PI's Weekly Media Digest: Projected cuts to violence prevention programs, the Women's March on Washington, health reform prospects
Violence and injury prevention
The Hill reported that Trump’s transition team is planning to cut $10.5 trillion in federal spending over the next 10 years, including eliminating 25 Violence Against Women grants totaling $480 million per year that are funneled through the Department of Justice. These grants include funding for state and tribal sexual assault prevention coalitions, family support in the justice system, protections for children who experience sexual violence, transitional housing, job training, and more. The proposed budget would also eliminate the Office of Community Oriented Policing Services and the Legal Services Corporation at the DoJ.
Health equity
The Women's March on Washington to protest the election and policies of Donald Trump has spread to all seven continents (a contingent of researchers will protest in Antarctica) and at least 57 countries. "The official platform the Women’s March on Washington released Friday places the demonstration in the context of not only suffragists and abolitionists but the civil right movement, the American Indian movement, and Black Lives Matter. Just two paragraphs into the four-page document, they note that “women have intersecting identities and are therefore impacted by a multitude of social justice and human rights issues.” Examples of this, including the especially urgent need for equal pay among women of color and the way they’re uniquely victimized by the criminal justice system, follow in the rest of the platform." The Women's March is also expected to be the largest protest gathering by people with disabilities in US history.
Alternet digs into voter suppression efforts underway across the country, including limiting early voting opportunities, limiting same-day voter registration, and requiring voter IDs.
Community environments
The New York Times waded into the debate over whether Supplemental Nutrition Assistance Program benefits should be allowed to cover sugary beverage purchases.
The CDC reported back on progress toward meeting the goals of the Healthy People 2020 campaign, with mixed findings -- smoking has fallen and physical activity rates have risen, but obesity among children and adults continues to rise.
A new report from the World Health Organization and National Cancer Institute finds that smoking and secondhand smoke cost the world more than $1 trillion and six million lives each year, with deaths projected to rise by more than a third in the next 13 years.
Via BMSG: “This piece from Vox uses statistics, examples and engaging graphics to explain the 21st century iteration of "white flight," and to point to inconsistencies in white Americans' assertions of wanting diversity and their housing decisions, which tell a different story.”
California
According to the Fresno Bee, "young and middle-aged whites in the Southern Central Valley are dying at an increasing rate, researchers said Wednesday at the release of a preliminary report that they said reveals a “health crisis of white death.” The rising death rates of whites in the counties, among the poorest in the state, are preventable and are “driven by acts of despair: drug overdoses, chronic alcohol abuse and suicide."
PoliticoPro reports that California has withdrawn its request for undocumented immigrants to be allowed to purchase health insurance through the Affordable Care Act, since the proposal was not approved by the time the Obama administration left office.
Mental health
A growing number of people resorted to hospital emergency departments to address mental health problems from 2006 to 2013, according to a recent brief from the Agency for HealthCare Research and Quality (AHRQ). ED visits for mental health concerns increased by more than 50% in the seven year period. According to the Healthcare Cost and Utilization Project (HCUP) brief, men from 45-64 years old were among the populations with largest increases in ED visits involving depression, anxiety or stress reactions. Increases in the rate of ED visits for both mental health and substance abuse problems were highest in communities with lower incomes, the study found. A National Academy for State Health Policy article notes that the study highlights the importance of reforms that help prevent and address mental health and substance use disorders before they result in ED visits, for example by better integrating mental health in primary care. The article also notes that the increases in the study took place before states expanded access to Medicaid under the Affordable Care Act.
An editorial in the New York Times examines the ripple effects of the opioid epidemic on children, from the baby who starved to death after his parents apparently overdosed, to the increase in children removed from their parents’ custody and placed in foster care. The growth mirrors a similar surge during the crack-cocaine epidemic.
People with mental health and substance abuse disorders, their families and providers are among the groups concerned about the potential repeal of the Affordable Care Act, USA Today reports: “The people helped the most by the ACA are the ones most likely to suffer from poor mental health and addiction. Nearly 30% of those who got coverage through Medicaid expansion have a mental disorder, such as anxiety or schizophrenia, or an addiction to substances, such as opioids or alcohol, according to the federal Substance Abuse and Mental Health Services Administration. That compares to the more than 20% of the overall population — 68 million people — who experienced a diagnosable mental health or substance abuse disorder in the past year, the American Psychiatric Association says.”
The US Drug Enforcement Administration is partnering with the Discovery Network and local and national coalitions to run Operation Video Challenge, a film contest to engage teenagers to make Public Service Announcements about opioid abuse.
The Fix reports that patients who have used prescription psychoactive drugs or have a history of mental health conditions have higher rates of opioid misuse, according to a study in the journal Pain.
Health systems transformation
Repealing the ACA would drain 12% of the CDC’s budget: “Removing the funding will mean less money for responses to outbreaks, less money to fight the opioid epidemic, less money to fight superbugs in hospitals, and less money for vaccination programs. It’ll also mean more scrambling for cash at already cash-strapped public health offices. “The indirect impact of the ACA repeal,” [Trust for America’s Health president] John Auerbach added, “is that the funding has to come from somewhere else.” In an interview with National Geographic, outgoing CDC director Tom Frieden warns against repealing the Prevention and Public Health Fund and speaks about the risk of running global health security on “one-time dollars.”
ASHTO’s Michael Frasier wrote a piece for The Hill urging lawmakers to keep the Prevention and Public Health Fund intact. TFAH released an analysis, including facts sheets for each state, that found the CDC would lose 12% of its annual budget if the PPHF is repealed, and states would lose more than $3 billion over five years from programs and grants supported by the fund. The analysis was covered by USA Today, and the Scientific American wrote about CDC and the PPPF. Tom Frieden said in an interview with National Geographic that he is worried about what will happen to CDC programs funded through the ACA if it is appealed.
Politico reports on a new CBO analysis saying Republican plans to repeal large parts of Obamacare would result in 32 million people losing health insurance and would double the price of insurance premiums within a decade. Specifically, “in the first year after repeal, 18 million people would lose insurance and premiums in the non-group market would spike by 20 percent to 25 percent, according to the CBO.”
PBS Newshour ran a piece on how the ACA enables healthcare providers to address SDOH and curbs costs by addressing the needs of high utilizers. Dr. Jeff Brenner of Camden Coalition of Healthcare Providers notes, “In America, we’re medicalizing social problems, and we’re criminalizing social problems, and we’re wasting huge amounts of public resources.” The piece focuses on intensive efforts to address social needs of patients, one patient at a time.