A possible precedent for health data privacy, a Chicago doctor's struggle against violence, & birth control's link to breast cancer, updated

Abdullah Hassan Pratt grew up on Chicago's South Side, just a few miles from the medical complex where he now works as an ER physician.

March 22, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Don't miss the compelling story of ER physician Abdullah Hassan Pratt, who grew up on Chicago's South Side and runs a pipeline program for kids in his community who don't otherwise have a clear path into the medical field.

Health tech Cerebral lawsuit could set a precedent for health data privacy Cerebral is a digital prescribing startup that now faces legal action after admitting earlier this month that it shared people's sensitive health information with Meta, Google, and other advertisers. That's a breach of the federal health data regulation known as HIPAA, but it's also a common practice among telehealth companies to gather data about customers' behavior on the site that can then be used to target ads later. A patient has filed a potential class-action lawsuit claiming Cerebral also violated other federal laws governing internet use. If the Cerebral case goes to trial, it might establish new guideposts for using people's personal data. It also could mean hard choices for people relying on services like Cerebral's because they lack other viable options."They're facing a really terrible tradeoff," Matt McCoy of the University of Pennsylvania said. STAT's Mohana Ravindranath and Casey Ross have more. health Study says different forms of birth control still carry the same small risk of breast cancer Today birth control comes in a pill, patch, implant, or injection, each carrying different formulations and doses of estrogen, progestin, or both. A surprising new study in PLOS Medicine says they all share a modest (under 1%) increase in breast cancer risk, similar to the connection between hormonal birth control and breast cancer that was forged in a large 1996 study, one that also said the risk declined after women stopped taking oral contraceptives. Estrogen and progestin prevent pregnancy by stopping the release of eggs from the ovaries, thickening cervical mucus, and thinning the endometrium. Those hormones also help breast cancers form and grow. The absolute risk that the new study found was also small, at under 0.5% for women under 50. "Newer forms of hormonal contraceptives behave pretty much the same as we've been using for decades," study co-author Gillian Reeves told STAT's Angus Chen. Read more. infectious disease  A second outbreak of Marburg fever hits Africa Africa is grappling with not one, but two outbreaks of Marburg fever, a disease that causes symptoms and a death rate comparable to Ebola, its viral cousin. Health officials in Tanzania announced yesterday that they had confirmed the country's first-ever Marburg outbreak, involving at least eight people so far, five of whom have died, including one health care worker. At least 161 people who have been in contact with the cases have been identified and are being monitored, Tanzanian Health Minister Ummy Mwalimu said in a press conference. Tanzania's transparency is in sharp contrast to the comportment of the government of Equatorial Guinea, which has been close-mouthed about a Marburg outbreak that began in that country in early January. The last update was released nearly a month ago, at which point there were nine confirmed, probable and suspected cases. It is believed additional cases have been detected, but the country has been unwilling to disclose the information globally. STAT's Helen Branswell has more.

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Closer Look A son of Chicago's South Side carries the torch of his slain brother in the struggle against violence Kayana Szymczak for STAT Emergency room physician Abdullah Hassan Pratt (above center) was teaching dozens of teenagers from Chicago's roughest and poorest neighborhoods how to find their way around a sheep heart sitting in a student's hands. Pratt grew up like many of them, in a predominantly Black neighborhood on the city's South Side, just a few miles from the University of Chicago medical complex where he now works.  They live with violence. One in five teens in the city says they've witnessed a fatal shooting. In 2012 Pratt's older brother Rashad died at age 28, gunned down a few hundred feet from the family home. "That was the turning point for me," Pratt said. "I decided I wasn't just going to be a good doctor, but a great one." His mentors challenged him: "Let this be the torch you carry." That means helping kids, but there is a toll. STAT's Usha Lee McFarling tells his story. health care For veterans, the financial burden varies with choice of health insurance As millions of Americans face the loss of Medicaid coverage and potential trouble paying medical bills, a new CDC report looks at financial burdens for another group: veterans under age 65. The country's 19 million veterans can enroll in the same plans as other Americans, but they are also eligible for VA health coverage and Tricare, offered through the Department of Defense. (Care for illness or injury during military service is free.) A national survey conducted from 2019 through 2021 found that 12.8% of veterans had problems paying medical bills, 8.4% had skipped medical care, and 38.4% were somewhat or very worried about paying medical bills if they got sick or had an accident. That compares to 11.3% of adults aged under 65 who lived in a family that had problems paying medical bills in the past 12 months. Veterans with VA health care only and veterans with Tricare reported similar or decreased financial burden of care compared with veterans having private insurance with or without VA health care. The authors urge further research on access, use, and other health issues. transplantation Opinion: Promised priority, living kidney donors wonder what will happen if they need one In an act of altruism, Martha Gershum donated a kidney to a stranger whose story she read in a newspaper. Last year living donors like her made up more than 15% of U.S. transplants, parting with a portion of their lung, liver, pancreas, or intestines or one of their kidneys. She was assured that if she ever needed a transplant to replace her remaining kidney, her gift put her at the top of the waiting list. That promise is in jeopardy, she writes in a STAT First Opinion. To combat equity issues, the United Network for Organ Sharing is changing how deceased donor organs are allocated. "While living organ donors will continue to receive extra 'points,' no one attribute will decide an organ match," she writes. "This change is profoundly unsettling to living kidney donors, … prompting us to ask: Will my priority status be preserved?" Read more.

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Thanks for reading! More tomorrow, P.S.: Sometimes we tell you about 3D printing in medicine. But 3D printing in food? Of cheesecake? You be the judge of what Nature: The Science of Food calls "software-controlled cooking."

elizabeth.cooney@statnews.com

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