John Colbert

January 24, 2020

Trends Archives

QUICK STAT (SHORT, TIMELY, AND TOPICAL)

John Colbert

January 24, 2020

Trends Archives

Adult Physical Inactivity Prevalence Maps By Race/Ethnicity

According to new state maps of adult physical inactivity made available by the Centers for Disease Control and Prevention (CDC) in January 2020, all states and territories had more than 15% of adults who were physically inactive and the estimate ranged from 17.3 to 47.7%. Inactivity levels vary among adults by race/ethnicity and location. The data come from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing state-based, telephone interview survey conducted by CDC and state health departments. Maps use combined data from 2015 through 2018 and show noticeable differences in the prevalence of physical inactivity by race/ethnicity. Hispanics (31.7%) had the highest prevalence of physical inactivity, followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%). Non-Hispanic blacks and Hispanics had a significantly higher prevalence of inactivity than non-Hispanic whites in the majority of states.

Driving Under The Influence Of Marijuana And Illicit Drugs Among Persons Aged ≥16 Years—U.S.

Data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) indicate that in the United States during 2014, 12.4% of all persons aged 16–25 years reported driving under the influence of alcohol, and 3.2% reported driving under the influence of marijuana. This report provides the most recent national estimates of self-reported driving under the influence of marijuana and illicit drugs among persons aged ≥16 years, using 2018 public-use data from NSDUH. Prevalences of driving under the influence of marijuana and illicit drugs other than marijuana were assessed for persons aged ≥16 years by age group, sex, and race/ethnicity. During 2018, 12 million (4.7%) U.S. residents reported driving under the influence of marijuana in the past 12 months; and 2.3 million (0.9%) reported driving under the influence of illicit drugs other than marijuana. Driving under the influence was more prevalent among males and among individuals aged 16–34 years.

HEALTH TECHNOLOGY CORNER

Benefit To Patients Using Wearable Devices Such As Fitbit Or Health Apps On Mobiles

According to a study reported in the December 2019 issue of the American Journal of Medicine, wearable devices have become a standard health care intervention with emerging health care technologies. These devices are designed to promote healthy behaviors and decrease risk for chronic ailments, such as cardiovascular disease and diabetes. A systematic search of 550 articles revealed little indication that wearable devices provide a benefit for health outcomes. Only one study showed a significant reduction for weight loss among participants. No significant reduction was discovered in cholesterol or blood pressure. A conclusion reached is that current literature evaluating wearable devices indicates little benefit of these items on chronic disease health outcomes. Although wearable devices play a role as a facilitator in motivating and accelerating physical activity, current data do not suggest other consistent health benefits.

Light-Degradable Hydrogels As Dynamic Triggers For Gastrointestinal Applications

Different kinds of medical devices can be inserted into the gastrointestinal tract to treat, diagnose, or monitor GI disorders. Many of these items need to be removed by endoscopic surgery after their function has been performed. According to an article published on January 17, 2020 in the journal Science Advances, engineers at the Massachusetts Institute of Technology have developed a way to trigger such devices to break down inside the body when they are exposed to light from an ingestible light-emitting diode (LED). A potential advantage is that light can act at a distance and doesn't need to come into direct contact with the material being broken down. Also, light normally does not penetrate the GI tract, so there is no chance of accidental triggering. Light-triggerable hydrogels have the potential to be applied broadly throughout the GI tract and other anatomic areas. By demonstrating the first use of light-degradable hydrogels in vivo, biomedical engineers and clinicians are provided with a previously unavailable, safe, dynamically deliverable, and precise tool to design dynamically actuated implantable devices.

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DEVELOPMENTS IN HIGHER EDUCATION

John Colbert

January 24, 2020

Trends Archives

Supplementing the information provided on page three of this issue of the newsletter, it is worth noting that the appropriations portion of the bill for higher education programs provides $2.5 billion, an increase of $163 million above the 2019 enacted level and $941 million above the President’s budget request. For federal student aid programs, the bill provides $24.5 billion, which is $75 million above the 2019 enacted level and $1.5 billion above the President’s budget request. Within this amount, the bill furnishes $865 million for the Supplemental Educational Opportunity Grant (SEOG) program, $1.2 billion for Federal Work Study, and an increase to the maximum Pell grant to $6,345.

A report issued on December 10, 2019 by the Pew Charitable Trusts on how the U.S. has changed in key ways in the past decade indicates that nonwhites now account for the majority of the nation’s newborns, as well as the majority of K-12 students in public schools. More than half of newborn babies in the U.S. are racial or ethnic minorities, a threshold first crossed in 2013. Nonwhite students also account for the majority of the nation’s K-12 public school students. As of fall 2018, children from racial and ethnic minority groups were projected to make up 52.9% of public K-12 students. With the passage of time, these facts will have an enormous impact on higher education in general and on the health professions in particular. Future issues of the ASAHP newsletter TRENDS will serve as a vehicle for discussing how the education sector will be affected by these kinds of societal changes.

Costs Associated With Attending College

Year-over-year increases in college expenses have grown steadily in the U.S. since 1981. Although the Pell Grant Program also has expanded at regular intervals, the maximum does not align well with much higher tuition costs. Consequently, students and their families increasingly find it necessary to take out various kinds of loans. Beyond the day when degrees are awarded, the amount of debt borne by recent college graduates may delay the attainment of milestones associated with adulthood later in life, such as buying a house, getting married, and having children. The situation is even more gloomy for students who have incurred substantial debt, but never ended up graduating from college.

A report made available on December 31, 2019 from the National Center for Education Statistics (NCES) describes four measures of the price of undergraduate education in the 2015–16 academic year: total price of attendance (tuition and living expenses), net price of attendance after all grants, out-of-pocket net price after all financial aid, and out-of-pocket net price after all aid excluding student loans. Estimates are based on the 2015–16 National Postsecondary Student Aid Study, a nationally representative survey of students enrolled in postsecondary institutions in the 50 states, the District of Columbia, and Puerto Rico. The total price of attendance consists of tuition and nontuition expenses (fees, books, supplies, transportation, and living expenses )., For example, full-time students at public two-year institutions had the lowest average total price of attendance at $16,100 in 2015-16. The average total price of attendance was higher at public four-year institutions ($26,900), higher still at for-profit institutions ($32,600), and highest at private non-profit four-year institutions ($48,000). The percentage of students with loans was greatest at private for- profit schools (74%) and lowest at public 2-year institutions (20%).

