Why do people use drugs? It’s one of those neglected questions with answers right in front of our noses. We just refuse to look. [Scientific American and Kaisier Health News]

Getting high—and overdosing—is after all, as American as apple pie. Over 46 million people in the U.S. have an alcohol- or drug-use disorder. Everyone knows someone who died, or who lost a son or daughter, mother or father, to a drug overdose, one of the 100,000-plus now yearly recorded nationwide.

Lost in today’s raging debate over drug policy and how to curb this spiraling mortality is the deep malaise that lies at the root of substance use in America. We are stuck on a loop, veering from “drug war” to legalization to backlash against legalization, without a record of improving lives and setting people on a successful path of recovery. And that’s because we are frankly unwilling to fix the economic cruelty that drives and keep people locked in dangerous drug use.

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The federal government last week signed off on Illinois’ 1115 waiver application that targets social determinants of health and behavioral health. [Health News Illinois]

The Centers for Medicare and Medicaid Services approved the plan, which supports programs for treating substance use disorders, offering employment support for people with disabilities, violence prevention and intervention, housing and nutrition.

CMS continues to review three requests related to a grant program to fund safety-net hospitals, the redirection of some disproportionate share hospital funding to fund strategies and interventions for improving the health of underserved communities, and funding for social determinants of health assessments and training of community health workers.

It encouraged Illinois to “explore using the approved (health-related social needs) services and … infrastructure to achieve the policy goals” of programs still under review.

The approval is effective through June 2029.

Department of Healthcare and Family Services Director Lizzy Whitehorn said in a statement that the approved plan “transforms and advances our state’s vision of an equitable and sustainable healthcare delivery system.”

“We thank … CMS for recognizing the connection between health-related social needs and healthcare outcomes,” she said. “The new services will be designed to bring sustainable, community-driven solutions to some of our most vulnerable residents and incorporate non-traditional providers into the Medicaid program.”

The agency said additional details will be announced later this month.

The announcement drew praise from Illinois’ two senators, who wrote to CMS Administrator Chiquita Brooks-LaSure this spring to urge approval.

“Expanding the reach of Illinois’s health care network is key to making reliable behavioral health services more accessible to individuals across our state,” said Sen. Tammy Duckworth. “This action by CMS helps move our state forward and ensures that we’re helping bring essential health services to Medicaid beneficiaries across Illinois.”

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As Conspiracy Theories Abound, Can We Restore Trust in Public Health?  With the House still investigating the pandemic, its origins, and our government's responses -- and with perhaps the most well-known public health figure in the hot seat (Anthony Fauci, MDopens in a new tab or window) -- now seems a good time to reflect on how we might begin to restore our trust in public health.[MedPage Today]

Understanding the Root of Conspiracy Theories

In the mid-to-late 90s, I worked for a member of Congress who represented the high desert of California. If you have never visited this area, it is both beautiful and dangerous. Hot and dry with few people, it is home to two of the most famous military facilities in the world: Edwards Air Force Base and Naval Air Weapons Station at China Lake. Both are renowned, though one more than the other. While the Space Shuttle occasionally landed at Edwards, affording it more attention, China Lake is not as well-known. Yet, it is the home to the development and testing of some of the most advanced weapons in the military's arsenal.

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The Illinois Department of Public Health announced Wednesday an expanded list of high-risk for lead exposure ZIP codes. [IL-DPH and WGN] 

IDPH is recommending increased mandatory testing for lead exposure of children who live within those areas.

One hundred and forty-eight new zip codes, representing parts of 60 Illinois counties, have been added to the list this year, bringing the total of high-risk ZIP codes to almost 1,200.

See List here by Zip Code>

IOMC is working with the Lead Abatement Resource Center Foundation on providing efforts to the children, families and communities. More details soon. 

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Robert Bulanon glanced at the sky and frowned at the rain. He hurried into his home and emerged, holding an umbrella over his head, picking his way between a barbershop pole, a pair of bus seats, a wheelbarrow, a grill where another man was cooking beef stew, and other objects scattered along the embankment of the canal. [Chicago Tribune] 

Photo Vincent Alban /Chicago Tribune

Bulanon, 52, is one of about 20 people who live in a set of makeshift shelters along the North Shore Channel between Foster and Bryn Mawr avenues on Chicago’s Northwest Side. A ladder leaned against the chain link fence, separating the river embankment from athletic fields at Northside College Prep, a selective enrollment high school.

By July 30, the residents will no longer be able to call the longtime encampment home. The next day, city departments are scheduled to begin clearing the tents and items, officials said, offering the group non-congregate shelter placement at a downtown hotel. Notices will go up starting the first week of July. The idea of relocating them has been talked about for years.

“They said, ‘We’re here to help; we could send you somewhere, a shelter or something,’”  Bulanon recalled of his first interaction with the city.

