Past winners

The Awards for Excellence in Health Care Journalism recognize the best health reporting in print, broadcast and online media. The contest is run by journalists for journalists and is not influenced or funded by commercial or special-interest groups.

The contest features a variety of categories and entries can include a wide range of health coverage including public health, consumer health, medical research, the business of health care and health ethics.

Contest entrants fill out a questionnaire that details how they reported the work they are submitting. AHCJ posts those questionnaires with the entries, allowing other journalists to learn about new sources, get story ideas and do similar reporting in their own communities.

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Awards for Excellence in Health Care Journalism: 2015 winners

Beat Reporting

First Place: John Carreyrou's 2015 Body of Work; John Carreyrou, The Wall Street Journal

Americans have been fascinated with successful entrepreneurs since Horatio Alger days. In recent years, Silicon Valley billionaires like Apple's Steve Jobs, Google's Larry Page and Sergey Brin and Facebook's Mark Zuckerberg have become icons. Elizabeth Holmes looked to be next. Claiming she was transforming medicine with her blood-testing company, Theranos Inc., the 31-year-old Stanford University dropout became a celebrity.

Theranos became the nation's largest private health care startup, with Holmes's stake valued at more than $4.5 billion. But a series of investigative articles by The Wall Street Journal's John Carreyrou detailed how Holmes and Theranos often have hit technological snags with employees filing complaints with three regulatory agencies alleging the company concealed problems, as Theranos performed millions of blood tests on patients.

Judges' comments: You’d think we would have learned our lesson by now. A flashy tech startup promises the moon. Investors pour in millions. The valuation skyrockets. But does the emperor have any clothes? In the case of Theranos, John Carreyrou wasn’t so sure. His deeply reported and powerfully written stories unveil trouble with the company’s products – and its promises. Regulators, the medical community and consumers took note. This is important, valuable work.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Kay Lazar's 2015 Body of Work; Kay Lazar, The Boston Globe

A New Jersey company with no track record owning nursing homes has been buying up Massachusetts facilities at a rapid clip, assembling 11 nursing homes in less than three years. Synergy Health Centers typically cuts staff soon after each purchase, and swaps out supplies for lower quality products. Quality of care has plummeted. But state regulators kept approving licenses for Synergy, and all of this was done behind closed doors.

Kay Lazar's coverage provided a micro and macro look at the problems, exploring the effect on families and the failures of the state's licensing system. The coverage concluded with an investigation that showed Synergy's owners were profiting handsomely as complaints climbed. It found that state regulators had failed to perform the most basic checks on company executives, and company finances, before granting licenses. The state health commissioner, whose agency grants licenses, acknowledged the system needs to be overhauled.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Fred Mogul's 2015 Body of Work; Fred Mogul, WNYC

These stories show the breadth of Mogul's work, combining investigative, enterprise, expository and breaking-news journalism with an emphasis on public health, health policy and health economics.

One story amassed vaccination data from New York City, New York state and New Jersey. The project focused on the lax enforcement of vaccination laws among New York City's public schools, and WNYC published a lookup tool for people to see the exemption rate of their local schools -- the most comprehensive one ever published in this region.

Another project engaged Columbia University climate scientists and environmental epidemiologists for a research project to investigate pollution exposure among urban exercisers. WNYC is the media arm of the multi-year, NIH-funded study, recruiting and deploying 'civilian scientists' with state-of-the-art air monitors to gather data on fine-particle and black carbon at street level.

Mogul's coverage of one of the largest-ever community outbreaks of Legionnaire's Disease had many prongs. In this quick-turnaround feature, WNYC explored what it takes to clean and maintain cooling towers and how some of them apparently become disseminators of the legionella bacteria.

Another piece of work looked at how, even after two full years of insurance exchanges and Medicaid expansion, people still don't understand how "Obamacare" works and are still falling through the cracks.