Opposition To Student Loan Forgiveness Rule

Congressional Democrats aim to prevent implementation of a Department of Education policy that would make it more difficult for federal student loan borrowers to cancel their debt based on misconduct by any college. Set to take effect on July 1 of this year, the Trump administration policy that was finalized last year establishes more stringent rules for when the government will wipe out the debt of students claiming they were misled or deceived by a higher education institution. Democrats are using the Congressional Review Act, a tool that allows Congress to stop recently enacted regulations with a simple majority in both chambers and the president's signature.

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HEALTH REFORM DEVELOPMENTS

John Colbert

January 24, 2020

Trends Archives

Approximately 18% of the U.S. economy, the largest in the world, is represented by the health sector, which suggests that there always will be something occurring within that domain that will prove to be newsworthy. Typical stories in the media and relevant topics in policy discussions revolve around the central issues of cost, quality, and access. The last item is guaranteed to continue to attract significant attention as long as there are any individuals in this country who lack health insurance coverage.

The Patient Protection and Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. Usually referred to as either the ACA or Obamacare, this key piece of legislation has been in the news since its various provisions began to unfold. Its enactment was supported wholly in Congress by Democrats in both legislative chambers, without a single Republican vote. That outcome alone essentially assured that the years ahead would be marked by strenuous efforts to repeal and replace its most important features either in whole or in part. Republicans came close to repealing the ACA in 2017 when they were the majority in both the House and the Senate and President Donald Trump occupied the White House, but the attempt did not meet with success, albeit by a close margin. Failure in Congress did not mean that opposition fervor would be diminished, however, as repeal efforts then shifted to the judicial arena.

Repeal Of the Individual Mandate Penalty Set The Stage For Repeal Of The ACA

As part of a successful attempt to overhaul U.S. tax law aimed at energizing the economy, Republicans were able to zero out the individual mandate penalty in 2017. Once that happened, they insisted that a mandate stripped of its penalty for not purchasing health insurance meant the provision no longer was enforceable and could not be considered as being constitutional. Because the mandate is viewed as being such an essential component of the Affordable Care Act, eliminating it led to a claim that the entire law now should be struck down. A federal district court in Texas subsequently declared the ACA invalid in December 2018.

Twenty-one Democratic attorneys general and the House of Representatives then appealed this ruling to to the Fifth Circuit. That court partially affirmed the district court in 2019 in a 2–1 decision, agreeing that the mandate absent a penalty is unconstitutional. Significantly, this narrow majority ruling did not include what should be done with the ACA as a whole. Instead, the case was remanded back to the Texas district court for a more complete severability analysis. A main issue awaiting resolution is whether the mandate can be severed from the ACA, leaving the rest of the law to continue to be constitutional. Meanwhile, the Democratic attorneys general have appealed the ruling by the Fifth Circuit to the U.S. Supreme Court. Whether it will accept the case and deal with it in 2020 is unknown at this juncture.

PCORI Remains In Effect While Some ACA Taxes Are Repealed

The Patient-Centered Outcomes Research Institute (PCORI) was established by the ACA to promote comparative effectiveness research to assist patients, clinicians, purchasers, and policymakers in making informed health decisions. Although it enjoyed widespread support from the time of inception, detractors viewed it as a politically-driven program with attendant dangers associated with central planning. During 2019, there was some opposition to reauthorizing PCORI. Instead, the Institute enjoyed bipartisan support and its funding was reauthorized for 10 years as part of appropriations legislation described on page three of this issue of the newsletter.

That same appropriations package affected the ACA in other important ways. Members of Congress fully repealed the health insurance tax beginning in 2021, along with the so-called Cadillac tax on beneficiaries who have expensive insurance policies, and the medical device tax beginning in 2020. Repeal of the medical device tax always enjoyed bipartisan support because many states have companies affected by it. A potential downside is that these taxes were intended to cover the costs of expanding health insurance coverage under the law. It is estimated that repealing them will result in the loss of approximately $400 billion in revenue over the next ten years.

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LABOR-HHS FUNDS ALLOCATED FOR FY 2020

John Colbert

January 24, 2020

Trends Archives

It is characteristic in any given year for Congress to be unable to complete work in the area of appropriations in time for necessary funds to be made available for the start of a new fiscal year each October 1. Instead, a series of short-term continuing resolutions (CRs) are implemented so that government functions can continue to operate. The year 2019 was no exception to this sequence of events. Even until late December when a CR was about to expire, there was no firm assurance that another one one would not be necessary.

Nevertheless, the holiday season proved to be a happier one as agreement was reached on how much funding to provide for a wide range of entities that come under the umbrella of the Departments of Labor, Health and Human Services, Education, and Related Agencies, which commonly are referred to as Labor-HHS. That piece of legislation was one of eight large bills that made up one minibus package (four national security bills made up another minibus package). The Labor-HHS bill included $184.9 billion in discretionary funding, an increase of $4.9 billion over the 2019 enacted level and $43 billion over the President’s 2020 budget request.

The Department of Health & Human Services (HHS) was allocated $94.9 billion, an increase of $4.4 billion above the 2019 enacted level and $16.8 billion above the President’s budget request. The largest increase, $2.6 billion, went to the National Institutes of Health. HRSA (the Health Resources & Services Administration) obtained $7.04 billion, a $193 million increase over the FY 2019 level. Within HRSA, Title VII health professions programs received $424.5 million, a $32.3 million increase over the FY 2019 level, and the Health Careers Opportunity Program was funded at $15 million. The Department of Education was awarded a total of $72.8 billion in discretionary appropriations, which was $1.3 billion above the 2019 enacted level and $8.7 billion above the President’s budget request, with the maximum Pell grant increasing to $6,345.

Moving forward, it is unclear to what extent any meaningful legislation involving social determinants of health, surprise billing, drug pricing, and lowering health care costs will be approved by Congress in 2020. One possible impediment to meaningful action is the necessity of having a trial in the Senate now that House officials have transmitted two articles of impeachment. Once the trial begins, its length could depend on whether both impeachment supporters and opponents agree to allow witnesses to testify. Also, a national election next November will contribute to a compression of the legislative calendar. Apart from determining the outcome to elect a U.S. President, all House members and one-third of the Senate who wish to remain in office must face the voters. As the time of the election approaches, campaign activities necessarily must take precedence over legislative business.

A related consideration is that even in the best of times, the nature of certain pieces of legislation will preclude any rapid action. The Higher Education Act (HEA), to cite one key illustration, last was reauthorized in 2008. That authorization expired in 2013. Now that almost seven years have elapsed and several hearings have been conducted, apart from separate bills currently being championed by members of the House and Senate, the prospect of reaching agreement any time soon does not appear to be on the near horizon.

