“People are already losing trust in vaccines: Only 40 percent of Americans believe it is extremely important for parents to get their children vaccinated, down from 64 percent in 2001. It is perhaps the most worrying trend in public health right now.
We have the tools to stop many infectious diseases — if we take advantage of them. Trump’s words are making it less likely that people will.”
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“Meanwhile, measles cases in the US matched their 2023 total over just the first few months of 2024. A local outbreak in Oregon has seen nearly two dozen cases since June; at least two people have been hospitalized.
A disease that was once effectively eradicated in the US — and which school mandates helped to stamp out — is mounting a comeback.
Donald Trump could choose to wield his tremendous influence to try to restore people’s faith in vital public health measures. He did it, if half-heartedly, during the pandemic and it had the desired effect. Instead, he’s stoking doubts about the value of vaccines, and courting the dangers vaccine hesitancy brings.”
“Many other developed countries with established pharmaceutical industries such as Japan, Canada, and the UK have implemented or are working to roll out their own incentives to spur antibiotic development. The Pasteur Act dwarfs these. This could potentially drive pharmaceutical companies to flock to the US market to make drugs deemed important there and not in other places.
“The size of the Pasteur Act is going to be so large that it ultimately draws developers to only focusing on the United States, only developing the drug so that it can be used appropriately in the United States, and only registering the drug in the United States, because that’s ultimately going to be sufficient revenue and incentive for what otherwise is not a very profitable market,” explained Rohit Malpani, a senior policy advisor at the Global Antibiotic Research and Development Partnership, or GARDP.
Cirz added that with a steady influx of Pasteur Act funds, pharmaceutical companies may be less interested in investing additional funds to figure out ways to manufacture their antibiotics more cheaply. Usually companies would continue investing so they can increase their profit margins by lowering manufacturing costs, but if profit margins are set by the US government, then there’s less incentive to make an approved drug cheaper, when it can divert attention to making even more drugs. Without that innovation for affordable production, the act may unintentionally prohibit developing countries such as India from being able to independently manufacture the drug.
Finally, while Americans with federal health insurance plans are guaranteed access to antimicrobials that receive support from the act, the proposed legislation does not provide any stipulations or guidance for ensuring global access to these drugs. Pharmaceutical companies are left to make decisions regarding pricing, manufacturing, and distribution of whatever antibiotics might be funded by the program, argued Ava Alkon, global health advocacy and policy adviser at Doctors Without Borders.
“What the act doesn’t do is attach any meaningful conditions to facilitate affordable access to people outside of those federal programs, and certainly not outside of the US,” said Alkon.
“From our years of work on access issues around the world, this generally results in products being sold to the highest bidder and being inaccessible in many contexts where they’re needed,” she said.”
“The US does have significantly fewer doctors per capita than some other wealthy nations, such as Germany and Sweden. But America’s physician-to-patient ratio is actually about the same as other developed countries — Canada, the United Kingdom, Japan, France — that still generally rank better on measures of health care quality than the US does. So aggregate numbers alone are not enough to explain the access problems that patients face, and experts disagree over whether we need to boost the overall supply of providers in the short term.
The bigger problem is misallocation in the US physician workforce, Coffman told me last year. We know that we don’t have enough doctors in certain important specialties: primary care, obstetrics, and psychiatry, for example. We also don’t have nearly enough providers in a broad swath of specialties practicing in rural and other low-income communities. Between 2010 and 2017, while large urban counties added 10 doctors per 100,000 people on average, rural counties lost three. As a result, metro regions had 125 doctors per 100,00 patients, while rural areas had 60.
America is littered with doctor deserts, areas where there are not enough primary care providers, much less specialists or hospital-level services. The federal government estimates that 80 percent of rural Americans live in medically underserved communities.
In the long term, the US will undoubtedly need more doctors in rural and urban areas alike. Groups like the Association of American Medical Colleges continue to project long-term workforce shortages, as boomer-generation doctors reach retirement age and the population of seniors requiring medical care swells.”
“Imagine you’re eight months pregnant, and you wake up in the middle of the night to a bolt of pain across your belly.
Terrified you might be losing your pregnancy, you rush to the emergency room — only to be told that no one there will care for you, because they’re worried they could be accused of participating in an abortion. The staff tells you to drive to another hospital, but that will take hours, by which time, it might be too late.
Such frightening experiences are growing more common in the wake of the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health decision, as doctors and other medical staff, fearful of the far-reaching effects of state abortion bans, are simply refusing to treat pregnant people at all.
