Health journalism provides plenty of compelling content. We tell stories of patients who have mystifying, painful or even incurable conditions, and we chronicle the causes and trajectory of diseases. But another fascinating narrative lies beyond the patient experience. Profiling the researcher who made an important new discovery or the doctor who specializes in treating a life-altering condition provides a different lens into medical care. Lunch & Learners agreed that profiles can be very satisfying to write – but also challenging to execute.

 Freelance journalists usually work alone, often at home, without support from workplace colleagues. Many staff writers now find themselves in the same position ever since the COVID-19 pandemic made hybrid work— some days in the office, some days at home — the new standard.

An accountability partner can help with workplace isolation. This tip sheet provides pointers for creating, structuring and maintaining an accountability partnership. 

Rather than a list of tips, this tip sheet is more of a glossary so that you can keyword-search an abbreviation you’ve come across in a study or at a conference. All these abbreviations are ones that might come up in cancer studies or conferences, though some of them show up in studies/conferences unrelated to cancer, such as IRB for Institutional Review Board, ECG for electrocardiogram, or UTI for urinary tract infection. 

Journalism may be our passion, but it’s also our business. At this Lunch & Learn, freelancers agreed that leveraging knowledge and sources on a topic is a vital part of building that business. At the same time, our contracts often deem our stories “work for hire,” which means the publication owns the copyright. Lunch & Learners shared how they are able to turn a story idea into multiple assignments while avoiding potential conflicts.

Five states (Arkansas, Arizona, Idaho, New Hampshire and South Dakota) are like canaries in a coal mine: early indicators of danger. Last weekend, Medicaid officials in those five states began unenrolling adults and children from Medicaid and the Children’s Health Insurance Program (CHIP), according to reporting from Tami Luhby at CNN. 

Writers may not realize it but one of our most valuable skills is diplomacy. Sometimes story edits go smoothly, but sometimes our stories come back again and again as they go up the chain of editors, and we’re barely able to keep our cool. Or, what happens when you and the editor disagree, or the editor is just doing a bad job? Learning how and when to push back is an art form. This Lunch & Learn covered editing scenarios and gave participants strategies for dealing with difficult editors or difficult situations, including when your editor leaves the publication while the story is under edit, and when multiple editors want multiple changes.

In this Lunch and Learn, participants discussed the challenges of setting up a professional website and whether it was worth the time, cost and effort.

February 2023

A type of research in which scientists alter the genetic code of pathogens with pandemic potential to understand how they might become more dangerous will be in the political and scientific spotlight this year. It’s among what’s covered under new recommendations for tightening protocols around any kind of research involving pathogens that are potentially highly transmissible, including viruses like SARS-CoV-2. 

With more and more stories being reported about the applications of artificial intelligence platforms in health care, it may be inevitable that most journalists writing about health care will touch on AI at some point. Here is a primer on what’s happening. 

As usual, we had a good showing of members who are freelance journalists. This month, we shared tips for navigating difficult interviews. Those situations can range from patients who graciously share an intense experience and who need to be interviewed with sensitivity and care to scientists who stubbornly persist in talking in jargon.

Finding success as a freelancer is more than pitching and publishing enough stories to pay the mortgage. Freelancing is a business. We need to find efficient ways to help manage our research and the money side of our creative efforts. Any amount of time we spend away from pitching and writing is money lost.

Working with accountability partners can bring out your better self. Such a partner can act as a sounding board for ideas and help keep your pitches going out like clockwork — with encouragement and regular check-ins. The September Lunch and Learn was aimed at helping writers establish and nurture this relationship.

In the coming year, more clues are expected to emerge aimed at unraveling the mystery of long COVID as dozens of global study results are released.

To help you with your coverage, here is a summary of what is known (as of October 2022) about long COVID, resources for finding studies to follow, and advice for writing about these Long COVID medical studies, how to find patients, and some experts to call.

In the coming months, we’re probably going to see a flurry of stories out of Puerto Rico on health-related consequences of Hurricane Fiona. Beyond writing about the storm’s immediate impact, consider pursuing stories that offer a more nuanced look at health care trends and funding in the U.S. territory.

We’ve all been conditioned to make assumptions about aging; many clichés have been ingrained since we were toddlers, according to aging expert Becca Levy, author of Breaking the Age Code.

Even the most diligent journalists can sometimes fall into the trap of perpetuating ageist stereotypes, whether it’s assuming that dementia is automatically part of getting older or that seniors can’t learn new skills. According to the National Institutes on Aging, here are some of the most common myths and misconceptions about older people.

It’s going to take a while before we know the effects of a recent court ruling that may limit HIV preventive care. But some clinicians are concerned that if it stands, infection rates may increase. The decision from a Texas judge comes as public health experts learn more about how COVID-19 pandemic restrictions on health care have influenced incidence trends among American race and ethnic groups.

Health journalists should know that antibiotic resistance is a quiet, but big threat to modern medicine. The threat has become so dire, that for some patients, the medical community has reached a “post-antibiotic” era, the CDC says. Check out some background information about this topic along with experts to contact and additional resources to aid your reporting.

As suicidal ideation, attempted suicides and actual suicides have increased in recent years, so has coverage of those topics and the discussion of how a journalist might best approach suicide in their reporting.

In this tip sheet, we’re suggesting three threads you can pull on to explain to readers what may be driving monkeypox trends in the U.S. and what we may be seeing here in the coming months. We’re also sharing a list of experts who can give you information about the disease and discuss health equity measures that may be associated with the disease’s demographic trends. 

It’s crucial to understand what’s at stake when the Food and Drug Administration (FDA) seeks expert advice on medicines and medical devices.

For that reason, we’re offering three tips on how to cover FDA advisory committee meetings. Here’s a summary of our suggestions, which we’ll explain in more detail below after providing some background.

You have just signed with a new client with the promise of a steady gig, or you have successfully pitched your dream publication. The contract arrives, and yikes! You see some worrisome clauses. Do you cross your fingers and sign or try and push back? There is no easy answer. Freelancers need to make a living, and sometimes we need to live with clauses in contracts we would rather not see. The best thing we can do is educate ourselves to understand what we are signing.

Whether you are reporting on a fast-turnaround news story or a juicy feature, gathering the information you need to tell your story can mean finding sources to interview, searching the medical literature, and digging through archives, databases, or social media on deadline. Participants from our May 19 Lunch and Learn dug into reporting and sourcing stories.

Many major decisions about medical care and health policy in the United States are settled in the wonky world of federal regulations, which are frankly a treasure trove for journalists. Why? Because federal agencies almost always have to publicly propose major rule changes before making them and allow the public to offer comments on these proposals.

This tip sheet focuses on health equity in three key reproductive health measures: unintended pregnancies, birth control use and abortion. Another recent tip sheet by Kerry Dooley Young, AHCJ’s core topic leader on patient safety, explored the use trends of mifepristone also known as RU-486, a medication used to terminate a pregnancy in its early states.

The graying of America is inescapable. The U.S. Census Bureau projects people over 65 will outnumber those under 18 for the first time in history – 77 million vs. 76.5 million – and comprise 21% of the population. We’re aging as a nation, but lifespan differs depending on a someone's racial/ethnic background, socio-economic status, lifetime access to health care and other factors.

American Indians and Alaska Natives (AI/ANs) are two groups whose longevity and health span are especially affected by these influences. While the AI/AN older population will more than double by 2060 to 648,000, AI/ANs have a lower life expectancy, lower quality of life, and are disproportionately affected by many chronic conditions when compared with other racial/ethnic groups, according to the CDC.

Ticks are emerging earlier from winter hibernation and staying active longer because of climate and deforestation, according to public health experts. Now Americans’ risk of infection from pathogens carried by the outdoor pests is rising.

As the U.S. baby formula shortage stretches into summer, it continues to underscore that income level, employment type and geography are factors that affect people’s access to basic nutrition. The crisis, caused in part by the shutdown of an Abbott manufacturing plant over concerns of food contamination, is also increasing awareness of existing disparities in maternal and infant health.

With the U.S. Supreme Court reversing the landmark Roe v. Wade case  on June 24, 2022 journalists can expect an increased focus on abortion pills.

The COVID-19 pandemic has helped sharpened the focus on palliative and end-of-life care. However, it is critical not to confuse or conflate these two concepts. End of life, or hospice care, is for people for whom a cure is no longer possible. They must meet certain guidelines to qualify for Medicare-reimbursed services.

Freelancers have a love-hate relationship with pitching. It is the best (and sometimes only) way to break into publications. Sometimes a pitch lands, and other times we get the silent “no” or a “sorry, this is just not for us.”

Even if a pitch doesn’t fly (and so many of them don’t), a strong pitch works as an introduction and puts you on the editor’s radar. While pitching has always been challenging, there is now much more turmoil in the business, and the publishing landscape has changed over the past two years. There are fewer publications than there were in the heyday of the glossy print magazine.

If you are going to cover the debate about the Medicare decision to limit payment for Biogen’s Aduhelm drug for Alzheimer’s disease, it’s critical to understand a major disagreement between two federal agencies.

Last year, The Food and Drug Administration (FDA) granted accelerated approval to Aduhelm, betting heavily on the potential of drugs that clear amyloid plaque in the brain. In April 2022, The Centers for Medicare and Medicaid Services (CMS) signaled greater skepticism about this approach.

We offer three tips below for reporting on Medicare’s coverage decision on Audhelm.

Fellowships look great on your resume, but they become increasingly competitive. Freelancers can have an especially tough time winning a fellowship because we have to find editors who will support the project through a strong reference letter and provide a place to publish the stories.

During AHCJ’s inaugural Lunch and Learn, we set out to find ways writers could keep their careers moving forward and generate a reliable income stream. With so much COVID upheaval, setting goals and planning out a steady income for the year has been a big emotional hurdle for some of us. While it might be difficult to imagine a future during a pandemic, we can still sit down and work out ways to meet our freelance goals and set up a workflow for the rest of the year that will bring a steady income.

Epidemiologists, physicians, sociologists and health equity experts are increasingly shedding light on the relationship between quality of health and educational attainment, insurance coverage, access to safe home environments and other social factors. That means journalists are expected to give more context about health trends — even if the story is about the latest diabetes statistics in U.S. race, ethnic and Indigenous groups.

Some one million adults aged 65 and older currently live with a substance use disorder (SUD), according to the Substance Abuse and Mental Health Services Administration (SAMHSA). While use of illicit drugs in older adults is much lower than among other adults, it’s on the rise. In the United States, the number of older adults needing treatment for substance use has tripled since 2000 — from 1.7 million to 5.7 million in 2020, according to the National Center for Equitable Care for Elders (ECE) at Harvard.

Yet drug abuse among older people remains underestimated, under identified, underdiagnosed, and undertreated. Substance use among older adults is especially complex as it is often not recognized because of other health-related aging conditions or is not treated effectively notes the ECE.

As freelance writers, we sometimes struggle with the decision to attend professional development conferences. Can we afford the travel — and the time off? For AHCJ’s Health Journalism conference, I have discovered over the previous decade that I can’t afford not to go.

Patricia Stinchfield, R.N., M.S., C.P.N.P., has just broken a glass ceiling, but it’s probably not the usual one you’re thinking of. As the president-elect of the National Foundation for Infectious Diseases (NFID), she’s not the first woman to lead the NFID. That would be Susan J. Rehm, M.D., from 2001-2004. But Stinchfield is the first nurse or nurse practitioner to lead the organization. Except George C. Hill, PhD, from 2008-2010, every past president of the NFID has been an MD.

Last year, April Simpson demonstrated what may be one of the most effective ways to write about the benefits of Medicaid expansion. A senior reporter covering racial equity for the Center for Public Integrity (CPI), Simpson wrote two articles showing how residents in Medicaid-expansion states gained better access to care than those living in neighboring states that did not expand eligibility for enrollment in Medicaid, as allowed under the Affordable Care Act.

Falls in older adults are common — one in every four elders experiences a fall every year, according to the CDC. Because of underlying conditions such as frailty or osteoporosis, falls can lead to broken bones, hospitalizations, loss of independence and the ability to age in place and even death. Falls are the leading cause of injury or death among people 65 and older, and prevalence is increasing to what some researchers call epidemic levels. Safer living environments and fall prevention programs can mitigate much suffering and save the health system money long-term.

When Jyoti Madhusoodanan worked with an American Sign Language interpreter for a story about deaf graduate students in the sciences, she didn’t know what to expect. She hadn’t used an interpreter for interviews before then, and wondered whether the responses would sound rehearsed.

Once the work began, Madhusoodanan said the interaction with her six sources was seamless. That may have been in part because Madhusoodanan shared some of the topics and even specific questions with the interpreter and the sources before the interviews, which she did over a video conference platform.

Testing in the U.S. has been challenging for myriad of reasons including lack of laboratory infrastructure, supply chain gaps, regulatory obstacles, lack of test production capacity and federal leadership attention. Public health experts say that for much of the pandemic, testing in the U.S. has been more about documenting cases than anticipating and altering the course of the pandemic.

Now that may be changing. By the end of January, millions more Americans will have access to rapid tests for detecting COVID-19 infections, raising numerous questions about how to use them and whether they will help the country move beyond the pandemic.

To help journalists cover this story, I compiled questions that have come up repeatedly over the past month including, why and how tests should be used, whether or not they work, how to obtain them and what they cost, resources for finding answers and experts to call.

Nearly every older adult wants to grow older at home surrounded by familiar friends, neighbors and possessions. A recent AARP Survey found that 77% of those over 50 and 90% of those over 65, prefer remaining in their own home despite potential challenges like steep stairs or doorways that are too narrow to accommodate a walker.

Are you fed up with the rigmarole some consumer publications put their freelance writers through? Award-winning writer Jen A. Miller has tips for branching out into Business2Business and Business2Consumer publications. 

When reporting on junk health insurance plans, one of the prerequisites is finding consumers willing to talk about how they fell victim to an egregious health coverage scam.

Such stories are most compelling when we feature an unsuspecting consumer willing to explain how he or she got swindled into buying what looked like a worthwhile health insurance plan that would cover the costs of routine or emergency care or a major illness.

Finding sources for these types of stories requires digging, along with knowledge of how social media works and knowing where to look, explains Jenny Deam, a veteran health care journalist for ProPublica.

Federal officials and telecommunications companies are working on a new national three-digit number to make it easier for people experiencing mental health crises to find help.

There are many angles for journalists who want to track how federal agencies are working to meet the July 2022 deadline for the new 988 dialing code. This code would be operated through the existing National Suicide Prevention Lifeline, 800-273-TALK which already operates 24 hours/day, seven days a week.

While it’s true that frailty may be a part of old age, it’s not always inevitable. It’s important to understand frailty, especially when reviewing studies or reports since some research or programs include only frail elders, while others may encompass “healthy” (read: not frail) older adults.

Aging is a series of interconnected processes of growing older, a biological phenomenon often referred to as "senescence.”

Frailty is a chronic, progressive condition categorized by at least three of five criteria:

• Muscle weakness
• Unintentional weight loss
• Low physical activity levels
• Fatigue
• Slow walking speed 

Whether you are new to covering COVID-19 or are just looking for a new resource, AHCJ can help with a list of 10 things to know to help you get up to speed. We will continue to update this list monthly as this health story evolves.

There’s no denying that MA plans are attractive to seniors because many of them offer multiple benefits for low monthly premiums. But the TV ads and almost all the promotional materials from the Medicare program and the insurers themselves do not mention that when enrolling in MA, seniors face a huge risk because MA plans are unlikely to provide the best coverage for seniors over time. Despite the risks, 71% of Medicare beneficiaries did not compare their options when shopping for coverage in 2019, according to this October report from the Kaiser Family Foundation. 

