When Sukky Bleck’s infant son was diagnosed last year with bilateral hydronephrosis, a condition preventing urine from draining from the kidney into the bladder, she started questioning herself. [Chicago Tribune]

“Was it something I did? What did I do wrong? How can I fix it,” the 27-year-old Southeast Side resident said.

Bleck said she soon became haunted by whether lead-contaminated drinking water might have contributed to his condition. While kidney damage from lead exposure is uncommon in the United States, according to the National Kidney Foundation, lead found in drinking water has been proven to cause kidney damage on rare occasions, usually after many years of exposure.

“I shouldn’t have to stockpile cases of water for my children’s home. No parent should,” she said. “The lead pipe crisis is not just a statistic. It’s a harsh reality we’re facing daily. Our children, our future are at risk.”

More>

Crisis in Black communities: Black residents in Cook County are the only racial group whose suicide rates are higher now than before the pandemic. The problem is even worse for men, whose suicide rates are more than three times higher than women in Cook County. Advocates say there isn’t much encouragement for men — particularly Black men— to discuss mental health. [Chicago Sun-Times]

Chicagoans want help: While grassroots mental health organizations and groups have popped up in the Chicago area, city-run resources haven’t done enough outreach in suicide prevention, say families who have lost loved ones. Also, a lack of messaging directly to communities in need — in addition to well-documented clinic closures — could have been a factor in higher suicide rates for Black residents, mental health advocates say.

Pain into purpose: Rafiah Maxie-Cole, 48, was inspired to start her own organization after her son, Jamal Clay, 20, died by suicide May 27, 2020, two days after George Floyd’s death. Soul Survivors of Chicago provides financial support through donations to those struggling with trauma, as well as mental health education centering specifically on Black, Indigenous and People of Color communities.

More>

###

Six practices to improve the quality of perinatal care

The death of Olympic champion sprinter Tori Bowie from complications of childbirth cast a spotlight on the high rates of maternal mortality in the U.S., particularly among Black women. Far from an anomaly, her death highlights the fact that Black women in the U.S. are three times opens in a new tab or window more likely to die from pregnancy-related causes than white women. [MedPage Today]

Global data show that the U.S. maternal mortality rate continues to exceed that of other high-income countries. Even more striking, maternal mortality rates among the highest-income Black women are just as high as for low-income white women.

More> 

###

Six municipalities will receive $41.5 million in state funds to help provide services like healthcare to asylum seekers, Gov. JB Pritzker announced Friday. [Health News Illinois] 

The majority of funds, nearly $30.3 million, will go to the city of Chicago. Other areas receiving funds include:

·    $8.6 million for Joliet

·    $1.3 million for Elgin

·    $1 million for Lake County

·    $250,000 for Urbana

·    $150,000 for Oak Park

Along with health services, the administration said the funds will be used for shelter, housing, food, wraparound services and legal support.

"Although we will still need significant federal support as this crisis continues, these grants will empower local governments to build out services and supports for new arrivals so we can successfully transition them into our state and give them the opportunity to complete their legal asylum process,” Pritzker said in a statement announcing the grants.

The funds are from a state budget allocation to the Department of Human Services. The agency will distribute the funds in partnership with the Metropolitan Mayors Caucus, which provides oversight on Notice of Funding Opportunity processes.

“Today's awards demonstrate our commitment to assisting recent arrivals from the southern border with the resources that they need to be successful,” said department Secretary Grace Hou.

The Pritzker administration said Illinois has received more than 15,000 new arrivals since last year.

The announcement came a day after Pritzker raised concerns over a plan by Chicago Mayor Brandon Johnson for a $29.4 million contract to build winter tent basecamps for asylum seekers.

Pritzker told reporters at an unrelated event that the city could instead create shelters in existing, unused buildings.

 “I have concerns about it, and we continue to have conversations about it,” Pritzker said.