Months after voters rejected the Bring Chicago Home referendum, which sought to raise millions for homelessness services by raising the city’s real estate transfer tax for property sales above $1 million, Chicago is at a critical juncture on how to address its rapidly growing homeless population.

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The US Department of Health and Human Services (HHS), through its Biomedical Advanced Research and Development Authority (BARDA), today announced that it has awarded Moderna $176 million to develop a prepandemic vaccine against H5 avian influenza. [Kaiser Health News & Univ. of MN]

In its announcement, HHS said the award helps bolster the nation's pandemic flu vaccine capacity, which currently relies on an older traditional vaccine platform. Moderna will leverage its domestic large-scale commercial mRNA vaccine manufacturing platforms and ongoing development of mRNA-based seasonal flu vaccines.

The award comes as officials confirm more H5N1 avian flu in US cattle and poultry.

Phase 3 trials could begin next year

Dawn O'Connell, JD, assistant secretary for preparedness and response at HHS, said the $176 million represents the base award and the agreement contains other options that allow the government to quickly pivot funding to other mRNA vaccines when new flu strains or other disease threats emerge. She said the H5 vaccine is in clinical development and that phase 3 trials could begin in 2025.

The award also includes an option for large-scale production and pandemic response. At today's briefing, Robert Johnson, PhD, director of medical countermeasures at BARDA, said it's too early to project production capacity. He said the number will depend on dosing information, which should be available later this year. 

Moderna said in a statement today that in 2023 it launched a phase 1/2 clinical trial of an investigational pandemic flu vaccine in healthy adults, which included candidates against H5 and H7 viruses, and results are expected this year. 

Meanwhile, fill-and-finish activity continues on vaccine from bulk stocks of candidate cell-based adjuvanted H5 vaccine made by CSL Seqirus, and O'Connell said the first of 4.8 million doses will be available in the middle of July, with production continuing through August. This is faster than the government had anticipated. 

Officials weigh early vaccine use for high-risk groups

As vaccine production and planning continues, federal officials are in ongoing discussions about how to best protect farm workers and others exposed to cattle.

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 A survey of low-income adults in four southern US states shows that nearly half of those disenrolled from Medicaid after COVID-19 pandemic protections ended had no insurance in late 2023, leading to struggles to afford healthcare and prescription drugs and threatening to broaden a gap that had narrowed during expanded governmental benefits. [University of MN] 

'These findings suggest that the recent unwinding of COVID-19 pandemic–related safety-net policies may worsen health care affordability and widen existing income-based inequities.'

The data were derived from 89,130 adult residents of Arkansas, Kentucky, Louisiana, and Texas participating in the National Health Interview Survey in 2019, 2021, and 2022. In 2023, states rechecked Medicaid eligibility after COVID-19 governmental protections expired, disenrolling millions. The average participant age was 48.0 years, and 51.6% were women.

Researchers from Beth Israel Medical Center and Harvard Medical School published the results late last week in JAMA Health Forum.

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The CDC's Advisory Committee on Immunization Practices (ACIP) endorsed new COVID-19 and influenza vaccines for the 2024-2025 respiratory virus season on Thursday. [MedPage Today]

In a unanimous 11-0 vote, the ACIP recommend that everyone 6 months of age and older should receive an updated COVID-19 vaccine, similar to last year's recommendation.

The committee also voted unanimously that everyone 6 months of age and older should receive an updated 2024-2025 influenza vaccine, with rare exceptions. Also, in another unanimous vote, members voted that high-dose inactivated (HD-IIV3) and adjuvanted inactivated (aIIV3) influenza vaccines are acceptable options for influenza vaccination in solid organ transplant recipients.

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Federal health officials with the US Centers for Disease Control and Prevention (CDC) have issued an alert, warning health professionals and the public about an increased risk for dengue virus infections in the United States. [MedScape]

The global incidence of dengue in 2024 is the highest on record, reported the agency.

In the Americas, more than 9.7 million cases of dengue have been reported in the first 6 months of 2024 — more than double the 4.6 million cases reported in all of 2023.

In the United States, Puerto Rico has declared a public health emergency, with 1498 dengue cases reported so far and a "higher-than-expected" number of dengue cases having been identified among US travelers in the first half of this year at 745 cases, according to the alert.

The CDC reports 197 dengue cases in Florida, 134 in New York, 50 in Massachusetts, 40 in California, 14 in Colorado, nine in Arizona, and eight in the District of Columbia, among others.

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The National Academies of Sciences Engineering and Medicine on Wednesday said law and policy changes aimed at eliminating health disparities have made slow and uneven progress improving racial inequities over the past 20 years. [Modern Healthcare]

The Ending Unequal Treatment report found that people of color in 2024 are still disproportionately uninsured, underutilizing care services and underrepresented in the healthcare workforce. The report is funded by the National Institutes of Health and Agency for Healthcare Research and Quality and is a follow up to the academies' 2003 study on pervasive inequities in care access, coverage and treatment between patients of color and their white peers.

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