A summary of important health news from the last week.
New restrictions under the Medicare Advantage plans could require patients to try low-priced drugs before high-priced ones. Medicare Advantage plans, which are run under private companies approved by traditional Medicare, cover approximately 20 million people across the country. Critics are concerned that patients will not be treated with their doctors’ drug-of-choice, while proponents argue that this move will pressure drug manufacturers to lower costs. Patients and doctors will be able to request exceptions from this policy.
E-cigarette use is an 'epidemic,' FDA chief says
The FDA has determined the use of e-cigarettes among teenagers to be at epidemic proportions, which has led the federal agency to consider taking e-cigarette products off the market. The FDA has also been taking action to limit the astronomical number of sales of e-cigarettes to minors, occurring via online and retail markets. This is the largest single enforcement action in the history of the federal agency.
A team of researchers from Harvard Medical School and the RAND Corporation reported last Monday that from 2006 to 2015, physicians provided no explanation for 29% of the opioid prescriptions they wrote. This research echoes concerns voiced by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) that inappropriate prescribing patterns among physicians in recent years have worsened the opioid crisis. In 2016 alone, 42,000 people dies from opioid-related deaths.
Home health care: It’s a grim world with victims on both sides
Motivated by personal experience with home health workers, reporter Linda Matchan started looking into home health workers. She found both neglect and abuse at the hands of home health workers, but also stories of people traveling from around the world to improve their lives and the lives of their families. This short documentary tells the stories on both sides.
By: Lamar Greene
Maternal mortality, death that occurs during pregnancy or shortly after, is used by the World Health Organization as an indicator of how healthy one country is compared to others. A common misconception is that maternal mortality is a public health issue reserved for developing nations. The United States, however, has the worst maternal mortality rate of any nation—despite spending more money on hospital-based maternity care than any other country in the world. Ranking 47th globally for maternal mortality, the United States also fares worse than many developing countries in protecting women from death during childbirth.
When looking at the factor of race, we see that black women are three to four times more likely to die as a result of childbirth than white women. According to the Centers for Disease Control and Prevention, this is one of the widest racial disparities present in women’s health, which is driving the international disparity for the United States. Furthermore, racial disparities in maternal mortality persist across income and educational levels for black women, revealing that traditional social protectants are not effective for black women in the maternal mortality crisis. In New York City, college educated black women are twice as likely to die from childbirth than white women who never finished high school. One study demonstrated this ideology as well by demonstrating that race/ethnicity was the strongest predictor for maternal death or near miss, with Black women suffering disproportionately from maternal death across income lines. 
The Serena Williams’ story, among others, help us to put a face to this reproductive injustice. Williams’ narrative paints a picture of how medical providers are not listening to women of color during the deliveries of their babies.
Many black women have turned to doulas to assist during their birthing process so that they can receive culturally competent care that is tailored to them. A doula is defined as a person who is trained to provide advice, emotional support, and physical comfort to mothers before, during, and shortly after childbirth. A doula is not to be confused with a midwife, who is a medical provider who helps to deliver the baby. Doulas and midwives, however, can and often do work together to support women during pregnancy. For many black women it is the difference between life and death.
Darline Turner, physician assistant and certified doula in Austin, Texas, took matters into her own hands when responding to the pressing human rights concern of disproportionately high rates of maternal mortality affecting black women. She was startled by the nonchalance and lack of urgency surrounding the issue. So she started Healing Hands Community Doula Project, an organization that provides pregnancy care and support to black women of all economic backgrounds. When discussing her vision for Healing Hands Community Doula Project, Turner said, “Any black woman who so desires will be able to have the support, resources, information, education to have a healthy full-term infant and to live to see that infant grow up to be an adult.”
There has been a surge of community health solutions like Healing Hands Community Doula Project that have increased culturally competent care for black women, which has been proven by research to be more effective than the medical system’s traditional approach. One such study focused on the impact of doulas on healthy birth outcomes and reveals that expectant mothers matched with a doula had significantly better birth outcomes compared to women who were not assisted by a doula. Doula-assisted mothers were four times less likely to have a low birth weight baby and two times less likely to experience a birth complication involving themselves or their baby.  These results show that there is hope that the maternal mortality crisis can be resolved. Doulas actively listen to mothers throughout their birthing process and provide them with emotional support so that the pregnancy process is tailored specifically to the needs of each individual mother.
The research and experiences documented about the doula movement signal that more solutions outside of the medical system may be effective in reducing racial disparities in maternal mortality. When speaking about the maternal mortality crisis, medical ethicist Harriet Washington looks to the past. She notes that “trying to understand a historical problem without knowing its history is like trying to treat a patient without eliciting their medical history–you’re doomed to failure.” Washington claims that the American medical system is still haunted by the history of slavery, which involved medical experimentation on enslaved African women to create the modern practice of gynecology and obstetrics.
The doula movement and other community health initiatives provide an alternative to the institutional racism that all black women face when entering the medical system, regardless of their level of education or income status. The State of New York has expanded the use of doulas to reduce childbirth deaths. Americans can only hope that the federal government or other state governments will take similar action because women of color cannot continue to wait for this urgent issue of human rights and reproductive justice to be addressed. Their lives literally depend on it.
A summary of important health news from the past week.
With physical activity levels continuing to trend downwards worldwide, a World Health Organization (WHO) study has shown that people are in need of lifestyle modifications. The researchers recorded people's activity levels at work and at home. Their results showed a distinction between wealthier and lower-income countries: the former seeing a larger shift towards more sedentary occupations and modes of transportation. Even still, physical inactivity proves to be "pandemic" and researchers agree that there is no simple solution to this worldwide problem. In this fight against physical inactivity, they are suggesting that "small changes" in daily life can help combat the lack of activity.
As climate change hurtles forward, wildfires are predicted to burn more frequently, creating cataclysmic scenes of smoke and ash that have already decimated California this summer. But very little is known about the health consequences of wildfires−so scientists are making these natural disasters into natural experiments. They are collecting data from towns and a local primate research center that have been hit and are likely to be hit in the future, analyzing blood samples, respiratory function, and even donated placentas for clues as to how wildfires impact health.
Researchers are showing a renewed interested in an infectious disease model for Alzheimer's Disease, which is a theory that was first suggested in the early 20th century. Some have noticed that the disease show similarities in pattern with infectious disease. Other researchers are interested in exploring the possibility of viruses, like herpes, which may combined with particular genetic combinations to contribute to the development of dementias and Alzheimer's Disease.
With STDs on the rise, back-to-school will include condoms in one big Maryland county
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