One of the nation’s experts on Medicare is health care journalist and former AHCJ president Trudy Lieberman (@Trudy_Lieberman). “People are being lured into Medicare Advantage plans with a false sense of security by the promise of no premium or a low premium,” she said.

“Medicare Advantage plans may leave gaps in coverage, and they come with large upfront, out-of-pocket costs. Also, MA plans usually have restrictive networks of hospitals and doctors.”

Lindy Washburn, a health care reporter for the USA Today Network, northjersey.com & The Record, is known for reporting on the many COVID-19 tragedies at VA nursing homes early in the pandemic. Nursing homes in New Jersey (both VA and privately owned) experienced a startling surge of COVID cases and deaths. Joanne Kenen’s “How we did it” on Politico’s investigation of state Veteran’s Affairs nursing homes, highlights Washburn as a must-read journalist if you’re covering local nursing homes.

Here is a list of other journalism organizations that AHCJ members might want to join or follow. They offer an assortment of training, networking, educational opportunities and job listings.

Climate change is one of the biggest public health threats today, particularly when it comes to health inequities or preventable differences in health outcomes caused by systemic, avoidable, and unjust social and economic policies and systems.

While climate change is a global phenomenon, the consequences impact places, people and communities at the local level. Low-wealth communities and communities of color across the country suffer a substantially higher burden. Climate change exacerbates these health risks and inequalities for some people and communities.

Subject librarian Katy Boss at New York University’s Arthur L. Carter Journalism Institute created an instructive guide to filing FOIA and state and local open records requests. Boss gave AHCJ permission to publish this lightly edited version of the reference tool. AHCJ core topic leader Barbara Mantel has added some links at the bottom that will be of interest to health care journalists.

Approximately 75% of acute myocardial infarctions (heart attacks) occur from plaque rupture brought on by atherosclerosis. The highest incidence of plaque rupture happens in men over 45; in women, the incidence increases after age 50. This gender difference in atherosclerosis prevalence is thought to be due to the protective function of female sex hormones, which decline after menopause.

Ransomware and other types of digital attacks are becoming increasingly common in the health care world. What better target than an organization that must operate around the clock, handles large amounts of money, and operates a highly complex business full of computers and humans often working under stress and time pressure?

While COVID-19 has been the focus of media attention over the past year, the HIV epidemic has continued its quiet spread worldwide.

June 2021 marks 40 years since the CDC first published a morbidity and mortality report about five men with pneumonia-like symptoms that are now known to have been caused by acquired immunodeficiency syndrome (AIDS).

It took several more years for scientists to determine the pathogen causing AIDS was the human immunodeficiency virus (HIV) and many additional years to determine HIV evolved from nonhuman primates. The CDC recently published a comprehensive history and context of the HIV and AIDS epidemic.

While there are plenty of advantages to covering virtual medical conferences from home, one of the biggest challenges is finding outside experts to comment on the research that has been presented. Here’s a list of tips I’ve learned over the past year to find those outside commenters even if the conference platform doesn’t allow me to see who’s attending the session.

(Updated May 31, 2021)

On March 11, 2020 the World Health Organization declared COVID-19, the disease caused by the SARS-CoV-2 coronavirus, a pandemic. See more about coronaviruses here. 

As of May 31: an estimated 33.3 million people in the U.S. were reported infected with SARS-CoV-2, and more than 594,500have died from complications related to COVID-19 since the beginning of the pandemic , according to data from the Johns Hopkins University & Medicine Coronavirus Resource Center, which developed one of the earliest and most respected tracking services. 

Globally, more than 170.5 million have been infected and 3.54 million have died, making this the world’s deadliest pandemic since the 1918 Spanish flu, which killed in the range of 17 to 50 million people globally over two years. 

Devex, a global development media platform, created this timeline of how the pandemic has unfolded since December 2019 when the virus was discovered in China. The Johns Hopkins site releases a daily one-minute video summarizing the most critical data the public needs to know each day about the pandemic.

As of March 2021, 36 states, the District of Columbia, and three U.S. territories (Guam, Puerto Rico, and U.S. Virgin Islands) have legalized medical cannabis, with 15 states permitting both medical and adult recreational cannabis use. Three additional states — Virginia, South Dakota, and New York — have passed recent legislation expanding use into the recreational/retail space.

Cannabis fever undoubtedly has taken hold across the nation and there’s one group in particular who appear eager participants: older adults. Data presented during the American Association for Geriatric Psychiatry’s Annual meeting demonstrates a 14% increase over three years in the proportion of older (mean age 72.3 years) Canadian adults reporting medical cannabis use. Notably, most (60%) were women, echoing previously-reported usage trends among women and gender-related drivers.

Food insecurity was already a serious problem for many older adults, and the pandemic has made a serious situation even worse.

Prior to the COVID-19 crisis, nearly 5.3 million seniors faced hunger in the U.S., according to the nonprofit Feeding America. The rate of hunger among seniors aged 60 and older has increased by 38% since 2001, and at the current rate, the number of food-insecure seniors may grow to more than 8 million by 2050. These older adults are often forced into impossible choices: paying for food, for medication, or for a roof over their head.

How do you find the most appropriate outside experts to comment on a study you’ve been assigned if it’s on a topic you’ve never covered and you know very little about? You already know you need more than a “liver cancer expert” or an “HIV expert” or a “nutrition expert.” You need a more finely tuned expert within the subfields of the topic who is intimately familiar with the specific research you’re covering, such as “PD-L1 immunotherapy for liver cancer” or “use of monoclonal antibodies to prevent mother-to-child transmission of HIV” or “metabolic effects of a plant-based diet on subcutaneous fat.” Here’s a step-by-step plan of what to do to find those experts with limited time.

In December, we wrote about Medicare Advantage (MA) plans and the television advertisements that touted their benefits. We warned that out-of-pocket costs could rise sharply if an MA member gets sick or injured.

But one angle in that story didn’t get enough coverage: The trouble any seniors in MA plans would face they wanted to disenroll in their MA plan to get more suitable coverage. Although we noted that my AHCJ colleagues Liz Seegert, who writes about aging, and Cheryl Clark, who reports on patient safety, have covered this topic well, health care journalists can and should do more reporting on this troubling aspect of Medicare Advantage.

News about Pfizer-BioNTech’s COVID-19 vaccine was so big in December that video crews recorded what would be an otherwise mundane scene as tractor-trailer trucks rolled out of Pfizer’s distribution center in Portage, Mich., starting on Dec. 13.

But for non-white Americans, this good news is only part of the story because Blacks, Latinos, Native Americans, and other people of color may be reluctant to get the vaccine, as Glenn Howatt reported for the Minneapolis Star Tribune. Howatt’s article is just one example of how journalists localize the national story about the vaccine for COVID-19. Also, it’s an excellent example of why people of color are reluctant to get the vaccine. Such reluctance is born of widespread disparities in the health insurance and health care systems in the United States.

Returning to a society where people can safely gather with friends, family and large crowds will take a combination of a vaccine and treatments to stop the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

The race to find a vaccine has spurred much media attention. As of mid-October, between 50 and 179 promising vaccine candidates were under study, with more than 50 having reached the human clinical trial stage.

Many of the studies and trials are taking place in the U.S. and are part of the White House’s Operation Warp Speed program. Many more are being conducted outside the country.

So what is political hype and what is real? Which vaccine candidates should reporters be paying attention to? How can they keep track of them and report findings responsibly to the public?

Here are some resources, expert sources and other tips to help you make sense of the COVID-19 vaccine race and report it responsibly. 

If you write anything about cancer treatment, it can be nearly impossible to avoid writing about immunotherapy. But reporting on immunotherapy can quickly become complicated, confusing and overwhelming. We hope this new tip sheet can help.

Interference from health insurers is one of the biggest problems physicians face when prescribing medications, diagnostic tests, or other treatments for their patients.

Frequently, insurers will deny such requests without offering any alternative. At other times, insurance companies will require a different course of treatment that the physician does not support. In recent years, health insurers have required physicians to use step therapy, meaning they’ll deny a certain medication and request that the physician prescribes another, usually lower-cost, drug instead.

A spate of police and vigilante slayings of unarmed African Americans and a global pandemic that has hit Blacks especially hard is fueling a surge in the number of Blacks seeking mental health counseling, including persons who never before have sought such care.

While there’s no firm data on the number of seekers, clinicians say they have plenty of anecdotal evidence. That uptick in Black patients represents a chipping away at many Blacks’ long-held stigmas against securing mental health care. Their doubts, in part, have been grounded in a belief that personal resilience — built up since slavery — will carry them through a mental health crisis.

That uptick is spotlighting  anew the nation’s longstanding shortage of Black psychiatrists, psychologists and clinical social workers. It also has ramped up questions of how well-prepared White clinicians, filling in gaps in a mental health workforce, are to handle Black patients.

The southern hemisphere just wrapped up the most severe flu season since the pandemic began, suggesting the possibility that a long-feared “twindemic” of flu and COVID-19 cases overwhelming hospitals could occur in the upcoming 2022-23 winter season.

Journalists should take this time to get up to speed on covering the flu — a disease that is often considered a nuisance winter illness, but health experts say needs to be considered a disease that can cause serious health complications, especially for pregnant women, children and older Americans.

Wendell Potter

Now that election day is only about a month away, one of the most important issues the country faces is how a new Congress and a potentially new administration will address the need for health insurance reform.

For health care journalists writing about health reform now and what might happen in 2021, it’s instructive to consider what Wendell Potter, a former public relations executive for health insurers, would suggest when covering this issue. The founder of Tarbell, a donor-funded and subscription-driven health care news site, Potter is one of the co-founders of Business Leaders for Health Care Transformation, a coalition of business leaders supporting the idea of a health care system that covers everyone with essential services regardless of income.

As a former executive for Humana and Cigna, Potter has good advice for health care journalists. During a recent telephone interview, offered a number of tips for reporters to consider.

We know the elderly are the most vulnerable to becoming ill and dying from COVID-19, but don’t yet fully understand the emotional toll of the virus on this population. It’s prompted The American Journal of Geriatric Psychiatry to call for more research into the mental health effects of the pandemic.

Retrospective studies of the 2003 SARS epidemic found that rates of suicide among older adults spiked during that time. It’s urgent to study the mental health effects of COVID-19 on older adults in real time so any adverse impact can be anticipated and minimized, according to geriatric experts.

Get more background, statistics and a list of experts to help inform your reporting on this important topic.

Two recent reports on the cost of health care services point out the need for more transparency on what consumers pay for health care services.

In both reports, the question underlying the research is a simple one: What’s the right rate?

Researchers have been asking this question about health care costs and quality for decades. Yet, in that time, the health care system has not shifted away from focusing on whatever the market will bear, as these two reports show.

Plasma ― the part of blood that contains antibodies and proteins ― is still under investigation for this use, and those leading randomized clinical trials now far they may have difficulty recruiting new patients due to the controversy.

As Hurricane Laura makes landfall in the southern United States, we’ve updated our list of resources to help reporters connect with public health officials and other sources.

Extensive flooding and damage to local health infrastructure means people will be dealing with the public health effects of the storm for a while.

Even if you’re not reporting on an affected location, this may be a good time to ask some questions of your local public health leaders and write about disaster preparedness issues.

Here are some resources to help craft those questions.

Taylor Knopf

In 2018 Taylor Knopf, an award-winning reporter for North Carolin Health News, embarked on reporting on successful harm reduction methods Europeans use to support people who use drugs.

With a vacation already booked, she tacked on a few extra days to do the reporting. Here are some tips she offers to other journalists who might consider reporting from a foreign country.

Many hospitals, including for-profit and nonprofits, have turned their collections offices into lawsuit machines that harm their patients and don’t do much for the hospitals, either.

While hospitals have stepped up their collection efforts, patient incomes have flatlined or fallen. Deductibles have soared, which means even the many patients who have health insurance can’t afford hospital care.

The COVID-19 pandemic has had far-reaching effects on older adults, far beyond the tens of thousands of cases and deaths striking those 60 and older. It also is highlighting the fragility of safety net programs and services that help to feed the estimated 1.5 million seniors who rely on senior centers, home delivery and food banks for healthy, nutritious meals. According to the Milbank Memorial Fund, the majority of these recipients are 75 and older, and live alone.

Liz Seegert provides additional background and statistics as well as story ideas, sources and questions to consider when writing about this topic.

Of all the skills needed for reporting on medical research, it’s hard to think of one that’s more important than being able to read and understand a single medical study. Fortunately, there is not a single “right way” to read a paper. But there many different ways to make sense of a paper that can help each journalist dvelop their own best practices.

Covering research on concussions can be challenging because it involves injuries that are difficult to categorize and the stakes are high, financially, ideologically and culturally, for the implications of the research. It’s particularly difficult to assess the value of the many screening and diagnostic tests that exist for concussion.

Supplements, including vitamins, minerals, herbs and other “natural” substances, frequently come up in medical studies, though the research is often not as rigorous as it is with drug treatments. 

If you are writing about supplements in any form, it’s helpful to check out the following tips to be sure you’re not inadvertently contributing to misinformation, exaggerating benefits, neglecting risks or otherwise leaving out important caveats.

Before the novel coronavirus pandemic, several states were looking at ways of expanding coverage – no matter what the outcome of the November election. But with the upheaval, uncertainty, and immense costs of coronavirus, much of it is on hold for now.

Here, I’ll highlight a few of the most notable states, including the status of Medicaid block grant requests.

It will take a while to learn all the ways the pandemic has affected the nation’s collective and individual mental health. But there are resources journalists can use now to begin teasing it apart and reporting on it. The tips and resources below all relate to covering the pandemic’s mental health impact, whether it’s coming up with story ideas, best practices for mental health reporting or learning about what past medical research has shown about pandemics and mental health.

At one time, direct contracts between employers and health care providers were rare, but no longer. Disney, Intel, General Motors, Whole Foods, Qualcomm and Boeing have jumped on this emerging trend in recent years, and Walmart’s enthusiasm for direct contracting may be the tipping point for this to become a mainstream strategy.

Problems with PCR testing for the COVID-19 viral infection dominated headlines during the first six weeks of the pandemic. Now that serology testing — testing for antibodies to COVID-19 — is picking up steam, there is a lot of important context and uncertainty that your audience may need.

To begin this quick primer, here are some basic concepts to understand before interviewing experts in immunity and epidemiology.

Along with regular coverage of peer-reviewed medical research on COVID-19 and the SARS-CoV-2 coronavirus, there has been a great deal of attention on preprints, which are complete drafts of research studies shared online before peer review. Journalists should be cautious when reporting on preprints and a tip sheet at Journalist’s Resource addresses six important factors to keep in mind when reporting on a study in this early format. Here is a summary of the key points.

Cannabis use is on the rise among older adults, thanks in part to an aging population that has more relaxed attitudes about the drug than do their parents’ generation. The increase in consumption — for medical and recreational reasons — has some researchers concerned, since there are few U.S. studies on long-term effects. There’s still a lot we don’t know about cannabis or its major components, CBD and THC, and their effects on older adults. 

Liz Seegert has some suggestions for story ideas, sources and questions to ask.

Year after year, economists, journalists and health care researchers have analyzed what hospitals charge for inpatient, outpatient, and emergency room care, and with good reason. Taken together, what health insurers, employers, federal and state governments and consumers spent on hospital care rose by 4.5% in 2018 to $1.2 trillion, according to a report from the federal Centers for Medicare and Medicaid Services’ Office of the Actuary. Spending on hospital care is only expected to rise.

