After over two years on the job, Department of Public Health Director Dr. Sameer Vohra last week laid out steps public health needs to take to address the challenges it faces. [Health News Illinois]

Vohra told members of the State Board of Health that IDPH is working during this relatively “calm” period post-pandemic to build the future foundation of the agency.

One step they're taking is to improve preparedness for any future outbreaks or novel pathogens. As an example, Vohra noted a new variant of mpox has started to spread in Africa and Europe. IDPH is evaluating its ability to respond if and when it comes to Illinois.

“Those efforts include making sure the state has the necessary resources to address the latest pathogens, as well as the community partnerships in place to aid in any response,” he said.

Another key is to “modernize” the public health system, including data management.

IDPH is also building up the public health workforce. And Vohra said they want to better invest in communities. 

He wants to improve community relations, a common refrain from the agency coming out of the COVID-19 pandemic.

Vohra said public health is “introducing ourselves again to the public.” 

Those efforts are not just to address mistrust of health officials and vaccines, but also to forge bonds with individuals and community organizations in areas that the health system has historically underserved.

And, while terms like “social determinants of health” have become more common, health officials need to better explain them to the general public, Vohra said. 

“We cannot do all of it by ourselves, but what we can do is be in a position where we are communicating that strategy of what public health is and what a public health approach is … so that we hit the root causes of many of the challenges that we face,” he said.

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Stress levels among modern-day parents appear to be growing at an alarming rate — so much so that U.S. Surgeon General Vivek Murthy recently issued an advisory calling parental stress an urgent public health issue.   [ The Hill]

Parents in 2024 are handling the traditional challenges of child care while dealing with stressors “previous generations didn’t have to consider,” Murthy, who is a father himself, said in the advisory.  

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The national official poverty rate (11.1%) was lower than the Supplemental Poverty Measure (SPM) (12.9%) in 2023, according to the U.S. Census Bureau's report, Poverty in the United States: 2023, released on Tuesday. [US Census Bureau]

However, an analysis of 3-year averages of poverty rates by states shows the SPM rate was lower than the official rate in 32 states.

The two poverty measures provide distinct indicators of U.S. economic well-being.

The SPM broadens the official poverty measure by accounting for government programs designed to assist low-income families that are not included in the official poverty measure while also including federal and state taxes and necessary expenses.

Continue reading to learn more about the national and statewide SPM rates.

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New research adds to a growing body of evidence suggesting that COVID-19 infection can be hard on mental health.  [MedScape].

A UK study of more than 18 million adults showed an elevated rate of mental illness, including depression and serious mental illness, for up to a year following a bout of COVID-19, particularly in those with severe COVID who had not been vaccinated. 

Importantly, vaccination appeared to mitigate the adverse effects of COVID-19 on mental health, the investigators found. 

"Our results highlight the importance COVID-19 vaccination in the general population and particularly among those with mental illnesses, who may be at higher risk of both SARS-CoV-2 infection and adverse outcomes following COVID-19," first author Venexia Walker, PhD, with University of Bristol, Bristol, United Kingdom, said in a news release. 

The study was published online on August 21 in JAMA Psychiatry.

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The worst of the COVID-19 pandemic is behind us. Age-adjusted COVID-19 mortality rates peaked in 2021 at 104.12 per 100 000 population (per 100 000 hereafter) and fell to 44.45 per 100 000 in 2022.^1,2 Provisional data suggest that COVID-19 mortality rates in 2023 were below 15.00 per 100 000.² This progress is welcome but deceptive. The US mortality picture is hardly ideal. Like the sand revealed as the tide goes out, the receding COVID-19 pandemic draws attention to rising mortality rates from non-COVID causes, a trend that predates the pandemic. [JAMA Network]

After 2010, life expectancy flatlined in the US while continuing to increase in other high-income countries.³ The primary cause was rising mortality rates in midlife (individuals aged 25-64 years). In 2015, Case and Deaton were among the first to call attention to this trend, which they first observed in the middle-aged White population.⁴ Subsequent studies documented the trend among young adults (aged 25-44 years) and middle-aged adults (aged 45-64 years) and other racial and ethnic groups.⁵

The many factors responsible for this trend—ranging from the opioid epidemic and increasing obesity rates to intensifying economic precarity—continued claiming lives during the COVID-19 pandemic. Indeed, COVID-19 poured fuel on the fire, accelerating increases in non-COVID mortality. For example, drug overdose deaths in the US more than tripled between 2000 and 2019 (from 4.15 per 100 000 to 19.14 per 100 000, respectively)¹ and then soared during the pandemic, peaking in 2022 at 30.14 per 100 000.²

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The FDA granted emergency use authorization (EUA) for an updated Novavax COVID-19 vaccineopens in a new tab or window to protect against hospitalization and death from circulating variants. [MedPageToday]

The protein-based shot represents a non-mRNA option for the 2024-2025 season, and follows the agency's recent approvals and authorizations of the updated Moderna (Spikevax) and Pfizer-BioNTech (Comirnaty) vaccinesopens in a new tab or window.

"The COVID-19 vaccines have had a tremendous positive impact on public health and vaccination continues to be the most effective method for COVID-19 prevention," said Peter Marks, MD, PhD, director of the FDA's Center for Biologics Evaluation and Research in the announcement.