###

This paper is composed of three distinct but interrelated parts that together map the past, present, and future of addressing racial inequities in Maternal and Child Health. Part I recounts the history and achievements of a Centers for Disease for Control and Prevention initiative in the 1980–90’s, led by the Prematurity Research Group in the Division of Reproductive Health, Pregnancy and Infant Health Branch. [Maternal Child Health Journal]

This initiative stimulated a paradigm shift in how we understand and address black infant mortality and the inequities in this outcome. Part II illustrates examples of some exemplary programmatic and policy legacies that stemmed either directly or indirectly from the Centers for Disease for Control and Prevention paradigm shift. Part III provides a discussion of how efectively the current practice in Maternal and Child Health applies this paradigm to address inequities and proposes a path for accelerating Title V agencies’ progress toward birth equity. 

Download paper here>

Medical practice is about the human interaction between clinicians and patients, but what does it mean when a technology with human-like attributes such as AI enters the examination room? How does the dynamic between clinicians and patients change when AI is involved? [JAMA]

In a recent interview, Kirsten Bibbins-Domingo, PhD, MD, MAS, editor in chief of JAMA and the JAMA Network, discussed this aspect of AI with primary care physician Ida Sim, PhD, MD (Video). Sim is codirector of a joint program between the University of California, Berkeley, and the University of California, San Francisco (UCSF) in computational precision health. She is also an elected member of the National Academy of Medicine and the American College of Medical Informatics.

The following is an edited version of the interview.

Dr Bibbins-Domingo: I think of you as a physician who’s been in this informatics research space for a long time. You’ve also thought about how we create structures for sharing data and making data more accessible, and now all of us are talking about AI, and it’s transforming how we’re going to practice. It’s transforming how we’re going to do science. Why are we talking with a different urgency right now?

Dr Sim:I t is an urgency, absolutely. I think November 30, 2022, is going to go down in history. That was the day when ChatGPT came out. I had been talking to other people here in Silicon Valley about ChatGPT-2.0, about DALL-E, and it was just mind-blowing what was going on in the computer science world that we were not seeing publicly. But November 30 changed that.

That was an inflection point, and this is why I think it’s so transformative. AI and machine learning are 2 different terms, but we won’t dissect those. A lot of the work previous to what the public sees has been machine learning. You take a bunch of data, stick it in a black box and out comes something. And that something is usually a prediction.

More> 

###

NIH-funded research sheds light on link between COVID-19 infection and increased risk of cardiovascular disease and stroke. [National Institutes of Health]

SARS-CoV-2, the virus that causes COVID-19, can directly infect the arteries of the heart and cause the fatty plaque inside arteries to become highly inflamed, increasing the risk of heart attack and stroke, according to a study funded by the National Institutes of Health. The findings(link is external), published in the journal Nature Cardiovascular Research, may help explain why certain people who get COVID-19 have a greater chance of developing cardiovascular disease, or if they already have it, develop more heart-related complications.

In the study, researchers focused on older people with fatty buildup, known as atherosclerotic plaque, who died from COVID-19. However, because the researchers found the virus infects and replicates in the arteries no matter the levels of plaque, the findings could have broader implications for anybody who gets COVID-19.

More> 

Health leaders said Tuesday that continued investments in public health and awareness campaigns are necessary to get ahead of the anticipated rise in long COVID cases in Illinois. [Health News Illinois]

Jerry Krishnan, associate vice chancellor for population health at the University of Illinois Chicago, said those in the clinical field are becoming more aware of the condition, but public awareness of the impact of long COVID remains low.

Initial research has shown that the economic toll of long COVID is over $1 trillion, Krishnan said. And that number is expected to keep increasing as individuals face symptoms like “brain fog” and persistent restlessness.

“We need to be thinking now about how to mitigate the health and economic burden of long COVID,” he told the Senate’s Public Health Committee during a hearing in Chicago. "It is definitely there, and just because it's not being tracked by the state doesn't mean it's gone.”

One of the main challenges, Krishnan said, is the lack of up-to-date data on COVID-19 trends in Illinois. 

He noted the Department of Public Health has stopped some of its COVID-19 reporting since the end of the public health emergency in May, which makes it more difficult to track trends and whether stakeholders are making any progress with their outreach efforts.

