Thursday, September 8, 2022 – Kaiser Health News

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Kaiser Health News Original Stories
Patient Satisfaction Surveys Earn a Zero on Tracking Whether Hospitals Deliver Culturally Competent Care
In an industry obsessed with consumer satisfaction national patient surveys still don’t get at an important question: Are hospitals delivering culturally competent care? (Rae Ellen Bichell, )
At 988 Call Centers, Crisis Counselors Offer Empathy — And Juggle Limited Resources
During a mental health crisis, a conversation with an empathetic listener can be lifesaving. But for in-person help, resources are in short supply in many parts of the country. (Brett Sholtis, WITF, )
Health Law
Judge's PrEP Coverage Ruling Could Undercut ACA's Free Preventive Care
Judge Reed O’Connor ruled Wednesday that coverage of the HIV prevention drug required by the Affordable Care Act violates a Texas employer’s religious belief. The decision could jeopardize free preventive drugs and screenings like colonoscopies or mammograms. The Biden administration is expected to appeal.
The New York Times: Texas Judge’s Ruling Puts Free Preventive Care In Jeopardy 
A federal judge in Texas ruled Wednesday that the Affordable Care Act’s process for determining what kinds of preventive care must be fully covered by private health insurance is unconstitutional, ramping up yet another legal battle over the 12-year-old law. The ruling, by Judge Reed O’Connor of the United States District Court for the Northern District of Texas, could jeopardize millions of Americans’ access to preventive services, including cancer screenings, alcohol abuse counseling and drugs that prevent H.I.V. infection. It does not take effect immediately, however, and legal experts said the Biden administration would almost certainly appeal. (Stolberg, 9/7)
Roll Call: Federal Judge Rules HIV Drug Mandate Violates Religious Freedom
In the case at hand, Braidwood Management Inc. et al. v. Becerra, six individuals and two businesses challenged the legality of the preventive care mandates under the Constitution and Religious Freedom Restoration Act. The latter prohibits any government agency from substantially burdening an individual’s religious practice. Braidwood provides health insurance to employees but objected to coverage for PrEP because the plaintiff believes the Bible is “the authoritative and inerrant word of God." The company argued that providing coverage of PrEP drugs "facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman." (Cohen, 9/7)
Reuters: Texas Judge Deems Obamacare HIV Prevention Drug Mandate Unlawful
The legal challenge argued that the free pre-exposure prophylaxis, or PrEP, requirement, as well as free coverage requirements for contraceptives and the human papillomavirus (HPV) vaccine, requires business owners to pay for services that "encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use" despite their religious beliefs. (Pierson, 9/7)
AP: Judge Rules Against Required Coverage Of HIV Prevention Drug 
The ruling was handed down by U.S. District Judge Reed O’Connor, whose courtroom in Fort Worth is a favored venue for conservative opponents of the federal health care law that’s also known as “Obamacare.” He ruled in 2018 that the entire law is invalid but was later overturned by the U.S. Supreme Court. … O’Connor also ruled that a federal task force that recommends coverage of preventive treatments, which is made up of volunteer members, violates the appointment clause of the U.S. Constitution. (Weber, 9/7)
Stat: Judge Invalidates Parts Of The ACA That Mandate Health Coverage Of Many Preventive Services And Drugs
Under the ACA, health insurers are required to cover an array of preventive health services — like cancer screenings and vaccines — at no cost. In particular, any service or drug that gets an “A” or “B” rating from the U.S. Preventive Services Task Force must automatically be added to that list of free services. … The list price of brand-name PrEP drugs also is more than $22,000 annually. But O’Connor argued the government does “not show a compelling interest in forcing private, religious corporations to cover PrEP drugs with no cost-sharing and no religious exemptions.” (Herman, 9/7)
Response from the Biden administration —
The Hill: Biden Administration ‘Reviewing’ Texas Judge’s Decision On HIV Drug Coverage
The Biden administration announced Wednesday night it was reviewing a Texas judge’s ruling that declared a part of the Affordable Care Act (ACA) requiring that health care employers provide HIV preventive drugs unconstitutional. White House press secretary Karine Jean-Pierre tweeted the administration was reviewing the decision because the ACA “has been the law of the land for over 10 years.” (Dress, 9/7)
Covid-19 Crisis
Israeli Team Unearths Antibodies That Can Fight All Known Covid Variants
The antibodies can tackle every covid strain, including delta and omicron variants, and could potentially be infused into patients. The recent study is based on earlier work where immune cells were sequenced from people who'd recovered from the original covid strain in Israel.
The Times of Israel: Two Antibodies Identified In Israel Can Fight All Known COVID Strains, Study Finds 
Israeli scientists say they have identified antibodies that are so powerful in neutralizing the coronavirus that they could eliminate the need for more vaccine boosters. A research team at Tel Aviv University experimented with numerous antibodies and found that two in particular neutralize all known strains of the coronavirus, including Delta and Omicron, in a lab setting. (Jeffay, 9/7)
Business Standard News: Two Israel-Based Antibodies May Fight All Known Covid-19 Strains: Study 
The study, recently published in the journal Communications Biology, is a continuation of a preliminary research conducted in October 2020, at the height of the COVID-19 crisis. At that time, the team sequenced all the B immune system cells from the blood of people who had recovered from the original COVID-19 strain in Israel, and isolated nine antibodies that the patients produced. (9/8)
Read the study —
Conformational flexibility in neutralization of SARS-CoV-2 by naturally elicited anti-SARS-CoV-2 antibodies
Another Spending Showdown Looms Over Covid Funding
Republicans are positioned to oppose President Joe Biden's request for billions in emergency relief funding for Ukraine, natural disasters, covid and monkeypox, and could rock stopgap spending bill negotiations.