Now that the novel coronavirus has dominated the news this year, high hospital charges have been relegated to the background. Kimberly Adams recently raised the issue of costs in her reporting for American Public Media’s Marketplace. 

Now that the United States, as of April 2, had more than 213,144 confirmed COVID-19 cases and more than 4,513 deaths, according to the CDC, the issue of how much hospitals charge may come under more scrutiny.

Key questions, such as just how contagious the virus is, how deadly it is and whether there will be widespread transmission outside of China, do not all have precise answers yet. To help answer such questions and others about prevention, the federal public health response, risk factors and similar concerns, the CDC’s COVID-19 FAQ page offers a relatively comprehensive list of questions with succinct answers and links to details.

We know that older adults and those with serious underlying medical conditions are among the most susceptible to complications from COVID-19, the disease caused by the novel coronavirus. The Centers for Disease Control and Prevention and the World Health Organization have issued warnings to those in the 60-plus demographic to take special care to minimize their risk of contracting this disease. Many of those who have died lived in a Seattle-area nursing home. 

There are plenty of story angles and resources for reporters to tackle as cases continue to climb.  

When covering a hot, fast-moving health issue like a disease outbreak, a severe weather event or other public health emergency, it can be a scramble to find the expert sources you need quickly. Still, it’s essential to ensure they are the right experts you need for the story you’re writing.

One of the big annual stories to watch in recent years is the impact that consolidation among health insurers will have on consumers. In recent years, several big deals have caused the nation’s largest health insurers to get even bigger and to enter new markets by acquiring related services, such as physician groups, pharmacy benefit managers and home health care providers.

With this background and the data in this new tip sheet, journalists should be able to find some new stories relevant to their area.

Deaths related to alcohol – about 88,000 a year – exceed overdose deaths from all other drugs combined, including opioids. But news organizations almost never cover alcohol as a public health epidemic on the scale of that seen with opioids or gun violence.

Alcohol is often perceived as an “acceptable” drug in U.S. society, and journalists are complicit in maintaining that dangerous perception as well as many other misconceptions about the drug.

One lesson some health care journalists have learned in recent years is that the nation’s pharmacy benefit management system is incredibly complex. The sheer complexity can make it a tough beat to cover.

To their credit, a team of journalists at the Columbus Dispatch in Ohio has produced an award-winning series that has pulled back the curtain that PBMs and pharma companies have used to obfuscate their dealings with each other and with health care purchasers and payers (meaning health plans).

What makes the series so interesting is that it’s about more than just pharmacy benefits in Ohio, says Cathy Candisky, one of the reporters on the team. What’s happening with PBMs in Ohio is likely going on in other states too, Candisky says. This is significant because when officials in one state have a problem, they look to other states for solutions.

In this tip sheet, Joseph Burns shares some of what that team has learned about PBMs.

As the opioid crisis has deepened – about 10.3 million Americans reported that they misused opioids in 2018 – there has been a surge in bacterial and viral infections that threaten to make the crisis worse.

The rise includes an increase in bacterial infections caused by Staphlococcus aureus, a pathogen that is often resistant to antibiotics – and a climb in new HIV, hepatitis and sexually transmitted diseases.

Bara Vaida has gathered story ideas, background reading and resources and a contact list for important sources on this topic.

Why are people afraid of the dentist? That was the question that three British researchers sought to answer in a recent review of internationally published studies on dental fear, dental anxiety judgment and dental phobia. 

The answer to the question is complicated, the reviewers found. Dental fears may be traced back to a variety of sources, including frightening early dental visits, anxieties transmitted by parents and other role models, traumatic experiences unrelated to dental care and personality traits that may make some people more vulnerable to anxiety, according to studies that were reviewed. 

By Bara Vaida and Mary Otto

Cancer is a set of diseases characterized by abnormal cell growth triggered by a genetic defect. Researchers know that genetic defects that cause cancer can be inherited, or the defects can be caused by environmental factors, such as smoking, and exposure to radiation. Infectious agents, such as viruses, bacteria and parasites, also can increase a person’s risk of developing cancer. 

In April 2019, the National Academy of Medicine (NAM) launched a Global Grand Challenge, a multimillion dollar competition to accelerate improvements and innovation in the realm of healthy longevity. It will be left to competitors from NAM’s projected pool of “science, medicine, public health, technology, entrepreneurship, public policy, social engineering, and beyond” to define the term.

The scope of the challenge – to even consider what is meant by healthy longevity, much less how to achieve it – was clear at the first meeting, held in early November in Washington, D.C. Speakers from countries facing challenges of aging as diverse as those of Rwanda and the United Kingdom spoke to policies their countries are implementing. Representatives from Thailand, Nigeria, and Japan spoke of on-the-ground endeavors in their nations. And academicians described the challenges an aging population presents in terms of the workforce, retirement planning and social justice. Finally, one speaker addressed the insidious nature of ageism, its prevalence, and what might be done about it.

The Affordable Care Act originally included Medicaid expansion in all states, but the Supreme Court, as part of the 2012 decision upholding the constitutionality of the individual mandate, made it optional. In those early years, only a handful of Republican-led states expanded the program, but several more signed on in subsequent years, in a few cases because of a change in political leadership or because of a voter referendum.

In a new tip sheet Rachana Pradhan – who had been covering Medicaid deeply at Politico and is now moving to KHN – explains what you need to know about partial expansion. Read more about the policy, the politics, the funding – and the impact on the uninsured.

Black women in the United States suffer from maternal mortality that is 30% to 40% higher than that of their white counterparts, according to the federal Centers for Disease Control and Prevention. 

Many health journalists who cover health disparities and women’s health issues have covered disparities in infant mortality, yet we don’t often do a deep dive into what happens to the survival of women of color during pregnancy, delivery and the year after giving birth.

The awareness of the disparities in pregnancy-related deaths for black women is bringing about change at the policy and legislative levels. Andrea King Collier has some suggestions for how to cover these changes.

Here’s an under-reported story that’s important for 22 million people in the United States: One in three Americans over age 65 are enrolling in Medicare Advantage plans rather than traditional Medicare. It’s a ratio that’s been growing every year.

Doctor appointments, hearing, vision, prescription drugs, rides to medical facilities, private home aid, doctors’ and nurses’ visits by telephone, and even home-delivered meals.

All at no additional cost.

But as I reported in a recent story for MedPage Today, there’s another side of the story that the ads — and often insurance brokers and plans themselves —  don’t mention. It’s that once you get into one of these plans and become ill and unhappy with services or your selection of providers, you may not be able to get out without incurring a lot more expense. The only time you can get out and transfer to traditional Medicare with a Medigap plan, without being subjected to Medigap denials for any medical conditions, is if you enroll at age 65.

An inevitable aspect of health reporting is covering outbreaks of foodborne illness. The Centers for Disease Control and Prevention estimates that one in six people in the U.S. get a foodborne illness each year, and 128,000 of them are sick enough to need hospitalization. About 3,000 people die from a foodborne illness each year.

This year, there have been dozens of cases of tainted food including romaine lettuce, basil, papaya, ground bison, as well as backyard hens, turtles and treats for dogs that have been linked to human illnesses. Further, there are a growing number of pathogens that are resistant to antibiotics that are being found in food. For example, resistant bugs in beef and cheese products sickened 255 people in 32 states in October 2019.

At Health Journalism 2019 in Baltimore, Rose Hoban, who founded and reports for North Carolina Health News, gave a presentation on rural health care that went way beyond statistics about shortages of doctors and hospital closures (though she, correctly, talked about that too.)

She introduced us to some community collaboratives and national initiatives that are taking fresh approaches to addressing both coverage and larger issues about health and wellbeing, including the socioeconomic factors that shape health and health outcomes.

In this useful and wide-ranging tip sheet, Hoban assembled many resources for AHCJ members who are covering rural health as well as social determinants. She opens by linking to an overview essay that challenges us to think more deeply about the assumptions and habits we bring to the health beat in an age of “intractable conflict.” She includes quite a bit of information about the Healthy Gorge Initiative in the Columbia Gorge region of Oregon, which has drawn national attention and kudos. Their leader presented at the conference.

Diane Atwood, a former health reporter for WCSH-Maine, learned a lot about reaching broadcast audiences over the course of her career, which came in handy when she retired. Actually, not really retired, just changing gears.

Atwood now writes a blog called Catching Health and not long ago, decided to start a podcast about what it’s like to grow old in Maine. Conversations About Aging looks at how Mainers deal with the good and bad that accompany aging, and some of the unique personalities who make up the state’s older population.

Here, she tells us about how she embarked on the podcast, including the details about what equipment she uses, her techniques, useful web hosts and tutorials, targeting an audience and much more.

Mark Twain once said, “The difference between the almost right word and the right word is really a large matter. ’tis the difference between the lightning bug and the lightning.”

Those of us who cover health insurance might apply this advice when we use the term “value-based care.” While health insurance executives and health system administrators prefer to use this term, what they usually mean instead is “value-based payment.” As Twain warned us, the difference is significant.

How can you be sure your expert source doesn’t have a shady past? What if your lead anecdote has a history of insurance fraud? Are you absolutely certain that the physician who gave you such quotable quotes during your interview actually is a doctor? (Don’t snicker — dozens of reporters have been duped before!)

This tip sheet below, based on an AHCJ webinar with Kate Howard of the Kentucky Center for Investigative Reporting, provides tips on how to vet every person you interview or otherwise quote in your work, with the goal of reducing the risk of embarrassment to you, your editors and your publication.

Lisa McGiffert led Consumer Reports’ Safe Patient Project for 15 years, and after 27 years with the advocacy arm of the organization, she retired last year. But she has not taken off her patient advocacy hat. Not by a long shot. She’s recently co-founded a nonprofit coalition called the Patient Safety Action Network (PSAN), to continue her work.

She spent several hours talking with Cheryl Clark about the trajectory of patient safety as an issue over time, from working on health reform during the Clinton administration to today’s pushback on patient protection progress made with the Affordable Care Act. Despite major gains in awareness and prevention policies and practices, there’s still a lot more to be done. She explains, with lots of tips for story topics she hopes we will write.

People tend to think of influenza as a nuisance winter illness that might keep one in bed for a few days, but it is a serious disease that kills thousands every year. The flu and pneumonia were among the top 10 causes of death in the U.S. in 2017.

Here is background on the flu and the vaccine, as well as recent coverage, expert sources and more resources to inform your reporting.

For more than 70 years, communities across the United States have been supplementing naturally occurring fluoride in water supplies to promote oral health.

Nearly 75% of Americans – more than 211 million people – are served by community water fluoridation (CWF) programs, according to the U.S. Centers for Disease Control (CDC).

Since its beginnings, water fluoridation has stirred controversy, with opponents asserting that the practice amounts to forced medication and poses health risks including reduced intelligence. Here, Mary Otto provides background and presents the most relevant studies on the subject.

Journalists covering medical research need to quantify the results of a study, which means they rely on effect size — the magnitude of difference between groups. 

There aren’t hard and fast rules for how much an effect size is needed to determine an intervention’s or exposure’s clinical significance, but there are very clearly defined ways to measure effect size. 

A Journalist’s Resource tip sheet on organoids can help journalists avoid the trap of overselling what this area of tissue research is and isn’t. Organoids are tissue models grown in a lab that can help scientists understand how the cells differentiate, grow, interact and respond to experimental intervention.

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As Hurricane Dorian reaches closer to landfall in Florida or southern Georgia this weekend, we’ve updated our list of resources to help reporters connect with public health officials and other sources.

Excessive flooding and damage to local health infrastructure means people will be dealing with the public health effects of the storm for a while.

Even if you’re not reporting on an affected location, this may be a good time to ask some questions of your local public health leaders and write about disaster preparedness issues. Here are some resources to help craft those questions.

Health officials say that thanks to factors including the disease-fighting power of optimally fluoridated water and toothpaste, complete tooth loss, called edentulism, is growing rarer among Americans.

Still, edentulism persists. It has been called the “final marker” of oral disease burden. And common oral health problems continue to place millions of Americans at risk. As with many health risks, the burdens of edentulism are not distributed evenly across all communities.

Though U.S.-based journalists may not see malaria as a local threat, public health experts urge journalists to get up to speed on covering the disease, because it is a global threat and it is showing up in more often in U.S. hospitals.

Infectious disease topic leader Bara Vaida has written a tip sheet that covers the history of malaria, efforts to eradicate it, how it infects people and some of the symptoms. She includes a list of story ideas for reporters and links to some background reading and news.

America’s shameful maternity mortality rate is closely associated with its high rate of Cesarean-section deliveries. Hospitals, physicians and mothers themselves share the blame for the high C-section rate, but employers, payers and multistakeholder state-specific initiatives may be the solution.

Thus, journalists who write for business or clinician audiences can find some good stories in efforts at payment reform for maternity care. "Childbirth and newborn care is the largest or second largest (after heart care) category of hospital expenditures, and it’s by far the largest category of hospital expenditures for state Medicaid programs, so even small improvements can result in large savings,” according to the Center for Healthcare Quality & Payment Reform.

We're compiling Democratic presidential candidates' plans on health IT topics such as telehealth, broadband access, remote patient monitoring, electronic health records and cybersecurity. This page will be updated.

Public health emergencies happen. From a severe flu season or measles outbreaks to a massive wildfire or hurricane, count on them to be a mainstay of covering health. It can be helpful to understand – ahead of time – how the government and other organziations have tried to prepare for these types of incidents.

Much of the challenge is that most of the nation’s health system belongs to private and non-governmental entities. Getting together to plan for a major disaster isn’t a top priority, health experts say.

Bara Vaida, AHCJ's core topic leader on infectious diseases, offers background on planning, funding and organizations, as well as story ideas and contact information for sources.

In recent years, officials at the federal level have made a point of including dentists in their work to stem the flow of opioids. A leader in the effort, Vivek Murthy, M.D., who served as U.S. surgeon general under President Barack Obama, urged health care professionals – including dentists – to consider alternatives to opioids when helping patients to manage pain.

As the authors of a 2016 research letter published in the Journal of the American Medical Association concluded, dentists had regularly prescribed opioids to treat post-extraction pain “despite evidence that a combination of nonsteroidal medications and acetaminophen may provide more effective analgesia for post-extraction pain.”

Mary Otto runs down the latest research, alternatives to using opioids for dental pain and offers an example of how to cover the story.

Are there doctors in your city/county/state who are too old to practice? How do you tell? And who’s to say?

One option underway at some facilities is to establish a policy to regularly screen older providers for mental or physical competency before they’re allowed to see patients. Some organizations are making this a condition of medical group membership or hospital staff privilege. But at what age should testing begin? 65, 70, 75? And what should be done with them if their scores aren’t quite up to par? Should all clinicians who touch patients be tested?

Warning: This is not an easy story to tackle. But regardless of where you live or who your readers are, it’s an important one that could impact the supply of providers in your area. Veteran reporter Cheryl Clark shares some background and resources based on her reporting.

Health policy experts caution that when health care purchasers tinker with payment incentives, the results can often have unintended consequences. In recent years, federal policy makers have raised concerns about the unintended results from Medicare’s Hospital Readmissions Reduction Program (HRRP).

In December, researchers published the results of a study of HRRP’s effects on mortality in JAMA that showed a rising number of patient deaths. They also cautioned that more analysis is needed.

At Health Journalism 2019, the annual workshop sponsored by AHCJ’s Right to Know Committee offered strategies to surmount the obstacles and teach the best strategies for getting the documents you need – and are entitled to have.

A panel at Health Journalism 2019 reviewed the basics of reading, interpreting and scrutinizing medical studies – study types, common stats, risk types, pitfalls to avoid and more. The panel covered sussing out the clinical relevance of study to tackling policy research to figuring out how to turn an obscure stat into a meaningful finding for your readers. Here are the presentations from the speakers.