Dr. Melissa Simon, director of the Center for Health Equity Transformation in the Feinberg School of Medicine at Northwestern University, said raising public awareness is also a major step to addressing long COVID. As a practicing OB-GYN, she said she still regularly talks with patients who have no idea of the effects of long COVID, especially on vulnerable populations.

She said stakeholders need to prioritize historically underserved individuals, specifically Black and brown residents. While roughly 15 percent of adults who caught COVID-19 in Illinois experience long COVID, Simon said the challenge is knowing what racial and ethnic groups bear that disproportionate burden of long COVID.

Both Simon and Krishnan said an important step to addressing that issue is to better fund the public health infrastructure.

“I think that all of that data combined are very compelling to to underscore why this is such a critical issue to not ignore,” Simon said. “Even though COVID is a topic that people want to run away from, especially in the political arena, Dr. Krishnan and I fully agree that COVID is not gone, it's here to stay, and it could get worse again.”

Arti Barnes, chief medical officer for the Department of Public Health, told lawmakers they are talking with federal partners about the need for better diagnostic coding for long COVID that will “capture severity as well as the associated symptoms.” 

Additionally, she said they have discussed the need for clinic-based claims data and social security disability claims related to long COVID to help the department better understand the impact of the disease in local communities.

While those discussions are ongoing, Barnes said the department is working with providers to better identify long COVID conditions so they can best serve patients.

They are also continuing the public push for COVID-19 vaccinations, saying that being vaccinated remains one of the best ways individuals can protect themselves from long COVID, she said.

Sen. Robert Peters, D-Chicago, said long COVID-19 is an issue that lawmakers will need to take a closer look at when they return next spring, 

 “We really have to mainstream this, and we got to make sure that the data that was discussed earlier is better tracked, particularly for people that have those intersectional identities,” he said. “We (also) need to make sure that we are pushing up federal lawmakers on this issue.”

###

Sen. Dick Durbin, D-Ill., filed a brief with other senators last week in support of allowing the Centers for Medicare & Medicaid Services to negotiate lower drug prices.  [Health News Illinois]

The amicus brief, filed in the District Court for the District of Columbia, argues that Congress was well within its rights when it approved a plan last year that gives the federal agency the authority to negotiate prices with drug manufacturers. 

The agency already negotiates costs with providers, lawmakers said, and the work is no different than what federal payers like the Department of Veterans Affairs are legally allowed to do.

“We’re telling the courts: The Medicare prescription drug program is squarely within Congress’s constitutional powers, and it’s working for families,” Durbin said in a statement.

Drug manufacturer Merck & Co. sued the federal government in June over the new authority, arguing it violates their constitutional rights by allowing the government to unilaterally impose its preferred price.

“The (law) wields the threat of crippling penalties to force manufacturers to transfer their patented pharmaceutical products to Medicare beneficiaries,” Merck said in its lawsuit.

 The Biden administration last month announced the first 10 drugs selected for Medicare price negotiation.

###

I’m an ER doctor: Here’s what AI startups get wrong about “ChatGPT for telehealth” The explosion of telehealth might seem like a huge opportunity for AI. But it is also a huge risk. [Fast Company]

As a practicing ER doctor, I’m quite excited by the potential of LLMs like ChatGPT for health care. I already use it as a communication tool for some of my patients, and sometimes feed ChatGPT detailed prompts of patient symptoms to generate possible diagnoses I haven’t yet considered.

As a part-time advisor to healthtech startups, however, I’m increasingly concerned that many in Silicon Valley are confusing the capabilities of LLMs as they relate to the practice of medicine. Especially telehealth.

The omnibus bill President Biden signed last January extends telehealth flexibilities on patient appointments and insurance coverage through December 31, 2024. Assuming insurers continue following suit until then, we have about a year to deliver on the promise of telehealth.

This might seem like a glowing opportunity for a program like ChatGPT. Thanks to the pandemic, virtual care/telehealth is now a standard procedure, with roughly 1 in 4 patient appointments conducted remotely. So why not integrate an LLM into the remote treatment process, acting as a virtual nurse practitioner which communicates to patients through text? Indeed, there are already a number of startups roughly based on that use case.

After treating thousands of people remotely since the COVID era, I should explain in vivid detail how bad an idea this is. 

More>

###