AP: GOP Gives Thumbs Down To Biden's $47B Emergency Request
President Joe Biden’s request for more than $47 billion in emergency funding to help Ukraine and tackle COVID-19, monkeypox and natural disasters is encountering deep skepticism from Senate Republicans, signaling a showdown ahead. The early resistance on the size and scope of the spending request points to the fraught negotiations to come as Congress labors to pass a stopgap spending bill that would keep the federal government running past Oct. 1 or risk a federal shutdown. (Freking and Mascaro, 9/7)
Fox News: Biden’s Request For $22B In COVID-19 Relief Sticking Point For Republicans In Government Funding Bill
President Biden's push for Congress to approve more than $22 billion in new COVID-19 spending is a nonstarter for Republicans in this month’s must-pass government funding bill. GOP lawmakers say that additional coronavirus funding is a sticking point for them in any deal to keep the government open past Sept. 30 — the deadline by which Congress must pass a budget bill or risk a shutdown. (Alic, 9/7)
Modern Healthcare: End Of Federal Support Means Big COVID-19 Costs For Insurers
Once the federal supply of coronavirus vaccines and treatments runs out, health insurers, employers and pharmacy benefit managers must strike deals with pharmaceutical companies on the prices for the Moderna, Pfizer-BioNTech, Johnson & Johnson and Novavax vaccines and treatments such as Pfizer’s Paxlovid and AstraZeneca’s Evusheld. The federal government anticipates that vaccine and drug procurement and distribution will shift to the private sector as soon as January. (Goldman and Tepper, 9/7)
In updates on the spread of covid —
Politico: New York Lifts Mask Mandate For Public Transit, Correctional Facilities, Shelters 
New Yorkers are no longer required, but still encouraged, to wear masks on subway trains, correctional facilities, detention centers and homeless shelters, Gov. Kathy Hochul announced Wednesday. (Young, 9/7)
AP: WHO: COVID Cases Drop Everywhere, But Pandemic Not Over 
The number of new coronavirus cases fell everywhere in the world last week by about 12%, according to the World Health Organization’s latest weekly review of the pandemic issued Wednesday. The U.N. health agency reported that there were just under 4.2 million new infections last week and about 13,700 deaths – a 5% drop. (9/7)
San Francisco Chronicle: Doctors Who Give False COVID Information Could Face Discipline With New Bill
AB2098 by Assemblymember Evan Low, D-San Jose, specifically calls out COVID-19 and would amend the definition of unprofessional conduct to prohibit doctors from giving patients “false or misleading information” about the coronavirus — including its risks, prevention and treatment — and about the “development, safety and effectiveness” of COVID vaccines. (Asimov, 9/7)
The Boston Globe: Baker Administration To Distribute 5 Million Rapid COVID-19 Tests For Mass. Municipalities And Food Banks
Five million free COVID-19 tests will soon be available to Massachusetts residents, including 1.5 million earmarked for food banks in the state, Governor Charlie Baker’s administration announced Wednesday. The Executive Office of Health and Human Services said municipalities can request free tests — as well as essential personal protective equipment such as KN95, surgical, and children’s masks — through Sept. 16. The tests and equipment are expected to arrive by the middle of October, the agency said in a statement. (Stoico, 9/7)
Clue To Long Covid Could Be Lingering Virus, Spike Proteins
Reports say it's increasingly thought the covid virus lingers in the body of long covid sufferers longer than for people who fully recover. Other research efforts into the illness are continuing, including by a billionaire-backed group.
The Wall Street Journal: A Key To Long Covid Is Virus Lingering In The Body, Scientists Say 
The virus that causes Covid-19 can remain in some people’s bodies for a long time.  A growing number of scientists think that lingering virus is a root cause of long Covid. New research has found the spike protein of the SARS-CoV-2 virus in the blood of long Covid patients up to a year after infection but not in people who have fully recovered from Covid. Virus has also been found in tissues including the brain, lungs, and lining of the gut, according to scientists and studies. (Reddy, 9/8)
Politico: Doctors Are Taking It On Themselves To Figure Out Long Covid 
Dozens of health care practitioners from across the country signed onto a recent Zoom call to talk about pain. Specifically, how much pain their patients with long Covid were in, what kind, and what — if anything — they could do about it. Members of the group, an ad-hoc collaboration of providers at more than 40 long Covid clinics, have met for more than a year but are still grappling with the same kinds of questions they did at the beginning: how to treat a new, complex and debilitating condition affecting millions of Americans. (Mahr and Messerly, 9/7)
Also —
Forbes: Billionaire-Backed Group Steps Up Hunt For Long Covid Treatment
A group of top researchers, clinicians and patients stepped up efforts to combat Long Covid on Thursday, launching a new billionaire-backed initiative to search for drivers of the poorly understood condition and ultimately find treatments to help the millions of people around the world living with the disease. (Hart, 9/8)
Los Angeles Times: New Research Initiative Will Focus On Root Causes Of Long COVID
The Long COVID Research Initiative will try to determine if SARS-CoV-2 is still present in those with long-haul symptoms and, if so, how it might be contributing to their ailments. (Money, 9/7)
Stress, Depression May Worsen Long Covid Risk
Severe covid and higher long covid risks have been linked to physical conditions, but now it's also thought that psychological conditions like stress and anxiety are connected too. Scientists also warn of a possible link between long covid and suicide.
Stat: Study: Stress And Depression Are Indicators Of Long Covid Risk
Studies have repeatedly suggested that physical conditions like immunosuppression and hypertension can increase a person’s risk not only for severe Covid but also long Covid. But in a new study, researchers found that psychological stressors such as depression, anxiety, and loneliness were more predictive of Covid patients’ likelihood of experiencing long Covid than classically associated physical factors. (Trang, 9/7)
CIDRAP: Sustained Psychological Distress May Be Tied To Long COVID 
Among a cohort who never had COVID-19 but tested positive within 1 year after baseline, depression, anxiety, stress, loneliness, and concerns about infection were linked to a 33% to 50% increased risk of self-reported postinfection symptoms lasting at least 4 weeks, as well as functional impairment, finds a study published today in JAMA Psychiatry. "We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID," said first author Siwen Wang, MD, a researcher in the Department of Nutrition at Harvard T.H. Chan School of Public Health, in a Harvard news release. "Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension." (Van Beusekom, 9/7)
NBC News: Stress, Anxiety Or Depression May Increase Long Covid Risk: Study
The new study comes with a few limitations. First, many of the people surveyed were employed as health care workers during the early months of the pandemic, so their stress levels might have been higher than that of the general public. If so, the study results could inflate the role of stress in developing long Covid. Second, participants self-reported their Covid cases, since testing wasn’t widely available at the beginning of the study. But the researchers were careful to address a third potential critique, which is that some long Covid symptoms overlap with symptoms of psychological distress, making it difficult to pinpoint their cause. (Bendix, 9/7)
Reuters: Long COVID's Link To Suicide: Scientists Warn Of Hidden Crisis 
Scott Taylor never got to move on from COVID-19.The 56-year-old, who caught the disease in spring 2020, still had not recovered about 18 months later when he killed himself at his home near Dallas, having lost his health, memory and money. "No one cares. No one wants to take the time to listen," Taylor wrote in a final text to a friend, speaking of the plight of millions of sufferers of long COVID, a disabling condition that can last for months and years after the initial infection. (Steenhuysen and Rigby, 9/8)
Reproductive Health
Michigan's 1931 Law Criminalizing Abortion Blocked
A state court judge placed a permanent injunction on prosecuting cases under the 90-year-old law, which bans abortion with no exceptions for rape or incest. It's one of three abortion-related cases working through the court that could be appealed to the Michigan Supreme Court.