After the proposals for short-term, limited-duration plans and association health plans became public early last year, the federal Centers for Medicare and Medicaid Services and the federal Department of Labor accepted comments on the rules governing them.

Before the rules became final, Noam N. Levey reported extensively on the public comments federal regulators received on both proposals.

His review of comments from health care groups gave him a thorough view of concerns about the proposed rules from those who work in health care and those who would implement the new rules. Also, his work was useful to at least one law firm that cited his article in a lawsuit it filed challenging the rules.

Outbreaks of mosquito-borne illnesses like dengue, chikungunya, West Nile and Zika are rising around the world. While the combination of the U.S.’s cooler climate and mosquito control programs have kept many of the worst mosquito diseases at bay, global travel, changing climate and the expansion of populations into new habitats are increasing Americans’ risks of contracting mosquito-borne diseases.

Get story ideas, resources and contacts for experts to help you cover mosquito-borne illnesses.

Compiled for a panel at Health Journalism 2019

In a perfect world, when you’re assigned an article that requires you to find patients, family members or other “real people,” you’ve followed Liz Szabo’s advice by setting yourself up on social media to already know where to find patients and to be in the loop of ongoing conversations. But we don’t live in a perfect world, and even if we did, sometimes you get an assignment with a short deadline on a topic you don’t cover much, if at all. Now you need the expedited route to finding patients STAT.

The World Health Organization reported that between 2015 and 2050 the global population of individuals over the age of 60 is expected to jump from 12% to 22%; in actual numbers that means an increase from 900 million to 2 billion people.

Aging may mean a decline in physical and/or mental health. In a 2010 article, then-U.S. Surgeon General David Satcher, M.D., Ph.D., asserted that mental and physical health in older adults is inextricably linked, but that some providers fail to recognize symptoms.

Phyllis Hanlon explores a program that trains older adults to act as behavioral health specialists and wellness coaches. These peer specialists learn to work with older adults who have physical and mental health problems that might include normal aging, cultural competence, anxiety, depression trauma, substance use and others.

A previous tip sheet provided five things to think about before you decide to cover an animal study.

But those aren’t the only considerations.

Here are five more from the same crowd-sourced social media post that will help you determine whether it’s a good idea to cover the study and what to keep in mind as you do.

Thinking about covering an animal study?

Here are five tips or considerations to keep in mind as you make your decision and then proceed with interviews and writing.

These tips come from a crowdsourced social media post and include attributions. 

This tip sheet is based on an interview with Gary Schwitzer, publisher and founder of HealthNewsReview.org, who, with his team, evaluated the quality of media coverage of medical research for more than a decade. The blog portion of the site ceased regular publication in December but remains a valuable resource for health care journalists, especially its 10 criteria for covering medical research.

He discusses how to report on costs, outcomes, harms, recognizing bias, disease mongering and more.

Ticks are emerging earlier from winter hibernation and remaining active for more weeks of the year as the climate is warming, according to public health experts. The result is that Americans’ risk of infection from pathogens carried by the outdoor pests is increasing.

“There are more tick-borne disease [cases] every year,” John Aucott, M.D., director of the Johns Hopkins Lyme Disease Clinical Research Center, told WebMD.

The CDC recorded 59,349 cases of tick-borne illnesses in 2017, and there were likely 10 times more cases, since cases of diagnosed Lyme disease (the most common tick-borne disease) often don’t get reported to the CDC, according to the agency’s own assessment of medical records and other data.

This primer on covering HIV was first published in 2017. Heather Boerner has updated it with scientific breakthroughs from the past two years.

She also urges caution in how some breakthroughs are conveyed, highlights disparities among those who are being treated and not, prevention interventions and the best way to  describe the result of some recent research.

Acknowledging that millions of Medicare beneficiaries have unmet oral health care needs, a diverse coalition of organizations, including Families USA, the American Dental Association, and the Santa Fe Group recently collaborated to study the idea of adding dental coverage to the program. Their white paper lays out a plan to add preventive and restorative dental services to the menu of medically necessary outpatient services currently covered under Medicare Part B.

Under the group’s scenario, a comprehensive dental benefit without dollar-value caps would cost the federal government $32.3 billion in the current year and raise the base premium for Part B benefits by an estimated $14.50 per month.

But dental coverage is not the only important benefit left out of Medicare. The program also largely excludes vision and hearing services, other analysts have observed.

The terms palliative and hospice care are often used interchangeably, but they’re not the same. While all hospice care includes palliative care, palliative care is not limited to the end of someone’s life.

Both palliative care and hospice care provide comfort, however, palliative care can begin at diagnosis, and at the same time as treatment, according to the National Library of Medicine. Hospice care begins after treatment of the disease and is stopped when it is clear that the person is not going to survive the illness.

Palliative care is appropriate at any age and at any stage during a serious illness, and can be provided along with curative treatment, according to the National Institute on Aging Care is provided wherever the patient may be — home, hospital, clinic or other specialized location.

If you’ve followed our earlier tip sheet for preparing to cover a medical conference ahead of time, you’ll already be on top of your game when you arrive.

Here are additional tips to keep the actual conference reporting moving efficiently as well. 

Michigan recently become the latest state to approve the use of midlevel dental providers – dental therapists – as part of an effort to expand oral health care to communities that have long lacked it.

With the new measure in place, Michigan joins Minnesota, Maine, Vermont and Arizona in approving the use of dental therapists statewide. The model also is in use on tribal lands in Alaska, Washington and Oregon.

The auxiliaries, often compared to nurse practitioners, have been in use in countries around the world for years, but are relatively new to the United States. They receive training in a range of dental services including drilling and filling teeth and work as members of dentist-headed teams.

Factors including the passage of the Affordable Care Act and the expansion of Medicaid in a number of states have contributed to rising revenues and burgeoning caseloads for community health centers. During this boom, many clinics have broadened their primary care programs to include dental and mental health services, researchers at the Henry J. Kaiser Family Foundation found.

As we age, our risk of cancer increases. In fact, age is the single biggest risk factor in developing cancer.

Some cancer treatments may be too harsh for aging bodies, especially those older cancer patients who may already suffer from complex medical needs by the time cancer settles in. Cognitive issues, diabetes, high blood pressure, cardiovascular disease, and problems with vision and hearing are all issues that can make the decision to treat more difficult and can worsen with cancer treatment.

On the flip side, because of improvements in cancer treatment and follow-up care, a greater number of older adults are surviving cancer. Yet, there isn’t much research on how to care for older cancer survivors, who may also suffer from comorbid conditions.

The dental therapist model got its start in the 1920s in New Zealand and is now well-established in many developed countries, including the U.K., Australia and the Netherlands.

In 2009, Minnesota became the first state government to pass legislation authorizing the model. Dental therapists are now working in underserved areas of the state. Maine and Vermont also have laws in place that allow dental therapists, although they are not yet working in those states. Dental therapist programs have been launched by tribal communities in Washington and Oregon. 

Other states are considering giving the model a try.

“States such as Florida, New Mexico, North Dakota, Washington and Wisconsin are now considering legislation,” wrote Jane Koppelman, senior manager for the Pew Charitable Trusts’ dental campaign in this January 2019 column, Efforts to Expand Access to Oral Health Care to Continue in 2019.

Over the years, teledentistry has harnessed evolving technology to link patients with to an expanding array of dental services.

Today, a small but growing number of dental hygienists, dental therapists and other providers are using portable intraoral cameras, digital x-rays and electronic communications to consult remotely with dentists on patient treatment plans; to provide screenings, referrals and oral health education, and to connect patients living in underserved and isolated communities with specialty and emergency consultations.

Scientific evidence overwhelmingly supports the safety and effectiveness of CDC-recommended childhood vaccines for protecting children against preventable infectious diseases such as measles, pertussis (whooping cough), rotavirus and meningitis.

“Vaccine hesitancy” as a term has emerged in recent years as a more neutral way to discuss attitudes toward vaccines, without identifying people strictly as “anti” or “pro” vaccine.

Get ideas for how to responsibly cover vaccine hesitancy in your community, as well as a list of experts to contact. 

A headline has a big job to do: It must catch a reader’s attention, offer the gist of a story but hold back just enough so the reader wants to read the entire story — all while remaining accurate and avoiding hype.

That’s a challenge with any story, but especially tough with articles about medical research, where oversimplifying is potentially more harmful than with other types of articles.

Diseases caused by mosquitoes, ticks and fleas tripled and nine new pathogens carried by these insects have been discovered in the U.S. since 2004, according to the Centers for Disease Control and Prevention. Water-borne bacteria that thrive in warm conditions have shown up in Alaska marine life and the number of bacteria resistant to most antibiotics is rising.

A common thread involved in all of these public health threats is climate change.

Ever since actor Michael Douglas used his battle with throat cancer in 2013 to help raise awareness about the disease, more has been learned about men’s particular vulnerability to HPV-related oropharyngeal cancers, Marie McCullough reported in a recent story for the Philadelphia Inquirer.

In the August 2018 report, Trends in Human Papillomavirus-Associated Cancers – United States, 1999-2015, federal researchers charted the climb of new HPV-related cancer cases in the U.S. from 30,115 in 1999 to 43,371 by 2015.

Since August, President Trump and the federal Department of Health and Human Services have been promoting short-term health insurance plans as a more affordable choice than health plans that comply with the requirements of the Affordable Care Act.

But reporters need to dig deeper to see how these plans affect consumers and the health insurance market in general because first looks can be deceiving.

Conferences can be hectic to cover, and it’s difficult sometimes to pin down the researcher or presenter you need, much less get quotes from other attendees about a particular presentation. Having a list of ready questions for these two common conference interview scenarios can help when you’re feeling flustered or your brain starts to reach conference carrying capacity.

Whether you use these exact questions, tweak them or develop your own, keep in mind that most of the time, what you primarily need is the clinical significance of the findings or, if there is no immediate clinical significance, what makes the findings important or surprising. Here are some questions to get you started.

All physicians, and especially those who care for patients with chronic conditions, complain that health insurers too often override their treatment decisions to control costs and ostensibly to improve care.

As of Jan. 1, health plans are allowed to override even more treatment decisions under a new rule from the federal Centers for Medicare and Medicaid Services. The rule allows Medicare Advantage plans use step therapy to restrict coverage when physicians prescribe drugs under Medicare Part B. In a step therapy protocol, a patient must fail to improve on a lower-priced medication before the insurer allows the patient to use a more costly drug, as Paul Sisson explained for The San Diego Union-Tribune. Also known as step protocol or fail first, step therapy is a form of prior authorization, a topic we covered in a tip sheet in August.

These days, it’s rare to open a medical journal, turn on the TV or read a newspaper without seeing one or more articles about the dreaded opioid epidemic. With government regulators, medical boards, risk managers and health plans now shadowing their practices, physicians are growing increasingly petrified of prescribing narcotics. 

So it stands to reason that many seniors with arthritic pain, neck and back aches, headaches or who are recovering from an injury may look for readily available, inexpensive substitutes they can buy without a prescription.

But while those OTC drugs may be safer than narcotics or opioids, they are not without serious — and arguably under-recognized — risks, especially for seniors whose stomach linings and ability to safely absorb pills and tablets diminish with age.

President Trump, along with immigration opponents, repeatedly assert that immigrants are bringing infectious diseases to the U.S., but never provide any data to back up their claims.

That is because virtually every public health expert says there isn’t any evidence that this is the case.

Learn more about how our public health system works to keep infectious diseases from entering the country and get resources to debunk this link between immigration and infectious diseases, here are some experts on the topic and links to recent stories.

After decades of decline, the number of people diagnosed with many sexually transmitted diseases in the U.S. began steadily rising in 2000. Five years ago, the number of cases sharply increased. Between 2013 and 2017, STD cases were up 31 percent.

The reasons for the increases are multi-faceted. They include decreased public health funding, lack of understanding about how STDs spread, social stigma, less access to health care and fewer health provider screenings. Social determinants also play a role in which populations are more at risk of exposure to an STD and whether they get treatment. Further, the opioid epidemic has been associated with increase in STDs among pregnant women, said David C. Harvey, executive director of the National Coalition of STD Directors during a Nov. 1 AHCJ webcast.

Learn more about the increase, story ideas, sources and experts to tap into for your reporting.

As mass shootings increase every year, health journalists have a responsibility to continue covering these tragedies — and possible prevention of them — as a public health issue. Here are some resources and tips for covering these unfortunate incidents.

First introduced to the public in 1944, antibiotics – drugs that kill harmful bacteria – have all but eliminated the threat of diseases that once killed millions. But overuse of these drugs in people and animal farming has resulted in the breeding of “superbugs,” germs that are resistant to most or all existing antibiotics.

As of 2013, at least 2 million people in the U.S. had contracted an antibiotic-resistance bacterium, with 23,000 dying annually as a result, according to estimates based on the most recent data available to the Centers for Disease Control and Prevention (CDC). The threat has become so dire, CDC officials have said, that for some patients the medical community has reached a “post-antibiotic” era.

Here are some resources for your reporting.

Maintaining good oral health during pregnancy is important to the overall health of women as well as their children, an interdisciplinary team of health care experts stressed in a respected 2012 national consensus statement on the topic.

“Evidence suggests that most infants and young children acquire caries-causing bacteria from their mothers,” said the authors of report sponsored by the National Maternal and Child Oral Health Resource Center at Georgetown University.

Learn more about the benefits of good oral health during pregnancy and the obstacles that many women face in obtaining care.

Affordable Care Act's open enrollment for calendar year 2019 began Nov. 1 and runs until Dec. 15, 2018, at Healthcare.gov or most state exchanges, although a few states have different sign-up periods.

As noted in a recent story for Washington Examiner, the Trump administration has instituted new regulations and changes for customers to navigate as they shop for health plans over the next several weeks. So keep these seven things in mind when reporting on open enrollment in your community.

Using appropriate terminology when reporting on medical studies is important not only for the sake of accuracy and clarity but also to avoid causing harm to populations with specialized, but often misused, terms. Such is the case with transgender people, whose experience with language is often already fraught when they must navigate misgendering with pronouns and outdated, inappropriate terms such as “transsexual.”

Tara Haelle provides a quick guide to terms you need to be familiar with, along with a link to a more extensive guide.

Parkinson's disease (PD) is a progressive disease of the nervous system that primarily affects older adults. It typically begins after age 50. The disease can be very hard to live with because it severely restricts mobility, making daily activities increasingly difficult. Many people will eventually require 24/7 nursing home care. While effective treatments exist to relieve some symptoms, there is no cure.

In some cases, struggles over restrictions in state dental practice acts have pitted dental hygiene and health advocacy groups against state dental boards and professional organizations representing dentists.

In a few significant cases, the Federal Trade Commission (FTC), under its charge to protect the health care marketplace from unfair competition and to ensure consumer access to care, has supported easing restrictions.

The FTC offers some comments on the topic in a new Pew policy brief.

This collection of data sets was compiled from speakers at the 2018 Urban Health Journalism Workshop. 

Reporters who have been covering medical research conferences for a while develop over time habits, strategies and routines for finding interesting research, getting the most out of the sessions, finding good on-site sources and — perhaps most challenging — managing time and workflow.

But the experience can be overwhelming to those just starting or who have only attended a couple conferences. Tara Haelle has some pointers that focus on what you can do in the weeks before a conference to make the on-site experience easier and less hectic.

One of the best ways to gauge the potential effect of a proposed rule is to review the comments that stakeholders submit to government regulators. For his report on how association health plans might work, Noam N. Levey, who covers health care policy for the Los Angeles Times, reviewed almost all comments that health care groups submitted to the federal Department of Labor after it proposed new rules governing association health plans.

