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FDA eyes artificial wombs, a lawmaker shares his mental health story, & why excluding trans youth from sports is a health issue

September 19, 2023
Reporter, Morning Rounds Writer
Good morning. On tap today is an FDA hearing to explore the safety, effectiveness, and ethics of testing artificial wombs in humans. Also: why physicians say sports bans for trans youth are a health issue and what secret shoppers found out about hospital prices.

reproductive Health technology

The FDA will consider artificial wombs today

UltrasoundAdobeStock_522060404

Adobe

I don't know about you, but I can still recall the 2017 video of a lamb fetus lying on its side in a "biobag" that looked like a plastic sack but was really an artificial womb supplying the oxygen and nutrients it needed to develop. Both amazing and unnerving, the artificial womb is now close enough to human testing that the FDA has convened a two-day panel starting today to discuss how to best evaluate safety and effectiveness, as well as the ethical quandaries in running clinical trials of the technology. 

The hope is to help severely premature infants mature until they're ready for more sophisticated life support, a process that would take about a month, STAT's Lizzy Lawrence explains. Scientists are thinking of infants born after less than 28 weeks' gestation, a population that represents less than 2% of all preterm births but has abysmal survival rates. Read more.


health

Physicians say barring trans kids from sports is a health issue

When thinking about the impact of banning gender-affirming  puberty blockers, hormones, and surgery on the health of trans youth, don't forget participation in sports, pediatric sports medicine physicians and health services researchers write in a JAMA Pediatrics commentary. Keeping trans kids out of sports would mean removing benefits of being physically active, such as improved mental health. Co-author Alexander Sin spoke with STAT's Theresa Gaffney. 

How is youth participation in sports a health issue? 

We know that sports activities for children are important for development. I think our emphasis needs to be on their health and wellness. Why do we care if this little boy assigned as female at birth wants to play as a boy?

And trans girls?

Our medical community is still learning. [Some research has found that] trans women are superior to cis women because of certain strength and speed measures. But the problem with this is that it doesn't translate to sports performance.

Read the full interview.


Health insurance

Medicare coverage isn't affordable for all, survey says

Screen Shot 2023-09-18 at 2.33.09 PMCommonwealth Fund 

Enrolling in Medicare doesn't put an end to medical bills. When people gain health coverage after turning 65, their visits to doctors' offices and out-of-pocket medical spending both bump up, a study found last year. Now new research from the Commonwealth Fund takes a closer look at the financial burden of health care expenses some older Americans bear. Most people choosing traditional Medicare coverage also have a Medigap plan to cover extra costs. People with private Medicare Advantage have more coverage, but also some hoops to jump through. The survey found: 

  • About 1 in 5 were underinsured, with costs too high for their income.
  • Overall more than 1 in 5 struggled to pay premiums, rising to 2 in 5 with low income.
  • More than 1 in 4 delayed or skipped dental care.
  • About 1 in 6 had medical bill problems or debt; more than 1 in 5 with low income.


Closer Look

'Still a lot of stigma, but it's a lot less': Rep. Adam Smith shares his mental health story

GettyImages-945318540Chip Somodevilla/Getty Images

Rep. Adam Smith (D-Wash.) hit rock bottom in April 2016, crushed by anxiety and chronic pain, he writes in his new memoir, "Lost and Broken." Other lawmakers have opened up about their struggles in recent years, including Pennsylvania Sen. John Fetterman on his clinical depression after a stroke last year and Sen. Tina Smith (D-Minn.) on her depression. Some highlights from Smith's conversation with STAT's Sarah Owermohle:

On criticism of Fetterman when he checked into an inpatient program: "There are responsibilities that come with the job, and if you are taking on an obligation, you have to be able to meet that obligation. I believe in the capacity of people to get better."

On stigma: "My colleague said, 'I've been struggling with a lot of those issues before. And I read your book, and I was like, it's okay to talk about this.' There's still a lot of stigma, but it's a lot less."

Read more.


hospitals

Good luck with hospital price comparison shopping 

Over the years government health agencies and health advocates alike have labored to pry open the black box of hospital prices. Even if you don't see yourself comparison-shopping for medical imaging or some other procedure, you might hope that if you did, prices would be available — and consistent. After all, Medicare's Hospital Price Transparency Rule requires hospitals to disclose cash prices and commercial payer–specific negotiated rates for 70 clinical services deemed to be shoppable.

New research in JAMA Internal Medicine tested two of those services at 60 U.S. hospitals, equally split among top-ranked, safety-net, and non–top-ranked, non–safety-net. Fewer than half of the hospitals offered prices online, and when prices were available both online and over the phone, most didn't match. For vaginal childbirth, prices were the same online or on the phone for only 3 of 22 hospitals, and for brain MRI, for 9 of 47 hospitals.


health

Job stress takes a toll on the heart

Work stress can break your heart, at least if you're a man working a white-collar job, according to a new study in Circulation: Cardiovascular Quality and Outcomes that followed people in Quebec for 18 years. The researchers found an association between coronary heart disease and two working conditions: job strain, when high job demands are met with low control over work, plus an effort-reward imbalance, when effort is high but salary, recognition, or job security are low.

Compared to people who didn't experience work stress, men who reported either form of it had a 49% higher risk of coronary heart disease and double the risk if they had both — about the same risk as obesity. For women, the results were inconclusive. Two possible explanations suggested by the authors as they urge more studies: Men had a higher prevalence of diabetes, hypertension, and high cholesterol than women, and women tend to have later onset of coronary heart disease than men. 


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What we're reading

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