“Ashtabula’s problems stand out compared with two nearby counties – Erie, Pa., and Chautauqua, N.Y. All three communities, which ring picturesque Lake Erie and are a short drive from each other, have struggled economically in recent decades as industrial jobs withered – conditions that contribute toward rising midlife mortality, research shows. None is a success story when it comes to health. But Ashtabula residents are much more likely to die young, especially from smoking, diabetes-related complications or motor vehicle accidents, than people living in its sister counties in Pennsylvania and New York, states that have adopted more stringent public health measures.
That pattern held true during the coronavirus pandemic, when Ashtabula residents died of covid at far higher rates than people in Chautauqua and Erie.
The differences around Lake Erie reflect a steady national shift in how public health decisions are being made and who’s making them.
State lawmakers gained autonomy over how to spend federal safety net dollars following Republican President Ronald Reagan’s push to empower the states in the 1980s. Those investments began to diverge sharply along red and blue lines, with conservative lawmakers often balking at public health initiatives they said cost too much or overstepped. Today, people in the South and Midwest, regions largely controlled by Republican state legislators, have increasingly higher chances of dying prematurely compared with those in the more Democratic Northeast and West, according to The Post’s analysis of death rates.
The differences in state policies directly correlate to those years lost, said Jennifer Karas Montez, director of the Center for Aging and Policy Studies at Syracuse University and author of several papers that describe the connection between politics and life expectancy.
Ohio sticks out – for all the wrong reasons. Roughly 1 in 5 Ohioans will die before they turn 65, according to Montez’s analysis using the state’s 2019 death rates. The state, whose legislature has been increasingly dominated by Republicans, has plummeted nationally when it comes to life expectancy rates, moving from middle of the pack to the bottom fifth of states during the last 50 years, The Post found. Ohioans have a similar life expectancy to residents of Slovakia and Ecuador, relatively poor countries.
Like other hard-hit Midwestern counties, Ashtabula has seen a rise in what are known as “deaths of despair” – drug overdoses, alcoholism and suicides – prompting federal and state attention in recent years. But here, as well as in most counties across the United States, those types of deaths are far outnumbered by deaths caused by cardiovascular disease, diabetes, smoking-related cancers and other health issues for residents between 35 and 64 years old, The Post found. Between 2015 and 2019, nearly five times as many Ashtabula residents in their prime died of chronic medical conditions as died of overdoses, suicide and all other external causes combined, according to The Post analysis of the Centers for Disease Control and Prevention’s death records.
Public health officials say Ohio could save lives by adopting measures such as a higher tobacco tax or stricter seat-belt rules, initiatives supported by Gov. Mike DeWine, a Republican generally friendly to their cause.”
“the White House points to a 2022 report to Congress from the Health and Human Services, Labor and Treasury departments, which found that not one of the 156 insurance plans and issuers studied were following rules requiring them to measure their compliance with the 2008 law.
The problem is actually quite simple, advocates of the Biden rules say.
“The insurers are cracking down on mental health reimbursement in order to save money,” said Sen. Chris Murphy (D-Conn.).”
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“Estimates vary, but the latest data from HHS indicates that more than half of adults with mental illness don’t get treatment. Treatment levels may be even lower for substance use conditions like opioid use disorder”
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“The new proposed regulations, from HHS and the Treasury and Labor departments, are open for public comment until Oct. 2.
If finalized, they would mandate that insurers analyze their coverage to ensure equivalent access to mental health care based on outcomes.
The companies would have to look at how they respond to requests from doctors to authorize treatments for mental illness, compared with physical ones, as well as audit their provider networks and examine how much they reimburse providers out of network.
“This is something that you would have expected the issuers and plans to be doing as part of their own internal analysis to ensure compliance,” said JoAnn Volk, co-director of the Center on Health Insurance Reforms at Georgetown University.”
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“Insurers say they agree that access to mental health care should be equivalent to that of physical health care.
But AHIP, the lobbying group for insurers, says the situation is more complicated than Biden makes out, and that workforce shortages are what’s behind barriers to care.
“Access to mental health has been, and continues to be, challenging primarily because of a shortage and lack of clinicians, which is why for years, health insurance providers have implemented programs and strategies to expand networks and increase access,” AHIP spokesperson Kristine Grow said in a statement.
The group said those include boosting telehealth coverage and integrating physical and mental health care. And it points to rising mental health care usage since the 2008 law as evidence that the law is working.”
“On abortion, on health care for transgender people, even on mental health care, the candidates were comfortable flexing governmental authority to dictate the terms of medical treatment.
But when it comes to using that same authority to protect people during a global pandemic or providing health coverage to people with low incomes, they don’t want the government getting involved.”
“The reality is that myocarditis is relatively low on the list of conditions that can cause a young athlete’s heart to stop. A range of uncommon conditions are more likely to underlie these events, and they’re not new: Medical experts have been
“the World Health Organization’s International Agency for Research on Cancer (IARC) declared aspartame as “possibly carcinogenic.” Another WHO committee, the Joint FAO/WHO Expert Committee on Food Additives (JECFA), independently assessed the ingredient, too, but maintained its existing recommendation — suggesting not that people cut the substance entirely out of their diets but that they limit their daily aspartame consumption to about 40 mg per kilogram (or about 2.2 pounds) of body weight. Diet soda contains about 200 mg of aspartame per 12-ounce can. By that measure, an adult weighing 60 kg, or roughly 132 pounds, would need to drink about 12 cans of diet soda a day to exceed the JECFA’s recommendation, assuming they had nothing else containing aspartame.
Making matters more confounding, the Food and Drug Administration had yet another take. It told Vox in an email that it had reviewed the information used in WHO’s assessment and “identified significant shortcomings” in the studies the agency relied on. “Aspartame is one of the most studied food additives in the human food supply,” the agency added.”
