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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Illinois’ infant mortality rate has improved, though Black infants continue to die at disparately higher rates, according to a report released Thursday by the Department of Public Health. [Health News Illinois]

There were 5.6 deaths per 1,000 live births in 2021, the most recent full year of data. The rate is down roughly 0.9 deaths from 2018. 

In 2021, Illinois saw 132,228 live births and 743 infant deaths, which occur before a child’s first birthday. 

Agency Director Dr. Sameer Vohra said that while progress has been made, the report “highlights that despite significant public health efforts, unacceptable racial and ethnic disparities persist.”

“IDPH, along with our partners, will continue to focus on the recommended strategies and key resources to improve health outcomes for pregnant people and their newborn infants,” Vohra said.

The mortality rate for Black infants is nearly three times higher than for infants born to white, Latinx or Asian women. According to the report, the inequity is “heavily influenced” by trends in deaths due to prematurity and sudden unexpected infant death, with Black infants being more than four times as likely to die of the latter than white and Latinx infants.

Prematurity and fetal malnutrition, birth defects, sudden unexpected infant death and complications with pregnancy or delivery caused about 70 percent of all infant deaths. 

The disparities align with an IDPH report released last year that found Black women are twice as likely to die from any pregnancy-related condition and three times as likely to die from pregnancy-related medical conditions as white women.

Thursday’s report also found the COVID-19 pandemic and subsequent recovery had little impact on overall trends in Illinois. Between 2020 and 2022, COVID-19 factored in 10 infant deaths, according to IDPH provisional data for 2022.

The national rate for infant deaths in 2021 was 5.4 deaths per 1,000 live births.

Vohra noted that maternal and infant health has been a major focus for policymakers in recent years. 

The current state budget includes $23 million for efforts that address disparities, like supporting community birth centers, establishing a diaper pilot program and creating child tax credits for low-income families.

A new law approved by the General Assembly this spring will task insurers with covering all pregnancy, postpartum and newborn care provided by perinatal doulas or licensed certified professional midwives. That includes home births and home visits. Coverage will also expand to home visits by board-certified lactation consultants and recommended products like breast pumps and feeding aids.

Another new law creates a task force within IDPH to identify and address healthcare disparities, including maternal and infant health rates.

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NEW YORK (AP) — U.S. suicides last year remained at about the highest level in the nation’s history, preliminary data suggests. [AP]

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A little over 49,300 suicide deaths were reported in 2023, according to provisional data from the Centers for Disease Control and Prevention. That number that could grow a little as some death investigations are wrapped up and reported.

Just under 49,500 were reported in 2022, according to final data released Thursday. The numbers are close enough that the suicide rate for the two years are the same, CDC officials said.

EDITOR’S NOTE — This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.

U.S. suicide rates have been rising for nearly 20 years, aside from a two-year drop around the beginning of the COVID-19 pandemic. So “a leveling off of any increase in suicide is cautiously promising news,” said Katherine Keyes, a Columbia University public health professor who studies suicide.

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Life expectancy declined in all 50 states and Washington, D.C., from 2018 to 2021, with New Mexico experiencing the largest decrease and Massachusetts the smallest, according to a new report from Forbes Advisor. [Beckers] 

To determine the states where life expectancy is falling the most and least during that period, the Forbes Advisor Life Insurance team examined the most recent data available from the CDC.

The states where life expectancy decreased the most, per the analysis:

1. New Mexico (-5.44%)

2. Mississippi (-4.96%)

3. Arizona (-4.7%)

4. West Virginia (-4.57%)

5. Louisiana (-4.5%)

6. Alaska (-4.49%)

7. Alabama (-4.13%)

8. Tennessee (-4.11%)

9. Arkansas (-4.10%)

10. Kentucky (-3.98%)

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Foster City, Calif., September 20, 2024 - Gilead Sciences, Inc. (Nasdaq: GILD) today announced it is issuing a voluntary recall of one lot of Veklury® (remdesivir) for Injection 100 mg/vial, to the consumer level. Gilead received a customer complaint and confirmed the presence of a glass particle in the vial during the company's investigation. [MedPageToday]

Risk Statement: The administration of an injectable product that contains glass particles may result in local irritation or swelling in response to the foreign material. The glass particulate can potentially travel, through the blood vessels, to various organs and block blood vessels in the heart, lungs or brain which can cause stroke and even lead to death. To date, Gilead has not received any reports of adverse events related to this recall.

Veklury® (remdesivir) for Injection 100 mg/vial is indicated for the treatment of COVID-19 in adults and pediatric patients (birth to less than 18 years of age weighing at least 1.5 kg) who are:

• Hospitalized, or
• Not hospitalized and have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death

Veklury® (remdesivir) for Injection 100 mg/vial may only be administered in settings in which healthcare providers have immediate access to medications to treat a severe infusion or hypersensitivity reaction, such as anaphylaxis, and the ability to activate the emergency medical system (EMS), as necessary.

The product being recalled is the lyophilized form of Veklury® (remdesivir) for Injection 100 mg/vial packaged in single dose clear glass vials in powder form. Veklury lot # 47035CFA was distributed nationwide in the United States, beginning 16 July 2024. NDC, lot, expiration date and distribution dates can be found in the table below.

Product Description	NDC	Lot #	Expiration Date	Distribution Date to Wholesalers
Veklury® (remdesivir 100mg for injection)	61958-2901-02	47035CFA	Exp. Date 11/2025	07/16/2024 to 08/07/2024

Gilead is notifying its distributors and customers via UPS next day air mail to pharmacies and is facilitating the return of any remaining vials from the affected lot. Facilities that have Veklury® (remdesivir) for Injection 100 mg/vial which is being recalled should stop using the affected lot and return the product vials per the instructions in the letter.

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