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PRESIDENT’S CORNER

John Colbert

January 24, 2020

Trends Archives

BY ASAHP PRESIDENT PHYLLIS KING

Interprofessional Education and ASAHP – Fostering a Culture of Collaboration

The Association of Schools Advancing Health Professions (ASAHP) has a strong commitment to improving collaboration and outcomes in health care by supporting Interprofessional Education (IPE). Through the leadership of Immediate Past President Susan Hanrahan, ASAHP’s commitment to IPE in both the academic and clinical learning environments has grown significantly and gained clarity over the past two years.

ASAHP’s interprofessional identity comes from both its structure and its actions. We built off these strengths identifying that interprofessional collaboration threads throughout all aspects of ASAHP. The dedicated section on IPE in the Journal of Allied Health has grown in popularity and impact. ASAHP continued its engagement as members of the Interprofessional Education Collaborative (IPEC) Council, the National Academies of the Sciences, Engineering and Medicine Global Forum on Innovation in Health Professional Education, and the Health Professions Accreditors Collaborative (HPAC). ASAHP’s Annual Meeting has been recognized by the American Interprofessional Health Collaborative (AIHC) as an Affiliate Conference in 2018 and 2019.

ASAHP also engages academic institutions, governmental and industry partners to translate interprofessional education to improve society by addressing workforce readiness, health outcomes and social determinants of health. We sponsored the inaugural ASAHP Summit in 2018 to bring together a diverse group of key stakeholders in dialogue to address issues regarding IPE, collaborative practice and work-force readiness. The 2019 Summit teamed up with ASAHP’s Clinical Education Task Force to conduct an on-campus event at Saint Louis University where representatives from academia and industry engaged in conversation regarding the CETF’s recommendations and co-creating action steps moving forward.

In 2018, ASAHP also started to recognize best practice in IPE through a new “ASAHP Excellence and Innovation in Interprofessional Education and Collaborative Health Care” award. This provided a mechanism for sharing model initiatives from our members by highlighting institutions for excellence in interprofessional collaboration. Texas Tech University Health Sciences Center and Indiana University Purdue University at Indianapolis were honored with the award in 2018 and 2019 respectively. Additionally, three ASAHP member institutions were recognized as “Programs of Merit” each year.

The upcoming ASAHP board strategic planning meeting will no doubt address how we advance IPE initiatives to leverage our identity and our commitment to quality improvement in health care through interprofessional collaboration. ASAHP has a unique combination of attributes that other organizations strive to achieve with our institutional and industry membership, leadership development/networking, international outreach, student engagement, well-regarded journal, and vibrant annual meeting. We look to accelerate our current momentum with a continued commitment to innovation, excellence and impact.

ASAHP is well-positioned to emerge as a leader nationally in IPE and collaborative practice.

Anthony Breitbach PhD, ATC, FASAHP
Professor/Director, Athletic Training
Saint Louis University

Phyllis King PhD, OT, FAOTA, FASAHP
President, ASAHP

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RESOLVING NETTLESOME HEALTH POLICY DISPUTES

John Colbert

January 24, 2020

Trends Archives

Controversies often are involved when initiatives are undertaken to arrive at the best approach to gaining wide acceptance of proposals involving contentious public policy issues, such as gene editing, euthanasia/assisted dying, and recreational use of marijuana products. A basic question pertains to deciding whom to involve in making decisions that enable these policies to move forward. Three possible groups are: elected public officials; health scientists and other experts in fields, such as ethics; and voters, along with other concerned members of the general public.

To note just one example, President William Clinton, along with British Prime Minister Tony Blair, announced at the White House on June 26, 2000 that the international Human Genome Project and Celera Genomics Corporation both had completed an initial sequencing of the human genome, the genetic blueprint for human beings. This landmark achievement was hailed as promising to bring exciting new approaches to prevent, diagnose, treat, and cure disease. Since that widely heralded occasion, germline gene editing provides a vivid illustration of a current topic that has emerged as a serious concern because of its potentially grave threat to the health of future generations.

Netflix offered a four-episode documentary series in October 2019 entitled “unnatural selection” as a means of furnishing an overview of genetic engineering, with an emphasis on the DNA-editing technology of CRISPR (clustered regularly interspaced short palindromic repeats) from the perspective of scientists, corporations, the public, and biohackers tinkering in garages. Apart from the goal of editing genes to eradicate certain diseases or even to produce so-called designer babies who will possess enhanced abilities (e.g, intellectual, artistic, and athletic), it should be obvious that there are great amounts of money to be made by entrepreneurs able to reach the finish line first with the most effective products.

The problem currently is that: some envisioned new gene therapies may not improve human lives, various species may be at risk of changing in unforeseen ways or perhaps even being eliminated, and assurance still is lacking on whether desired sought after improvements ever will materialize. The Netflix episodes feature discussions with (1) residents of Nantucket Island in Massachusetts who are apprised of a proposal to modify a species of mice affected by ticks that cause disease among humans, (2) inhabitants of New Zealand where rats are killing off many breeds of birds, and (3) villagers in Burkina Faso, Africa where mosquitos continue to cause children to die from malaria.

In all three settings, the notion of Gene Drive to change an entire species to achieve a purported social good encounters resistance. A major concern is that apart from positive outcomes that are touted by proponents of genetic interventions, it remains worrisome that no firm guarantees can be offered regarding possible unanticipated, dangerous outcomes that might occur. While members of the general public may lack the sophisticated knowledge of scientific experts, their basic instincts make them wary of approving proposals that are equivalent to attempting to play God.

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HOUSING DISCRIMINATION AND RACIAL CANCER DISPARITIES

John Colbert

November 25, 2019

Trends Archives

In areas with greater mortgage discrimination, the gap between black and white cancer mortality rates was larger (correlation coefficient [r] = 0.32; P = .001). This relationship persisted in sex‐specific analyses (males, r = 0.37; P < .001; females, r = 0.23; P = .02) and in models controlling for confounders. As described in the November 1, 2019 issue of the journal Cancer, mortgage discrimination is associated with larger black‐to‐white cancer mortality disparities. Some areas are exceptions to this trend. Examination of these exceptions and of policies related to housing discrimination may offer novel strategies for explaining and eliminating cancer disparities. Racial cancer disparities represent a substantial proportion of the overall mortality disparity between blacks and whites and are a major consideration in the provision of clinical care and public health practice and policy. In 2010, cancer accounted for 17% of the life‐expectancy gap between black and white populations, second only to heart disease for women, and, for men, third, also after homicide. A higher chance of mortgage application denial for black applicants tends to reduce black home ownership and increase the likelihood of renting. As opposed to being able to purchase, renting results in a reduced ability to accumulate home equity—a primary source of wealth—which may limit resources available to offset the financial burden of cancer.