Levey’s analysis of these comments is important because it offers a window into the concerns of health insurers and the other organizations impacted by AHPs.

The United States is facing a rural hospital closure crisis. If you are a health reporter in a rural state, chances are you’ve covered some aspect of this story. In fact, one challenge with covering this crisis is how to write about it with fresh and engaging angles with impact.

Here are some lessons that Bram Sable-Smith learned while reporting a series of stories last year on the rural hospital in Pemiscot County, Mo., the state’s poorest county.

The health sector is implementing AI tools to help clinicians make care decisions at a fast pace. What are the ethical implications of these products, and what questions should journalists think about when reporting on AI?

Rebecca Vesely reached out to Danton Char, M.D., assistant professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine, to discuss the emerging ethical issues. Char is researching the bioethics of machine learning and co-authored a piece in The New England Journal of Medicine earlier this year about the ethical challenges of implementing AI in health care.

Influenza, a disease caused by a virus that attacks the lungs, is endemic to humanity. The virus is always circulating and often strike populations in the late fall or winter seasons.

When flu virus attacks the respiratory system, it can weaken the immune system leaving the body vulnerable to contracting other serious diseases like pneumonia and tuberculosis, and cause death.

Learn about new research showing “strong associations” between the development of respiratory infections, especially influenza, and heart attacks and strokes in older adults. Get more background, data, contact information for experts and some questions that reporters should be pursuing in this tip sheet.

Many times people in poverty live in crowded conditions, have limited access to quality health care, must work when they are sick, eat less nutritiously, get less sleep, face more stress and are more likely than others to abuse drugs and alcohol. All of these factors hinder immunity and increase susceptibility to infection and death.

For journalists looking for story ideas, the connections between socioeconomic issues, the opioid epidemic and infectious diseases is a rich area for exploration. Bara Vaida has compiled this tip sheet to help with resources and ideas to help journalists cover the essential topic of social determinants and infectious diseases.

Those living in North Carolina, South Carolina and southern Virginia are in the bull's-eye of Hurricane Florence. Given the forecast for excessive flooding, it is likely people in those states will be dealing with the aftermath for awhile.

Even if you’re not reporting on an affected location, this may be a good time to ask some questions of your local public health leaders and write about disaster preparedness issues. Here are some resources to help you craft those questions, followed by some links specific to the Carolinas and southern Virginia.

For health care journalists, there’s the state and local angle involving how the hospitals you cover are doing in providing care to mothers during pregnancy and childbirth.

In some states, such as California, Massachusetts and Nevada, hospitals are doing relatively well in keeping mothers safe from harm. But in other states, such as Louisiana, Georgia and Indiana, they are not. She noted that Vermont, New Hampshire and Alaska had no data available on maternal death rates.

During the Health Journalism 2018 conference in Phoenix, one presenter was unequivocal about the significance of value-based care in lowering costs and improving quality.

Sam Ho, M.D. and chief medical officer at UnitedHealthcare, said executives at the company were “maniacal” about the value-based care model for delivering and reimbursing care. Ho recounted the company’s history supporting this approach, which dates to 2001 in its California and Texas markets.

Other observers, however, aren’t so sure that value-based care is where the market is headed — or whether it’s even producing a significant shift in health care delivery.

In spite of efforts by dental directors and oral health coalitions to preserve dental services in their states, history has offered many examples of adult dental benefits disappearing from Medicaid programs.

Because adult Medicaid dental benefits are not federally mandated, they often end up on state budget chopping blocks in times of fiscal austerity. Ironically, the care dwindles or disappears when beneficiaries may need them the most.

The lack of coverage and money to pay for care takes a toll on the oral health of low-income adults, with an estimated 42 percent of poor American working-aged adults suffering from untreated tooth decay, according to federal data.

The problem of food insecurity is growing worse as our population ages and socioeconomic disparities increase.

Food insecurity is not just worrying about getting the next meal. It is a strong predictor of chronic disease and diabetes, heart disease, stroke and lung disease, say the experts at Meals on Wheels America. Older adults already have higher health care costs and take more medications compared with the rest of the population; these economic realities really squeeze low-income older adults. In addition to worsening physical health problems, poor nutrition can also contribute to mental health problems such as anxiety and depression.

Every month or so, it seems there’s a horror story about prior authorization. Last month, for example, CNN’s Jen Christensen reported about a teenager in Massachusetts who died of a seizure after being unable to get prior authorization to renew a prescription for her medication.

Each of these situations show that for health insurers, providers and patients, prior authorization is complex and often deeply controversial.  This year, the health insurance industry issued a plan to improve prior authorization and increase timely access to treatment. Learn about that plan and how the industry intends to pursue its goal.

Delirium is among the most common mental disorders seen in older adults, with more than 7 million hospitalized Americans suffering from the condition each year. It is associated with many complex underlying medical conditions and can be hard to recognize. It can also be life threatening, especially for the elderly.

Liz Seegert explains the risk factors of delirium, how family members can spot it and programs established to prevent the condition. She includes contact information for sources and experts, as well as a number of story ideas.

In an effort to get a clearer view of how rhetoric has shaped the media coverage of community water fluoridation over the years, researchers looked at more than five decades worth of news coverage surrounding 11 community water fluoridation (CWF) referenda in three U.S. cities: Portland, Oregon, Wichita, Kansas and San Antonio, Texas.

They analyzed the language used in the news articles and compared it with the rhetoric used by fluoridation proponents such as the American Dental Association (ADA) and opponents such as the Fluoride Action Network (FAN).

From its beginnings in New Zealand, the dental therapist model has evolved over nearly a century and is now being used in several countries around the world as a cost-efficient way of way of expanding access to dental care, particularly to underserved populations.

Still, dental therapists are relatively new to the United States. Learn more about where the model is in use and where it's been discussed.

When reporting on suicide, it’s important not only for reporters to have reliable data but also to be conscientious about the language and tone they use.

Suicide is one of the unique topics in which the very reporting of it can influence how much more frequently it happens, so simply doing your job as a journalist has the unfortunate potential to influence the news itself in this scenario.

These tips are a quick-and-dirty list from the World Health Organization’s guide, “Preventing Suicide: A Resource for Media Professionals.”

We all need a good night’s sleep, every night. However, at least half of all older adults complain of chronic poor or insufficient sleep. Despite popular misconceptions, older adults need as much sleep as do younger people — about 7 to 9 hours, on average each night. Older adults may suffer from certain health conditions, have pain, or side effects from medication which can make a good night’s sleep difficult, if not impossible. Poor sleep is linked to numerous health issues, from hypertension to depression, and to potentially increased risk of Alzheimer’s disease.

Outbreaks and infectious disease can be difficult topics to cover. Stories need to be informative, sensitive and scientifically sound – all without inducing panic. When there were several Ebola cases in the United States starting in 2014, it was easy to feed public fear with inflammatory media coverage. When covering the recent outbreaks, what can journalists learn from that experience to avoid incendiary coverage while still respecting the public’s right to know?

Here are resources, infectious disease experts to interview and websites with useful tips about reporting on Ebola, emerging infectious diseases and lessons learned.

Ridesharing companies Lyft and Uber are making inroads – so to speak – in the health transportation space with new partnerships and platforms this year that aim to help patients get to their medical appointments.

These partnerships seem like a win-win-win for providers, patients and the ride sharing companies. But there are many ways that ridesharing for medical appointments could fall short of its potential.

In a recent 13-part series about databases frequently used in medical research, JAMA Surgery provided a 10-item checklist for researchers to use to ensure they are using the most appropriate database in the most appropriate way for their research.

The article, “A Checklist to Elevate the Science of Surgical Database Research,” is intended for researchers. However, it doubles nicely as a list for journalists to use in thinking about questions they should ask researchers who use large databases in their research.

Surveillance is the process or system for tracking cases of risk factors, medical conditions, disease cases, adverse events, etc. Journalists often must rely on surveillance programs to report on outbreaks or side effects or in doing investigative research, but it’s important to know what kind of surveillance you’re using.

Tara Haelle explains two basic types of surveillance and why understanding the difference is essential.

Some tips, story ideas, past stories and experts to help you report on using 990 forms to report on hospital finance.

Hypertension is a common, but serious chronic condition among adults worldwide. In the U.S., The American Heart Association (AHA) estimates that nearly half of all adults in the United States – about 103 million people – have high blood pressure. Only about half (54 percent) of them have it under control, according to the CDC. About one of every five people with the condition are unaware that they have it.

Covering health insurance markets can be a daunting task. Insurance itself can be extremely complicated, especially when writing about it for the first time. Also, health insurers have complex structures. The largest insurers are for-profit, and their financial data are relatively easy to find and sift through.

However, many other insurers are private or not-for-profit, or they are part of a health system, all of which makes reporting on their financial data more difficult. On top of all these complications, each state regulates health insurers differently. For journalists covering this beat, here are some resources Bob Herman uses regularly

In the United States, far too many people – including many older adults – don’t get what they need to keep them from getting and spreading vaccine-preventable diseases. Yet the National Adult Vaccination Program says there are 50,000 vaccine-preventable deaths in the United States each year.

However, global travel and trade can spread diseases quickly, leaving seniors vulnerable to infection. Here, Bara Vaida and Eileen Beal discuss the risks of not being vaccinated, the reasons seniors aren't getting vaccinations, and also provides story ideas for reporters.

Speaker's presentations and tip sheets from AHCJ's 2018 conference.

Health care data are increasingly being collected by nonprofits and private companies as part of their work and business – the good news for reporters is this data can be easily accessible and at no cost.  

As long as it’s used responsibly, data collected by commercial entities can often help journalists write about an issue in a quicker and more timely manner, said Casey Ross, national correspondent at Stat News, during a panel at a Health Journalism 2018. 

Ross was joined by Jim Rivas of Doximity, an online network of more than 1 million medical professionals in the U.S., and Josh Gray, vice president of athenaResearch and health care reporter Felice J. Freyer of The Boston Globe, who moderated the panel.

Two top freelancers at Health Journalism 2018 – Linda Marsa and Heather Boerner – and attorney Ruth Carter offered a series of great tips to help you start thinking of your freelance work as a real business … and make it pay like one.

Leaders at a growing number of U.S. medical centers and military hospitals have begun using an integrative health approach to provide care to patients. They point to growing evidence that combining complementary therapies such as yoga, meditation, acupuncture, nutritional counseling and health coaching with more conventional medical services can help improve health outcomes, according to panelists who spoke about newest efforts at integrative health at a Health Journalism 2018 session.

Hispanics, together with non-Hispanic blacks, Native Americans and Alaska Natives, have poorer oral health than other U.S. racial and ethnic minorities, studies have found. April is National Minority Oral Health Month and a good opportunity to look at oral health care in those diverse communities.

We’ve all seen the commercials for adult diapers and have probably thought, “that will never happen to me.” However, bladder control problems, which include conditions like stress incontinence, urge incontinence and overactive bladder (OAB), affect about 30 million people in the U.S.

The prevalence of incontinence and OAB increase with age, but they’re not inevitable. Effective treatments and therapies exist — from medications to exercise to surgery. Even so, misconceptions and stigma can lead to psychological or emotional barriers to getting treatment and living well with this condition.

Republican-controlled states are taking a fresh look at the subsidized expansion of Medicaid under the Affordable Care Act following a major shift in the federal government’s stance on 1115 demonstration waivers.

The Department of Health and Human Services’ recent green light for work requirements, drug tests, premiums and other policies rejected by previous administrations is attracting the interest of states that already expanded Medicaid and are now looking to tighten restrictions on the program, as well as states that never expanded Medicaid in the first place.

But for states looking to implement the newly-allowed restrictions, many difficult questions lie ahead.  Here’s a guide to understanding some of the economic and ideological battles playing out in the states.

We have all read stories of houses so cluttered that emergency personnel can’t enter to rescue a fire victim or help someone in need of urgent medical care. There are reality TV series revolving around the problem of hoarding. While it may make for sensational stories, hoarding, particularly among older adults, is a growing public health issue, often requiring intervention by social service agencies, police, fire departments and mental health professionals.

Find out more about what hoarding is, risks associated with it and treatment options.

Annie Waldman

Government records officers frequently cite privacy restrictions to deny data requests.

ProPublica has often negotiated with or contested rulings by government institutions to pry data out of them. Its persistence has led to groundbreaking findings, such as an analysis of birth complications for the "Lost Mothers" series. Over the years, reporter Annie Waldman has amassed a variety of tips and tricks on how to overcome or circumvent these restrictions. Here are some tips on how to overcome or sidestep these barriers.

This year’s severe flu season has increased the spotlight on the development of a “universal” influenza vaccine – a vaccine that would be effective against most strains of the flu.

But that vaccine has been elusive.

In 2011, Francis Collins, director of the National Institutes of Health, told USA Today that he was “guardedly optimistic” a universal flu vaccine would be within reach in five years after scientists identified pieces of the virus that consistently appeared in seasonal and pandemic flu viruses.

Seven years later, however, scientists aren’t even close to a universal vaccine because the science isn’t there, Stat News’ Helen Branswell reported. It turns out that the pieces of the virus identified as being consistent between strains don’t seem to stimulate the immune system enough to create a vaccine target.

Though developing a bioweapon is a violation of the 1972 U.N. Convention prohibiting the development, production and stockpiling of infectious diseases, national security experts continue to worry that a terrorist or a rogue country could develop and unleash a bioweapon, that could kill or damage people, animals or the food supply.

Most recently, national security officials have expressed concern that North Korea is working on developing a biological weapon and has assembled a team of scientists that may be able to turn a cache of pathogens that could cause smallpox or spread anthrax, the Washington Post reported.

For journalists looking for local bioterrorism angles, consider looking into whether there is a BioWatch program running in the community and is it working? Are any local scientists working on pathogen-altering research? And for more bioterrorism resources, check out our new tip sheet on covering bioterrorism.

This year is starting off with one of the worst flu seasons in a decade. As of the week ended Jan. 27, the number of hospitalizations due to the flu is the highest it has been in nearly a decade, and flu activity has been as highest reported since the peak of the 2009 swine flu pandemic, the CDC said. The CDC was also quick to note that this outbreak isn’t a pandemic.

It is likely that flu won’t be the only outbreak in 2018. Over the past year, there was an outbreak of yellow fever in Brazil, plague in Madagascar, cholera in Yemen and measles in Minnesota. While no one knows what else might occur in 2018, there is likely to be another infectious disease outbreak somewhere in the world in the coming year.

Several reports have looked at the risks of fire and explosions related to electronic cigarettes, with a case in Hawaii getting the latest attention.

Mary Otto summarizes and links to the reports, provides an overview of the problem and the regulatory bodies involved, as well as some information about the public health implications of e-cigarettes.

Melissa Patrick

Geriatric care managers have been around for decades and their numbers continue to grow, but many people have never heard of them.

The Aging Life Care Association (ACLA), the trade association for the industry, says geriatric care managers provide a “holistic, client-centered approach to caring for older adults or others facing ongoing health challenges.” 

The number of Americans ages 65 and older is projected to more than double from 46 million today to over 98 million by 2060, according to the Population Reference Bureau. That adds up to a growing population of seniors primed to need more health care services – including geriatric care managers –  in the coming years.

Kristen Schorsch

As Medicaid managed care spreads, it is important for reporters to understand how it works and where to get the information we need to do solid accountability reporting about it.

Although research is mixed about whether managed care saves money for states, programs have exploded nationwide because health plans typically are paid a fixed amount per enrollee, which helps states predict their costs for the year.

This is an important story to follow in your state. Kristen Schorsch explains six things to pay attention to.

