Category Archives: Public health

R.I. program provides care outside hospitals in effort to reduce ER use

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Emergency department

Photo by KOMUnews via Flickr

Using community health workers to work with frequent emergency room visitors is showing some success in reducing ER use.

The latest installment of “Cost of Diabetes,” a yearlong series by Rhiannon Meyers of the Corpus Christi (Texas) Caller-Times, looks at what Rhode Island is doing to help prevent and manage diabetes.

A “Communities of Care” program pairs peer navigators, who are community health workers, with Medicaid patients who are seen in an emergency room four or more times in a year. The peer navigators “try to figure out why [the patients] keep going to the emergency room and help them access resources they need, from housing to transportation to doctors’ appointments. The peer navigators also continuously check in with patients to make sure they are seeing the doctor as needed and taking their prescriptions to avoid unnecessary hospitalizations.”

Officials at UnitedHealthcare, which contracts with Rhode Island Medicaid, say they’ve seen a 30 percent decrease in ER use and have possibly saved up to $600,000, according to preliminary results. And those results are prompting people to look at the program as a model, said Dr. Rene Rulin, medical director of Rhode Island Medicaid at UnitedHealthcare.

(Hat tip to Keldy Ortiz.)

Las Vegas hospital sends 1,500 patients with mental health issues to other cities

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Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Nevada has been shipping mental health patients out of state as it has cut funding for mental health services, according to a Sacramento Bee investigation.

In recent years, as Nevada has slashed funding for mental health services, the number of mentally ill patients being bused out of southern Nevada has steadily risen, growing 66 percent from 2009 to 2012. During that same period, the hospital has dispersed those patients to an ever-increasing number of states.

Cynthia Hubert, Phillip Reese and Jim Sanders report that Rawson-Neal Psychiatric Hospital in Las Vegas, the primary state psychiatric hospital, put more than 1,500 patients on Greyhound buses bound for other cities.

The reporters reviewed bus receipts kept by Nevada’s mental health division. Southern Nevada Adult Mental Health Services has had a contract with Greyhound since July 2009, a bus company spokesman said. He also revealed that “Greyhound has contracts with ‘a number’ of hospitals around the country, but declined to identify them.”

Mental health professionals in other places are quoted as saying putting someone with a mental illness on a bus is risky and several said their counties don’t do it.

The Center for Medicare and Medicaid Services is investigating Rawson-Neal and the situation has prompted statements from California’s Senate president and a member of the U.S. Commission on Civil Rights.

Government officials, researcher make case for policy influencing healthy behavior #ahcj13

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Mina Kim

About Mina Kim

Mina Kim is a health reporter at KQED-San Francisco. She is attending Health Journalism 2013 on an AHCJ-California Health Journalism Fellowship, which is supported by The California HealthCare Foundation.

Well-structured, comprehensive health policy can change behaviors according to panelists Susan Kansagra, Manish Sethi and Giridhar Mallya. They have been working to address different health issues – gun violence, smoking, and obesity – and shared their strategies at Health Journalism 2013.

Giridhar Mallya, director of policy and planning at Philadelphia’s Department of Public Health, helped launch a campaign to combat obesity there and, after decades of rising obesity rates, the city is seeing declines. The key, Mallya said, was in treating the issue as an environmental disease rather than in individual problem, and that meant altering the environment to give people a chance at being healthy.

“Changing the context is really the sweet spot of public health,” Mallya said. “Change the context so people can default to healthy decisions.” Continue reading →

Boston program specializes in treating homeless #ahcj13

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Desiree Robinson

About Desiree Robinson

Desiree Robinson is a producer/host at WBAI-Corona. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Larry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program, addresses visiting AHCJ members.

Photo by Desiree RobinsonLarry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program, addresses visiting AHCJ members.

“I’ve been locked up in mental institutions and prison. If it hadn’t been for the team here, I wouldn’t be talking to you right now. When I’m feeling depressed, I pick up the phone and I call my psychiatrist and talk.”

These are the heartfelt sentiments of Larry Adams, patient and chairman of the consumer advisory board of the Boston Healthcare for Homeless Program (BHCHP). First of its kind in the nation, BHCHP serves 12,000 patients through over 60,000 visits a year in more than 80 locations. For more than 25 years their mission has been to provide or assure access to the highest quality health care for all homeless men, women, transgender and children in the greater Boston area.

As part of one of the field trips offered at Health Journalism 2013, journalists toured the bright and warm facility where health care teams mobilize to serve the most underserved of Boston’s residents. Continue reading →

Tipping point: Stress affects soldiers and their families #ahcj13

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Janine Weisman

About Janine Weisman

Janine Weisman is editor of the Newport Mercury. She is attending Health Journalism 2013 on an AHCJ-Rhode Island Health Journalism Fellowship, which is supported by The Rhode Island Foundation.

The physical manifestations of stress are something Kenneth Pitts, M.S., research scientist at the U.S. Army Research Institute of Environmental Medicine in Natick, Mass., knows a heck of a lot about. A U.S. Army veteran who deployed to Afghanistan, Kosovo and Panama during his 23 years of military service, Pitts opened his talk with a YouTube video portraying how to drive a Hummer in Iraq: Basically, never stop, even if that means bumping other vehicles out of the way and driving the wrong way to avoid encountering an improvised explosive device.

“They think their life depends on it,” Pitts said.

Maintaining that level of alertness has lasting physiological effects, disrupting the body’s levels of the stress hormones adrenaline, prompting the first wave of the fight-or-flight response, and cortisol, which supports the body as it takes action. Cortisol is known to increase the storage of emotional memories.