Reuters: Michigan's 90-Year-Old Abortion Ban Is Unconstitutional, Judge Rules 
A 1931 Michigan law banning abortion with no exceptions for rape or incest violates the state's constitution, a state court judge ruled on Wednesday, barring any prosecutors from enforcing it. Judge Elizabeth Gleicher of the Michigan Court of Claims found that Michigan's constitution guarantees a right to bodily autonomy including abortion. The ruling is a victory for providers including a Planned Parenthood affiliate, which had sued to block the law. (Pierson and Singh, 9/7)
NPR: A 1931 Law Criminalizing Abortion In Michigan Is Unconstitutional, A Judge Rules
Michigan Court of Claims Judge Elizabeth Gleicher ruled the Michigan Constitution's due process clause is expansive enough to cover reproductive rights. "The Michigan Constitution protects the right of all pregnant people to make autonomous health decisions," she wrote, and later: "Exercising the right to bodily integrity means exercising the right to determine when in her life a woman will be best prepared physically, emotionally and financially to be a mother." (Pluta, 9/7)
In abortion updates from Ohio, South Carolina, and Minnesota —
Columbus Dispatch: Abortion In Ohio: Judge's Hearing Set For Thursday On 6-Week Ban
Those challenging Ohio's six-week abortion ban say a Hamilton County judge could rule as soon as Thursday on whether the law should remain in effect. Ohio's abortion clinics filed a new lawsuit in Hamilton County Common Pleas Court last week to block Ohio's current abortion restrictions, which have been in place since the day the U.S. Supreme Court overturned Roe v. Wade. Ohio law bans doctors from performing abortions after cardiac activity is detected, which can be as soon as six weeks into pregnancy. (Balmert, 9/7)
AP: Abortion Floor Debate Splits South Carolina Republicans 
The South Carolina Senate’s three Republican women all said Wednesday that they could not support an abortion ban that did not include exceptions for pregnancies caused by rape or incest. Two different attempts to get the exceptions back into the bill failed later in the day. Senators adjourned Wednesday evening without a final vote. (Collins, 9/7)
AP: Judge Who Voided Minnesota Abortion Limits Blocks Appeal Bid 
A Minnesota judge who struck down key restrictions on abortion in the state has rejected a bid by a county prosecutor who hopes to appeal the ruling. Ramsey County District Judge Thomas Gilligan ruled Tuesday night that Traverse County Attorney Matthew Franzese is not entitled to intervene in the case. Franzese had hoped to pursue an appeal after Attorney General Keith Ellison declined to challenge Gilligan’s previous ruling that Minnesota’s restrictions were unconstitutional. (Karnowski, 9/7)
From Tennessee, Texas, and Iowa —
AP: Nashville: No License Plate Readers In Imposing Abortion Ban
Law enforcement in Nashville will be prohibited from using license plate readers to enforce Tennessee’s anti-abortion laws, city council members decided. The move comes after Tennessee, which is politically controlled by Republicans, enacted one of the strictest abortion bans in the U.S. last month. Under the law, almost all abortions are outlawed and doctors who violate the statute risk felony convictions. (Kruesi, 9/7)
Houston Chronicle: Texas Abortion Laws Led To 3-Day Delay For Woman's Treatment
Kristina Cruickshank knew she had lost her unborn baby. In her 15th week of pregnancy, a large fluid-filled sac surrounded the fetus, most prominently around the head and neck. Massive cysts, some filled with blood, covered her enlarged ovaries in a “spoke wheel pattern,” according to her medical records. Additional fluid had filled parts of her abdomen. (Gill, 9/7)
Iowa Public Radio: Abortion Bans Could Have Far-Reaching Impacts On The Black Community In The Midwest
When Jasmine Burnett got pregnant as a young college student in Indiana in 1998, she didn’t know exactly what her future would look like. Burnett had an abortion at around eight or nine weeks of pregnancy. She said it changed her life – for the better. (Krebs, 9/7)
In related election news —
Politico: ‘They’re Getting Killed Among Women’: Skeptical Female Voters Stand In Way Of GOP Senate 
Republicans this election cycle thought they had finally achieved a breakthrough with suburban women after years of losing support. Now, as the primary season has all but ended, the GOP is back where it once was: Appealing directly to skeptical female voters, the women whose support will make or break the party’s drive to retake the Senate majority. A sure sign: One after the other, Republican nominees in top Senate battlegrounds have softened, backpedaled and sought to clarify their abortion positions after the Supreme Court’s Dobbs decision that overturned Roe v. Wade. Another is that male candidates have begun putting their wives in front of the camera to speak directly to voters in new television ads. (Allison, 9/6)
Reversing Course, FDA Committee Backs Experimental ALS Drug
News outlets report that the FDA is not required to follow the panel's advice on the drug, developed by Amylyx Pharmaceuticals, but that is the likely outcome. The decision, in a 7-2 vote Wednesday from the FDA's Peripheral and Central Nervous System Drugs Advisory Committee, came as a reversal from a vote against the drug in March.