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WHY AN INSECT APOCALYPSE MATTERS

John Colbert

November 25, 2019

Trends Archives

In the grand cosmological scheme, insects although being relatively small and occasionally quite annoying, it is highly unlikely that the human species could survive without them. In marked contrast, the Anthropocene (the current geological age, viewed as the period during which human activity has been the dominant influence on climate and the environment) may be characterized as placing a much larger focus in the form of conservation efforts and public attention on big, charismatic mammals and birds, such as tigers, pandas, and penguins. Nevertheless, the bulk of animal life, whether measured by biomass, numerical abundance, or numbers of species, consists of invertebrates such as insects. According to a paper appearing in the October 7, 2019 issue of the journal Current Biology, recent studies from Germany and Puerto Rico suggest that insects may be in a state of catastrophic population collapse. German data describe a 76% decline in biomass over 26 years, while the Puerto Rican study estimates a decline of between 75% and 98% over 35 years. Corroborative evidence suggests that such declines are not isolated. Causes are much debated, but almost certainly include habitat loss, chronic exposure to pesticides, and climate change. The consequences are clear. Insects are integral to every terrestrial food web, being food for numerous birds, bats, reptiles, amphibians, and fish, and performing vital roles such as pollination, pest control, and nutrient recycling. Also, terrestrial and freshwater ecosystems will collapse without insects.

Occasionally, this ASAHP newsletter has served as a vehicle for demonstrating how humans stand to benefit from research involving other species. An article published on October 22, 2019 in the journal eLIFE discusses, for example, how ants, despite their behavioral simplicity, have managed the tour de force of avoiding the formation of traffic jams at high density. At the macroscopic level, ant traffic is best described by a two-phase flow function. At low densities there is a clear linear relationship between ant density and the flow, while at large density, the flow remains constant and no congestion occurs. From a microscopic perspective, the individual tracking of ants under varying densities revealed that ants adjust their speed and avoid time consuming interactions at large densities. The results point to strategies by which ant colonies solve the main challenge of transportation by self-regulating their behavior. Humans and ants are among the few species that engage in two-way traffic. Maintaining a smooth and efficient traffic flow while avoiding collisions is challenging for humans while ants seem to be masters of traffic management. They efficiently can move back and forth between their nests and food without overtaking or passing each other, forming a steady stream of traffic. Studying ant traffic management has been a source of inspiration for scientists working with large groups of interacting particles in many fields, including molecular biology, statistical physics, and telecommunications. It also has relevance for managing human traffic, particularly as scientists and engineers develop autonomous vehicles that might be programmed to work together cooperatively as ants.

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AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY

John Colbert

November 25, 2019

Trends Archives

Dialogue About The Workforce For Population Health Improvement

The Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine on March 21, 2019 convened a one-day workshop to explore the broad and multidisciplinary nature of the population health workforce. The event included speakers from professional and accrediting organizations, community health workers, supervisors, and policy experts and featured national and local examples of cross-sectoral collaboration to advance population health. The main objectives of the workshop were to explore the following topics that resulted from the Statement of Task for the workshop: (1) Facilitating a population health orientation/perspective among public health and health care leaders and professionals; (2) Framing the work of personnel such as community health workers (CHWs), health navigators, and peer-to-peer chronic disease management educators within the context of population health; and (3) Leveraging the competencies of public and private sector workforces, such as education, transportation, and planning, that are working to include a “health in all policies,” community livability, or well-being orientation in their activities. Workshop proceedings can be obtained here.

Economic Consequences Of Millennial Health

A new report by Moody’s Analytics revealed the serious impact millennials' health could have on the U.S. economy. Compared to when Generation X was the same age, millennials are projected to experience slower economic growth and pay more in health care costs over the next decade, which could have a crippling effect on the economy. Two different scenarios of millennial health and what the impact may be over the next decade are described in the study. If millennial health continues to decline and goes unaddressed over the next 10 years, the report predicts that in comparison to Gen Xers at the same age, millennials may experience some of the following outcomes: Health care treatment costs could rise as much as 33%; Mortality rates could rise as much as 40%; and Millennials’ annual income may, on average, be reduced by as much as $4,500 per person, as poor health will likely lead to job loss or reduced working hours. Moody’s Analytics analyzed the Blue Cross Blue Shield Health Index SM, which quantifies more than 300 health conditions to identify which may affect Americans’ longevity and quality of life. It is powered by annual data from more than 41 million commercially insured Blue Cross and Blue Shield (BCBS) members nationwide. The report can be obtained here.

Driving Toward Age-Friendly Care For The Future

The concept of age-friendly health systems resonates with most older patients and their caregivers, especially patients with multiple chronic conditions, according to a survey by WebMD released by the John A. Hartford Foundation. In general, caregivers perceived the older adults they cared for as having more chronic conditions. Age-friendly health systems focus on prioritizing the “4Ms” of care: what matters to patients; promoting mobility; ensuring medications do not interfere with quality of life; and treating dementias, depression and other mentation-associated conditions. Age-friendly health systems require attention to what matters to older individuals and their caregivers in order to ensure high-value care resulting in consumer satisfaction. The good news is that 87% of the more than 2,700 respondents to this survey of older adults and family caregivers report satisfaction with the care they have received in the past 12 months. This high satisfaction, however, has some caveats. For instance, it decreases as a patient’s health becomes more complicated and the number of health conditions increase. Survey results can be obtained here.

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QUICK STAT (SHORT, TIMELY, AND TOPICAL)

John Colbert

November 25, 2019

Trends Archives

Adolescents’ Engagement With Unhealthy Food And Beverage Brands On Social Media

According to an article in the latest issue (March 2019) of the journal Appetite, which still is in progress, 70% of adolescents reported engaging with any food/beverage brands on social media and 35% engaged with 5 + brands. Non-Hispanic Black and less-acculturated Hispanic adolescents were more likely than non-Hispanic White adolescents to engage with brands. Approximately one-half reported engaging with brands of fast food (54% of participants), sugary drinks (50%), candy (46%), and snacks (45%), while just 7% reported engaging with all other categories of food/beverage brands. Watching television more than 2 hours-per-day was associated with any brand engagement; while using other screens more than 2 hours-per-day was associated with following 5 + brands. The study surveyed U.S. teens in the age bracket 13-17 about their engagement (liking, sharing, or following) with food and beverage brands on social media, such as Facebook; their time spent watching TV and other screens (cellphones); and demographic characteristics.

