North Carolina’s radical health experiment in offering prescriptions for produce

A pilot program seeks to address social determinants of health with healthy food deliveries and housing assistance.

September 22, 2023 Check out STAT+

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By Annalisa Merelli General Assignment Reporter

Buongiorno, this is Nalis. My little dog Tuna and I have a lot to share with you this morning — news of a potentially massive strike, new research awards, and prescription peaches! We hope you enjoy our missive, and have a wonderful end to this week.

BUSINESS Historic health care worker strike looms  Courtesy of SEIU-UHW As many as 85,000 Kaiser Permanente health care workers could go on strike in October — mostly those in ancillary roles such as certified nursing assistants; surgical, imaging, and radiological technicians; and pharmacists. The strike could affect up to 12 million people served by Kaiser's hospitals and medical offices across nine states, reports my colleague Brittany Trang. Members of the Coalition of Kaiser Permanente Unions, which represents 40% of Kaiser's health care workers, are protesting chronic short-staffing, which they say is increasing their workload and compromising patient services, as well as wages, which workers say don't allow them to keep up with the cost of living. Representatives of the union say Kaiser has not been engaging with their demands, but the company says it's confident it will reach a resolution before the contract expires Sept. 30. Read more. RESEARCH Lasker Awards honor AI discoveries and eye-opening breakthroughs  The winners of the prestigious 2023 Lasker Awards for biomedical research were announced yesterday in New York. Here are the recipients, which come with a $250,000 prize: The Basic Medical Research Award went to Demis Hassabis and John Jumper, the inventors of AlphaFold, a deep learning system using AI to map the structure of 200 million proteins. AlphaFold, developed by DeepMind, Google's AI sister company, can accurately predict both protein structure and possible mutations. The Clinical Medical Research Award went to James Fujimoto, David Huang, and Eric Swanson. In the 1990s, the trio invented optical coherence tomography, a non-invasive test which allowed accurate and fast detection of retinal diseases. Finally, the Special Achievement Award honored Dutch physician-scientist Piet Borst's 50-year career, which includes discoveries across fields including oncology (on understanding drug-resistant cells) and parasitology (on how sleeping sickness evades the immune system's defenses).  Read more. CLOSER LOOK A prescription for health: Fresh peaches Allison Joyce for STAT When Hippocrates (possibly) said "Let food be my medicine and medicine be my food," he might have been talking about a pilot program in North Carolina that delivers fresh food — peaches, oranges, snap peas, grains, and meat — to patients on Medicaid, even those who don't have a regular place to live.  As Wudan Yan writes in this story, North Carolina's $650 million Healthy Opportunity Project, or HOP, involves delivering healthy food to families, as well as addressing other social determinants of health such as housing and transportation. The goal is to see if they can improve health outcomes — not only by lowering things like blood sugar and obesity, but also by helping keep people out of emergency rooms, hospitals, and nursing homes.  Early results show food deliveries, sometimes called "produce prescriptions," are more effective than food stamps at improving health. But some people still fall through the cracks: Those who turn 65 and roll off Medicaid onto Medicare are no longer eligible, despite the food or housing insecurity they may still have. Read more.

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endHEALTH How did Covid change diabetes rates in children? A few studies thus far have highlighted an increase in childhood diabetes (both Type 1 and 2) during the Covid-19 pandemic, possibly as a consequence of autoimmune reaction triggered by the respiratory virus. New research shows that although the incidence of diabetes among children went up in 2020 and 2021, certain racial and ethnic groups suffered more than others.  The study, published on September 21 in JAMA Network Open, looked at data from Kaiser Permanente Southern California, comparing yearly rates from 2016-2019 and from 2020-2021. Among its findings: during the third and fourth quarters of 2020, overall diabetes rates rose among youth ages 10-19 but "especially among Black and Hispanic individuals, suggesting a disproportionate burden of type 2 diabetes among these youth during the pandemic period of our study." The rates of Type 1 diabetes also increased most significantly among Black children, if not as strikingly as for Type 2. FIRST OPINION 988: How about an app for that?  If a phone can come preloaded with a stock market app, it can come with a suicide helpline app, writes Mark Goldstein, a physician who founded the Division of Adolescent and Young Adult Medicine at Massachusetts General Hospital, in STAT's First Opinion. The US suicide hotline 988 is over a year old, but still too hard to reach, writes Goldstein: The number isn't included as an option among the emergency numbers (such as 911, or 311) that can be initiated from a locked screen and even without network coverage. And a person in distress, especially a teenager, may have trouble remembering the correct digits, including because it deviates from the standard template of emergency numbers ending in 11. There should be an app for that, suggests Goldstein: A simple icon could start a call to 988 when tapped and save lives. Sure, he says, there would be some challenges (ensuring privacy and limiting accidental calls) — but none insurmountable. Read more.

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Thanks for reading! More on Monday — Annalisa

annalisa.merelli@globe.com

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