Tips from an editor at Health Journalism 2017.

Mary Otto

Concerns about the overuse of antibiotics in dentistry have been growing in recent times. In 2016, a group of experts weighed in on the problem in an article in the Journal of the American Dental Association, cautioning dental providers about the unintended consequences of antibiotic use.

They have concluded that antibiotics prescribed by dentists may be contributing to the spread of C. diff, which in 2011 killed more than 29,000 people in this country alone.

Read more about changes in dental prescribing practices and what your readers, listeners or viewers need to know when they have dental work done.

The just-approved tax bill awaiting President Donald Trump’s signature contains provisions that will have a profound impact on health coverage and the health industry. As we reported earlier, the House and Senate bills differed. The Senate prevailed on most health-relevant provisions, and that was generally better for med schools, grad schools, and hospitals. But it was the Senate that paved the way for the repeal of the individual mandate in the Affordable Care Act.

As expected, the Federal Communications Commission on Dec. 14, 2017, voted 3-2 along party lines to end rules that prohibited Internet service providers from blocking websites or charging varying fees for speed and access to online content and services.

By reversing Obama-era rules that protected a free and open Internet, the FCC is moving us all into uncharted territory. Start-ups, small businesses, local news organizations, individual blogs and small or rural health providers could fall behind in their ability to serve their customers online. This decision could exacerbate the digital divide and health disparities.

In the past decade, thousands of U.S. primary care practices have reorganized themselves as patient-centered medical home (PCMH) practices, making medical homes the most widespread type of health care delivery and payment reform so far. The concept likely will become even more popular in the years ahead because the federal government’s Quality Payment Program included some medical home practices in its advanced alternative payment model (APM), making them eligible for incentive payments.

The term “medical home” dates back to the 1960s, but the concept did not gain traction until about a decade ago.

The House and the Senate both have passed tax bills which have provisions that will deeply affect health care, ranging from repeal of the individual mandate to repeal of a tax credit meant to help businesses comply with the Americans with Disabilities Act.

Since the bills are not identical, the final legislation must first be negotiated in a conference committee. Not all the provisions will survive, although the final bill most likely will more closely resemble the Senate version, which includes repeal Affordable Care Act’s individual mandate.

Learn more about the health provisions at stake.

The Centers for Medicare & Medicaid Services was scheduled to roll out a refresh of its Hospice Compare database, the latest among its websites scoring quality in health care settings.

The data should have been available by late November, but technical issues delayed the release until Dec. 12.

Despite that delay, this is a good time for stories about end-of-life care that readers might discuss with family members during the holidays. Coverage can explore what the federal measures show – and what they don’t but should – for the nearly 4,500 hospices across the country.

HIV is a treasure trove of story ideas. In a companion tip sheet, Heather Boerner listed some things she thinks general news coverage about HIV gets wrong, along with how to correct those mistakes.

Here she shares what you need to know to cover the new science of HIV.

If you care about the health of communities, about social determinants of health, or about health policy, HIV is a treasure trove of story ideas. But in Heather Boerner's years of covering HIV, for publications including The Washington Post, The Atlantic, Medscape and PBS NewsHour, there are lots of things that she thinks general news coverage about HIV gets wrong. 

See what they are and how to improve your coverage of this important topic.

Growing awareness of the importance of remaining active throughout life has given rise to an “active-aging industry.” General contractors now build houses with aging in mind; designs include elevators, lower counters, wide doorways and other amenities that enable seniors to remain living safely in their homes. And many communities have active senior centers, while private and public health centers, gyms and YMCAs offer programs specially geared toward older adults.

Reporters can use information in this tip sheet as a springboard for many potential stories — from local community initiatives that encourage seniors to get up and move, to policy debates in state houses and Congress on issues like transportation, long-term care, food and nutrition, housing and safety net programs.

The most recent wave of reporting on sexual abuse and sexual harassment began with the report on Harvey Weinstein’s decades of abuse in Hollywood, but other accusations of sexual assault and harassment by prominent figures continue to dominate the headlines. As more survivors of sexual assault and harassment come forward, journalists face a dual challenge.

At first, these stories might not seem related to medical research. However, it’s important for journalists to provide context and help readers understand the causes and impact of sexual assault and perhaps report on what evidence-based prevention and treatment looks like. Many stories may blend findings from medical studies with the stories of survivors themselves. 

AHCJ has summarized some of Dart’s key recommendations and several others in this tip sheet.

While previous generations were more likely to have had ready access to alcohol, baby boomers had easier access to alcohol, and other substances, such as marijuana, cocaine, crack, and prescription medications. Some people developed lifelong habits and disorders, and some reached late life with their substance use disorders intact.

Janice Lynch Schuster points out that alcohol addiction and alcohol use disorders are among the worrisome trends in substance abuse among older adults. She reminds journalists who cover issues of addiction and treatment that even 85-year olds can have addiction or dependency problems. However, because of their age, substance abuse, whether from alcohol, opioids or other substances, may be mistaken for other health problems like cognitive decline or confusion.

Writing about medical studies focused on transgender issues and experiences means using the appropriate terminology, whether a trans individual is interviewed or specifically addressed in a story or not.

This tip sheet covers the do’s and don’ts of reporting on trans issues and pitfalls to avoid.

By establishing a strong following on Facebook through relentlessly covering the issue on her profile, Heather Wolford branded herself as the "go to" local reporter for coverage of heroin and opioid-related topics. When the public thinks of the heroin crisis, they feel comfortable enough to reach out and share information with her.

Don’t trust Facebook? Well, in a county of about 70,000 residents, news travels fast. And it travels on social media. To cover something as taboo as opioid addiction in small-town America, you must leverage social media.

Wolford shares some tips on how to manage your social identity (mostly through Facebook), and other ways to become a “go to” resource for your area.

Not all medical and health research comes from peer-reviewed medical studies. Reports from think tanks can contribute to chasing down a story as well.

But relying on research from think tanks requires some homework to ensure a full understanding of the think tank’s objectives, biases, history, funding and other characteristics which could influence their findings.

In a 24-page report for CQ Researcher, Bara Vaida examines how the Ebola and Zika outbreaks illustrated clear gaps in preparedness and what the globe has been doing to respond. She also addresses the issue of bioterrorism and whether the U.S. is prepared for a biological attack. 

The in-depth paper looks at the background of infectious diseases as well as emerging threats, leadership and collaboration in th global health community and predictions about the next pandemic. An extensive bibliography and related reading list offer a guide to sources for reporters. CQ Researcher has granted access to this report for AHCJ members.

It seems like every week there's a new press release about a new health innovation center opening up shop.

Since passage of the Affordable Care Act in 2010, which emphasized the transition from patient volume to value, innovation centers have been popping up all over the country. Becker's Hospital Review has identified at least 50 hospitals with innovation programs.

Ever wonder which emerging diseases to watch? You’re not alone. Even for scientists, it’s difficult to tell which disease will be the next Ebola, or when it will happen. Many dangerous outbreaks in recent years have been both zoonotic and viral, so animal-borne viruses are a good place to look for the next one.

Many diseases on this list are also zoonoses and caused by viruses, and all are emerging infectious diseases – or they have the potential to re-emerge in the near future.  

The World Health Organization defines vectors as organisms that pass diseases from animals to humans or between humans. Mosquitoes are probably the most widely known vector, but ticks, fleas, sand flies, freshwater snails, and triatomine bugs are all examples of vectors that can transmit disease.

There are a number of vector-borne diseases circulating in the United States, including Zika, West Nile and Lyme disease. In the coming years, these diseases may be a growing threat to an increasing number of Americans as a result of climate change. Here is some background on diseases you might be called upon to write about.

The next big thing in global health doesn’t get much attention.

Zoonotic diseases, or zoonoses, spread from vertebrate animals to human beings from viruses, bacteria, fungi, or other communicable agents, and scientists estimate 75 percent of new emerging infectious diseases will be zoonotic in origin. Humans and animals have a close relationship on an increasingly crowded planet, and this means zoonoses will be the diseases to watch in the near future.

But most people haven’t heard of zoonotic diseases, and most journalists haven’t covered them. In fact, these infectious diseases rarely make headlines or the nightly news until human-to-human transmission reaches potential pandemic proportions.

These terms and resources offer context on future zoonotic-related outbreaks and how global partnerships can make prevention possible.

Mary Otto

The Children’s Health Insurance Program (formerly known as the State Children’s Health Insurance Program) has enjoyed broad support through much of its history, and state officials have received reassurances from Capitol Hill that funding for the program will continue.

But over the past summer, as Congressional leaders remained divided over many issues, children’s advocates became  “increasingly anxious” about the program’s future, Tricia Brooks, a senior fellow at the Georgetown University Center for Children and Families, said in a September commentary in Health Affairs.

Liz Seegert

We all have read the stories: elderly adults scammed out of their life savings by unscrupulous contractors, telemarketers, caregivers, bankers, or even family members. Not only is this ethically horrific, but there are often serious health consequences for the victim.

Tara Haelle

Few things are more frustrating, humbling or sometimes even confidence-shaking than embarking on a story heavy into research – then not feeling equipped to assess the methods and statistics.

Some reporters may even explicitly avoid reporting on research or may do a poor job when unexpectedly assigned a story because they feel their math skills are too weak. Others may be whizzes with numbers who love math but still come across studies that require knowledge or skills outside their wheelhouse.

People in Texas will be dealing with the aftermath of Harvey for a long time. Even if you’re not reporting on an affected location, this may be a good time to ask some questions and write about disaster preparedness in your region.

Here are some resources specific to Texas, as well as resources that can be used by anyone covering preparedness issues.

Mary Otto

Dentists are among the leading prescribers of opioid pain medications in the country, according to numerous studies. The prescriptions often are written for patients after tooth extractions – including approximately 3 million mostly young adults who have wisdom teeth extracted each year. As awareness has grown about the risks of addiction, some in the dental profession have reassessed their prescribing habits.

In this tip sheet, find out what the research says about dental prescribing as well as how dental organizations have responded and steps that are being recommended to combat the problem.

Liz Seegert

You probably have heard of shingles, a condition caused by reactivation of the chicken pox virus in older age. But without experiencing it, it may be difficult to imagine just how painful it can be or how serious a threat the complications that accompany this disease may pose for the older population.

Learn more about the condition, the very serious complications that it may bring, how it affects people, how it can be prevented and how it's treated. This tip sheet includes a list of story ideas, resources and experts to contact.

Mary Otto

Is the lack of dental care for senior citizens a concern in your area? Have health officials in your state explored the consequences of the shortage of dental care for community-dwelling seniors, or those living in nursing homes? Is a nonprofit or community organization taking a creative approach to meeting the need?

The nonprofit Oral Health America periodically publishes a state-by-state report card that analyzes oral health among elders. How did your state do on the most recent “State of Decay” report card? 

Janice Lynch Schuster

Since the late 1990s, researchers have known about the negative effects of adverse childhood experiences (ACEs) on adult health, particularly their dose-related effect on risks for several major conditions, including cancer, heart disease, lung disease and suicidality.

For those just getting started in looking at the issue, AHCJ member Janice Lynch Schuster pulled together some basic tips on covering it, drawn in part from an event hosted by the Aspen Institute, a nonpartisan educational and policy organization based in Washington, D.C.  as well as a panel at Health Journalism 2017.

A panel of freelancers at Health Journalism 2017 in Orlando shared a wealth of valuable pieces of advice for freelancers, and developed the following summary of the most pertinent points. Others in the audience chimed in with their own tips; they are also included.

Mary Otto

While the Affordable Care Act (ACA) only imperfectly addressed American's wide lack of dental coverage, oral health advocates and analysts have applauded progress in getting oral health benefits to more Americans under the health care reform law.

With the possible revamping or dismantling of the law, concerns are being raised that dental benefits could be lost. Learn more about how dental benefits are handled through Medicaid and some exchanges and how such benefits could be affected.

Louise Norris

In mid-April, the Department of Health and Human Services published its market stabilization final rule. The regulations gave states new flexibility to determine whether health plans sold in the exchange (qualified health plans, or QHPs) have adequate provider networks and prescription drug formularies that aren’t discriminatory in their design.

HHS notes that shifting responsibility to states is a direct result of President Trump’s executive order that directed federal agencies “to provide greater flexibility to States and cooperate with them in implementing healthcare programs.” In promulgating the new rules, HHS explains that they are “committed to returning to states their traditional authority to regulate health plans.”

Joseph Burns

One of the main ideas behind the Affordable Care Act was the concept that physician practices, hospitals, accountable care organizations and other groups of providers would deliver population health. But since Congress passed the act in 2010, defining how population health is delivered has been challenging.

The terms population health and population health management have become ubiquitous among health care providers, wrote Tamara Rosin, a reporter for Becker’s Hospital Review. But, she added, “Despite their prevalence, the industry has yet to decide on a single definition of ‘population health.’” She was reporting on a panel discussion that Becker’s sponsored on the topic and included in her article definitions of the term from five hospital executives.

Mary Otto

Professionally applied dental sealants offer effective protection against tooth decay. Moreover, progress has been made over recent decades in getting these useful treatments to kids.

Still, the work is far from done. Overall, fewer than half of American children have received the thin plastic coatings applied to the biting surfaces of newly-erupted molars. Particularly concerning to health officials and oral health advocates is the shortage of sealants among low-income children, who face an elevated risk of disease and suffer from higher rates of untreated decay.

Now that a recent report has renewed the call for communities to bolster their support of school-based sealant programs, this might be a good time to see how your state is doing regarding getting sealants to kids. Is there a school sealant program you can visit in your community? If there isn’t one, why not? This tip sheet offers resources to help you take a closer look.

Andy Schneider, a research professor with Georgetown University's Center for Children and Families, compiled these resources for a panel at Health Journalism 2017.

Rebecca Vesely

The premier hacking conference DEF CON this summer will, for the first time, include a hackathon of medical devices. It is a sign of the significant growth in the use of connected medical devices and their vulnerability to threat actors and other intruders.

So for journalists covering hospitals, clinics, health systems and home health, it is worth keeping an eye on the security aspect of medical devices. While the security of computer systems and electronic medical records has drawn increasing media coverage, medical device security has not.

Here are some questions journalists can ask health facilities on their beats about the security of medical devices.

Dan Goldberg

Medicaid has evolved a lot in the five decades since it was signed into law. Now, the American Health Care Act would cut more than $800 billion from Medicaid over 10 years. Rightfully, there has been a lot of focus on what that would mean for low-income adults. But Medicaid also is a lifeline for roughly 6 million seniors, most of whom cannot afford Medicare’s cost-sharing requirements.

Because Medicaid is a jointly operated program, federal actions often require state reactions and state budgets provide a trove of stories. Medicaid is among any state’s most expensive, and fastest growing, programs so every governor looks for ways to contain costs. 

If the Affordable Care Act’s Medicaid expansion is rolled back in a repeal package, governors across the country are going to have some difficult choices to make, and it will be hard to cut services without impacting seniors.

Liz Seegert

Parkinson’s Disease (PD) is a chronic, degenerative neurological disorder that affects about one in 100 people over age 60. Since it is a progressive disease, symptoms worsen over time. There’s no known cause or cure, but medication and surgery can help manage symptoms. Most people's symptoms take years to develop and can live for years with the disease.

The incidence of Parkinson’s increases with age. However, an estimated 4 percent of people with PD are diagnosed before age 50. Actor Michael J. Fox was only 29 years old when he learned he had the disease. Men are one and a half times more likely to have Parkinson’s than women.

Janice Lynch Schuster

One perennial issue for reporters covering the social determinants of health is the fact that millions of people in the United States – from pregnant women and children to at-risk adults and seniors – go hungry, not just for an afternoon but for entire days or more.

