Update on research on COVID and its long term implications. 

CONCLUSIONS AND RELEVANCE This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

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 A pair of new studies shine a light on how overcrowding and staffing shortages may be impacting emergency department (ED) wait times and patient care access. [Patient Engagement HIT]

The studies, based on EHR data from across the country, were published in JAMA Network Open by researchers from the VA Ann Arbor Healthcare System, the University of Michigan Institute for Healthcare Policy and Innovation, and Yale University.

In the first study, researchers examined how hospital occupancy, the percentage of occupied staffed inpatient beds, was associated with long ED wait length or boarding times.

Between January 2020 and December 2021, researchers found that boarding times were greater than four hours nearly 90 percent of the time when occupancy was greater than 85 percent.

... By December 2021, median boarding times were over nine hours at the five percent of hospitals with the greatest occupancy.

The Joint Commission, a national accrediting body for hospitals, stressed that boarding times over four hours is a patient safety concern.

Full article here>

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Healthcare’s cross-sector collaboration on health equity work is something that Jay Bhatt, MD, the executive director of Deloitte’s Center for Health Solutions, hasn’t seen at a level like this before. The work to give everyone an equal opportunity for health and well-being is happening across the care continuum, with a renewed focus on retail health clinics and other alternative care sites coming to the fore. [Patient Engagement HIT]

“We’re creating more access points and putting opportunities to address drivers of health,” Bhatt, who’s also the executive director of the Deloitte Health Equity Institute, told PatientEngagementHIT in a Zoom call. “We're seeing grocers and retailers partner with community health centers and other care settings to enable access to care in the context of addressing healthy behavior and shopping and food security as well as connection to other social service agencies.”

Alternative care sites, such as retail health clinics, urgent care clinics, telehealth, and virtual health options, create more front doors through which patients can get medical care. And when looking at traditionally marginalized groups, especially Black and Brown populations, this is important.

Full article here>

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A guest post from members of the planning team for the Pathways to Prevention (P2P) Workshop on Achieving Health Equity in Preventive Services (Antoinette Percy-Laurry, Carrie N. Klabunde, Melissa C. Green Parker, Pamela L. Thornton, LeShawndra N. Price, and Rick A. Berzon) and the ODP’s portfolio analysis team (Charlene A. Liggins and Cristan A. Smith)

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death, disability, and health care spending in the United States. Many chronic conditions can be prevented, delayed, or caught and treated early. However, despite the progress in research and clinical care, many Americans continue to receive less than recommended preventive health care; this is especially the case for communities that experience a high burden of disparities in chronic diseases. This means not everyone has an equal opportunity to be as healthy as possible. [NIH Office of Disease Prevention] 

In 2019, we organized the P2P Workshop: Achieving Health Equity in Preventive Services to assess the state of the science on equity in the use of clinical preventive services and develop a research agenda for moving the field forward.

After the workshop, we brought together representatives from eight NIH Institutes and Offices and seven federal agencies for a Federal Partners Meeting to discuss agency activities and resources relevant to the workshop and create an action plan. Participants identified opportunities for federal agencies to address many of the workshop panel’s recommendations (PDF), organized around four cross-cutting themes:

1. Integration of Services and New Delivery Models
2. Need for Innovative Methods
3. Community Engagement and Systems Approaches
4. Workforce and Training.

As we progress through that action plan, we’ve come to recognize that increasing the use of implementation science in the work done by the NIH, our federal partners, and researchers in the field will be a critical part of making progress toward health equity in preventive services.

Why focus on implementation science to improve health equity?

Applying implementation science concepts and methodologies has proven successful in increasing the adoption of many evidence-based practices. Implementation science identifies factors that make it harder or easier to achieve the uptake of evidence-based clinical innovations. We believe that linking health equity research with implementation science offers new possibilities for addressing the workshop panel’s recommendations and improving the use of evidence-based clinical preventive services.

What research is the NIH currently supporting in this area?

To better understand the ways in which implementation science is already being used to advance health equity research—and where it is still lacking—we conducted a brief review of the NIH’s research grant portfolio (PDF) using the NIH RePORTER database.

