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Pharmacy deserts, Manchin's impact on health policy, and a promising asthma app

November 10, 2023
Annalisa-Merelli-avatar-teal
General Assignment Reporter

Hello and happy Friday, Nalis here. I am excited to be an official member of the Morning Round lineup as of this week, so you'll be hearing from me (and Tuna, my tiny dog currently napping in the sweater I forced him to wear) every other Thursday, if not more often. 

politics

How Manchin's decision could impact health policy 

Sen. Joe Manchin will not run for re-election, which could have big implications for health policy by imperiling Democratic control of the Senate, STAT's John Wilkerson tells us.

Manchin is a moderate Democrat in the conservative state of West Virginia. It's not clear who will run to replace him, but it will be an uphill battle for Democrats to keep Manchin's seat.

Manchin's primary involvement in health care policy has been the opioid epidemic. He also featured prominently in the debate over the Inflation Reduction Act, which allowed Medicare to negotiate drug prices, for reasons unrelated to health care. Manchin used his position in the barely Democratic-controlled Senate to get his way on energy policy, which delayed the bill's passage for several months.

His daughter, Heather Manchin Bresch, was the CEO of the drug firm Mylan, which was harshly criticized for drastically hiking the price of EpiPen, an emergency treatment for allergic reactions. 


health tech

Apple's promising asthma app 

An experimental asthma management app developed by Apple and insurer Anthem (now Elevance Health) can keep people on Medicaid out of the emergency room, according to early findings from a large randomized trial of the technology.  

The intervention uses the Apple Watch and a sleep tracking mat, along with an app, to get people to better understand their symptoms and triggers so they can keep their asthma under control. Even though analyses of asthma outcomes and cost savings are still forthcoming, some of the leaders behind the app are buzzing about the potential to help reach millions of low-income people.

They're calling for a broader release, through Apple or the insurer. Whether that happens may depend on factors that have nothing to do with the study's success, reports STAT's Mario Aguilar. It's not clear the app would gel with Apple's current consumer-minded health mindset. And at insurers, successful experiments can hit snags when they are explored for larger populations. Read more.


health care

Walking twenty blocks for a prescription refill: The health toll of pharmacy deserts

GettyImages-1483681106

Scott Olson/Getty Images

Across the U.S., retail chains like CVS and Rite Aid are shuttering stores even as independent pharmacies have a hard time surviving against their larger competitors. The result is a growing number of pharmacy deserts, STAT's Anika Nayak reports — putting people's ability to refill prescriptions and access medications and vaccines at risk.

Pharmacies tend to close first where there is a larger pool of patients on Medicare and Medicaid, which have lower reimbursement rates for drugs than commercial plans. This means low-income and Black, Latino, and Indigenous neighborhoods, such as Chicago's South Side, are at the center of the pharmacy shortage crisis. "The mass closure of pharmacies fail vulnerable communities," said Dima Qato, an associate professor at the University of Southern California School of Pharmacy. Read more.



public health

Health care workers behind on Covid boosters

Flu season is upon us, and with it reminders to get your flu — and, as of 2021, Covid — shots. Yet new survey data published by the CDC shows vaccine uptake has been low even among the people who should be most up to date with their seasonal jabs.

In the 2022-2023 respiratory virus season, only 20% of health care personnel were up to date with Covid shots. Flu vaccination rates among health care workers were behind pre-pandemic levels, and often insufficient. In acute care hospitals, 81% of workers were vaccinated against the flu in 2022-2023, compared to 86% in 2020-2021 and 90% in 2018-2019. Among nursing home workers, only a minority (47%) had received a flu shot last fall and winter, compared to 66% in 2020-2021 and 69% in 2019.


academia

When pre-med requirements deter future doctors

With the end of affirmative action, medical schools have to look at other ways to promote diversity among their student body. One option may be changing current pre-med requirements, writes David Velasquez, a medical student and pre-med tutor at Harvard, in STAT's First Opinion. 

Less than one in six of students who start college hoping to become doctors go on to do so. Velasquez writes that pre-medical studies, with their focus on rote repetition and subjects (think organic chemistry or biology) that have little direct application in medical school, end up deterring prospective doctors from pursuing their studies. He suggests reforming the requirements to include more pertinent classes — anatomy, for instance, or learning about socio-economic and commercial determinants of health. This could help retain students who, often because they don't have doctors in their immediate circle, conflate dull or discouraging pre-med courses with actual clinical work. Read more.


mental health

Most U.S. counties lack maternal mental health support

Mental health issues are the most common complication of pregnancy, occurring both before and after childbirth. Yet a new report from the Policy Center for Maternal Health shows 70% U.S. counties don't have sufficient resources to support new mothers' mental health, and as many as 150 fall into what the report's authors call "maternal mental health dark zone," where the risk is especially high and the resources insufficient. 

The states with the largest presence of such dark zones were Texas, Michigan, Tennessee, Louisiana, Oklahoma, and Indiana. But counties lacking resources are everywhere in the  U.S.: Los Angeles is the county with the largest gap in specialized maternity mental health providers.

Overwhelmingly, high risk factors — such as domestic violence, unemployment, and high teen pregnancy rates — tend to be more common in rural areas, which are more often lacking in resources and are more likely to be home to non-white and/or Latino women of reproductive age.


More around STAT
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What we're reading

    • Man receives the first eye transplant plus a new face. It's a step toward one day restoring sight, STAT

    • This hybrid baby monkey is made of cells from two embryos, Nature

    • CDC data show highest level yet of vaccine exemptions for kindergartners, Washington Post

    • Health disparities drive everything from school absenteeism to loneliness, say experts, STAT
    • After antidepressants, a loss of sexuality, The New York Times

    • What if psychedelics' hallucinations are just a side effect? The Atlantic


Thanks for reading! More on Monday — Nalis


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