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• In 2021-2022, 23% of adults experienced a mental illness in the past year, equivalent to nearly 60 million Americans.
• More than 5% of the U.S. adult population (12.8 million people) reported experiencing serious thoughts of suicide. After slight decreases in suicide deaths in 2019 and 2020, the number of individuals who died by suicide in 2022 was the highest number ever recorded in the U.S.
• 13% of youth ages 12-17 reported experiencing serious thoughts of suicide. The percentage of youth reporting suicidal ideation was highest among youth who identified as Native Hawaiian or Other Pacific Islander (25%) and more than one race (20%).
• 1 in 5 youth had at least one major depressive episode (MDE) in the past year. Over half of them – nearly 3 million youth - did not receive treatment. Of those who did receive treatment, only 65% said it helped them.

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Other news by state>

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When pediatrician Eric Ball opened a refrigerator full of childhood vaccines, all the expected shots were there — DTaP, polio, pneumococcal vaccine — except one. [KFF Health News]

“This is where we usually store our covid vaccines, but we don’t have any right now because they all expired at the end of last year and we had to dispose of them,” said Ball, who is part of a pediatric practice in Orange County, California.

“We thought demand would be way higher than it was.”

Pediatricians across the country are pre-ordering the updated and reformulated covid-19 vaccine for the fall and winter respiratory virus season, but some doctors said they’re struggling to predict whether parents will be interested. Providers like Ball don’t want to waste money ordering doses that won’t be used, but they need enough on hand to vaccinate vulnerable children.

The Centers for Disease Control and Prevention recommends that anyone 6 months or older get the updated covid vaccination, but in the 2023-24 vaccination season only about 15% of eligible children in the U.S. got a shot.

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As updated coronavirus vaccines hit U.S. pharmacy shelves, adults without health insurance are discovering the shots are no longer free, instead costing up to $200. [The Washington Post]

The federal Bridge Access Program covering the cost of coronavirus vaccines for uninsured and underinsured people ran out of funding. Now, Americans with low incomes are weighing whether they can afford to shore up immunity against an unpredictable virus that is no longer a public health emergency but continues to cause long-term complications and hospitalizations and kill tens of thousands of people a year.

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The country still faces a health crisis for new and expecting mothers, despite progress in recent years, members of the congressional Black Maternal Health Caucus said Monday in Joliet. [Health News Illinois] Rep. Lauren Underwood, a Democrat from Naperville and caucus co-chair, highlighted increased funding for the National Institutes of Health to support research and develop solutions to address mortality rates. But, she said the U.S. still has the highest maternal mortality rate of any high-income country, and the COVID-19 pandemic exacerbated long-standing issues. “It's devastating and it's tragic," she said. "Moms across America are demanding a comprehensive solution." Underwood renewed her call for Congress to pass the caucus’ maternal health package, which would boost funding for community-based organizations, the perinatal workforce, data collection and efforts to address social determinants of health. “(The package) is not a Band-Aid, it's not a messaging bill, it's not a commemorative resolution and it is not a study,” Underwood said. “It is the comprehensive solution to end preventable maternal death across the United States." An Illinois Department of Public Health report released last year found Black women are three times more likely than white women to die from medical complications during pregnancy and childbirth. Dr. Monica Bertagnolli, director of the National Institutes of Health, said that many deaths occur during the year after delivery of an infant. Four of five deaths are deemed preventable. The agency is supporting 12 organizations that are implementing “culturally appropriate research projects (that address) factors that can lead to pregnancy-related complication and death.” “In short, they are charged with addressing all of the complicated variables that contribute to poor survival for women,” Bertagnolli said. The caucus highlighted efforts in Illinois to address the crisis, including a recently signed law that requires insurers to cover all pregnancy, postpartum and newborn care provided by perinatal doulas and licensed certified professional midwives.  Sen. Lakesia Collins, a Democrat from Chicago who sponsored the legislation, said the law provides access to culturally sensitive care workers who can relate to Black women as they go through their pregnancies. Coverage for midwives and doulas will also be crucial to non-Black individuals, especially those in rural communities who may not have easy access to maternal care. “No matter what your economic status is, what race you are, women will have access to good maternal healthcare,” Collins said.

Federal leaders discuss steps to improve maternal health Medicaid coverage and bolstering the workforce are key steps that the federal government can take to improve maternal health outcomes, officials said Monday at a panel hosted by the Black Maternal Health Caucus in Joliet. Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services, said Medicaid and the Children's Health Insurance Program cover nearly 40 percent of the births in the country.  That's one reason President Joe Biden’s administration pushed to expand postpartum coverage for women to 12 months after birth, which 46 states now provide. “We were seeing many women fall off of coverage,” Brooks-LaSure said of the previous standard policy of covering two months after birth. “Many of the deaths in maternal health happen postpartum … It's been a priority of the caucus, and certainly our administration, to cover women postpartum.” Additionally, Brooks-LaSure said they have seen buy-in from providers on a designation launched last year identifying hospitals and health systems that participate in a perinatal quality improvement collaborative program and implement evidence-based care to improve maternal health. “Many private companies liked this concept and have partnered with us to really encourage hospitals to meet the standards that we are setting forth of having a collaborative of implementing best practices,” she said. Carole Johnson, administrator of the Health Resources and Services Administration, said they are “laser-focused” on getting services for those who have historically struggled to access healthcare, which makes maternal healthcare a priority. That includes supporting education institutes that train doulas and midwives and expanding wraparound programs for pregnant individuals and new parents. “Being a new parent is hard,” Johnson said. “Being pregnant is hard. Having someone you can trust, who can be your voice, who can help be your advocate in a system that, frankly, is too hard to navigate, we can make a real difference with that.” Another key to addressing maternal health is public-private partnerships, Brooks-LaSure said. They work with state Medicaid programs to build relationships with community providers and organizations that can “move the needle” on maternal health.  Johnson said partnerships with local organizations can help agencies like HRSA identify promising models and practices, which can then be added to their grant programs and replicated in other parts of the country. ###