Another report focused on a dying woman who needs a lung transplant and why it's particularly deadly to live in New York, which has the lowest organ donor registration rate in the country. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Trade Publications/Newsletters

First Place: The Lost Girls; Apoorva Mandavilli, Spectrum

Autism is frequently seen as a disorder that affects only boys or men. We know much less about how autism affects girls and women. Using powerful stories of three women and emerging science in this field, this story takes us through what it is like to be a woman with autism. The central thesis is that when autism's symptoms intersect with gender, the lived experience of a woman with autism can be dramatically different from that of a man with the same condition.

Judges' comments: This entry is important because the media often underreports women's health issues; it was good to see a story focused on autism and girls and women and how the diagnosis differs from that of boys and men. "Lost Girls" was compelling in its use of real-life stories to show that autism often goes unrecognized in young women and is misdiagnosed as other conditions. Too often health journalism makes perfunctory or clumsy use of these stories to illustrate the human impact of the problem involved. Statistics, study summaries, and policy analysis bear most of the burden of detailing an issue. But in this piece, the intimate stories of the individual women harmed by poor diagnosis give the reader an otherwise unattainable depth of understanding. In telling these stories, it describes the emerging science in the field, points out its historical shortcomings, and talks about programs that are beginning to address the unique needs of young women with the disease. In other words, the reporting was broad as well as deep.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Unequal States: Mapping Healthcare's Diverging Paths; Beth Kutscher, Modern Healthcare

This series represented the culmination of an idea, in late 2013, to examine how Medicaid expansion was affecting hospital finances. It's a topic Beth Kutscher followed for two years, and in late 2014, she was awarded a fellowship from AHCJ to take the reporting and data analysis to the next level. The stories combined original data analysis with on-the-ground reporting in four states. Although some of the findings were counter-intuitive (Medicaid expansion did not appear to have a larger impact on operating margins in states that expanded eligibility for the program), Kutscher worked to  highlight the nuances in the numbers. I also explored how hospitals were using the additional funds they're seeing now that their charity care costs are decreasing.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: The drug rep will see you now; Frederik Joelving, The BMJ

"India's 'health camps:' The drug rep will see you now" reveals for the first time how pharmaceutical companies are boosting drug sales in India through unchecked screening programs billed as corporate social responsibility. At free "health camps" across the country, sales reps and technicians from international and local firms have tested millions of poor people for chronic diseases, with doctors prescribing their products in return.

Experts say the programs are likely to label many healthy people as sick, fueling over-treatment, and they appear to have helped manufacturers push expensive drugs over cheaper brands. They also violate national regulations, which prohibit anyone without a medical license from performing screening and diagnostic tests. Yet drugmakers such as U.S.-based Abbott Laboratories tout the health camps as examples of good corporate citizenship.

Last year, when India made corporate social responsibility mandatory, Abbott decided that screening and health camps would be among its core CSR efforts. For this article, made possible by a research award from The Investigative Fund at the Nation Institute, reporter Frederik  Joelving visited a number of health camps in India and interviewed three dozen reps, technicians and doctors involved in the events. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Investigative (large)

First Place: A Matter of Dignity; Chris Serres and Glenn Howatt, (Minneapolis) Star Tribune

Minnesota has always prided itself on providing generous, progressive care to people with disabilities and mental illnesses. Three decades ago, it helped lead a national movement to close large state mental hospitals, transferring thousands of patients to small private group homes that were regarded as a more humane alternative. Then, however, time stopped. While a disability rights revolution swept much of the nation, inspired by a landmark Supreme Court ruling in 1999, Minnesota remained wedded to an obsolete and demeaning model of care.

By the time reporters Chris Serres and Glenn Howatt began investigating the topic last year, Minnesota's network of group homes and sheltered workshops for people with disabilities had grown into a $1 billion industry that left some 20,000 adults stuck in isolated settings, deprived of therapy, and subject to neglect and abuse. Minnesota had become the most segregated state in the nation for working adults with disabilities and faced sanctions by a federal judge and the U.S. Department of Justice.