Stat: In Reversal, FDA Advisers Vote To Support Approval Of Amylyx's Drug For ALS
At the end of an unusual and dramatic meeting on Wednesday, an independent panel of advisers to the Food and Drug Administration recommended the approval of a new drug to treat people with ALS developed by Amylyx Pharmaceuticals. (Feuerstein, 9/7)
AP: FDA Panel Backs Much-Debated ALS Drug In Rare, 2nd Review 
The Food and Drug Administration advisers voted 7-2 that data from Amylyx Pharma warranted approval, despite hours of debate about the strength and reliability of the company’s lone study. The FDA is not required to follow the group’s advice, but its positive recommendation suggests an approval is likely later this month. The FDA has approved only two therapies for the disease, amyotrophic lateral sclerosis, or ALS, which destroys nerve cells needed for basic functions like walking, talking and swallowing. (Perrone, 9/7)
The Boston Globe: In A Surprise, FDA Committee Recommends ALS Drug By Cambridge Company, Reversing Previous Vote
The unexpected reversal, which was partly due to pleas from patients and their families and partly due to additional data presented by Amylyx, bodes well for the company. But it is only a recommendation. FDA regulators have the final say in authorizing or rejecting the drug by the end of the month. (Cross, 9/7)
The Wall Street Journal: Amylyx’s ALS Drug Backed By FDA Advisers 
“To deprive ALS patients of a drug that might work—it’s not something that I’ll feel terribly comfortable with. In the previous meeting it wasn’t that clear,” said Liana Apostolova, a neurology professor at the Indiana University School of Medicine, who voted for the drug. Other panel members said the evidence for the drug’s effectiveness was weak. “We essentially have a single study with many nontrivial scientific concerns,” said Caleb Alexander, a professor of epidemiology and medicine at Johns Hopkins Bloomberg School of Public Health, who voted against the drug. (Whyte and Walker, 9/7)
NBC News: In Reversal, FDA Panel Votes To Recommend Experimental ALS Drug
Mark Weston, the panel’s patient representative, who voted in favor of the drug both times, said that he was “disappointed” with the lack of persuasive data, but noted the unmet need for better treatments for the disease. Dr. Kenneth Fischbeck, a neurologist at the National Institutes of Health, said the company's new analysis contained no new data. (Lovelace Jr., 9/7)
Cancer Research
Cancer Cases On The Rise Worldwide For Those Under 50: Study
Researchers find a global increase in early onset cancer diagnoses, and that the risks may increase with every generation. The rise is likely due to shifts toward more sedentary lifestyles and Western diets heavy on processed foods.
USA Today: Western Diet, Sedentary Lifestyle Likely Factors In Global Rise In Cancer For Adults 50 And Under
Cancer is on the rise among adults under the age of 50, new research suggests. Early onset cases of cancers of the breast, colon, esophagus, kidney, liver, and pancreas are among those that have risen worldwide since about 1990, according to a study by researchers at Brigham and Women’s Hospital in Boston, and published this week in the peer-reviewed journal Nature Reviews Clinical Oncology. (Snider, 9/7)
ABC News: Cancers In Adults Below 50 Have 'Dramatically Increased': Report
Researchers said breast, colon, esophagus, kidney, liver, and pancreas cancers among others have shown a drastic rise beginning in the 1990s. "From our data, we observed something called the birth cohort effect. This effect shows that each successive group of people born at a later time (e.g., decade-later) have a higher risk of developing cancer later in life, likely due to risk factors they were exposed to at a young age," Shuji Ogino, MD, Ph.D., professor and physician-scientist, said in the report, suggesting increasing risk with each generation. (Grant, 9/7)
And there’s a possible link between frozen embryos and cancer —
New York Post: Kids Born From Frozen Embryos May Have Increased Cancer Risk: Study
New research out of Sweden suggests that babies born from frozen embryos were more at risk to develop cancer than those born through other methods. The findings, which were published in peer-reviewed journal PLOS Medicine, were based on a study of almost 8 million children from four European countries.“[There is] a higher risk of cancer in children born after frozen-thawed embryo transfer in assistant reproduction, a large study from Nordic countries found,” said co-author Ulla-Britt Wennerholm of the University of Gothenburg in Sweden. (Fleming, 9/6)
Newsweek: Kids Born From Frozen Embryos More Likely To Develop Cancer: Study
The most common forms of the disease were leukemia and those affecting the central nervous system. The study did not find IVF or other types of assisted reproductive technology (ART) led to any greater risk of cancer. The link only existed for frozen embryos. ART allows an embryo to be created from a human egg and sperm in a laboratory. A doctor usually immediately transfers the embryo to the uterus. However, the practice of freezing and later thawing before implantation is increasing worldwide. (Kitanovska, 9/5)
On breast and ovarian cancer —
Stat: Gilead Drug Prolongs Survival Of Women With Form Of Breast Cancer
Gilead Sciences said Wednesday that its cancer drug Trodelvy prolonged the survival of women with the most common form of breast cancer by just under 30% — a clinical trial result that could lead to a better treatment option for patients with advanced disease and strengthen the drug’s commercial outlook. (Feuerstein, 9/7)
Medical News Today: Breast Cancer: Less Sitting, More Physical Activity May Lower Risk
Physical activity and less sedentary time have been linked to a lower risk for breast cancer in observational studies. While research suggests a generally consistent link between breast cancer risk and physical activity, the link between sedentary time and breast cancer risk is less clear and less well-studied. Most studies investigating the link between breast cancer and physical activity or sedentary time have been observational in nature. This means that rather than providing a causal link, they provide a correlation that may be subject to biases. (Lennon, 9/7)
PBS NewsHour: Who’s At The Greatest Risk Of Ovarian Cancer?
Nearly 20,000 women will receive a new diagnosis of ovarian cancer this year and more than 12,000 will die from the disease. Dr. Carol Brown, a gynecologic cancer surgeon and chief health equity officer at Memorial Sloan Kettering Cancer Center, joined Amna Nawaz to discuss who should consider themselves at the greatest risk of ovarian cancer. (Nawaz, 9/7)
On prostate cancer —
KCCI: Iowa Man With Advanced Prostate Cancer Finds Hope In New Treatment At DSM Hospital
In the spring of 2022, the Food and Drug Administration authorized Pluvicto, an infusion treatment delivering radiation to targeted cells in the body causing the cells to die. David Clark is one of two patients at John Stoddard Cancer Center undergoing the trial, with physicians overseeing. "This really is kind of the last resort," said Dr. Arshin Sheybani, a physician at John Stoddard Cancer Center. (James, 9/7)
On President Biden’s cancer “moonshot” —
AP: Biden To Channel Kennedy In His Push For A Cancer 'Moonshot'
President Joe Biden next week will highlight his plans for drastically reducing cancer deaths and boosting treatments for the disease in what he has called “this generation’s moonshot,” the White House announced Wednesday. Biden’s speech at the John F. Kennedy Presidential Library and Museum in Boston on Monday will come on the 60th anniversary of his predecessor’s speech outlining his vision for putting the first man on the moon. The White House said Biden will outline what his administration is doing to “end cancer as we know it.” (9/7)
Outbreaks and Health Threats
Vaccines Working: US Monkeypox Outbreak Slows
Media outlets report on the successful impact of vaccines and public awareness of how to reduce exposure risk on slowing the monkeypox outbreak. Racial differences in reported cases remain, however — but during Atlanta's Black Pride event the vaccine effort is shown to have worked.
