special report
What Americans can learn from Portugal's health system
Crystal Milner/STAT
Portugal has a life expectancy of about 82, nearly four years longer than the U.S., despite spending just 20% of what the U.S. does on health care per person. It wasn't always that way. In 1950, the U.S. had a life expectancy of 70 years, while Portugal's lingered at 60, among the lowest for developed nations.
So what changed? STAT's Usha Lee McFarling spent two weeks reporting in Portugal earlier this year to find out, speaking with dozens of health care workers, patients, and policy experts. Usha told me she's obsessed with Portugal, and has visited quite a few times. "I wondered how does this little tiny country, far from rich, do so well?" she said in a DM.
Central to Portugal's success is a focus on locally available primary and preventative care. It's not a perfect system, but it may be better than ours. Learn more in Usha's fantastic story. I read it yesterday and am still thinking about an older woman that Usha spoke with at one clinic, who left, then came back to say one more thing. She was concerned about what might happen if something negative was written about the national health system. "It's the only chance the poor people get," she said.
After reading that story, check out the second one about what surprised Usha most in her reporting: Like many European countries, Portugal does not collect information on race. This means there is no good understanding of how bad racial disparities there are.
accidents
E-scooter injuries triple since 2019
The number of injuries that people get while riding e-scooters and e-bikes in the U.S. has tripled since 2019, a jump fueled largely by alcohol and drug use, according to a study published yesterday in the journal Injury Prevention.
Researchers performed a retrospective analysis of emergency room data from the 2019-2022 National Electronic Injury Surveillance System. There were about 4,000 total emergency department visits related to these accidents, the vast majority of which were from scooters. (Just 320 injuries were from e-bikes.) Alcohol use was reported in 8.6% of e-scooter injuries, and younger males had higher odds of being in an accident related to alcohol or substance use.
first opinion
Will Congress reauthorize this groundbreaking mental health law?
In 2022, two years after emergency physician Lorna Breen died by suicide, federal legislation was passed in her honor to protect the mental health of clinicians. The act has helped develop suicide prevention resources tailored to health care workers, supported well-being programs at 45 local hospitals, and provided training for health care leaders to tackle the root causes of burnout.
The Dr. Lorna Breen Health Care Provider Protection Act expired this year, and has yet to be renewed. In a new First Opinion essay, two authors (including Breen's brother-in-law, Corey Feist) argue that without reauthorization, any progress that's been made could stall or disappear entirely. Read more. And from the archives, you can listen to former STAT editor Pat Skerrett interview Feist and psychiatrist Wendy Dean about mental health, burnout, and moral injury among health care workers when the act was first proposed.
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