In 2015, almost 11 million adults and more than 500,000 children and adolescents experienced “very low food security,” according to the Economic Research Service of the U.S. Department of Agriculture (USDA). That means one or more members of a household had reduced their food intake.

Mary Otto

This year's panel on oral health at Health Journalism 2017 offered a wide-ranging discussion of important stories unfolding in the world of oral health, including potential changes to Medicaid, possible changes in funding for CHIP and changing models of dental care.

For background that will help you learn more about these many unfolding stories and how they might impact people in your state and community, here are some useful resources.

This advice was compiled by these speakers on a panel about tackling big projects in small newsrooms at Health Journalism 2017.

Andis Robeznieks

Updated: June 13, 2017 - This tip sheet has been updated to reflect the VA's decision to replace its homegrown EHR.

With the Trump administration promising big changes at the VA in terms of care access, coordination and delivery, reporters should keep in mind the colorful history and uncertain future of the VA's EHR system. Besides military spending and the border wall with Mexico, an EHR replacement is one of the few areas where President Donald J. Trump has proposed increasing spending.

Health care reporter Andis Robeznieks offers background and some tips for what to watch for as this process moves ahead.

Lead contamination and its health consequences have re-emerged as a critical issue in the wake of the Flint municipal water crisis in Michigan. Reporters from Philadelphia to Cleveland and beyond are taking a deeper look at the presence of the contaminant in their communities and how it is affecting residents.

National tracking of this public health crisis is limited, however, and many localities follow their own course. A recent AHCJ’s webcast covered the challenges in tracking down reliable data on lead contamination and its effects.

Here are some additional sources for your reporting.

Mary Otto

Dental amalgam is the material at the center of the National Resources Defense Council’s mercury rule lawsuit.

It is a mixture of mercury and powdered metals, such as silver, tin, copper and zinc, that is defined and regulated as a medical device by the U.S. Food and Drug Administration (FDA).

While dental amalgam has been found to emit low levels of mercury vapor, it is considered safe for most dental patients over the age 6. The current FDA rules on amalgam safety date from 2009. However, health officials worldwide long have had serious concerns about the environmental impact when amalgam waste is disposed of after a procedure.

This lengthy but informative slide presentation from an experimental psychologist at the University of California, Berkeley, was intended for social scientists, it provides a number of helpful tips in understanding what types of P-hacking exists, how to spot it, and what can and should be done to address it. 

In the debate over repealing Obamacare, everybody is correctly focusing on what happens to the Medicaid expansion programs and the subsidized plans sold through the Affordable Care Act online exchanges. But there’s a potential threat to another, much bigger part of the health insurance market.

Employers are worrying that when it comes to providing affordable health insurance for their workers, the Republican cure might be worse than the disease.

The prevalence of Type 2 diabetes is projected to skyrocket among older adults in the next two decades. This trends places millions of older people at risk for serious and life-threatening complications, such as renal disease, retinopathy, heart disease and amputations. That can lead to reduced functioning, the need to enter an institution and higher mortality – with resulting higher costs to the health system.

By 2034, diabetes is expected to affect around 14.6 million Medicare-eligible individuals. Spending related to the disease among the Medicare-eligible population is projected to increase to $14.6 million by 2034, with associated spending nearly quadrupling from $45 billion in 2009 to $171 billion, according to the American Diabetes Association (ADA). 

Find out more about how diabetes can add to the complications of aging and some solid resources to consult for your stories.

The Affordable Care Act (ACA) led to the biggest expansion in mental health services in several decades, helping to close long-standing gaps in access and coverage for as many as 60 million people.

President Donald Trump promises to gut the federal law, which would include its substantial protections for people with mental conditions. Health care advocates warn that repealing the ACA would have a severe effect on the 43.6 million people living in the United States with a psychiatric illness and the 21.5 million with a substance abuse disorder, according to a 2014 government survey.

In this tip sheet, Sarah Ferris runs down the key ways in which repealing the ACA could affect people with mental illnesses or addictions. These are some important issues to consider when reporting about repeal and replacement efforts.

Tampa Bay Times feature writer Lane DeGregory wanted to explore the issue of physician-aid-in-dying, which was legal in a few states and had just been passed in Canada and California. To do so, she and a photographer found a couple to follow as the husband faced his last days with ALS. She wrote about the project here.

This is a tip sheet that she and photographer Eve Edelheit shared at a newsroom brown bag.

The big health data bazaar: Author and journalist Adam Tanner has tips for covering the hidden trade in patient data. Tanner has written two books on the subject, finding that the business of patient data is an opaque trade that is hard to unravel.

He says that the big health data bazaar is complicated but fascinating, and one worthy of further reporting as society grapples with the balance between allowing patients to control their own data, and allowing outsiders to study it to advance commerce and science.

This tip sheet provides an overview of what kind of data is out there, how it is used, who the big players are in the business, why we should care and questions that journalists should explore.

The U.S. Food and Drug Administration's Jan. 27 warning about homeopathic teething tablets follows a 2016 announcement after investigators concluded that new reports of adverse events showed similarities to cases observed back in 2010 when the agency cautioned consumers against using one popular brand, Hyland’s Teething Tablets.

Following the 2016 warning, national pharmacy chain CVS announced a voluntary recall of all brands of homeopathic teething products and removed them from store shelves.

In November, Raritan Pharmaceuticals, a contract manufacturer for Homeolab USA, said that it was voluntarily recalling homeopathic teething and earache remedies containing belladonna extract due to the potential for variation in the content of belladonna extract in the products. Hyland's earlier had issued a press release defending the safety of its products.

Learn more about the teething process, homeopathy and how doctors advise parents to help their children get through this process without turning to potentially dangerous treatments.

Health care journalists covering addiction, overdoses, and the heroin epidemic are likely to learn that the health insurance system appears to be part of the problem. That’s what Terry DeMio found on her beat in southern Ohio and northern Kentucky. Since January 2016, DeMio has been the Cincinnati Enquirer’s heroin epidemic reporter.

Rather than paying for the best medications for drug addicts in need, health insurers often require patients to start with the lowest-cost drugs. Then if the lowest-cost prescription fails, insurers then pay for the next highest-cost drug. Called fail-first or step therapy, this process repeats until the patient finds the one that works. Meanwhile, the patient suffers or could die, DeMio said.

Here are some resources for covering this growing topic.

Deciding whether to report on a clinical trial or other medical study requires considering factors that range from the study’s news value to the strengths and weaknesses of the study itself. The former is far easier for journalists to determine than the latter.

This tip sheet is the first in a series pointing out red flags that journalists should watch for in the studies they cover. Seeing one in a study doesn’t mean it shouldn’t be covered. In fact, sometimes a study with a lot of red flags is worth covering if it has strong news value but runs the risk of being misinterpreted in other articles. In that case, covering it may present an opportunity to ensure an accurate representation of the study, its limitations and implications compared with other coverage that may or may not cover it so judiciously.

The prevalence of multigenerational grandfamilies in America is impacting the oral health of both grandparents and the children they are raising, according to the findings of a recent survey conducted on behalf of Oral Health America.

There are probably grandfamilies in your community who would be willing to speak about the multigenerational challenges and rewards they have encountered in finding care and staying healthy.

As you report on the effort to add a dental benefit to Medicare, here are some things to keep in mind.

A combination of factors made freelance journalist Mark Taylor think more about the cost and dangers of falling.

He's in his early sixties and has cared for enough family and friends who have fallen to know that falls pose a huge risk.

When he attended the Gerontological Society of America's annual conference, he stumbled across a poster session illustrating the enormous cost of falls on our nation’s seniors, both physically and financially. The price tag for falling victims and their families and society was estimated to exceed $34 billion in 2013.

He learned that falls are not an expected, normal consequence of growing older and they can be prevented. His tip sheet contains more important information about aging and falls to help inform your reporting on the topic.

Republicans in Congress aim to vote to repeal the Affordable Care Act in the first 100 days of Donald Trump’s presidency.

Even with Trump in the White House, the GOP won’t be able to get a full repeal of the ACA through the narrowly divided Senate. Instead, Republicans will use a legislative tactic called reconciliation, which will enable them to push massive budget-related bills through the Senate without the threat of a Democratic filibuster.

Sarah Ferris has prepared a guide to some of the bewildering D.C. budget lingo and process for this to take place.

Three things have come together to throw a spotlight on the health care needs and challenges of older adults identifying as lesbian, gay, bisexual, or transgender.

In this tip sheet, Eileen Beal explains why and shows how that means there’s more demand than ever before to better cover the health and care needs of what until recently had been a “marginalized minority.”

She also offers a number of specific story ideas and an extensive source list - with contact information.

All but a relative handful of incarcerated persons in the United States go home. But those sentenced to longer – if not lifetime – prison stays mainly account for an increasingly older population in state and federal correctional facilities.

While the federal Bureau of Justice Statistics has been tracking that surge, it has not tallied the prevalence of mental illness among prisoners who are aging. Moreover, aging persons — imprisoned or not — are at greater risk for certain mental illnesses.

A comparatively small coterie of university researchers, alongside physicians and others providing care for those behind bars, say older inmates’ mental illnesses run the gamut. These researchers and clinicians have begun, even if incrementally, to try to empirically measure mental health problems among aging inmates, adding, they say, to what is a relatively small body of research about this group of individuals.

Health insurance premiums obviously are going up – and we’re all, appropriately, writing about it. Affordability is a political issue, affordability is a consumer issue, and affordability is an economic sustainability issue.

But we need to do it accurately, not sloppily. Here are a few quick suggestions:

Nobody wants to make a mistake in a story, yet a few errors can slip past our best efforts.

Fact checking is especially critical for freelancers as our credibility depends on filing accurate stories – even if magazines have fact-checkers, do you really want to send in a story with misnamed drugs or misspelled sources? Or, if you find your patient interviews from online discussion groups, you’ll need to make certain they actually have the disease you’re writing about.

In this tip sheet, prepared in conjunction with an AHCJ webcast, author and freelancer Brooke Borel provides step-by-step tips on how to check your story for errors, how to annotate your stories for a checker, materials you need and when to start annotating. Borel is the author of the recently-published, “The Chicago Guide to Fact-Checking”.

American hospitals may have some of the most advanced medical technology in the world, but they hold an unimpressive record of ensuring their patients continue to get better after they leave. Roughly one in six Medicare patients ends up back in the hospital within a month, and researchers believe a third of those readmissions may be preventable.

The federal government publishes individual hospital readmission rates on its Hospital Compare website, and Medicare is in the fifth year of cutting payments to hospitals with high rates of rehospitalizations. Public scrutiny and financial hits from the penalties are prompting many hospitals to take steps to avert so many returns.

Advances in science are contributing to a growing appreciation of the interrelationships between oral and systemic conditions. Here are some resources to get you started in reporting on this trend in your community.

If you are covering the social determinants of health care, chances are you will need some data on areas such as income and gender that can influence health. One place to find everything from the number of doctors in a particular part of the country to demographic information on veterans is the U.S. Census Bureau. This federal agency culls data not only from the U.S. Census taken every ten years but also from a host of other more frequent surveys.

The bureau’s American Fact Finder tool lets users search for a specific set of characteristics for a particular community such as housing, income, poverty and race. It also offers various maps, charts and other visual data.

The “young invincibles” live up to their name. They don’t think they’ll get sick or hurt, and so they take bigger risks than most people, including the risk of going without health insurance. Because of this, they have posed a challenge for insurers and the Obama administration.

Young, healthy Americans are a crucial demographic to the success of the Affordable Care Act. Their participation in Obamacare exchanges is important to help balance out the cost of older enrollees more likely to get sick and need medical care more often.

When reporting on aging, one complicated issue journalists eventually will encounter is “brain death.”

Understanding the nuances of this issue is vital since media reporting shapes public perceptions and so can impact more than 120,000 Americans on waiting lists for a replacement heart, liver or kidney. Nearly two out of three Americans over age 50 are registered to be organ donors, according to the Department of Health and Human Services, but because of insufficient organ donations sometimes caused by the confusion around brain death, those who need a donation may not receive one in time.

Author and researcher Alan Cassels explains some ways to improve reporting on this important issue, including definitions and potential sources.

An Appalachia Health News story by Kara Leigh Lofton highlighted West Virginia’s push to encourage more schools to promote a simple oral hygiene routine shown to significantly reduce tooth decay. The reporter did a great job at summing up the thinking behind the effort.

A newly published Cochrane Review report serves as a reminder of the effectiveness of school mouth rinse programs. “Regular use of fluoride mouth rinse under supervision results in a large reduction in tooth decay in children’s permanent teeth,” concluded the authors of the paper.

In West Virginia, mouth rinse program supplies are offered to schools at no cost, Lofton explained, but participating schools need a volunteer or staffer willing to lead the program. At the time Lofton aired her report, an estimated 9,600 students in the state were getting fluoride rinses at school. But more children could benefit if more schools signed up for the program, West Virginia officials believe.

The same could be true in your state.

Mental trauma, like many health subjects, can require a special sensitivity to report about, especially when dealing with its victims.

Journalists are not immune from the experience of interviewing victims, and may be unsure how to manage their own emotions and response.

Here are some tips for health journalists when interviewing people who have experienced one or more traumatic events.

In an age when health care organizations are managing massive amounts of (often sensitive) data, cloud computing can help with storage, analytics and security of that data. Cloud computing is the advanced use of information and communications technology to remotely deliver a range of services including programs, storage, processing and tools. 

Rebecca Vesely provides some background on cloud computing in health care, including what it is, how health care organizations use it, security concerns and what questions reporters should ask about how it's being used.

Maggie Clark’s Two Million Kids series for the Sarasota Herald-Tribune has explored many facets of the state’s troubled Medicaid program: the dearth of preventive and specialty care in many communities, the problems faced by providers, the decade-long legal battle to reform the system.

Clark also looked at the shortage of oral health care services for poor children in Florida. Here she offers story ideas, background and sources of data to help other reporters cover oral health in low-income children.

Breaking news on cyberattacks at hospitals and health plans is increasingly common.

Here are some tips on reporting on health care data security breaches, including definitions what questions reporters should be asking and helpful resources.

A University of California San Francisco (UCSF) study published earlier this year laid out a protocol for the use of silver diamine fluoride (SDF) for arresting the disease process that drives tooth decay.

This appears to be promising news as “Until now, no option for the treatment of dental caries in the United States besides restorative dentistry has shown substantial efficacy,” wrote the authors.

Because it has been classified as a topical fluoride, dental auxiliaries are also beginning to explore the use of silver diamine fluoride. The Oregon Board of Dentistry moved to allow dental auxiliaries to apply silver diamine fluoride soon after it was cleared for marketing by the Food and Drug Administration in 2014, Donna Domino reported for DrBicuspid.com.

Learn more about this product so you can report on whether it's being offered as an option by dental care providers in your area.

For many reasons, the health insurance system leaves some consumers unable to cover the full cost of care. When that happens, some patients turn to medical funding companies to help them pay their bills. Often, physicians and other providers will refer their patients to medical funders who pay the providers and then collect from these patients. The problem, as journalists Alison Frankel and Jessica Dye learned last year, is that consumers sometimes suffer when dealing with unscrupulous medical funding companies. Dye (@jdye) is a legal correspondent for Reuters in New York. Frankel (@AlisonFrankel) is the editor, On The Case for Thomson Reuters.

As they reported last year, “In the little known world of medical lending, financiers invest in operations to remove pelvic implants from women suing device makers — and reap an inflated share of the payouts when cases settle.”

In their investigations for Reuters, they reported how these investors profit by financing care for desperate patients and how business groups called for a probe of medical funders.

