then produced a health system performance “score” for each of the five racial and ethnic groups in every state where we were able to make direct comparisons between those groups and between groups in other states. (For complete details on our methods, see How We Measure Performance of States’ Health Care Systems for Racial and Ethnic Groups.)

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Federal agencies with competing interests are slowing the country’s ability to track and control an outbreak of highly virulent bird flu that for the first time is infecting cows in the United States, according to government officials and health and industry experts. [KFF / Washington Post]

The response has echoes of the early days of 2020, when the coronavirus began its deadly march around the world. Today, some officials and experts express frustration that more livestock herds aren’t being tested for avian flu, and that when tests and epidemiological studies are conducted, results aren’t shared fast enough or with enough detail. They fear that the delays could allow the pathogen to move unchecked — and potentially acquire the genetic machinery needed to spread swiftly among people. One dairy worker in Texas has already fallen ill amid the outbreak, the second U.S. case ever of this type of bird flu.

Officials and experts said the lack of clear and timely updates by some federal agencies responding to the outbreak recall similar communication missteps at the start of the coronavirus pandemic. They point, in particular, to a failure to provide more details publicly about how the H5N1 virus is spreading in cows and about the safety of the milk supply.

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The city and state are in the planning stages to combine Chicago’s legacy homeless shelter system with its system for migrants, according to government officials, and turn it into a unified shelter structure, an idea advocates for the homeless have long championed. [Chicago Tribune]

The “One System Initiative” will shift a “permanent shelter management to the non-profit workforce,” Illinois Department of Human Services spokesperson Daisy Contreras said in a statement. Currently, the city contracts with Favorite Healthcare Staffing, whose sizable overtime has contributed to tens of millions of dollars in city payments to the firm staffing the city’s migrant shelters.

The state’s office to prevent and end homelessness will lead the initiative with more than 25 community-based agencies participating, Contreras said. Planning sessions are set to begin at the end of April and go through the spring. 

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Various metaphysical concepts -- those that transcend physical explanations or rules -- have influenced the field of medicine throughout history and continue to play a role today. The understanding of how mental processes can affect physical health is a key example. This is evident in the field of psychosomatic medicine, which studies the influence of psychological factors on physical conditions. [MedpageToday]

While the practice of medicine is grounded in the physical body, the motivations and values that guide physicians often transcend physicality. The drive to heal, to alleviate suffering, and to improve quality of life are fundamental motivations for many in the medical field. These are not simply biological drives, but metaphysical ones, rooted in empathy, compassion, and a commitment to service.

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The city and state are in the planning stages to combine Chicago’s legacy homeless shelter system with its system for migrants, according to government officials, and turn it into a unified shelter structure, an idea advocates for the homeless have long championed. [Chicago Tribune]

The “One System Initiative” will shift a “permanent shelter management to the non-profit workforce,” Illinois Department of Human Services spokesperson Daisy Contreras said in a statement. Currently, the city contracts with Favorite Healthcare Staffing, whose sizable overtime has contributed to tens of millions of dollars in city payments to the firm staffing the city’s migrant shelters.

The state’s office to prevent and end homelessness will lead the initiative with more than 25 community-based agencies participating, Contreras said. Planning sessions are set to begin at the end of April and go through the spring. 

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In part two of this exclusive video interview, MedPage Today editor-in-chief Jeremy Faust, MD, talks with Monica Bertagnolli, MD, the 17th director of the National Institutes of Health (NIH), about the day-to-day work at the NIH on pandemic preparedness, the importance of looking for new approaches to testing, and the status of long COVID research. [MedPage Today]

Faust: Hello, this is Jeremy Faust, editor-in-chief of MedPage Today. We're joined today by Dr. Monica Bertagnolli. All right, I'd like to talk a little bit about the NIH and pandemic preparedness. Broadly speaking, is this something that the NIH is thinking about? Obviously there was some involvement, obviously during the pandemic, of the COVID-19 pandemic, including the NIH was hosting guidelines for COVID clinical policies and that sort of thing. What's the day-to-day work at the NIH on pandemic preparedness like?