Judges' comments: In a deeply moving series, the Minneapolis Star Tribune exposed a tragedy hidden from view: the systematic isolation of Minnesota’s developmentally disabled in remote group homes and dead-end jobs. The reporting team mapped zip codes to document the distant locations of group homes and sheltered workshops. They embarked on a Herculean reporting effort to win the trust of residents. The series’ breathtaking writing – and incontrovertible findings – got immediate results. Prominent lawmakers introduced legislation to overhaul the state’s outmoded grant system, the Governor pledged significant reforms and a key Minnesota agency announced that it would phase out subsidies to sheltered workshops.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Clash in the name of care; Jenn Abelson, Jonathan Saltzman and Liz Kowalczyk, The Boston Globe

The Globe's Spotlight Team exposed an open secret at American hospitals: doctors sometimes start a second operation before the first is finished, meaning that patients are, in effect, sharing their surgeon. And the Globe found one remarkably consistent pattern in its investigation: Patients seldom know, depriving them of a chance to say "no" beforehand. The first story detailed the extraordinary internal debate at Massachusetts General Hospital, one of America's best hospitals, where a handful of doctors and other staff for years objected to surgeons shuttling back and forth between two patients.

In December, the Spotlight team published the findings of a national survey it conducted of 47 hospitals about the practice of surgeons running two rooms. While it is common for doctors to start a second operation before the first is complete, few hospitals call on surgeons to explicitly tell their patients when their operations are double-booked. The survey also revealed that there is little consensus or scientific research on what surgical procedures are appropriate for double-booking, the allowable degree of overlap, and the proper role for surgical trainees. Disputes over surgeons running simultaneous cases have erupted at hospitals across the country in recent years, from Rush University Medical Center in Illinois to Vanderbilt University Medical Center in Tennessee. The conflicts were, at the time, treated as local and separate events, and simultaneous surgery remained unknown to much of the public.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Injured Nurses; Daniel Zwerdling, NPR

When you or a loved one checks into a hospital, maybe you get great care. But reporting reveals that if you could peek behind the employee's side of the curtain, you would likely find that an epidemic is sweeping through the nursing staff: nursing employees suffer more debilitating back and arm injuries than any other occupation. And those injuries are caused mainly by doing their every day jobs of lifting and moving patients.

Studies show that hospitals can reduce the rate of injuries, dramatically. Yet, executives at most hospitals across the nation have done little about it. They're largely ignoring the studies that show that when nursing staff move patients the way that nursing schools and hospitals have taught for a hundred years, they put such dangerous loads on their backs that they're at high risk for serious injuries.

The reporter discovered that the hospital industry has helped block efforts across the nation to pass state laws that would require hospitals to protect nursing staff from getting disabled. The VA –  often the subject of scandal – has quietly become the nation's leading example of how to protect nursing employees from getting injured.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Investigative (small)

First Place: Warehousing our Children; Lauren Sausser, The Post and Courier

South Carolina sends its youngest foster children into group homes and institutions at a higher rate than any other state in the country, even though experts agree that these facilities may subject some children to severe abuse and neglect and that they don't provide the kind of emotional support most children need.  Lauren Sausser investigated the group homes industry. She found that an untold number of foster children in South Carolina custody are neglected, over-medicated with powerful psychotropic drugs, beaten and sexually abused in group homes and institutions every year.

The state warehouses them for millions of dollars a year at taxpayer expense, but state laws shield group homes from almost any scrutiny. The public has no real way to evaluate where children are kept healthy and safe. Meanwhile, as other states have reduced their reliance on group homes by expanding foster family programs or finding relatives for these children to live with, South Carolina has largely resisted change.

Judges' comments: In a months-long investigation that resulted in immediate action by South Carolina policymakers, reporter Lauren Stausser depicts abuse and neglect in group homes for the state’s youngest foster children. Nearly a fourth of South Carolina’s foster children under age 13 are placed in these homes, the highest rate in the country. For the first time, the state was forced to show which of group homes had been investigated for harming children. Impressive reporting and a moving account of harm to children.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Inside Our Hospitals: What the St. Luke's antitrust trial documents show; Audrey Dutton, Idaho Statesman

Using evidence that was sealed from public view during a federal trial against St. Luke's Health System, the Idaho Statesman's series examined what goes into the business decisions made by Idaho's largest and most powerful health care organizations. The stories illustrates how local hospitals make investments based on what competitors are doing in markets such as maternity care, and how they push doctors to keep patients/referrals inside of their own systems. The series digs into the power struggles and financial hostage-taking that occurs when Idaho insurers and hospitals negotiate prices, which ultimately shapes how much Idaho consumers pay for health care.