Emergency Department Visits For Sport And Recreational Activity Injuries

National Health Statistics Reports on November 15, 2019 indicates that during 2010–2016, approximately 2.7 million annual ED visits for sports injuries were made by patients aged 5–24 years. The top five most frequent activities that caused ED visits for sports injuries were football (14.1%), basketball (12.5%), pedal cycling (9.9%), soccer (7.1%), and ice or roller skating or skateboarding (6.9%). Visits caused by playing football and basketball accounted for a higher percentage of visits by males than females (20.2% compared with 2.2%, and 14.3% compared with 8.9%, respectively), whereas visits caused by gymnastics and cheerleading accounted for a higher percentage of visits by females (11.8% compared with 2.1%). Visits for injuries to the upper extremities decreased with increasing age (37.1% for those aged 5–9 to 27.4% for those aged 20–24), whereas visits for injuries to the lower extremities increased with increasing age (16.2%) for those aged 5–9 to 41.0% for those aged 20–24).

HEALTH TECHNOLOGY CORNER

3D Bioprinting Of A Vascularized And Perfusable Skin Graft Using Human Keratinocytes

Researchers at Rensselaer Polytechnic Institute have developed a way to 3D print living skin, complete with blood vessels. The advancement, published online in the journal Tissue Engineering Part A on November 1, 2019 is considered a significant step toward creating grafts that are more like the skin that human bodies produce naturally. Presently, whatever is available as a clinical product is similar to a fancy Band-Aid, according to investigators participating in the study, because although it may provide some accelerated wound healing, it eventually just falls off and never really integrates with the host cells. A significant barrier to that integration has been the absence of a functioning vascular system in the skin grafts. More work will need to be done to address the challenges associated with burn patients, which include the loss of nerve and vascular endings. The grafts this study’s team has created bring researchers closer to helping individuals with more discrete issues, such as diabetic or pressure ulcers.

Jointly Optimized Microscope Hardware For Accurate Image Classification

Since its invention, the microscope has been optimized for interpretation by a human observer. With the recent development of deep learning algorithms for automated image analysis, there now is a clear need to re-design the microscope’s hardware for specific interpretation tasks. To increase the speed and accuracy of automated image classification, according to an article published on December 1, 2019 in the journal Biomedical Optics Express, engineers at Duke University present a method to co-optimize how a sample is illuminated in a microscope, along with a pipeline to classify automatically the resulting image, using a deep neural network. They demonstrate how their learned sensing approach for illumination design automatically can identify malaria-infected cells with up to 5-10% greater accuracy than standard and alternative microscope lighting designs and show how the new procedure can translate across different experimental setups while maintaining high accuracy.

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DEVELOPMENTS IN HIGHER EDUCATION

John Colbert

November 25, 2019

Trends Archives

November 20, 2019 marked the occasion for the release of data on first-year earnings of college graduates according to the academic programs in which they matriculated that are broken down for the first time by program level. Derived from federal tax data, information can be obtained for more than 40,000 programs, showing that median debt exceeded median first-year earnings by more than $1,000 for 6,520 of them.

A dollars and cents analysis should be of value as families decide how much they are willing to invest in programs that ultimately could lead to financial outcomes commensurate with the amount of money spent to obtain proper academic credentials needed for entry into the employment market. A potential downside is that decisions will be made that displace passion in order to acquire more earthly gains in the form of future salaries. A job provides one kind of satisfaction while having a passion for a particular field produces a feeling of satiety and self-fulfillment of a quite different nature. Students and their families must cope with the difficulty of deciding whether to pursue academic preparation in a field that one loves, which may not pay well later on, for an alternative that may be much less interesting, but substantially more remunerative.

Student Assistance, Recognition Of Accrediting Agencies, And State Agency Procedures

The Secretary of the U.S. Department of Education (USDE) on November 1, 2019 amended regulations governing the recognition of accrediting agencies, certain student assistance general provisions, and institutional eligibility, as well as making various technical corrections. The revised regulations continue the emphasis on accountability that has been characterizing federal involvement in accreditation, and providing additional opportunity for accreditation to embrace innovation, along with some streamlining of federal recognition (the periodic review of accreditation). Revised regulations addressing accountability: (1) Increase expectations by USDE concerning student achievement through the collection and analysis of key data and indicators, including institution’s or program’s performance and measures of student achieve- ment; (2) Require more transparency on regional accreditor websites regarding the states in which the organizations operate; (3) Mandate institutional disclosure to accreditors of any law enforcement actions or prosecutions that lead to adverse action; and (4) Protect students through enhanced institutional disclosure requirements about whether programs lead to licensure or qualification to sit for a licensing exam.

Revised regulations addressing innovation: (1) Provide more flexibility for innovation for institutions and accrediting organizations by encouraging accreditors to establish different methods of monitoring institutional success and provide opportunities for experimentation; (2) Open the door to student aid for non-institutional educational offerings from colleges and universities, including partnerships with alternative providers; (3) Provide a simpler path for new accrediting organizations to gain recognition to give priority to student needs and outcomes rather than traditional measurements; and (4) Enable more dual enrollment opportunities through flexibility in standards allowing high school teachers in certain circum- stances to teach these courses.

State Authorization of Distance and Correspondence Education regulations also have been updated and streamlined. The revisions make clear an institution’s responsibilities and the role of State reciprocity agreements while ensuring students have the information they need to make informed decisions. States that join a reciprocity agreement can no longer layer additional State higher education authorization requirements on institutions that participate, but can continue to apply other State laws and regulations that apply to all entities doing business in a State. The final regulations will provide students with more options to pursue a higher education credential of value, transfer credits between institutions, and qualify for career advancement.

Most provisions in the final rule are scheduled to take effect on July 1, 2020. Sections that include State Authorization were effective November 1, 2019. Sections that modify the timeline that accrediting organizations are to follow to become federally recognized will be effective on July 1, 2021.

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HEALTH REFORM DEVELOPMENTS

John Colbert

November 25, 2019

Trends Archives

Political campaigns for elected office can be exhaustive affairs for voters, particularly when they occur in months and even more than one year in advance of an election. A more optimistic view of the matter suggests, however, that these contests are enormously valuable in shedding light on the nature of important social issues and how best to address them.

Health care represents close to 20% of the U.S. economy, the largest in the world. Even when healthy, individuals want to know they are protected to a great extent from the ravages of illness and disease by being able to have insurance coverage. In its simplest form, they want to derive comfort from knowing that cost will not inhibit them from obtaining the care that they need when they need it from the providers they wish to furnish treatment.