See full article here> 

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Children as young as 5 years old can now receive an updated COVID-19 booster following a decision by the Food and Drug Administration to expand its authorization of reformulated shots from Moderna and partners Pfizer and BioNTech. [Healthcare Dive] 

Moderna’s vaccine, which was previously cleared in adults 18 years and older, is authorized for use in children at least 6 years of age. Pfizer and BioNTech’s vaccine can now be used in children 5 years old and up, after previously being available for those 12 years or older. 

The FDA’s authorizations come a little less than three weeks after the companies submitted applications to expand use of their updated shots, which are adapted to better protect against the omicron variants that are currently most prevalent in the U.S. 

“Since children have gone back to school in person and people are resuming pre-pandemic behaviors and activities, there is the potential for increased risk of exposure to the virus that causes COVID-19,” Peter Marks, the head of the FDA’s Center for Biologics Evaluation and Research, said in a statement on the authorizations.

Full article here>

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After 'unprecedented" jump in 2020, firearm-related homicides increased another 8.3% last year.  

Rates of gun-related homicides and suicides both jumped by over 8% in 2021, and to levels not seen in 30 years, according to CDC data.

From 2020 to 2021, homicides involving firearms increased from 6.12 to 6.63 per 100,000, while gun-related suicides increased from 8.07 to 8.75 per 100,000, reported Thomas Simon, PhD, of CDC's National Center for Injury Prevention and Control, and colleagues, writing in the Morbidity and Mortality Weekly Report.

What's so concerning about these findings, said Simon, is that they follow on the back of an already "unprecedented" 35% increase in firearm homicides from 2019 to 2020. 

Full article here> 

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Evidence-based strategies should be implemented to eliminate the stigma and discrimination around mental health conditions, according to an extensive report from The Lancet Commission.[MedPage Today]

Group outlines six goals, including training for healthcare workers. 

The Commission's recommendations are intended for a broad cross section of stakeholders, including governments, international organizations, schools, public and private employers, and healthcare workers and their organizations, noted co-chair Graham Thornicroft, PhD, of King's College London, and more than 50 global colleagues in The Lancet.

Full article here> 

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During the height of the pandemic, 4 in 10 Americans misled others about their COVID-19 status or their adherence to public health measures designed to prevent the spread of the virus, according to a study published Monday in JAMA Network Open, a journal of the Chicago-based American Medical Association. [Chicago Tribune 10.10.2022]

Researchers found that about 42% of adults admitted they had engaged in some form of misrepresentation related to having COVID-19, vaccination or compliance with pandemic protocols. The results were based on a survey of more than 1,700 adults nationwide conducted in December 2021 — a time when coronavirus cases were surging across the country, including in the Chicago area.

Full article here> 

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Mental illnesses often go untreated, especially for people in racial/ethnic minority groups. Among U.S. adults with mental disorders, racial/ethnic minorities are only half as likely as Whites to get treatment; they are also more likely to drop out before completing their treatment. As a result, although they are less likely than Whites to have a mental disorder in their lifetime, racial/ethnic minorities have more severe cases of mental disorders.

There are multiple reasons why people with mental disorders may not get treatment. An NIMHD-supported study aimed to uncover some of these reasons among Asians, Blacks, Latinos, and Whites by using data from three nationally representative surveys conducted from 2001 to 2003. The data included survey responses from 1,417 adults with untreated mental disorders for 12 months. All individuals were interviewed to assess their conditions, including anxiety, substance use, and behavioral and mood disorders, ranging from mild to severe. The survey asked about reasons for not seeking treatment or for discontinuing treatment early. Some reported reasons were that the respondents wanted to handle the problems themselves, did not think their problems were severe, or did not believe that the treatment would work. Other reasons cited were that people could not afford or access treatment, especially in disadvantaged neighborhoods with fewer health providers.

The survey data showed that Latinos and Asians were more likely than Blacks and Whites to report that they received no treatment for mental disorders lasting 12 months. Latinos and Asians were also more likely to report that they did not think they needed treatment.

Full article here>

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