The Statesman also reported how the buyout tore apart what had been Idaho's largest multispecialty practice and cost St. Luke's tens of millions of dollars. The series revealed among other facts that a Statesman employee's own medical costs spiked 490 percent after her doctor joined St. Luke's – and when that patient complained, executives internally bemoaned the fact that she understood what caused the price increase and mulled whether to write off the charges. Finally, the report noted that much of the trade-secret information was anything but. One sealed document, for example, was a Medicare Cost Report, which was easily obtained through FOIA.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Fields of Toxic Pesticides Surround the Schools of Ventura County -- Are They Poisoning the Student; Liza Gross, The Nation with the Food & Environment Reporting Network

California's $43 billion agricultural industry and pesticide regulators have long argued that Latino children attending schools near intensively farmed plots face no undue risks from pesticides.

Liza Gross collected data for 66 pesticides for all 58 California counties over six years and mapped the pesticides (with help from geographic information system experts at UC Davis) to ZIP code. She overlaid the pesticide data with demographic data and found that, while applications of many of these pesticides had fallen statewide since 2007, a handful of communities saw a dramatic increase.

By 2012, then the most recent year for which data was available, more than 29 million pounds of these chemicals – more than half the total used in the state – were applied in just 5 percent of California's 1,769 census ZIP codes. In two ZIP codes applications of these toxic pesticides, which were already among the highest in the state, rose between 61 percent and 84 percent from 2007 to 2012. These two areas – among ten ZIP codes with the highest use of these pesticides in California – are 70 percent Latino, mostly due to the large number of farm jobs in the area. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Consumer/Feature (large)

First Place: The Double Mastectomy Rebellion; Lucette Lagnado, The Wall Street Journal

We investigated a trend that cancer doctors have found both baffling and disturbing: the dramatic increase in women with early-stage breast cancer choosing to undergo double mastectomies. We probed why younger women in particular were disregarding the advice of their physicians and the available medical data and opting to remove a perfectly healthy breast after they were clearly told that the surgery would not increase their survival. We specifically focused on women who did not have the obvious risk factors such as a genetic predisposition to breast cancer or a familial history of the decision. Indeed, what was fascinating about the story was how many women without such risk factors were still choosing this radical course. 

Judges' comments: We  felt this piece was beautifully written and exposed an illogical trend. It did a great job of explaining what is fueling the trend and why it is dangerous.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Searching for a new liver; traveling for transplant; Karen Shakerdge, Joel Patterson and Mia Lobel, WHYY's The Pulse

In this nine-minute radio feature listeners join a young stonemason from Boston as he copes with a failing liver and tries to figure out what to do about it. One option, his doctors explain, is to go elsewhere. Through his journey, we learn about the geographic disparities of liver transplantation in this country and a proposal on the table that would change the way livers get allocated. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Risks Are High at Low-Volume Hospitals; Steve Sternberg and Geoff Dougherty, U.S. News & World Report

An analysis of Medicare data for a number of common procedures and conditions revealed that patients treated at hundreds of U.S. hospitals that performed small numbers of certain procedures were at much higher risk of dying or suffering significant complications. What made this story most compelling is that despite three decades of published evidence showing the relationship between volume and outcome the practice has persisted, with some hospitals doing 25 or fewer procedures over the three years of data examined. The reporters chose to focus on hip and knee replacement, because the procedures are so common and adverse events can be devastating.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Consumer/Feature (small)

First Place: Tiniest preemies, toughest decision; Markian Hawryluk, Bend (Ore.) Bulletin

When children are born between 23 and 25 weeks of gestation, doctors leave it to the parents to decide when to resuscitate, forcing them to choose between saving the life of their baby and the possibility of lifelong disability.