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Citing the changing needs of incoming migrants to Chicago, the Cook County Board of Commissioners Thursday approved a transfer of $70 million originally dedicated to providing them health care to instead cover costs of food service for new arrivals. [Chicago Tribune]

The funding represents the majority of the $100 million Board President Toni Preckwinkle dedicated in her $9.6 billion 2024 budget to the county’s Disaster Response and Recovery Fund. The remaining $30 million was allocated toward “municipal or local government costs” related to incoming migrants and “other disasters that may happen in 2024.”

Cook County legal counsel Laura Lechowicz Felicione said last year’s migrant health care expenses, which totaled $25 million, were covered by surplus dollars and “various expense lines, mostly in salaries and wages.”

“We expect that we’ll be able to cover that expense again this year” using the surplus, she said. That frees up the $70 million to reimburse the city of Chicago for costs related to feeding asylum-seekers in intake or shelters. The resolution leaves room for the money to also be used to support other “costs related to funding operations for the new arrivals.”

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A disease originating in a remote area halfway around the world can travel to the U.S. in as little as 72 hours.[KFF Health News and NPR]

That's why the Biden administration has launched a new effort to improve the ability of the U.S. to prevent, detect and respond to the spread of infectious diseases.

While the U.S. has long been the global leader in health security, the White House's new Global Health Security Strategy, announced today, strives to make the country even better prepared for future pandemics, outbreaks and biological threats regardless of where they occur. However, experts in the field worry the new strategy does not go far enough and financial realities will limit the effort's impact.

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Advocates joined Gov. JB Pritzker Monday to call on lawmakers to approve a $10 million investment in the upcoming budget to help eliminate medical debt for 340,000 low-income Illinoisans. [Health News Illinois]

Pritzker told reporters at a press conference in Chicago that a statewide program could relieve an estimated $1 billion in medical debt.

“As we continue to negotiate and pass a balanced budget, this low-cost program to eliminate medical debt will alleviate a major burden on families across Illinois,” he said.

The program would work with the recently renamed Undue Medical Debt, a New York-based nonprofit that has been working to wipe out medical debts since it got its start in 2014.

Pritzker plans the initial investment to be part of a four-year effort that would, in total, erase an estimated $4 billion of medical debt for over 1 million Illinoisans.

The proposal would mimic an initiative from Cook County, which county board President Toni Preckwinkle said Monday has aided more than 200,000 residents in eliminating nearly $350 million of debt.

“Medical debt relief is a crucial step, and it is part of a broader, equitable strategy to enhance the financial stability and support the holistic well-being of Illinois residents,” she said.

Fourteen percent of Illinoisans have medical debt in collections, according to Pritzker’s office. However, that number jumps to nearly 20 percent in Black and Brown communities.

State leaders were joined by Loyola Medicine CEO Shawn Vincent, who recently announced his health system will forgive over $112 million in medical debt. The move will affect more than 60,000 Illinoisans.

“This initiative underscores our dedication to alleviating the burden of medical debt on our patients in the communities that we serve,” he said.

The press conference comes after a recent report found that medical debt relief did not improve the mental health or the credit scores of debtors, on average. Those whose bills had been paid were just as likely to forgo medical care as those whose bills were left unpaid.

Pritzker noted Monday that the study’s findings were compiled from 2018 to 2020, and that the results “were not indicative” of what is now being seen with the organization. He said larger municipalities have made efforts to address medical debt and have received positive feedback.

“There has been a lot of improvement in the program, and we're really pleased to continue the progress,” he said.

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Experts worry a recent rise in long COVID cases — fueled by a spike in winter holiday infections and a decline in masking and other measures — could continue into this year. [MedScape]

A sudden rise in long COVID in January has persisted into a second month. About 17.6% of those surveyed by the Census Bureau in January said they have experienced long COVID. The number for February was 17.4.

Compare these new numbers to October 2023 and earlier, when long COVID numbers hovered between 14% and 15% of the US adult population as far back as June 2022.

The Census Bureau and the Centers for Disease Control and Prevention (CDC) regularly query about 70,000 people as part of its ongoing Pulse Survey.

It's Not Just the Federal Numbers

Independently, advocates, researchers, and clinicians also reported seeing an increase in the number of people who have developed long COVID after a second or third infection.

John Baratta, MD, who runs the COVID Recovery Clinic at the University of North Carolina, said the increase is related to a higher rate of acute cases in the fall and winter of 2023.

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