Presently, several candidates are competing to determine which one will secure the nomination for the presidency in 2020. Rightfully so, they focus much of their potential electability in the eyes of voters on how they plan to address health care issues in this country. Proponents of a Medicare For All initiative promise to offer an extensive range of benefits by the government at no cost to patients. Their appeals differ on the basis of details, such as the time needed to implement the new program and how to pay for it. Other candidates stress the need to maintain a system of private insurance coverage.

As debates continue to unfold, policy analysts who support as well as those who oppose such proposals weigh in with their respective critiques of what is being touted as an overhaul of a a remarkably complex system. An advantage of their doing so is that a clearer picture emerges of whether ideas currently being proposed will represent either an improved or perhaps even a worse future arrangement.

Hospital Compare Data On Quality

November 4, 2019 began a 30-day preview period for hospitals to see the data that will be reported publicly on Hospital Compare next year. As part of the Inpatient Psychiatric Facility Quality Reporting (IPFQR), Hospital Inpatient Quality Reporting (IQR), Hospital Outpatient Quality Reporting (OQR), and Prospective Payment System (PPS)-Exempt Cancer Hospitals Quality Reporting (PCHQR) programs, hospitals have 30 days to preview their data prior to public reporting on Hospital Compare. As part of this preview, hospitals (excluding cancer hospitals) also will see an updated Overall Hospital Quality Star Rating that publicly will be reported on Hospital Compare next year.

Hospital Price Disclosure Rule

On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) finalized policies that follow directives in President Trump’s Executive Order, entitled “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” that lay the foundation for a patient-driven healthcare system by making prices for items and services provided by all hospitals in the United States more transparent for patients so that they can be more informed about what they might pay for hospital items and services.

CMS is finalizing the proposal to define hospital “items and services” to mean all items and services, including individual items and services and service packages, that could be provided by a hospital to a patient in connection with an inpatient admission or an outpatient department visit for which the hospital has established a standard charge. Examples of these items and services would be supplies, procedures, room and board, use of the facility and other items (generally described as facilities fees), services of employed physicians and non-physician practitioners (generally reflected as professional charges), and any other items or services for which a hospital has established a standard charge.

It is highly likely that the hospital industry will mount a legal challenge to the imposition of this rule. At issue is a requirement that hospitals make public the rates they negotiate with insurers for all services.

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MASS MEDIA FOCUS ON CAPITOL HILL

John Colbert

November 25, 2019

Trends Archives

Recent weeks have involved an enormous amount of attention on Capitol Hill by the mass media, primarily due to events involving an effort to impeach President Donald Trump. Whatever the outcome of an attempt to unseat him as the White House’s occupant, a significant amount of important business continues to be pursued by members of both the Senate and the House of Representatives. Funding for key governmental operations is on temporary hold until disagreements can be resolved about what to fund and for what amounts.

Unable to complete business by the start of a new fiscal year on October 1, a continuing resolution (CR) was used to maintain operations until November 21. Recognizing that much appropriations business remains unfinished, members of both the House and Senate approved a second continuing resolution (CR) to fund the federal government through December 20. President Trump signed it on November 21.

The Patient Protection and Affordable Care Act of 2010 (ACA) resulted in the creation of the Patient-Centered Outcomes Research Institute (PCORI). As an example of that agency’s operations, on November 19 of this year its Board of Governors approved $70 million to fund 21 studies and related projects designed to improve care for health conditions that impose high burdens on patients, their families, and the healthcare system. Eighteen of the awards, totaling about $65 million, will fund studies comparing the most effective ways to treat a range of illnesses and health conditions. Three of these investigations focus on health issues of concern to older adults—two on hearing loss and one on safer prescribing of glucose- lowering drugs for individuals with Type 2 diabetes. Three other studies focus on children’s health issues; two seek to improve treatment of anxiety in children and adolescents; and one seeks to prevent obesity among preschoolers in rural, underserved areas.

Many federal initiatives, such as the Higher Education Act (HEA) and PCORI must be reauthorized at stated intervals to continue operating. Even when they no longer are authorized, there is pressure to enable them to continue functioning because of the essential functions that they perform. Some programs tend to be more vulnerable than others, however, and there always is a risk that an unauthorized entity could be eliminated. For example, the past few decades have involved several attempts to jettison the Agency for Healthcare Research and Quality. A way of reducing such danger is to seek the enactment of reauthorization legislation. A step in that direction was launched on November 19, 2019 with the introduction of S. 2897, a measure to reauthorize PCORI in order to boost research into health care costs.

Even when legislators agree on the importance of existing programs, technical difficulties can obstruct further progress. A case in point is funding for historically black colleges and other minority-serving institutions, which recently expired. Both Senate Republicans and Democrats support reauthorizing $255 million a year, but cannot agree on the best mechanism for doing so. A Republican proposal is to furnish permanent funding by including the measure in reauthorization of the Higher Education Act (HEA), which has not been reauthorized for the past six years. Critics among Democrats object to holding this form of support as hostage in a much larger bill that is not destined to go anywhere soon because of its complex nature.

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PRESIDENT’S CORNER

John Colbert

November 25, 2019

Trends Archives

BY ASAHP PRESIDENT PHYLLIS KING

A New....

Decade (2020 – 2029)

Association Name (Association of Schools Advancing Health Professions)

President (Phyllis King)

Strategic Plan (2020 – 2025)

I am honored, eager, and ready to serve ASAHP as your new President. Past leadership has positioned the Association well from a staffing, budget, and leadership perspective to enable the Association to sustain effective practices and take on new initiatives that advance and enhance the Association’s mission and vision. Special appreciation goes to Susan Hanrahan and the board for their great work.

The ASAHP Board is holding a strategic planning retreat in January. We will revisit what strategies and initiatives have and are serving the Association well, and what new actions should be taken to meet the needs of the Association in a rapidly changing environment. The outcomes of this retreat will be shared with the membership for feedback and endorsement. We will welcome your volunteerism to support the new plan.

Ongoing activities currently include tweaking the Institutional Profile Survey for administration to institutions in 2020, planning for the 2020 Leadership Development Program (applications are now being accepted for participants), generating publications and presentations on Interprofessional Education, surveillance and engagement in federal and legislative policies and actions affecting health care education, research and practice, advancing the work of the International Task Force and Tri-Alliance to develop a global rehabilitation health worker certification in rehabilitation, and supporting Alpha Eta.

The future of health and health care will likely be driven by digital transformation. Exponential change and innovations in healthcare practice will continue. I invite you to join me in embracing change and designing our destiny. This will require activism, engagement, education, strategy, and partnerships. Together we can do this!