Judges' comments: Topics like these make it easy to tug at heart strings as parents face a “gut-wrenching” choice: Let extremely premature babies die in peace or keep them alive and likely to face a lifetime of major disabilities. Where this story excels is that it not only captures the parents’ pain but also weaves in the legal and statistical uncertainties, the conflicts felt by doctors themselves, and sophisticated discussions of the latest medical protocols.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: The public health dilemma of a fading black community; David Kroman,

The Odessa Brown Children's Clinic was built in the 1960s in the heart of Seattle's historically African American Central District. No other clinic in the region is better equipped to treat sickle cell disease, an overwhelmingly African American disease. But as Seattle grows, the Central District is being gentrified and families that used to walk or bus short distances to the clinic are being pushed outside the city limits. Because resources for sickle cell are so scarce in the region, families are nevertheless forced to commute long distances to meet appointments at Odessa Brown. As a result, proactive care and community support – both at the core of Odessa Brown's mission and essential to managing sickle cell – have become much more difficult. The staff of Odessa Brown admitted that, as the community it was meant to serve fades, the clinic is breaking its promise of being accessible and open to all. As a potential solution, the clinic's leadership is considering satellite clinics across the region to increase access.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Growing a family tree: Finding lost relatives is getting easier with genetic testing & social media; Sonya Collins, Genome

Direct-to-consumer DNA testing and social media are helping people find family, including sperm donor parents, biological parents who gave children up for adoption, and parents and/or siblings that were unknown to them for other reasons. Finding family and/or undergoing genetic testing can help fill in the gaps in a family medical history that might have otherwise been mostly blank.

This feature tells the story of Sonny Varela, who never knew who his father was. He found his father when a DTC genetic test happened to lead him to a first cousin. When the first cousin was uncooperative and only provided Varela with his initials, Varela tracked down the full name through LinkedIn, then pluggged that name into, which led him to his half-siblings, who led him to his father.

Besides leading Varela to an entire paternal family that he never knew, the information that he gathered during his search has taught him about his genetic predisposition for certain diseases and his ethnic heritage. The possibilities that DTC genetic testing and social media allow could bring health benefits for people who don't know both their parents and also has major implications for sperm banks and adoption agencies that "guarantee" anonymity.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Health Policy (large)

First Place: Hidden Errors; Ellen Gabler, Milwaukee Journal Sentinel

In this investigation, Milwaukee Journal Sentinel reporter Ellen Gabler found that laboratories across the nation are not following basic policies and procedures designed to ensure the accuracy of tests results. A secretive system hides mistakes from the public and allows medical laboratories – some among the most well-respected in the nation – to cut costs at the expense of patients.

The accrediting organizations that inspect the majority of major laboratories are allowed to keep their inspection reports private. In fact, federal law requires it in most cases. Gabler found the accrediting groups were missing major violations. The Joint Commission – a nonprofit that has long touted itself as a quality leader with rigorous performance standards – had been quietly flagged by regulators in 2014 for missing too many serious problems that could harm patients. After filing more than three dozen open records requests for documents and data, and reviewing tens of thousands of pages of inspection and regulatory reports, Gabler was able to identify serious problems in labs throughout the country.

Judges' comments: "Hidden Errors" is a comprehensive, authoritatively written story on an issue of universal concern. Ellen Gabler grabs the reader at the start with relatable examples and weaves patient stories throughout to keep the reader engaged. The graphics are easy to understand and add to the story. Gabler's reporting is detailed and her storytelling is top-notch.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Drug Problems: Dangerous Decision-Making at the FDA; John Crewdson, David Hilzenrath and Michael Smallberg, Project On Government Oversight

The public depends on the FDA to ensure that medicines are safe and effective, but through many months and almost 30,000 words of reporting, this investigation revealed dangerously lax FDA oversight of prescription drugs. POGO's ongoing, multi-part investigation shows that the FDA has:

  • set low standards

  • approved drugs based on flawed clinical trials

  • taken a toothless approach toward doctors who violate standards of clinical trials