“You can maintain that 60 miles per hour but you’re going to wear out your car,” Pitts said, noting that chronic stress produces increased inflammation that is linked to heart disease, strokes and autoimmune disorders. Continue reading →

Getting past conventional wisdom in the prescription drug epidemic #ahcj13

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Alysia Santo

About Alysia Santo

Alysia Santo is a reporter at The Albany Times Union. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Drug-induced fatalities are one of the only preventable causes of death that’s rising, rather than decreasing.

That’s because deaths from prescription narcotics have exploded, and as the panelists at a Health Journalism 2013 panel explained, there are ways to get past the talking points of this “epidemic” and decipher some of the causes for the public.

Lisa Girion, an investigative reporter with the Los Angeles Times, went document diving to get to the root of the problem in a multi-part series she reported with Scott Glover called “Dying for Relief.” Continue reading →

Workplace-based health initiatives target smoking, mental health, nutrition #ahcj13

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Paula Burkes

About Paula Burkes

Paula Burkes is a business writer at The Oklahoman. She is attending Health Journalism 2013 on an AHCJ-Healthier Beat Fellowship, which is supported by The Leona M. and Harry B. Helmsley Charitable Trust.

Is your workplace making you sick?

Experts at Health Journalism 2013 in Boston said it can — and does.

Bad bosses can cause employees to lose sleep, while smoking blue-collar workers face the toughest challenge kicking their nicotine habits and the highest stress jobs are those that are highly psychologically demanding, but with little autonomy, they say.

In one Harvard School of Public Health study of nurses who work in nursing homes, those who had bosses with poor management skills on average got 30 minutes less sleep than those with good managers, said Cassandra Okechukwu, Ph.D., an assistant professor of social and behavioral services at Harvard. Continue reading →

Journalists share tips for weighing hospital rankings #ahcj13

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Jane Lerner

About Jane Lerner

Jane Lerner is a staff writer at The (Rockland) Journal News. She is attending Health Journalism 2013 on an AHCJ-New York Health Journalism Fellowship, which is supported by the New York State Health Foundation.

Photo by Pia ChristensenMarshall Allen, standing, was joined by his ProPublica colleague for a workshop about hospital rankings.

Can every hospital really be better than every other hospital at everything?

Hospital public relations folks and the people who produce rankings, such as Leapfrog and HealthGrades, would like us to think that’s the case.

But, as journalists, we need to take a critical look at the ever-increasing number of hospital rankings that land in our inboxes, said Marshall Allen and Olga Pierce, both of ProPublica.

The pair outlined tips we can use to decipher information during a workshop, “Making sense of hospital ratings: A guide for reporters,” at Health Journalism 2013 in Boston. Continue reading →

Experts stress lifestyle changes as prevention, treatment for diabetes #ahcj13

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Diabetes is prevalent in the United States, and the numbers continue to balloon.

In a Health Journalism 2013 session focusing on type 2 diabetes, a panel of experts discussed the threats of the disease, its growth and possible treatment. The panel was moderated by Tennesseean reporter Tom Wilemon.

Rich Siegel, M.D., co-director of Tufts Medical Center’s Diabetes Clinic, said that the threats of diabetes and obesity – or “diabesity” – in adolescents and young adults is a 21st century time bomb. According to a 2012 study from the National Health and Nutrition Examination Survey, diabetes among adolescents rose 23 percent from 2000 to 2008.

Siegel said the keys to combating type 2 diabetes are diet, activity and education. Medication plays a role, with both injectable and oral medication available. He added that, after 90 years of use, insulin is still the most effective treatment. Surgery can even be an option, but not a first option.

“The idea of surgery is towards the bottom of the list,” Siegel said.

David M. Nathan, M.D., director of the MGH Diabetes Center and Clinical Research Center and professor of medicine at Harvard Medical School, cited a 2012 Centers for Disease control study showing that 26 million people in the United States have diabetes, a majority of them with type 2 diabetes. This is about 8 percent of the population. He added that nearly 2 million cases are diagnosed a year and 72 million American are pre-diabetic. According to an American Diabetes Association, $245 billion is spent every year on the disease.

In treating type 2 diabetes, Nathan stressed the importance of treating for the long haul, focusing on prevention and avoiding complications down the road. He cited a Diabetes Prevention Program Outcomes Study that showed that lifestyle changes reduced the development of type 2 diabetes by 58 percent, more than medication or a placebo.

Osama Hamdy, M.D., Ph.D., the medical director of Joslin’s Obesity Clinical Program and an instructor at Harvard Medical School, estimated that the cost to treat diabetes will reach half a trillion dollars in the next 12 years. He also suggested lifestyle intervention for diabetes prevention and treatment.

Relating global health to your local audience #ahcj13

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Katherine Kam

About Katherine Kam

Katherine Kam is an independent journalist in the San Francisco Bay area. She is attending Health Journalism 2013 on an AHCJ-California Health Journalism Fellowship, which is supported by The California HealthCare Foundation.

Multiple drug-resistant tuberculosis and counterfeit or contaminated drugs have been major problems in countries abroad, but we are now hearing about such problems closer to home. And the issue isn’t limited to infectious diseases or drugs.

“People here are very concerned about the air pollution from Beijing because of the concept of shared air,” said Salmaan Keshavjee, M.D., Ph.D., Sc.M., an associate professor at Harvard Medical School who is an expert in infectious diseases.

Global health can be a hard sell for local audiences, but journalists can find ways to make it relevant, according to Keshavjee and Muhammad Zaman, Ph.D., an associate professor of biomedical engineering at Boston University. Both spoke on Friday at Health Journalism 2013 in a session called “How to relate global health to your local audience.”

Diseases can cross borders in an age of easy global travel. American tourists go on vacation in places such as Romania and Belarus – where multi-drug resistant tuberculosis is a growing problem. Continue reading →