Hi there. I’m Isa Cueto, filling in for Liz today, though nobody could ever fill those well-worn running shoes. In her honor, and to get the week started, a song: “Liz” by Remi Wolf.

Exclusive: Maternity care ‘deserts’ on the rise across the U.S.

(Molly Ferguson for STAT)

A new report from March of Dimes underlines a staggering problem: Over a third of all U.S. counties — home to seven million women — are maternity care deserts. And more counties were added to the list last year. “Every time a new report comes out, we seem to be going in the wrong direction,” said Stacey Stewart, the group’s president and CEO. “You're taking an already severe situation and it's just getting worse.” The U.S. has the highest maternal mortality rate among comparable wealthy countries (a rate that’s increasing year over year, and is highest among Black women).

One of the driving factors is one residents of rural areas have noticed for years: hospital closures, STAT’s Theresa Gaffney writes. Other stressors, including the pandemic and increased abortion restrictions, have experts worried that risks will only mount for pregnant people who live in care deserts, and for their babies. Read more.

What is an 'Environmental Justice' office supposed to do?

The new (and tiny) environmental justice office within Health and Human Services wants to tackle everything from national data issues to low-income subsidies and toxins in hair products. But how will it do that? Started in May, the office is still unfunded and staffed with just two people, on loan from other health agencies. Another hurdle: the agency doesn't have regulatory authority over environmental quality, and environmental issues are usually fought on the state and local level. Environmental Justice is still struggling to figure out exactly where to go from here, or how, STAT’s Sarah Owermohle reports. “It’s an enormous opportunity and responsibility,” said Renee Salas, a climate and health fellow at the Harvard T.H. Chan School of Public Health. “I hope that they are given the resources with which to do it.”

In first analysis, colonoscopy reduced cancer incidence but not death

The first randomized trial of colonoscopy screening is out, and the results are … complicated. At first glance, data showed that inviting people to get a colonoscopy didn't reduce colon cancer deaths, but did reduce cancer incidence by 18%. “This is a landmark study,” Samir Gupta, a gastroenterologist at UCSD, told STAT’s Angus Chen. "And I think we were all expecting colonoscopy to do better.”

Doctors were hoping that screening people’s colons at least once a decade could render colon cancer extinct. There was some evidence to support that theory: Past research always showed that colonoscopy could put a huge dent — on the order of 70% — in the incidence and mortality from colon cancer. But those weren’t randomized trials. The new results raise an uncomfortable question: “Maybe colonoscopy isn’t as good as we always thought it is.” Read more here.

Closer look: Indiana tried to pilot telepharmacies. They all shut down, but that hasn’t stopped retail giants

(Molly Ferguson for STAT)

Telepharmacies were meant to solve a rural crisis: “pharmacy deserts,” where people must drive long distances to acquire much-needed medications. Lawmakers and local officials bought in, and attended ribbon-cutting ceremonies for the much-anticipated storefronts. But in Indiana, they've all shut down, leaving patients in a bind once again. In the three years since the state’s first telepharmacy opened, four storefronts that were licensed to do remote dispensing have shut down, or failed to open in the first place, STAT’s Katie Palmer reports.

To Dima Qato, a pharmacy systems and policy researcher at the University of Illinois Chicago, that’s a “red flag that telepharmacies may not necessarily be the solution to pharmacy deserts,” even as more states approve their use. What they could be, though, is a way for already-profitable pharmacies, including retail giants like CVS and Walgreens, to further bolster their bottom lines. Indiana may soon see another first: CVS has filed paperwork to open its inaugural remote dispensing facility in the state. Read more.

What should I eat? A data-driven star-rating system could help sort that out

There’s widespread confusion about how diet and lifestyle ties into health, especially how certain behaviors contribute to chronic disease. Clickbait headlines, contradictory studies and grocery cart contents reflect the uncertainty. Cow’s milk is bad, and then it’s good. Butter must be gone, but then it’s back. It’s hard for people to know what, exactly, is good advice.

In come University of Washington researchers, who analyzed hundreds of studies in hopes of helping consumers, clinicians and policymakers cut through the noise. A new tool from the Institute for Health Metrics and Evaluation (of Covid-model fame), unveiled yesterday in Nature Medicine, uses a 5-star rating system to show how much evidence exists to support some diet and lifestyle changes. For example, data suggest increasing vegetable consumption from one to four servings per day carried about a 23% reduction in stroke risk. That has a three-star rating. More here.

‘The second we think we know what we are doing, we fall flat on our face’

Wes Ely, a critical-care physician at Vanderbilt University Medical Center, has become a leading voice (in op-eds, TikToks and a book) on recovery after trauma or grueling illness. As the pandemic marches on, he’s increasingly concerned about an ensuing epidemic of chronic disease. STAT’s Usha McFarling spoke with Ely in this Q&A. A tidbit:

In your book, you describe saying to patients, “I will not leave you.” It’s not something you typically hear doctors saying to patients. Can you talk about how you communicate with patients?

If somebody was in the streets and they were broken, I’m not going to stand 20 feet away from that person and minister to them at a distance. And yet, when patients come into the ICU and they’re super, super sick, that distance caring is exactly what our culture evolved into, where instead of being at the bedside and holding their hands, looking in their eyes, oftentimes we’re caring for them from the door. And throughout Covid, we literally were outside their room with the glass door shut, a worst-case scenario. That’s why I’ll whisper in their ear and say, “I’m present. I’m your doctor. I’m not leaving you.”