  • allowed misleading marketing

  • provided inadequate warnings about drug hazards

  • slighted reports of drug-related deaths and injuries

  • made other dubious judgments that advanced the interests of pharmaceutical companies while putting patients at potentially deadly risk.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: No Place Like Home; Kelly Grant, Elizabeth Church and Fred Lum, The (Ontario) Globe and Mail

Ontario is shifting health care out of hospitals and long-term care facilities and into homes in an effort to save money and allow the sick and elderly to remain at home. In Canada health care delivered by physicians or in the hospital is publicly funded, but home care falls into a grey zone that is not clearly protected by the country's Health Act.

This series uncovered a public home care system plagued by inconsistent standards of care, byzantine processes and a troubling lack of transparency for patients and family caregivers. Reporters found that assessment standards are changed, services reduced and clients cut off in reaction to budget shortfalls and patients win or lose for no reason other than their addresses and how generously their local agencies are funded.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Health Policy (small)

First Place: Living on: Improving the odds of organ transplants; David Wahlberg, Wisconsin State Journal

This nine-part series examined key policy issues in three aspects of organ transplantation: organ allocation, deceased donation and living donation. Access to transplants, especially kidney and liver transplants, depends on where patients live, a data analysis showed.

A new kidney allocation system helps healthier patients get better kidneys, but it doesn't address geographic disparities in access to kidney transplants. Rates of donation after circulatory death, an alternative to the more common donation after brain death, vary greatly around the country. If more hospitals aggressively pursued the procedure, 16,000 more transplants could be done annually, a study found. Policymakers are considering imminent death donation, in which organs would be recovered just before life support is removed, which raises ethical questions.

A new organ preservation technique could allow the use of many organs now discarded or not recovered. Living organ donors are rarely tracked more than two years, so little data is available on their long-term complications. Regulators have taken steps to make living donors more aware of their risks, but critics say their safety is still in the hands of transplant programs that profit from doing transplants. No national registry of living donors exists. Many living donors lose wages and incur other costs in order to help others. Policymakers are looking at reimbursing more of those costs – or even paying donors, which raises ethical questions – to encourage more living donation. Meanwhile, transplant chains are helping more patients find matched living donors.

Judges' comments: This was a timely and comprehensive look at the state of organ donation that shed new light on a system that effectively determines who lives and who dies. The series of compellingly written articles took a provocative look at possible solutions, and put a human face on the ethical debate over the risks of being a living organ donor, and even when a person can be considered dead.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Maternal health: Ebola's lasting legacy; Erika Check Hayden, Nature

As of March 2015, Ebola had infected more than 23,900 people, killing more than 40 percent of them. As fears escalated throughout the affected region, pregnant women faced a particularly dramatic toll. Many were turned away from basic care on the mere suspicion of an infection, and even in previous outbreaks it appeared that those who contracted the disease had incredibly low chances of survival. These impacts threatened to wipe out major improvements made to maternal care in the past decade and a half in Sierra Leone, Liberia and Guinea and were predicted to result in 120,000 maternal deaths by the end of the year with lasting effects to the health of the nation. This report lays out the difficult challenges health care providers face and some of the ways organizations such as Doctors Without Borders were trying to grapple with the problem.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Running on empty; Kristen Schorsch and Jason McGregor, Crain's Chicago Business

In an unprecedented statewide analysis of hospital capacity, reporters found that facilities across Illinois were emptying out. In 2013, nearly four of every 10 hospital beds were vacant when hospitals were at their busiest. Tiny rural hospitals downstate and aging ones in impoverished parts of Chicago were the hardest hit. Clusters of half-empty hospitals sat just miles apart. Chicago is one of the most fragmented hospital markets in the country, with 95 hospitals in a six-county area competing to survive. Fewer patients are walking through their doors for a host of reasons.