I wish you a safe and joyous holiday season.

Phyllis King

Get to know your President here.

Photos of the Board of Directors can be obtained here.

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TECHNOLOGICAL IMPERATIVE CHALLENGES

John Colbert

November 25, 2019

Trends Archives

A technological imperative is just one of many conceptual tools (e.g., economic, preventive, and epidemiological) that offer a convenient framework for considering the health care realm. Readers of Victor Hugo’s novel Notre-Dame de Paris may recall his vivid characterization of the hunchback Quasimodo. It is less likely, however, that there will be any similar recollection of a depiction in the book of cathedral archdeacon Claude Frollo, whose famous slogan was “Ceci tuera cela” (This will kill that), which occurred to him as he touches a printed book while glancing nostalgically at the church towers. “This” (signifies the book), while “that” (represents the medieval cathedral and the entire world it symbolizes).

What Frollo had in mind is the disruptive potential of technological innovations. The invention of the printing press meant that the flock of spiritual followers no longer would have to rely exclusively on clerical proclamations to discover and interpret information, which heretofore would have remained unknown to them. As noted in the book, Creative Economy and Culture: Challenges, Changes and Futures for the Creative Industries, a chapter on Ceci tuera cela points out that democratic, secular print culture would supersede the authority of the church, along with the system of beliefs and images embodied in the great edifice where action is portrayed.

It appears reasonably clear that a constant array of technological innovations has the potential to have a transformative influence on the health care sphere. Many new developments are intended as improvements. Nonetheless, it is the unintended negative consequences of various changes to the existing order that sometimes prove to be worrisome challenges due to the prospect that technological advances often bring in their wake many impacts of a mixed blessings nature.

February 2019 marked the 10th anniversary of passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, an effort to accelerate the conversion of physician and hospital paper charts to electronic records, but widespread adoption not always has been accompanied by projected benefits. Instead, EMRs are associated with the onset of physician “burnout” and also in disrupting effective communication patterns between clinicians and their patients. Moreover, a finding reported in the November 2019 issue of the journal Health Affairs indicated that while hospitals gave 95% of discharged patients access to view, download, and transmit their information, only about 10% of those with access used it. Underuse can produce its own train of undesirable side effects.

As more applications are integrated into everyday life, artificial intelligence (AI) is predicted to have a globally transformative influence on economic and social structures similar to the effect that other general‐purpose technologies, such as electricity have had. A manuscript in the November 2019 issue of the American Journal of Industrial Medicine introduces a cautionary note, however, regarding key issues for occupational safety and health, along with selected implications that include job displacement from automation and management of human‐machine interactions. Hence, as technology unfolds, it continues to warrant close scrutiny.

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LEARNING ABOUT FIDGETING WHILE FIDGETING

John Colbert

October 22, 2019

Trends Archives

Since it is more than quite likely that the editor of the Association’s newsletter experienced some fidgeting while preparing this edition, it is possible that some readers also could undergo something comparable while reading it. According to an article that was published in the October 2019 issue of the journal Nature Neuroscience, psychologists have ascribed fidgeting to boredom, a form of stress relief, or perhaps as a subconscious way to increase memory. Also, fidgeting may take place even when one seemingly is engaged actively in a task. It is unclear, however, the process by which fidgets go about modulating their neural activity across the brain. Certain brain regions drive actions (such as motor cortex) and many others receive this information (such as sensory areas), in part to distinguish self-generated from movements that are not self-generated. Investigators who participated in the study reported in the aforementioned publication show that in expert mice performing a task, movements that are not task-related dominate the single-trial neural activity. This finding is exciting because it underlines why measuring behavior and other variables are key for exploring the neural code. Apart from whatever value might be associated with this discovery, as an aside it also might be somewhat comforting to know that somewhere out there, a group of expert mice is working on our behalf to enhance a more human-oriented understanding of neural activity.

return to october 2019 trends

PARKINSON’S DISEASE AFFECTS WOMEN AND MEN DIFFERENTLY

John Colbert

October 22, 2019

Trends Archives

Not all demographic groups are affected by disease pathophysiology in the same way as shown in a review published in the August 2019 issue of the Journal of Parkinson's Disease. Growing evidence indicates that Parkinson's disease (PD) affects women and men differently. The article presents the most recent knowledge about these sex-related differences and highlights the significance of estrogens, which play an important role in the sex differences in PD. Although the risk of developing this disease is twice as high in men than women, it is women who experience a more rapid disease progression and a lower survival rate. By drawing attention to sex-related differences and disparities in PD, the investigators hope that recently gained knowledge will further encourage the scientific community and policy makers to foster the development of tailored interventions and the design of innovative programs - for example in care practices - that meet the distinct requirements of women and men with PD.

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EVIDENCE FOR LATINO PREFERENCES FOR METAPHOR AND ANALOGY

John Colbert

October 22, 2019

Trends Archives

It is not too surprising to come to a realization that individuals from different cultures may be inclined to communicate and describe the world differently. A manuscript in the November 2019 issue of the Personality and Social Psychology Bulletin documents one such cultural difference previously unexplored by psychologists: receptiveness to metaphors. Spanish-speaking Latinos were contrasted with Anglo-Americans, Asian Americans, and Latinos who do not habitually speak Spanish. Across four experiments, the investigators showed that relative to these other groups, Spanish-speaking Latinos show stronger preferences for metaphoric definitions, better recall of metaphors, greater trust in both scientific and political arguments that use metaphor, and stronger liking for and desire to connect with persons who use metaphoric speech. Given the substantial representation of Latinos throughout the United States, it definitely is worth considering future directions and implications for improving cross-cultural communication.

Recognizing that Spanish-speaking Latinos display a relatively stronger preference for metaphors in defining abstract constructs and in demonstrating enhanced memory for metaphors in narratives, the findings are particularly relevant in the health care arena. Great emphasis is placed today on how health status is affected by social determinants. Language differences can have a decisive impact on the ability to achieve positive health outcomes. Thus, both from the perspective of patients describing their symptoms to health care practitioners and in their obtaining a greater understanding of diagnostic terminology, the use of metaphors is a tool that can play a highly valuable role.

