Pressure grows on health care to do its part to combat climate change

(CHRISTINE KAO/STAT)

Wild weather swings — floods, fires, heat waves — are the immediate effects of fossil fuel we feel, and hospitals are not immune. Nor, like us, are they free of blame: Health care accounts for 8.5% of the nation’s greenhouse gas emissions and hospitals are the biggest drivers. Beyond energy to heat and power their buildings, there are other sources: anesthetics, other volatile gases, and fleet vehicle emissions. Then there’s “red bag,” or biological, waste; paper recycling; and used needles tossed in sharps containers.

Yet hospitals have long been laggards in even tracking and reporting their emissions and waste — much less reducing them, STAT’s Karen Pennar reports. But forces may be converging now to push hospitals and the health care system to rev up the massive effort required to reduce their dependence on fossil fuels. Read more.

'Monkeypox and HIV have collided,' CDC says

The monkeypox outbreak may be waning, but a new CDC report paints a stark picture of what the virus can mean for people whose immune systems are severely weakened. It’s particularly devastating in people with HIV whose disease is not controlled and when monkeypox care is delayed — up to four weeks, the report says, for some of the 57 patients hospitalized from August through October with severe monkeypox complications. Almost all had severely weakened immune systems, most often because of HIV infection (83%), for which many had received no treatment. Almost a quarter had unstable housing.

Nearly a third needed ICU care for symptoms that extended beyond painful rashes to organ dysfunction (lungs, eyes, brain, or spinal cord). Twelve patients died, including several deaths whose cause remains under investigation. Racial and ethnic disparities mirrored the overall monkeypox outbreak. “Monkeypox and HIV have collided with tragic effects,” CDC’s Jonathan Mermin said in a statement.

Groups launch revamped LGBTQ+ health care provider directory

A pair of like-minded groups have teamed up to launch a revamped, searchable directory of health care providers who understand the unique needs of LGBTQ+ patients, STAT's Tara Bannow reports. The free LGBTQ+ Healthcare Directory features providers in the U.S. and Canada. While the directory itself has been around for years, the Tegan and Sara Foundation and GLMA — Health Professionals Advancing LGBTQ+ Equality recently came together to update it by adding the search functionality, accessibility standards, and new guiding principles.

This comes at a time when finding gender-affirming care providers could become more difficult. Children’s hospitals and other providers of such services have stripped information from their websites amid threats and harassment from right-wing pundits. Tara and Kate Sheridan's recent STAT investigation found all but three of the 20 children’s hospitals targeted on social media have modified their websites, often by removing information about physicians or services offered.

Closer look: After Fetterman-Oz debate, experts on stroke see chance for better understanding

(KRISTON JAE BETHEL/AFP VIA GETTY IMAGES)

uesday night’s debate between Democratic Senate candidate John Fetterman (above) and Republican Mehmet Oz shines a light on stroke, issues that follow, and perceptions that conflate language skills with cognitive abilities. Fetterman at times stumbled over his words, jumbled what he was saying, and took long pauses. None of these were a surprise to experts, reflecting an auditory processing disorder that can make it appear he’s not hearing certain phrases. But “even if someone is having trouble retrieving words or names, a person’s intelligence can still be intact,” Adena Dacy of the American Speech-Language-Hearing Association told STAT’s Andrew Joseph.

Stroke can make it more difficult to decode words’ meaning and come up with what to say, experts said. They also hope the attention on Fetterman will raise awareness and acceptance of accommodations commonly used by people with disabilities, including a closed-captioning system like the one Fetterman used. Read more.

Republican ideas to reform Medicare could cause a stir in health care

Here’s a new flashpoint on the midterms campaign trail: Democrats are hitting Republicans on their plans to change Medicare. Spending on entitlements like Medicare is usually the third rail in politics and Republicans’ official campaign platform provides scant detail, but earlier this year House Republican lawmakers issued a policy paper that outlined several concrete ideas to change the program. The moves would upend the status quo for the entire health care industry — and beneficiaries.

Many of the proposals — on eligibility age, competition, payments to insurers and hospitals — would cross powerful interests, making them difficult to enact politically. While congressional Republicans could gain more leverage after the midterm elections, it’s unclear how much they could accomplish over the next two years with a Democrat in the White House. Changes to the program over the next two years would also likely require the buy-in of some Senate Democrats. STAT’s Rachel Cohrs explains.

Bystander CPR less common for Black and Hispanic people after cardiac arrest

Most people don’t receive potentially lifesaving CPR if their hearts suddenly stop beating, but there’s a racial disparity in how often bystander CPR is offered, a NEJM study reports. Black and Hispanic people in cardiac arrest were less likely than white people to get CPR, at home or in public, whether the neighborhood where it happened was predominantly white, Black or Hispanic, or integrated. Neighborhood income didn’t matter.

Black and Hispanic people typically have worse survival after out-of-hospital cardiac arrest than white people. The authors point to CPR training, which is less common in Black and Hispanic communities, and dispatcher-instructed bystander CPR, which may not be as readily available, or available in the language bystanders speak. “Our efforts to decrease cardiovascular morbidity may be complicated to some extent by a legacy of structural racism that has left many of our communities segregated and with inequitable social determinants of sudden cardiac death,” an editorial says.

What to read around the web today

Montana may be moving away from its innovative plan for setting hospital prices for public workers, Kaiser Health News
Gene treatment for rare epilepsy causes brain side effect in 2 children, New York Times
WHO releases list of threatening fungi. The most dangerous might surprise you, NPR
America’s Adderall shortage could kill people, Wired
Opinion: Kids with cancer deserve more than a cure, STAT