CNBC: U.S. Monkeypox Outbreak Is Slowing As Vaccines Become More Accessible, Health Officials Say
The U.S. monkeypox outbreak is slowing as vaccines have become more available and there’s broader public awareness about what actions individuals can take to lower their risk of infection, according to White House health officials. (Kimball, 9/7)
AP: Monkeypox Cases Dropping, But Racial Disparities Growing 
The White House said Wednesday it’s optimistic about a decline in monkeypox cases and an uptick in vaccinations against the infectious virus, despite worsening racial disparities in reported cases. Promising to ramp up vaccination offerings at LGBTQ Pride festivals around the country in the coming weeks, Dr. Demetre Daskalakis, the deputy coordinator of the White House national monkeypox response, said more than 460,000 doses have been given. An end to the virus’ spread, however, is not in sight. (Seitz, 9/8)
Atlanta Journal-Constitution: Monkeypox Vaccine Efforts During Atlanta Black Pride Successful
As monkeypox vaccine supply begins to outpace demand, many have received first doses, signaling a step in the right direction to health officials after over a dozen vaccine events were held in the metro area through Labor Day. Monkeypox has disproportionately affected Black men who have sex with men, with this population accounting for 78 percent of cases in Georgia, according to DPH, as of August 31. Local health officials have worked to ensure that vaccines are readily available to the communities impacted the most. (Thomas, 9/7)
Las Vegas Review-Journal: Monkeypox Cases In Clark County Still Increasing But At A Slower Rate
New cases of monkeypox continue to be identified in Clark County but at a slower rate than in previous weeks, a trend seen in much of the country. “I’m holding my breath because it would appear that in many parts of the country, we’re kind of plateauing,” said Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University. (Hynes, 9/7)
WBOY: West Virginia University Student Tests Positive For Monkeypox 
A West Virginia University student tested positive for monkeypox on Wednesday, according to an email sent to students. The student, who resides off-campus, was seen by healthcare providers and is currently isolating and recovering. According to the Center of Disease Control and Prevention, there have been eight confirmed cases of monkeypox in West Virginia. (Ruggieri, 9/7)
Congressional hearings are scheduled —
Bloomberg: Monkeypox: Senate Health Committee Sets Schedule For Hearings On Response
Heads of the US Centers for Disease Control and Prevention, Food and Drug Administration, National Institute of Allergy and Infectious Diseases and the Health and Human Services Department’s preparedness office are slated to testify Sept. 14 at 10 a.m., according to a statement from the office of Senator Patty Murray of Washington state, who chairs the Health, Education, Labor and Pensions Committee. Bloomberg reported last month that the hearing was planned for mid-September. (Muller, 9/7)
Also —
BuzzFeed: Monkeypox Is Leaving Working-Class People In Financial Ruin
More than 20,000 Americans have been diagnosed with monkeypox, the virus that’s been declared a national public health emergency, during this ongoing outbreak. The CDC has advised those who contract it to isolate for the duration of symptoms, which typically last two to four weeks. But with little to no laws guaranteeing workplace sick leave in the US, this lengthy quarantine period can put people who catch monkeypox in a precarious financial position long after their lesions heal. For some, it’s meant being unable to earn an income and turning to GoFundMe to survive. (Reinstein, 9/7)
Health Industry
Walmart, UnitedHealth Pair To Provide Preventive Care For Seniors
Value-based care for Medicare beneficiaries are one target, but reports say the team effort will also offer virtual health care to all age groups. Separate reports say UnitedHealthcare is planning on selling Affordable Care Act plans to people in Missouri and 3 other states starting 2023.
Reuters: Walmart, UnitedHealth To Offer Preventive Healthcare Program For Seniors 
Walmart and healthcare giant UnitedHealth Group are planning to team up to provide preventive care for people aged 65 and up, and virtual healthcare services for all age groups, the companies said on Wednesday. (McLymore, 9/7)
Modern Healthcare: UnitedHealth, Walmart In Medicare Advantage Deal
UnitedHealth Group subsidiary Optum's data and analytics tools will guide Walmart Health clinicians to provide value-based care for Medicare beneficiaries, according to the companies. The initiative will begin in January at 15 Walmart Health locations in Florida and Georgia before expanding elsewhere, and the partners project it eventually will serve hundreds of thousands of patients. The companies also will market a co-branded Medicare Advantage plan in Georgia and Walmart Health Virtual Care will be in-network for some UnitedHealthcare commercial members in January. (Berryman, 9/7)
In news about UnitedHealthcare —
Star Tribune: UnitedHealthcare Plans To Start Selling Obamacare Coverage Again In Missouri
UnitedHealthcare is seeking regulatory approval to begin selling coverage to individuals in Missouri and three other states in 2023, expanding the insurer’s return to a market it largely abandoned five years ago. (Snowbeck, 9/7)
In other health care industry news —
The Boston Globe: Hospitals Scale Back Spending As Multimillion Dollar Losses Mount
Facing multimillion dollar operating losses in the most recent quarter, several midsized and small Massachusetts hospitals and systems have begun intense efforts to scale back spending, as they grapple with the aftermath of COVID. (Bartlett, 9/7)
Montana Free Press: Study Finds Montana Underpays Medicaid Providers By Tens Of Millions
For Dave Eaton, hiring enough staff to help developmentally disabled clients in Livingston with day-to-day tasks is a constant, brutal cycle. Out of every 10 people who come to work at Counterpoint Inc., the small nonprofit he leads, Eaton estimates three leave within a year. Eaton, the organization’s longtime executive director, attributes the high turnover to one key factor: finding people who want to work a tough job for less than $16 an hour isn’t easy. (Silvers, 9/7)
Stat: A New Report Brings Telehealth Fraud Risk Into Focus
Washington’s attempts to permanently lock in telehealth coverage have been hobbled by a fear that virtual care could drive up Medicare fraud and spending. But a new watchdog report offers early evidence that only a small portion of providers are billing for virtual care in a potentially fraudulent way, suggesting that targeted interventions could crack down on abuse. (Ravindranath, 9/8)
KHN: Patient Satisfaction Surveys Earn A Zero On Tracking Whether Hospitals Deliver Culturally Competent Care 
Each day, thousands of patients get a call or letter after being discharged from U.S. hospitals. How did their stay go? How clean and quiet was the room? How often did nurses and doctors treat them with courtesy and respect? The questions focus on what might be termed the standard customer satisfaction aspects of a medical stay, as hospitals increasingly view patients as consumers who can take their business elsewhere. But other crucial questions are absent from these ubiquitous surveys, whose results influence how much hospitals get paid by insurers: They do not poll patients on whether they’ve experienced discrimination during their treatment, a common complaint of diverse patient populations. Likewise, they fail to ask diverse groups of patients whether they’ve received culturally competent care. And some researchers say that’s a major oversight. (Bichell, 9/8)
State Watch
Major Hospital's Generators Fail During Calif.'s Heat-Driven Blackouts
Santa Clara Valley Medical Center in San Jose was left without power for about four hours Tuesday when backup generators failed to work. News outlets report on other impacts of dangerous heat, gender-affirming care, and more public health stories.