Hospitals and doctors are being paid to keep patients healthy and away from costly overnight stays, and can get reimbursed at lower rates if they don't. Advances in technology have led to same-day surgeries. Huge population shifts gutted many minority neighborhoods in the city anchored by hospitals. Consumers have plenty more options to get care, with clinics popping up inside retail pharmacies like Walgreens that compete with family physicians. The ripple effect? A lot of empty hospital beds. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Public Health (large)

First Place: A Game of Chicken; Lynne Terry, The Oregonian

Over a 10-year period, Oregon and Washington health officials traced salmonella outbreaks to Foster Farms chicken. They repeatedly alerted the U.S. Department of Agriculture, which failed to warn consumers and declined in two outbreaks to take significant enforcement action. Foster Farms spent millions on improvements and now reports one of the lowest rates of salmonella contamination in the industry. But many of the same practices and cultural hurdles that contributed to the way USDA handled public health concerns are still in place today. 

Judges' comments: In a year-long exploration, Lynne Terry investigated repeated salmonella outbreaks traced to infected chicken from one of the nation’s largest producers. The real story emerges as Terry exposes the feeble regulatory practices of the United States Department of Agriculture, showing that the agency has been neither prompt nor effective in protecting consumers. Written with discipline and fairness, the expose demonstrates how important investigative journalism can be when others fail to
protect the public health.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Poverty's Poison; Michael Hawthorne, Chicago Tribune

Nationally, the steady decline in cases of childhood lead poisoning is considered a major public health success story. But a Chicago Tribune investigation revealed that lead hazards are festering in the same parts of Chicago that have given the city a national reputation for violence and academic failure. Alarming levels of the brain-damaging metal are poisoning more than a fifth of the children tested each year in parts of low-income, predominantly African-American neighborhoods, even as lead poisoning has been largely eradicated in more prosperous areas of the nation's third largest city.

Politicians and policymakers have yet to catch up to this underappreciated factor in Chicago's seemingly intractable problems, treating the toxic legacy of lead paint and leaded gasoline as a scourge of the past.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Third Place: Living Lonely; Mark Johnson, Milwaukee Journal Sentinel

The two-part series "Living Lonely" takes on the seldom-examined public health problem of loneliness. The first piece, "Solo in their twilight years" tells the stories of Audrey Brennan and Angeline Tesch, two elderly women living in the same apartment complex south of Milwaukee, suffering from a condition considered to be as harmful to human health as smoking: loneliness. The story explains how prevalent loneliness is among America's elderly, afflicting approximately 35 percent, and why it is so harmful.

In study after study, loneliness has been found to shorten lives and increase the risk of a host of illnesses including Alzheimer's disease, high blood pressure, alcoholism, depression, poor sleep, stress and suicide. One study found that while pollution increases the risk of an early death by 5 percent, obesity by 20 percent and alcohol abuse by 30 percent, loneliness raises the risk 45 percent – on par with smoking.

The second piece, "Love endures as memory fades," tackles the loneliness that can afflict men and women who still have their spouses, but have become caregivers for them because of Alzheimer's disease. Few studies have examined loneliness in this population but those that have reveal higher rates of loneliness among Alzheimer's caregivers. The story follows the former governor of Wisconsin, the last man one would have expected to become lonely. Martin Schreiber's descent into loneliness began when his wife was diagnosed with Alzheimer's disease. 

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Public Health (small)

First Place: The Brief Life and Private Death of Alexandria Hill; Brian Joseph, University of California, Berkeley

Squeezed by high caseloads and tight budgets, child welfare agencies across the country increasingly are turning to private, nonprofit organizations and for-profit companies to recruit, screen, train and monitor foster parents.

"The Brief Life and Private Death of Alexandria Hill" is the product of an 18-month investigation by Mother Jones, in partnership with the Investigative Reporting Program at the University of California Graduate School of Journalism, which examines the human consequences of foster care privatization. Brian Joseph describes several cases of child abuse and neglect at the hands of foster parents vetted and monitored by private agencies.

Judges' comments: The effort involved in creating this piece was clearly extraordinary, the writing is very strong and the subject-matter haunting. The writer provides example after example of ways in which companies that are supposed to train and monitor foster parents fail children in the most horrible ways. The writer does a great job in showing the problem in tragic detail. It is sometimes disturbing to read but oh so very necessary.