“A federal judge delivered a stinging rebuke to Florida Gov. Ron DeSantis and the Republican-controlled Legislature over rules and a new state law that banned minors from receiving “puberty blockers” and other types of gender-affirming care.
U.S. District Judge Robert Hinkle on Tuesday blocked the state from applying the ban to three minors whose parents are part of an ongoing lawsuit, saying they would “suffer irreparable harm” if they were not allowed to continue access to hormones and other types of treatment.”
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“The American Academy of Pediatrics and the American Medical Association support gender-affirming care for adults and adolescents. But medical experts said gender-affirming care for children rarely, if ever, includes surgery. Instead, doctors are more likely to recommend counseling, social transitioning and hormone replacement therapy.”
“Pharmacy benefit managers are companies that, behind the scenes, determine what patients have to pay for medications. They manage insurance benefits for prescription drugs, dictating which drugs are covered by insurers and what costs patients will face when they fill their prescriptions.
To do that, they negotiate discounts, or rebates, with drug manufacturers and afford privileged status to the companies that give them the best deals.
And over the past few decades, as the prescription drug market has evolved and become more lucrative, so have PBMs. They run their own mail-order and specialty pharmacies. More recently, they have begun merging with health insurers, creating behemoth companies with the power to determine where and how billions of dollars are spent within the US health system.
Pharmacy benefit managers have become known as the mysterious middlemen of the pharma trade — and as a useful scapegoat for drug companies seeking to deflect blame from their own pricing practices.
Now the Senate, as part of forthcoming prescription drug legislation, appears poised to impose new rules on them. The committee overseeing health care debated last week a slew of measures requiring PBMs to be more transparent about their business and cracking down on some of their moneymaking practices.”
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“Experts generally agree that these companies play a role in driving up drug costs for some US patients, even as they negotiate discounts with drugmakers that benefit others, and that the amount of secrecy about their financial arrangements warrants scrutiny.
But reforms to the PBM industry aren’t a cure-all for making drugs more affordable: Sanders said the PBM measures being considered in the Senate would not meaningfully lower the cost of medicine for most people, even if they would bring more accountability and transparency to the sector.”
“Supporters of gas stove bans argue that the gas needed to fuel them is bad for the climate and that the emissions they produce within the home are bad for your health.
Steve Everley, writing in National Review in January, covered several flaws in the most recent studies finding serious health impacts from gas stoves. Experimental studies that found links between gas stoves and child asthma used airtight rooms without ventilation. The author of another much-touted meta-analysis finding a link between gas stoves and child asthma said their study “does not assume or estimate a causal relationship.” Masses of earlier studies, Everley notes, have found no health impacts from gas stoves.
In the short-term, mandated electrification of appliances is probably worse for the climate. On-site use of gas stoves and furnaces uses almost all the energy in the gas. Generating electricity from gas and then using that electricity to power appliances is much less efficient. Of New York’s 10 largest power plants, for instance, five are powered by natural gas.”
“In March 2020, in the uncertain first weeks of the pandemic, Florida Gov. Ron DeSantis acted and talked like most other politicians. He shut down public schools and prohibited visitors at nursing homes. He expanded testing capacity and closed parks out of what he called a need to meet the Centers for Disease Control and Prevention’s guidelines on social distancing. By early April, he had issued his own version of a stay-at-home order and was urging his state’s residents to stay “spiritually together, but to remain socially distant.”
Three years later, DeSantis has transformed himself into the face of an anti-“woke,” anti-public health movement that blossomed during the pandemic — the leader of an administration that was willing to not only defy the public health consensus but to control and manipulate information in order to advance its narrative of a crisis that has killed more than 1.1 million Americans, including more than 87,000 Floridians.
A report this month from the Tampa Bay Time revealed that DeSantis’s state surgeon general had altered scientific data in order to justify his official position that young men should not receive the Covid-19 vaccine. DeSantis, who has criticized former President Donald Trump for deferring to public health officials like Anthony Fauci, has embraced conspiratorial talking points. He has suggested profits and not public health drove the Covid vaccine campaign and convened a state grand jury to investigate any “misconduct” on the part of drug manufacturers and the scientific community related to the vaccines.”
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“What’s clear is something changed, and quickly. Within a month of pleading with Floridians to remain socially distant, DeSantis had begun to reopen the state’s economy. As months went by, he became more brazen in his willingness to bend the truth around Covid and staffed his administration accordingly. Within a year, he had hired a Covid vaccine skeptic as his surgeon general, who would later be accused of altering study data to advance that agenda, and was fighting cruise ships over their plans to impose vaccine mandates for their passengers.”
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“In March and April, the governor’s approval ratings sagged. For those who wanted him to be aggressive in fighting Covid-19, he was not doing enough. For the conservative voters beginning to believe an alternative narrative of the pandemic, his response was an overreaction. As he fumbled through the first few weeks of Covid-19, DeSantis seemed to satisfy no one.
So the governor picked a lane. DeSantis sided with the Republican base upon which he would depend for his political future.
One public health expert who spoke directly with DeSantis around that time, who, like others I interviewed, did not want to be quoted by name for fear of retribution, said the governor referred specifically to senior residents in conservative areas like the Villages as “my people” and appeared preoccupied most with them when considering the response to the coronavirus. Later on, his vaccine-skeptical agenda reflected the mood of many conservative voters, who had glommed onto mischaracterizations about the risks of Covid-19 and conspiracy theories about the vaccines meant to stop it.
DeSantis’s pandemic response helped make him into a national figure, valorized among conservatives and villainized by Democrats and many public health experts.”