Bay Area News Group: Backup Generators Failed At San Jose Hospital During Blackouts
On one of the hottest days in the city’s recorded history and with energy officials anticipating possible blackouts, backup generators failed at a major Santa Clara County hospital in San Jose on Tuesday night, leaving parts of the facility entirely without power for around four hours. (Greschler, 9/7)
More on the dangers of excessive heat —
USA Today: Climate Change: Heat Officers Take On Risks Presented By Extreme Heat
In Phoenix, David Hondula's new role has allowed the city to centralize its extreme heat response, he said. His team takes a two-prong approach, mixing short-term solutions, such as cooling centers and direct relief outreach with longer-term projects, like increasing green space and shade. (Fulton, 9/8)
On gender rights in Florida and Texas —
Politico: Groups Sue Florida Over Medicaid Ban On Gender-Affirming Care
A coalition of transgender rights groups sued Florida over new regulations that block the state’s Medicaid program from covering the costs associated with gender-affirming care. The lawsuit, filed Wednesday morning in Tallahassee federal court, argues the ban, which Florida’s chief Medicaid regulator finalized last month, violates the federal equal protection clause and prevents an estimated 9,000 transgender state Medicaid enrollees from receiving critical gender-affirming care. (Sarkissian, 9/7)
Dallas Morning News: Ken Paxton Joins Other GOP State Attorneys General In Signing ‘Women’s Bill Of Rights’
Texas Attorney General Ken Paxton announced Wednesday he is backing the “Women’s Bill of Rights,” a document being pushed by Republicans that calls for, among other things, a person’s sex to be defined under state and federal law as “his or her biological sex (either male or female) at birth.” The GOP elected officials and candidates promoting the document say “gender ideologues” are trying to redefine womanhood. (Caldwell, 9/7)
In other health news from California, Iowa, and North Carolina —
San Francisco Chronicle: California Becomes First State To Test Drinking Water For Microplastics
On Wednesday, California became the first place in the nation, and perhaps the world, to begin requiring water agencies to test for the contaminant. State water regulators, after years of working with more than 20 labs in seven countries to pioneer a means of monitoring microplastics, adopted new testing and reporting requirements that will take effect next year. (Alexander, 9/7)
Iowa Public Radio: UIHC Eating Disorder Program To End Inpatient Services
The University of Iowa Hospitals and Clinics is ending its Eating Disorder Program’s inpatient care this fall. (Smith and Krebs, 9/7)
North Carolina Health News: New Housing Program Faces Hurdles 
North Carolina’s state Medicaid office is sending millions of dollars to organizations that help people with housing, domestic violence, and other chronically stressful situations. (Donnelly-DeRoven, 9/8)
Mental Health
CDC Says 1 In 4 Young Adults Are Seeking Mental Health Care
New data from the CDC shows that the biggest rise in adults seeking care in the last year was in the 18- to 44-year-old group. Separate reports show nearly a third of non-newborn pediatric admissions from 2016 to 2020 were linked to mental health care.
The Hill: About 1 In 4 Young Adults Getting Mental Health Care: CDC 
Almost a quarter of all young adults received mental health care treatment last year, according to recently released data from the Centers for Disease Control and Prevention (CDC). The number of adults aged 18 to 44 who received mental health care in the past 12 months saw the biggest increase from 2019, rising from 18.5 percent to 23.2 percent. The percentage of all adults who received mental health treatment also increased from 19.2 percent in 2019 to 21.6 percent in 2021. (Gans, 9/7)
Axios: Kids And Teens Were Hospitalized For Mental Health At Increasing Rates Even Before The Pandemic
Nearly a third of non-newborn pediatric hospital admissions from 2016 to 2020 were linked to mental health needs, according to a new report from the Health Care Cost Institute. (Dreher, 9/8)
Axios: More U.S. Adults Receiving Mental Health Treatment
Nearly 22% of all U.S. adults received some form of mental health treatment in 2021, up from about 19% just two years earlier, new data from the CDC's 2019–2021 National Health Interview Survey shows. (Reed, 9/7)
Cerebral’s quality of care is scrutinized —
CBS News: Expert Alarmed By Mental Health App Cerebral's Speedy Sessions And Prescriber Qualifications
More users of Cerebral, one of the largest online mental health care providers, are reporting they have problems with Cerebral's quality of care. In June, CBS News reported on how some users were concerned about how the startup was treating people for conditions such as depression and ADHD. (Werner Wernera and Kegu, 9/7)
CBS News: Video: Former Patient Alleges Mental Health App Cerebral Mishandled Her Case 
In a follow-up to a CBS News investigation of online mental health app Cerebral, CBS News’ Anna Werner takes a look at new concerns about how the platform, which offers therapy and prescriptions, handles people experiencing serious mental health issues. We hear from one woman who says Cerebral mishandled her case – with nearly fatal consequences. (9/7)
In mental health news from New Jersey, Texas, Pennsylvania, and elsewhere —
New Jersey Monitor: Report Finds Decrease In Mental Health Help For Black And Latino Students 
Over the past decade, access to in-school mental health services has decreased for Black and Latino students while slightly increasing for white and Asian students, according to a new analysis of state data. The report, from left-leaning think tank New Jersey Policy Perspective, notes that because of New Jersey’s higher poverty rates for children of color, and the “profound influence” poverty has on mental health, the trends should cause great concern. (Nieto-Munoz, 9/7)
The Texas Tribune: Mental Health Of Texans Affected By Climate Change And Extreme Weather
The first thing Dana Jones, 61, tells you to do when you enter her gray-blue house in Melrose Park is walk along the off-white tile, up and down, through her dining room, while she watches carefully for your reaction. “Do you feel it?” she asks. (Douglas, 9/8)
KHN: At 988 Call Centers, Crisis Counselors Offer Empathy — And Juggle Limited Resources 
On a Friday evening at a call center in southeastern Pennsylvania, Michael Colluccio stirred his hot tea, put on his headset, and started up his computer. The screen showed calls coming in to the suicide prevention lifeline from around the state. Colluccio, 38, said he knows what it’s like to be on the other end of one of those calls. “So, I had a suicide attempt when I was about 10, 11 years old,” Colluccio said. “And we do get callers who are about that age, or quite young, and they are going through similar stressors.” (Sholtis, 9/8)
Opioid Crisis
In West Virginia, Drug Overdose Deaths Fell. Elsewhere, The Crisis Continues.