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AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY

John Colbert

October 22, 2019

Trends Archives

Preparing The Current And Future Health Care Workforce For Interprofessional Practice

The Health Resources & Services Administration published a report, "Preparing the Current and Future Health Care Workforce for Interprofessional Practice in Sustainable, Age-Friendly Health Systems." It is the the 17th Annual Report authored by the Advisory Committee on Interdisciplinary Community-Based Linkages (ACICBL) to the Secretary of the United States Department of Health and Human Services and to the Congress. ACICBL is a Federal Advisory Committee that provides advice and recommendations to the Secretary on a broad range of issues dealing with programs and activities authorized under Title VII, Part D of the Public Health Service (PHS) Act. Recommendations provided in this iteration are designed to promote broad changes within the health care system to advance age-friendly practices, train the health care workforce in age-friendly care, and improve the care of older adults, while also facilitating the reduction of burnout and the promotion of wellness and resilience among health care providers. The report can be obtained here.

Integrating Social Care Into The Delivery Of Health Care

How can services that address social needs be integrated into clinical care? What kind of infrastructure will be needed to facilitate that integration? To begin answering such questions, the National Academies of Sciences, Engineering, and Medicine assembled an expert committee to examine the potential for integrating social care services into the delivery of health care with the ultimate goal of achieving better and more equitable health outcomes. The resulting report, Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health, identifies and assesses current and emerging approaches and recommends ways to expand and optimize social care in the health care setting. It can be obtained here.

Older Americans’ Views On Navigating The Health Care System

A majority of older Americans who are ages 60+ (79%) are prepared to age well, but nearly 7 in 10 (68%) are at least somewhat concerned about their health as they age, and nearly half (46%) need assistance understanding their health insurance benefits once they have chosen a plan. A survey conducted by The Harris Poll, commissioned by Anthem, Inc. and the National Association of Area Agencies on Aging reveals that while most respondents are confident in some aspects of navigating the health care system, there is opportunity for better understanding of their benefits, bill, diagnosis, and treatment. Among the respondents, which included U.S. adults, 65% reported that they had some type of Medicare insurance coverage. The report can be obtained here.

Survey On State And Local Income, Poverty, And Health Insurance Statistics

The U.S. Census Bureau released its most detailed look at America’s inhabitants, places, and economy. New state and local statistics on income, poverty, and health insurance are available in briefs, detailed tables, data profiles, and more. The American Community Survey (ACS) also produces statistics for more than 40 other topics. Results can be obtained here.

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QUICK STAT (SHORT, TIMELY, AND TOPICAL)

John Colbert

October 22, 2019

Trends Archives

Death Rates By Marital Status For Adults Age 25 And Older: United States, 2010-2017

A new report from the National Center for Health Statistics (NCHS) presents trends for 2010–2017 in age-adjusted death rates by marital status (married, never married, divorced, or widowed) at the time of death for adults aged 25 and over. The age-adjusted death rate for married persons aged 25 and over was lower than for those who were never married, divorced, or widowed. It declined 7% (839.8 per 100,000 U.S. standard population), while the rate for never-married persons also declined, by 2% (from 1,466.1 to 1,443.6). The rate for widowed persons was the highest of all marital status groups and increased 6% during the period, from 1,567.2 in 2010 to 1,656.9 in 2017. The rate for divorced persons aged 25 and over was stable during the period and was 1,368.8 in 2017. Rates for married men were the lowest of all marital status groups and declined 7% from 2010 (1,012.1) to 2017 (942.9) while for women, rates also declined 7% between 2010 (612.1) and 2017 (569.3).

Prevalence Of Screening For Social Determinants Of Health

Social needs are linked to health outcomes. Identifying patients with unmet social needs is a necessary first step to addressing these needs, yet little is known about the prevalence of screening. Most hospitals and physician practices don’t screen patients for social determinants of health such as food insecurity, housing instability, utility and transportation needs, and interpersonal violence, according to a study described in the journal JAMA Network Open on September 18, 2019. Surveys administered from June 2017 to August 2018 to 2,190 physician practices and 739 hospitals found that about 16% of practices and 24% of hospitals reported screening for all five factors, while 8% of hospitals and 33% of practices screened for none. The most commonly screened-for factor was interpersonal violence, occurring at 75% of hospitals and 56% of practices. Almost 50% of academic hospitals reported screening, compared with 23% of hospitals overall. Facilities that serve economically disadvantaged patients were more likely to screen.

HEALTH TECHNOLOGY CORNER

Hierarchical Encoding Of Attended Auditory Objects In Multi-Talker Speech Perception

Humans easily can focus on one speaker in a multi-talker acoustic environment, but how different areas of the human auditory cortex (AC) represent the acoustic components of mixed speech is unknown. A team of Columbia University neuroengineers has uncovered the steps that take place in the brain to make this feat of picking out a single voice possible, according to an online article that became available in the journal Neuron on October 21, 2019. The discovery helps to solve a long-standing scientific question as to how the auditory cortex, the brain's listening center, can decode and amplify one voice over others -- at lightning-fast speeds. This new-found knowledge also stands to spur development of hearing-aid technologies and brain-computer interfaces that more closely resemble the brain. An end goal is to understand better how the brain enables individuals to hear so well, plus to create technologies so that stroke survivors can speak to loved ones, or to enable the hearing-impaired to converse more easily in a crowded setting.

Exergaming And Virtual Reality For Health: Implications For Cardiac Rehabilitation

According to an article published online September 12, 2019 in the journal Current Problems in Cardiology, cardiac rehabilitation (CR) programs focused on improving the health trajectory of patients with cardiovascular disease strive to increase physical activity (PA) and cardiorespiratory fitness. However, historically low compliance with recommended PA has prompted exploration of alternatives to traditional courses of exercise therapy. One alternative, exergaming, or the requirement of physical exercise inherent to a video game's activities, has shown to have a promising impact in improving patient self-efficacy for exercise training using digital hardware (e.g., the Wii or the Xbox Kinect). Moreover, novel technologies in virtual reality can provide an engaging, immersive environment for exergaming techniques, maximizing goal-oriented training, and building self-efficacy for patients during CR. The concept of a “Clinical Arcade” is introduced as a new approach to integration of these techniques in CR care.

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Adult Physical Inactivity Prevalence Maps By Race/Ethnicity

Driving Under The Influence Of Marijuana And Illicit Drugs Among Persons Aged ≥16 Years—U.S.

HEALTH TECHNOLOGY CORNER

Benefit To Patients Using Wearable Devices Such As Fitbit Or Health Apps On Mobiles

Light-Degradable Hydrogels As Dynamic Triggers For Gastrointestinal Applications

More Articles from Dec 2019 - Jan 2020 TRENDS

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PRESIDENT’S CORNER

LABOR-HHS FUNDS ALLOCATED FOR FY 2020

HEALTH REFORM DEVELOPMENTS

DEVELOPMENTS IN HIGHER EDUCATION