PI's Weekly Media digest: Secretive ACA repeal effort moves ahead, smoking rate gap widens by socioeconomic status, and EPA delays air pollution rule
The Washington Post covers what it calls “America’s new tobacco crisis,” the fact that while smoking rates in the US have fallen to historic lows, the socioeconomic disparity in who smokes and who doesn’t has widened dramatically. Among less-educated adults, the smoking rate is over 40%. “By nearly every statistical measure, researchers say, America’s lower class now smokes more and dies more from cigarettes than other Americans… This widening gap between classes carries huge health implications and is already reshaping the country’s battle over tobacco control. Cigarette companies are focusing their marketing on lower socioeconomic communities to retain their customer base, researchers say. Nonprofit and advocacy groups are retooling their programs for the complex and more difficult work of reaching and treating marginalized groups…” Meanwhile, the increasing invisibility of smoking and smokers in upper- and middle-class circles is drying up funding, interest, and political support for smoking cessation programs. “There’s this tendency now to blame the ones still smoking,” said Robin Koval, president of Truth Initiative, a leading tobacco-control nonprofit group. “The attitude is: ‘You’re doing it to yourself. If you were just strong enough, you’d be able to quit.’ ” What isn’t taken into account, Koval said, are the vast resources tobacco companies are spending to hold on to their last remaining strongholds. “Poorer people don’t smoke because anything’s different or wrong about them,” Koval said. “Their communities are not protected like others are. They don’t have access to good health care and cessation programs. If you have a bull’s eye painted on your back, it’s harder to get away.”
A small group of senators continue to work secretively on an ACA repeal bill. Senate Majority Leader Mitch McConnell’s strategy for passing the AHCA appears to hinge on misinformation about the bill’s consequences, as well as “sabotage, speed and secrecy” to take advantage of the distractions of a turbulent political landscape. Last week, Senator McConnell fast-tracked the AHCA, cutting out the committee process and blocking his Senate colleagues and the public from learning what’s actually in the bill until it’s too late. It’s even possible that the Senate will vote before the CBO score is released. The Senate version is expected to mirror the House version, which would cause 23 million people to lose health insurance, restructure Medicaid to cut benefits and beneficiaries, pare down health insurance benefits like maternity and newborn care, hike premiums for older and sicker people, defund Planned Parenthood, zero out the Prevention and Public Health Fund, and result in over a million jobs lost. Vox healthcare reporter Sarah Kliff describes the levels of “obstruction and lying” to mask the contents of the bill as unprecedented.
KQED reports on new data from the California Office of Statewide Health Planning and Development, which has found that emergency room visits by Medi-Cal patients have spiked by over 75% since the Affordable Care Act took effect. “The architects and proponents of Obamacare had argued that once people got health coverage they would stop going to the ER so much, because they could visit primary care doctors instead. But in reality, people who were uninsured before the ACA were actually reluctant to go to the ER unless they were “about to die,” because they would be saddled with big bills, said state Sen. Richard Pan (D-Sacramento), a pediatrician. Under Medi-Cal, though, patients aren’t worried about those expenses. And old habits die hard: A newly-insured patient accustomed to visiting the ER for treatment might not immediately switch to a primary care doctor who is, “just a name — not somebody you know,” Pan added. Still, experts believe fewer Medi-Cal patients would be visiting the ER if there were more doctors willing to treat them.” California ranks 47th in terms of fee-for-service reimbursements for doctors treating Medicaid patients. $465 million in California’s new budget, passed Thursday, would go toward boosting Medicaid reimbursement rates for doctors and dentists.
The East Bay Times reports that cancer-causing chemicals in local drinking water have increased in recent years, nearly exceeding federal public health standards.
According to the Guardian, the Environmental Protection Agency proposed delaying new air pollution rules for two years, dismissing risks to children’s health by saying: “Any impacts on children’s health caused by the delay in the rule will be limited, because the length of the proposed stay is limited. The agency therefore believes it is more appropriate to consider the impact on children’s health in the context of any substantive changes proposed as part of reconsideration.” … Environmental groups castigated the EPA over the delay, saying children would be at heightened risk from cancer-forming pollutants such as benzene if the rule were lifted. The regulation applies to about 18,000 oil and gas facilities in 22 states.
In an opinion piece for STAT, Harold J. Bursztajn suggests the selfie culture may not be all bad. He argues photos have the potential to heal, as he found in viewing the photos of Henryk Ross, who, with the help of his wife, Steffie, documented life in Lodz, Poland, under Nazi rule, a time and place where Bursztajn’s parents met. Bursztajn writes: “At a time when Nazi and Stalinist photographers were using their cameras to generate cold, impersonal images of dominance and superiority, Ross was using his to create images of everyday life in the ghetto that were brimming with compassion and mutual respect… In Ross’s hands, the camera became a creative, artistic, therapeutic instrument that empowered mental health.”
A series of drug overdoses in Georgia has prompted the state’s Attorney General Chris Carr to launch an investigation into drug manufacturers’ marketing and sales practices, according to the Daily Report, a legal news publication in Atlanta. "America's biggest drug problem isn't only on our streets, it is also in our medicine cabinets," he said in a press release. At least a half dozen deaths and a number of illnesses have been linked to a street drug that was reportedly being sold as the painkiller Percocet but apparently was another substance.
NJ.com reports that Gov. Chris Christie, who is heading the President’s commission on opioid abuse, wants to relax patient privacy laws in the case of people who overdose on drugs. Christie argues that there should be an option to notify a spouse, partner or parents when someone is revived from an overdose so that loved ones are alerted to the problem. The proposal raises concerns among those who believe that in all cases, it should be up to individuals to determine whether their medical information is released, especially to people other than healthcare providers.
Almost 16% of people over the age of 60 experience some kind of abuse, according to a WHO-funded report published in the Lancet Global Health. According to the report, which is based on 52 studies in 28 countries, more than 11% experienced psychological abuse, the most common problem. The study also looked at rates of financial abuse (6.8%), neglect (4.2%), physical abuse (2.6%), and sexual abuse (0.9%).
Top Michigan state health officials have been charged with involuntary manslaughter after people died from drinking contaminated water in Flint.
A shooting in Alexandria, Virginia, on Wednesday targeted GOP members of Congress and staffers as they practiced for a charity baseball game. The alleged shooter has a history of violence against multiple women.