From March 2021 to March 2022 deaths from drug overdoses fell nearly 4% from the previous year, the CDC says. And Rolling Stone covers a "staggering" number of soldier overdose deaths in Fort Bragg. Separately, the DEA warns of rainbow candy-like fentanyl and the risk to kids.
AP: CDC: West Virginia Sees Decline In Drug Overdose Deaths
Overdose deaths in West Virginia declined during the second year of the COVID-19 pandemic, health officials said. From March 2021 to March 2022, West Virginia saw 1,485 overdose deaths, according to data released by the Centers for Disease Control and Prevention. That was a decrease of 3.6% from the 1,541 deaths for the year ending in March 2021. (9/8)
Rolling Stone: ‘These Kids Are Dying’ — Inside The Overdose Crisis Sweeping Fort Bragg
A staggering total of 109 soldiers assigned to Fort Bragg died in 2020 and 2021. Dozens have lost their lives there to drug overdoses. Now, their families are demanding answers — and accountability. (Harp, 9/4)
AP: Jury Awards $77M In Suit Against Addiction Treatment Center
Nick Carusillo died when he was hit by multiple vehicles on a Georgia interstate, just days after he was abruptly discharged from an addiction treatment center. Now his parents hope a substantial jury verdict in their favor will prompt change that helps others suffering from mental illness and substance abuse. (Brumback, 9/7)
On fentanyl use —
Detroit Free Press: Rainbow Fentanyl May Lure Young People, DEA Warns
In Michigan and across the country, drug dealers are selling fentanyl that looks like candy in an attempt to lure young people and get them hooked on the powerful synthetic opioid, according to the U.S. Drug Enforcement Administration. “Rainbow fentanyl — fentanyl pills and powder that come in a variety of bright colors, shapes, and sizes — is a deliberate effort by drug traffickers to drive addiction amongst kids and young adults,” DEA Administrator Anne Milgram warned in a prepared statement. (Kovanis, 9/7)
Stat: Fentanyl Test Strips Could Help Save Lives. In Many States, They’re Still Illegal
Nothing has made the nation’s addiction epidemic more deadly than fentanyl’s infiltration of the drug supply. Yet in more than a dozen states, tools used to detect the ultra-potent synthetic opioid are still classified as drug paraphernalia — making it a crime to possess or distribute them. (Facher, 9/8)
Lifestyle and Health
Not So Sweet: Artificial Sweeteners Linked To Heart Disease
Artificial sweeteners Aspartame, Sucralose, and Ace K may be culprits behind some heart disease, and researchers are reportedly warning they shouldn't be thought a healthy sugar substitute. Also: Forehead thermometers, the new Apple Watch with women's health features, and more.
Press Association: Sweeteners Aspartame, Sucralose, Ace K Linked To Heart Disease In Study
Academics have identified a possible link between artificial sweeteners and heart disease in a new study. Researchers said that food additives "should not be considered a healthy and safe alternative to sugar". (Pickover, 9/7)
NPR: Forehead Thermometers Could Be Less Likely To Detect Fevers In Black Patients
The chances of a forehead thermometer detecting fevers in Black patients were 26% lower than oral thermometers. Though the differences were small, the researchers noted that fevers could slip under the radar if the number is below commonly used thresholds. (Archie, 9/8)
ABC News: New Apple Watch Feature Designed To Help Women Track Fertility: What To Know
The newest model of the Apple Watch will offer women features to track their menstrual cycles and when they may be the most fertile, Apple announced Wednesday at a launch event at the company's California headquarters. Among the Apple Watch Series 8's advanced features is a temperature sensor that offers an estimate for the last time a woman wearing the watch has ovulated. (Kindelan, 9/7)
CBS News: Technology Seeks To Save Firefighters From "Forever Chemicals"
The Environmental Protection Agency limits the safe threshold for exposure to two of the most common PFAS (PFOA and PFOS) to nearly zero, or less than one part per trillion. But firefighting foam, known as AFFF, contains concentrations of 10 million parts per trillion — more than a thousand times higher than EPA guidance — according to Amy Dindal, PFAS program manager for Battelle, a scientific nonprofit that has developed promising technology to eliminate the problem. (Strassmann, 9/7)
Stat: Juul Settlement Won’t Overhaul The E-Cig Landscape, Experts Warn
On Tuesday, a group of more than 30 attorneys general announced they had reached a “landmark” $438.5 million settlement with the e-cigarette maker Juul over its alleged marketing toward children. But the settlement doesn’t have nearly the scope or the import of earlier efforts to rein in tobacco companies’ marketing, experts told STAT. (Florko, 9/8)
Also —
The Washington Post: Scientists Find Evidence Of Oldest Known Surgery, From 31,000 Years Ago
Archaeologists have uncovered the remains of a young hunter-gatherer in Borneo who survived the amputation of the lower left leg around 31,000 years ago, in a discovery that could rewrite the history of surgery. The findings, published in the journal Nature on Wednesday, are believed to be the earliest known example of a complex amputation, predating other Stone Age surgeries by tens of thousands of years. (Pannett, 9/7)
Health Policy Research
Research Roundup: Covid In Children, Vaccines; Effects Of Pandemic
Each week, KHN compiles a selection of recently released health policy studies. This week, we highlight research from the Center for Infectious Disease Research and Policy (CIDRAP).