It’s part of what some reproductive health activists see as a disturbing progression from bans on abortion to a climate of suspicion around all pregnant patients. “People are increasingly scared even to be pregnant,” said Elizabeth Ling, senior helpline counsel at the reproductive justice legal group If/When/How.
The fall of Roe has led to an ever-widening net of criminalization that can ensnare doctors, nurses, and pregnant people alike, leading to devastating consequences for patients’ health, experts say.
Complaints of pregnant women turned away from emergency rooms doubled in the months after Dobbs, the Associated Press reported earlier this year.”
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“The Dobbs decision has created an environment in which people experiencing miscarriage are treated as criminals or crimes waiting to happen, advocates say — or sometimes both.
In October 2023, an Ohio woman named Brittany Watts visited a hospital, 21 weeks pregnant and bleeding. Doctors determined that her water had broken early and her fetus would not survive, but since her pregnancy was approaching the point at which Ohio bans abortions, a hospital ethics panel kept her waiting for eight hours while they debated what to do. She eventually returned home, miscarried, tried to dispose of the fetal remains herself, and was charged with felony abuse of a corpse.
The charges were ultimately dropped, but experts say her case is part of a larger pattern.”
“Even if the CDC data isn’t perfect, many scholars agree that far too many people are dying during and after childbirth in the United States.
We have many sources of information about maternal mortality, said Laurie Zephyrin, a senior vice president for advancing health equity at the Commonwealth Fund. The CDC’s National Center for Health Statistics releases the numbers that have been most debated recently, but the agency also has a Pregnancy Mortality Surveillance System that employs medical epidemiologists to comb through death records from pregnancy up to a year after birth. Meanwhile, state and local maternal mortality review committees also independently investigate maternal deaths. “All three of these ways of collecting data are showing that we have a problem in this country,” Zephyrin said.
We can also understand US maternal health better by putting it an international context. Comparing maternal mortality across countries can be complex, for some of the same reasons it’s complicated to count maternal deaths within the US. Some countries use a pregnancy checkbox like the one added in the US while others do not, leading to concerns that other nations may be underreporting maternal deaths, making the US look worse by comparison.
However, we know that the US lags behind other countries when it comes to policies proven to improve maternal (and overall) health. Among wealthy countries, the US is the only one without universal health care, said Munira Gunja, a senior researcher with the Commonwealth Fund’s International Program in Health Policy and Practice Innovations. It’s also the only one without federally mandated paid parental leave, and it’s the only country that doesn’t provide home visits and other comprehensive postpartum care, instead often limiting birthing people to a lone doctor’s appointment six weeks after birth. “The US is a clear outlier, particularly when it comes to postpartum support,” Gunja said.
Meanwhile, everyone involved in the debate over counting maternal deaths agrees that Black birthing people are dying at a disproportionately high rate. That disparity shows up whether you use the CDC’s method or Joseph’s, and it’s indicative of bigger problems within the US health care system, experts say. Black Americans in general have a lower life expectancy than white Americans, and Black babies are more likely to be stillborn or die in infancy. “This is across the board, not just in maternal health,” said Angela D. Aina, co-founder and executive director of the Black Mamas Matter Alliance.
Some have argued that the language of “crisis” is unproductive, frightening pregnant people and prospective parents and clouding the search for solutions. “The constant drumbeat that maternal mortality is ‘commonplace’ and that pregnancy is ‘deadly’ doesn’t empower me with information to make my own decisions,” Jerusalem Demsas writes at the Atlantic. “It just stresses me out.”
Reasonable people can disagree over what constitutes a crisis and over the best way to measure how often Americans experience the tragic situation in which a person who is already sick dies from their illness after giving birth.
But experts do not disagree on the basic premise that too many pregnant and birthing people are dying in America, that many of their deaths are preventable, and that we already know some of the reforms — from paid leave to better prenatal and postpartum care — that would save their lives.”
“the PNAS paper didn’t just convert microplastic units to nanoplastic units. The techniques did allow for the detection of a greater amount of plastic in the water, but the implications of that were played up in the media in the most dire way possible. The Washington Post headline referenced “100 to 1000 times more plastics.” The subhead of that article proclaims: “A new study finds that ‘nanoplastics’ are even more common than microplastics in bottled water.” In that article we are told, “People are swallowing hundreds of thousands of microscopic pieces of plastic each time they drink a liter of bottled water, scientists have shown—a revelation that could have profound implications for human health.”
Emphasis on “could.” There are no good studies on what the effects of these particles are. Most of the media outlets that covered the nanoplastic discovery disclose that there’s never been a documented effect on health from the particles, but they still can’t resist framing the discovery with maximum alarm.”