When journalist Ted Alcorn visited an alcohol detox center in Gallup, New Mexico, he had little idea his reporting on the impact of alcohol on his state would grow into a multi-part, 21,000-words-and-growing series digging into why New Mexico residents die from drinking at much higher rates than those in other states. Alcorn’s remarkable package, Blind Drunk, was published by New Mexico In Depth in July 2022. Alcorn is an AHCJ Health Care Performance fellow and covered this story as a part of the fellowship program.
A reporter with credits at The New York Times and other national publications who also lectures at Columbia University’s Mailman School of Public Health and NYU’s Wagner School of Public Service, Alcorn shared with AHCJ how his project came about and how he waded through the enormous amount of research that went into it.
This conversation has been edited for clarity and brevity.
Photo by Barbara Olsen via pexels.
Baby boomers may be living longer than their parents or grandparents, but they’re not necessarily healthier than previous generations at the same ages. New research published in The Journals of Gerontology: Series B, shows that later-born generations of older adults in the United States are more likely to have more chronic health conditions than the generations that preceded them.
The prevalence of multi-morbidity — which affects between 55% and 98% of the U.S. population age 65 and older, represents a substantial health threat to aging populations as the number of older Americans increases. Multiple chronic conditions (MCCs) also place a tremendous strain on the health system, such as increased demand for various specialists, more frequent hospitalizations, a need for more complex care coordination and medication management.
MCCs also put more financial pressure on Medicare, which pays for almost all health care for those over 65. This demographic currently makes up about 16% of the U.S. population — but will account for 21% of all Americans — about 77 million — by 2030. That number is expected to soar to 97.5 million by 2060, according to the U.S. Census Bureau.
The images that accompany health stories can have a significant impact on people’s understanding, attitudes and behaviors regarding a health issue. I repeatedly beat the drum about using appropriate imagery for stories related to vaccines. But plenty of other health topics have their pitfalls when it comes to imagery.
- Images accompanying stories about a disease can shape public perception of the disease and those who have it.
- Medical imagery in the media and textbooks has a history of racism and exclusion of people of color.
- Using Black skin images of monkeypox for stories about the current outbreak in predominantly white people perpetuates casual racism by associating Black people with the disease and may lead white people to dismiss their disease risk or not recognize a potential monkeypox rash.
These images from the Marshfield Clinic can be freely used in journalistic stories to illustrate monkeypox on white skin.
The field of dermatology has recently been reckoning with how skin conditions are depicted, whether in news stories, medical textbooks or journals, or other online resources. When nearly all photos of skin conditions are on white skin, doctors may misdiagnose or entirely miss a condition in people of color because the disease looks different on darker skin, potentially harming patients of color. The Journal of the American Academy of Dermatology created a Skin of Color Image Atlas to ensure such images are available to physicians.
But an opposite and just as harmful problem has emerged: Media outlets covering the monkeypox outbreak are frequently using images of Black people even though nearly all cases are among white people.
Photo by Evan White via pexels
Two of the most influential and esteemed medical journals — if not the top two — are the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA). JAMA is more widely circulated than any other medical journal in the world. NEJM has the highest impact factor (number used to measure the importance of a journal) of any medical journal (IF 74.7). So, the combined authorship of articles in these two journals is a reasonable yardstick for assessing the diversity of researchers represented in the most influential medical studies.
That’s exactly what a new study published in the Journal of Racial and Ethnic Health Disparities has analyzed. The findings are discouraging in light of all the lip service in the past decade about needing to improve parity and diversity in medical research. Before I go into more details about the study, here are a few key takeaways:
• Women and racial/ethnic minorities aren’t just heavily underrepresented — their representation as lead or senior authors isn’t increasing in any meaningful way in either NEJM or JAMA.
• It will take centuries for the proportion of Black and Hispanic lead and senior authors to match the population of Blacks and Hispanics in the U.S.
• As journalists, we can’t change who study authors are but we can control who we contact for outside comments. We can and should also make a point to seek out women, gender minorities and Black and Hispanic researchers and clinicians.
• We can also pay attention to the authors of the studies we review. And when presented with two equally impactful studies to cover, we can opt for the one with more diversity among the authors.
Photo by Jo Naylor via Flickr.
Mental and behavioral health disorders have reached a historic peak. And once again, the nation’s lack of inpatient psychiatric beds has become a major point of concern, a renewed focus of researchers and an important story for journalists to follow.
Reporters should note that even before the pandemic, those who had championed community-based rather than hospital-based care for people with mental illness had been heavily rethinking the wisdom of closing psychiatric hospitals. A system of community-based care has yet to be built out.
During the pandemic, a record number of patients have sought mental and/or behavioral health care for the first time; the mental health of the severely mentally ill, including those who couldn’t get in-person medical appointments, often suffered. And the number of children needing psychiatric care increased, though the tally of pediatric psychiatric beds is particularly low.
In the last few months, newly published studies have cited everything from an accelerating decline in psychiatric beds that began roughly a half-century ago to difficulty accurately estimating just how many such beds the nation needs but doesn’t have.