CIDRAP: SARS-CoV-2 Antibodies In Kids After COVID May Peak At 1 To 3 Months 
In a group of nonhospitalized children 0 to 16 years old, SARS-CoV-2 neutralizing antibody levels peaked at about 84% 1 to 3 months after they tested positive for COVID-19 but remain high for more than a year, finds a single-center study published yesterday in JAMA Pediatrics. (Van Beusekom, 8/30)
CIDRAP: Half Of Kids With Omicron Test Positive At 7 Days—Beyond CDC Guidance
Almost half of children infected with the original Omicron COVID-19 strain still tested positive 7 days after they first had symptoms, calling into question guidance from the US Centers for Disease Control and Prevention (CDC) on how long to isolate, according to a small study late last week in Clinical Infectious Diseases. (8/29)
CIDRAP: 37% Of A Group Of Maryland Preschoolers With COVID-19 Had No Symptoms
An 8-month COVID-19 screening study of 175 Maryland households with at least one child aged 0 to 4 years finds that 37% of preschoolers had no symptoms, suggesting that screening only symptomatic children may not be enough to prevent outbreaks in this age-group. (9/1)
CIDRAP: Preschoolers' Parent Confidence In COVID Vaccines Wanes As Safety Shown
Today in Morbidity and Mortality Weekly Report (MMWR), survey results show that parental confidence in COVID-19 vaccines dipped after authorization for preschoolers, and surveillance reveals that most adverse events after mRNA vaccination in this age-group were mild or moderate. (9/2)
CIDRAP: COVID's Hidden Victims: New Orphans And Essential Workers 
A pair of new studies describe COVID-19–related parental loss and occupational death rates, with a global analysis finding that children were more likely to be orphaned if they live in the poorest countries with high rates of noncommunicable diseases, and the other showing that essential workers in California had higher rates of coronavirus deaths and excess deaths than those with less workplace exposure. (Van Beusekom, 9/1)
In covid vaccine research —
CIDRAP: MRNA COVID Vaccines Protect Against Severe Omicron For At Least Half A Year
COVID-19 mRNA booster vaccines offered protection against severe COVID-19 caused by the Omicron variant for at least 6 months, and three doses of China's inactivated vaccines were more protective than two doses but not as protective as three doses of mRNA vaccines, finds a study from Singapore published today in JAMA Network Open. (Van Beusekom, 8/26)
CIDRAP: Study: COVID-19 Vaccine Incentives Do Not Improve Uptake
Small incentives to get a COVID-19 vaccine, including amounts of $10 to $50, do not meaningfully increase COVID-19 vaccination rates amongst the vaccine hesitant according to a California study. The study is published in Vaccine. (8/31)
In other pandemic research on C. diff and domestic abuse —
CIDRAP: Study: US C Difficile Prevalence Fell During COVID-19 Pandemic
The prevalence of Clostridioides difficile infection (CDI) in the United States declined during the COVID-19 pandemic, but inpatient mortality and treatment costs were higher, according to a paper published yesterday in Open Forum Infectious Diseases. (8/26)
CIDRAP: Infant Abuse, Domestic Violence Spiked Amid COVID
JAMA Network Open published two studies yesterday on child abuse in France and domestic violence in Japan early in the COVID-19 pandemic, the former finding that the rate of abusive head trauma (AHT) in infants nearly doubled and the latter showing that calls to domestic-violence help centers rose significantly. (Van Beusekom, 8/31)
Editorials And Opinions
Viewpoints: Mental Health Of Rural Americans Needs Attention; Kids Struggle With Pandemic Learning Loss
Editorial writers delve into public health topics.
The Tennessean: Organizations Must Confront Mental Health Challenges In Rural America
When country music legend Naomi Judd tragically passed away on April 30, it was a sobering reminder of the many people who are suffering with mental health challenges in rural America. (Jeff Winton, 9/7)
The New York Times: Can America’s Schoolchildren Recover From The Pandemic? 
Most K-12 schools throughout the country are now back in session, and this school year, the fourth of the pandemic, is finally poised to approach prepandemic normalcy, as most school districts have dropped their classroom mask mandates and other Covid safety protocols. (Spencer Bokat-Lindell, 9/7)
Scientific American: The Number Of Children Orphaned By COVID Keeps Rising 
As an epidemiologist, I am used to studying waves of infection and measuring the rise and fall of deaths. While the deaths of parents and grandparents from COVID crash and recede, the pattern of children affected by orphanhood resulting from the death of a caregiver is entirely different. (Juliette Unwin, 9/7)
The Washington Post: Spanking Harms Children’s Health. Why Do Schools Still Allow It?
When it comes to parenting, there are few topics with enough data to support one clear, “right” approach: Should I sleep-train “cry it out”-style or try the “fade-out” method? Should I use timeouts or redirection? Based on the available evidence, reasonable people can disagree. But if ever there were a practice with a mountain of research supporting its abolition, corporal punishment is it. (Joel Warsh, 9/7)
The Boston Globe: Two Red States Show How The Nation’s Public Health System Can Be Fixed 
The coronavirus pandemic exposed the shortcomings of the US public health system. There is a decentralized set of 2,800 public health agencies that are understaffed, undervalued, and uncertain about their mission. But two Republican-led states are demonstrating how bipartisan reform can lead to a better and more fiscally stable public health system. (Michael S. Sparer and Lawrence D. Brown, 9/8)
The Tennessean: Telehealth Can Brighten Tennessee's Future By Adding More Medical Providers
Four months ago, COVID-era telehealth permissions were extended indefinitely. Healthcare providers of all kinds can continue to use telehealth and get paid the same rate for in person services, and providers can continue to use telehealth to satisfy the requirements to begin online prescribing. (Jeremy C. Kourvelas, 9/6)
Modern Healthcare: Value-Based Care Starts At The Bedside 
As an immigrant child from a war-torn nation, medicine was not the path I would have chosen to contribute to social justice. During medical school, I realized that the science of medicine could change the course of pathologies that are inherited at least partly due to socioeconomic factors—and as a physician, I could right a wrong. (Dr. Abi Sundaramoorthy, 9/5)
The Hill: Healthy School Meals Should Be Available To All U.S. Students – Permanently 
School meals are healthier than the average American diet for most of the 30 million children who participate in national programs, scoring better than average on the Healthy Eating Index. On school days, these children consume as much as half their daily calories at school. Increasing their nutrition quality even further by shifting away from processed meats and foods high in added sugar and sodium, and toward meals higher in whole grains, legumes, and vegetables, could yield an additional $1.5 billion per year by helping to prevent diet-related diseases and providing environmental and climate benefits. (Roy Steiner, 9/7)
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