AHCJ members: Log in to see the archived story and the questionnaire about how the entry was reported.

Second Place: Cradle of Shame; Lauren Sausser and Doug Pardue, The (Charleston, S.C.) Post and Courier

While South Carolina's infant mortality rate is lower than ever, it remains significantly higher than the national average. In fact, in some rural South Carolina counties, the infant mortality rate more closely resembles the rates in many third-world countries. Statewide efforts to reduce the alarming numbers have recently shown some progress, but this four-part investigation revealed that babies in rural counties, especially black babies, continue to die at rates double and triple the rates of babies in metropolitan parts of the state. Also troubling, the most promising programs to reduce infant deaths don't always target the geographic areas that need the most help and some of these programs receive little or no state investment.

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Third Place: The missing generation; Jessica Wright, Spectrum

The story describes the "missing generation" of people with autism: adults who grew up long before autism became part of the public vernacular. Most of these adults with autism are probably still 'missing' – that is, living with misdiagnosis, or no diagnosis at all. As a result, we have little understanding of what it means to age with autism. The few hints we have are concerning: years of depression and suicide attempts, poor medical care, an elevated rate of preventable illnesses and possibly an increased risk of parkinsonism. Efforts to identify and help adults with autism are finally underway, but for many, these efforts are too little, too late.

The story explores these concerns through the life of one man with autism, Scott, who did not receive a diagnosis until 55 years of age. Having a diagnosis has allowed Scott to live alone for the first time, but came too late to fully erase the scars of years of poor medical treatment and support. Scott's story is complemented by those of two other adults who were diagnosed after age 50: B.P., for whom a second diagnosis came tragically too late, and Anita, who by discovering herself also finally found love.

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First Place: The Dysfunction in Drug Prices; Jonathan D. Rockoff, Ed Silverman, Joseph Walker and Jeanne Whalen, The Wall Street Journal

The U.S. market for prescription drugs is an Alice-in-Wonderland corner of capitalism, immune to the usual forces of supply and demand. A team of Wall Street Journal reporters exposed the inner workings of a dysfunctional system that fuels corporate profits on unrestrained price increases, with no accountability to the patients, businesses and government payers that must bear the cost.

Judges' comments: A number of first-rate entries tackled the question of how pharmaceutical companies price drugs. The WSJ team looked at every possible angle of that issue, including an in-depth international comparison that showed the U.S. consumer is subsidizing drugs even for countries that have higher median incomes. This is a model of a thoughtfully conceived series combining enterprising reporting with clear writing to illuminate the forces driving U.S. drug prices higher – vital reporting that educates policymakers and consumers.

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Second Place: Medicare Advantage Overcharges; Fred Schulte, The Center for Public Integrity

Medicare Advantage is a fast growing alternative to traditional Medicare coverage run mostly by private insurance companies. These health plans have enrolled about a third of people eligible for Medicare at an annual cost to taxpayers of about $150 billion. For most of the past decade, these health plans have been paid based on a formula known as a "risk score" that is supposed to pay higher rates for sicker patients and less for those in good health.The Center for Public Integrity used government data to show that risk scores in many health plans were rising far faster than the norm. The series strongly suggested that the plans were "upcoding," or exaggerating how sick many patients were to boost their revenues. In 2015, we uncovered numerous previously-secret audits and other documents that revealed for the first time how some health plans had overbilled the government by billions of dollars and largely gotten away with it.

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Third Place: Deadly Outbreaks, Dangerous Scopes; Chad Terhune and Melody Petersen, Los Angeles Times

Exclusive reporting by Chad Terhune and Melody Petersen linked the outbreak of deadly superbug infections at UCLA and other hospitals to a sophisticated medical device and revealed that the leading manufacturer long knew about the problems but failed to alert doctors to the danger. By piecing together details from individual outbreaks around the world, Terhune and Petersen exposed a pattern of problems with the Olympus duodenoscope that had been missed or ignored by federal regulators. 

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