For this tip sheet, we asked Frankel and Dye for advice on how journalists could cover this story.

If it’s hard for health care journalists to keep up with Medicare’s flood of announcements about new and revised programs, imagine what it must be like for the poor consumers who actually have to use Medicare.

In fact, Medicare’s complexity has been identified in research as a significant deterrent to broader consumer use of the program’s wide range of benefits. Even though Medicare has an open enrollment period each year that basically amounts to a free “do over” for consumers, seniors can be so intimidated by the process that they just stick with what they have even if it’s inferior to other options.

With this in mind – and having spent the past two years answering reader’s Medicare questions for PBS NewsHour – here are 10 items (and, yes, this is a made-up number for the list gods) that health care journalists might like to know as they shape their plans for Medicare coverage

The American Hospital Association (AHA) reports that telehealth is becoming increasingly important to health care delivery in this country. In fact, 52 percent of hospitals employed telehealth technology in 2013 and another 10 percent were in the planning stages of adopting the technology at the time of the study. The shortage of medical professionals, access to patients living in rural areas and patient mobility issues has made telehealth an appealing option.

But what about telemental health (also called tele-therapy or telepsychology), especially for older adults? This type of health care delivery is seldom offered in the general population, and for older adults it’s practically non-existent.

Clinical literature is filled with questionable evidence and poor data quality reported in randomized controlled clinical trials and observational studies. It is critical that journalists have the skills to navigate the system and independently evaluate the quality of evidence. Clinical decisions may be based on inappropriate methods unless questioned and addressed by skilled journalists.

Health journalists in particular have an obligation and opportunity to tease the threads of innovation, drug discovery, and regulatory environments to provide informed context and a powerful narrative. 

This is particularly critical when evaluating studies regarding older adults and other vulnerable groups. When reviewing methodology, these factors should be taken into consideration.

If you’re relatively new to reporting on medical studies or looking for a refresher as you dive back in after a long hiatus, Sharon Begley’s blog piece earlier this year and this quick-and-dirty refresher at AHCJ’s Medical Studies core topic area are great places to start. But as you spend more time reporting on research, you need to learn more of the nuts and bolts and drill down into specifics of study design, drug approval, and related topics.

You need a Medical Research 201 rather than a 101. Here’s one way to conduct a self-guided tutorial if you already feel comfortable with the basics.

An apple a day keeps the doctor away – providing we can eat it.

Oral health predicts whole body health, and is one of the 12 leading indicators for the U.S. Department of Health and Human Services’ Healthy People 2020 initiative. Former U.S. Surgeon General David Satcher’s landmark 2000 Oral Health In America referenced the associations between periodontal (gum) disease and systemic diseases and conditions. Research aimed at gaining a fuller understanding of the relationships between oral and systemic diseases and conditions continues.

The World Health Organization emphasizes the role diet and nutrition play in oral health, including its influence on craniofacial development, risk of oral infections, cancer and dental and periodontal disease.

Dietician and writer Melinda Hemmelgarn offers some things that journalists should know to raise awareness of risk, lead consumers to care and promote the critical role of diet and nutrition in protecting oral health.

Reporting on hospital ratings — the “best of,” “top ten” and other rankings designed to help consumers with decision making are not necessarily all they’re cracked up to be. So much more goes in to these rankings than just the letter or number grade. Savvy reporters should pause and consider many angles before jumping in to proclaim that their local hospital is “best,” “worst” or somewhere in between.

Ratings certainly help with improving transparency and the patient’s right to know. However, it’s important that journalist know how to read between the lines and question the methodology and potential biases.

Here’s a tip sheet based on ideas presented at an event last month sponsored by AHCJ’s New York chapter. A panel moderated by ProPublica senior reporter Charles Ornstein featured Robert Panzer, M.D., chief quality officer at the University of Rochester Medical Center and a steering committee member for the Healthcare Association of New York State; Leah Binder, chief executive of the Leapfrog Group; and Marshall Allen, a reporter for ProPublica.

Sometimes you just need a quick-start guide to reporting on medical studies or a refresher if you haven’t done it in a while. Drawing from three different sources, here’s a five-minute tip sheet you can skim between tasks. 

It includes guidance on reporting on animal studies, conflicts of interest, reliance on p-values, absolute and relative risk, causation and correlation, transparency, replication and providing context.

MACRA is the 2015 law that created Medicare's new payment system. It is the successor to the certified electronic medical record (EHR) Meaningful Use (MU) program. MACRA is set to have a profound effect on physician practices in the years to come.

In this tip sheet, Rebecca Vesely explains how it affects doctors, what the leading physicians' associations thing about it, how it affects the adoption of electronic health records, some key dates that reporters should keep in mind and links out to more explanations and resources.

New studies are backing up a basic assumption about wealth and health and in the United States: It matters where you live. Geography contributes to social mobility, health disparities and the income divide.

Policymakers and politicians are taking note, but with such a complex topic, how can journalists make a difference?

Three recent reports help explain the numbers and show where the discrepancies lie. Carolyn Crist outlines the reports and then some questions and issues for reporters to look into.

The area of pharmacogenetics, or how genes affect a person's response to drugs, is a fast-growing commercial segment of genetics. The basic science is sound and decades old. It involves identifying how a patient responds to medicine, and so helps physicians avoid bad reactions and figure out what dose is best for each individual. Today, clinical laboratories are selling hundreds of these tests to patients and doctors without substantive trials, independent validation or solid proof that they actually are accurate or even useful to patients. Among the fast-growing areas for these tests are psychiatry and in assessing how patients respond to opioids.

When writing about how these tests work, skepticism is in order. These tests are highly complex and their algorithms are proprietary. Reporter Beth Daley offers advice on what to look for in your reporting.

Health information exchange is the action of sharing relevant health information electronically among trusted clinical partners regardless of physical location.

The information sharing can be about a single patient to enhance the care of that patient. Or, the information can be about a group of patients for the purposes of public health tracking and improvement. 

Learn more about the concept, why it's important and get some ideas on how to cover it locally.

Jonathan Rockoff, a reporter at The Wall Street Journal who covers the pharmaceutical and biotechnology industries, has done some ground-breaking work on drug prices.

A great example is The Dysfunction in Drug Prices, reported by Rockoff and his colleagues last year. It won a 2015 Award for Excellence in Health Care Journalism for writing on the business of health and it was a finalist for the Pulitzer Prize.

Rockoff spoke about drug costs at Health Journalism 2016 in Cleveland. In an essay accompanying his AHCJ award submission, Rockoff and his co-authors wrote about the lack of a centralized database on drug prices and how they basically had to build their own. Short of that, this tip sheet suggests some ways you can find and understand the data.

Photo: Matthias Müller via Flickr

With an increasingly aging prison population, how to care for inmates with chronic illnesses or other infirmities and those at the end of life has become an urgent challenge for federal and state governments, and for inmate and elder rights advocates.

An increasing number of prisoners need wheelchairs, walkers, canes, portable oxygen, and hearing aids. Many are incontinent or forgetful and need assistance to get dressed, go to the bathroom, or bathe, according to the Connecticut Office of Legislative Research. Authorities must balance appropriate care with ballooning health costs, determine who will provide care and pay for it. The situation is squeezing state correctional budgets, health services, safety-net programs and local communities.

Liz Seegert offers statistics, story ideas and resources for reporters to cover how this is impacting their local communities.

The terms “wearables,” “wearable technology“ and “wearable devices“ refer to electronic technologies that are worn on the body or clothing to perform computing tasks. Generally, wearables are able to store and transmit data, and information can be accessed in real-time.

The most commonly used wearables today are fitness trackers worn on the wrist made by FitBit, Jawbone and other competitors. But there are others: smart fabrics, smart backpacks, jewelry, headgear, belts and even diapers are in development. 

Rebecca Vesely, AHCJ's health IT core topic leader, breaks down exactly what they are, their economic impact, consumers' concerns and story ideas for reporters to pursue.

Adults with incomes below 100 percent of the federal poverty level (FPL) are three times more likely to have untreated tooth decay than adults with incomes above 400 percent of the FPL.

More than one third of poor elders have lost all their teeth – compared with 16 percent of those with incomes at or above 200 percent of the FPL. These and other facts come as reminders that poor oral health places a disproportionate burden upon poor adults in the United States, the nonpartisan Medicaid and CHIP Access and Payment Commission concluded in a report to Congress on the status of adult Medicaid benefits around the country.

Resources contributed at Health Journalism 2016 by Stanton L. Gerson, M.D., of University Hospitals.

It took five years for Congress to reauthorize the Older Americans Act, (P.L. 114-144), but President Obama signed it into law on April 19, 2016. The new legislation funds the OAA through FY2019.

It includes several important updates to the original 1965 legislation (and subsequent revisions), including funding increases, greater focus on elder abuse, help for non-profits, service organizations and consumers, more emphasis on home and community based services, and technical assistance for senior centers.

AHCJ's core topic leader on aging, Liz Seegert, runs down key components of the law, history of the law, what programs it affects and offers up story ideas and a list of experts to serve as sources.

More than one-third of Americans face “serious challenges” in obtaining dental care, for reasons that include high cost and lack of insurance, too few providers accepting Medicaid patients and a variety of mobility and transportation problems, according to a recent report sponsored by Pew Charitable Trusts.

The following is some background and other resources that may aid you when developing stories in your area about this important social determinants of health issue.

“When I saw Spike Lee’s Katrina story, I said to myself, ‘That’s the way I want to tell stories,’” said Collier (@andreacollier) during a panel at Health Journalism 2016 on multimedia skills for freelancers.

In any election year, you can bet that politicians will pay a lot of attention to voters’ concerns. The stakes are even higher in a presidential election year, which is one reason why – after years of relative silence on a rapidly growing opioid epidemic – Congress and the Obama administration have recently started rolling out a variety of solutions.

In this timely tip sheet, AHCJ member Alicia Ault offers colleagues some tips to covering the growing national issue. She includes background on the issue, as well as what legislators, the White House and other government institutions are doing and story ideas for reporters to pursue.

The National Council on Aging defines mental disorders as “health conditions that are characterized by alterations in thinking, mood or behavior (or some combination thereof), associated with distress and/or impaired functioning.”

As the U.S. population ages, the need for mental and behavioral health services is increasing. Addressing and treating mental and behavioral health problems is especially important for older adults living in underserved communities, and for those living in poverty, according to the American Psychological Association (APA).

Recent studies indicate that about one-fifth of adults age 65 and older (20.4 percent) met the APA criteria for a mental disorder (including dementia) over the prior 12 months. While many older adults suffer from depression, anxiety and mood disorders also are common. Good mental health is important for overall wellbeing. Here are some tips and sources for writing about mental health as people age.

Republicans talking about their ideas for replacing the Affordable Care Act often propose selling health insurance “across state lines.” The general thrust of the idea is to boost competition in state insurance markets by providing consumers a wider array of plans from which to choose.

How is this proposal for interstate insurance sales different than what currently exists in the marketplace, where the nation’s largest health insurers (Aetna, United HealthCare, etc.) already sell policies in multiple states? And what evidence do we have about whether the idea would be successful? What has happened in the handful of states that have already tried it? What effect would it have on the uninsured? Rachana Pradhan covers a few things you need to know.

At Health Journalism 2016, investigative reporter Fred Schulte shared a list of sources he uses when reporting on Medicare, Medicare Advantage and fraud.

Independent journalists Andrea King Collier and Katti Gray, with Heidi de Marco of Kaiser Health News, presented a panel about multimedia journalism at Health Journalism 2016. Here is a list of useful websites and tools they suggest for other journalists.

Telemedicine is the use of telecommunications for clinical care. The American Telemedicine Association defines it as two-way video, email, smartphones, wireless tools and other forms of telecommunications that provide primary care, specialty care, remote monitoring, consumer and medical information and medical education. 

In writing and reporting on telemedicine, exact definitions matter because patients, organizations and policymakers see it differently. It can be very broad and open-ended or very precise. The explanation of exact uses can be finagled to manipulate payment and legality.

This collection of resources for freelancers was presented at Health Journalism 2016. It includes tools for tracking time, organizing, running a business, transcription and more.

Patient voices bring an added dimension to health care stories, but connecting with patients meeting certain demographics often can be more challenging than locating medical experts.

In this tip sheet, Lisa Esposito, a health reporter for U.S. News & World Report, offers some ways to find those patients to serve as sources and issues one caution.

One premise behind the formation of accountable care organizations is that physicians and other health care providers would have financial incentives to deliver high quality care at lower costs. But research is indicting that the financial incentive may not be sufficient to foster improvements in care.

In other words, physicians don’t earn enough from the financial incentives to focus on improving quality of care. For journalists this point is important because health insurers and health systems often claim that by establishing new payment arrangements, physicians and other providers will be paid more for quality and quality scores will rise.

The question journalists can ask now is this: Are physicians and providers being paid enough for focusing on quality of care to make a difference in patient outcomes?

Each year, the release of new datasets makes it more exciting to cover health care. No longer are we limited to comparing states to one another to look for differences. No longer are doctors’ practice patterns protected by outdated privacy rules. We have entered an era in which we can compare one doctor to another. And what we’re learning is that there are huge, seemingly unexplainable, differences among them.

This tip sheet, from ProPublica's Charles Ornstein, offers both very broad data sources, as well as more granular ones. None of the data sets cover individual claims-level data, which require special permissions and often cost a lot of money.

You may be familiar with the term “age-friendly city,” but do you know what goes into being one?

It’s a concept we’ll likely be hearing more about as the worldwide older population is poised to surpass those under age 65 by mid-century.

Thousands more cities and towns need to be better prepared for the wave of aging baby boomers. That means making changes to meet the long-term health, housing, transit, social and civic needs of a population that routinely live well into their 80s and 90s. Key considerations include universal design, accessibility, health care services, “walkability” and ability to age in place.

Here are some important ways to assess age-friendliness and livability.

As a gay man in his mid-twenties, I knew HIV testing was a normal part of my health care regimen, but I knew little else about lesbian, gay, bisexual and transgender (LGBT) health care.

Each minority group has its own special health care concerns and issues, but did LGBT health mean more than HIV and AIDS? When I looked deeper, what I found are complex issues that impact one of the smallest and most diverse populations. 

Alan Cassels

We have an opioid crisis in the United States. Every day in this country there are 45 deaths and 30 emergency room visits due to the effects of these powerful painkillers, according to the CDC.

Poor and inappropriate prescribing among elderly people, especially instances of polypharmacy (the prescribing of multiple drugs) contributes to the risk of adverse drug reactions. The use of opioids in the elderly merits special attention for several reasons.

For journalists assigned to cover prescription drugs or health issues among the elderly, here are some helpful basics about different types of pain medication, opioid prescribing to the elderly and what is driving the growth.

Erin Mershon

Hospitals have been merging and acquiring physician practices at a breakneck pace over the last several years. Hospital representatives argue they need to join forces in order to better share resources, such as expensive IT systems, and to coordinate care in the manner that the Affordable Care Act has encouraged. But the trend has drawn criticism from insurers, state attorneys general and federal antitrust enforcers, who warn that consolidation can also give hospitals monopoly power to drive up prices and hurt consumers.

Here are five things to know when you report on hospital mergers and efforts by antitrust officials to challenge them.

Mary Otto

What does recent federal data reveal about how dental benefits are working on federal and state insurance marketplaces so far? In “Dental Benefits in Health Insurance Marketplaces: An Update on Policy Considerations” the National Academy for State Health Policy (NASHP) takes a look. 

In one perhaps surprising development, young adults aged 26-34 have turned out to be the group most likely to purchase stand-alone dental coverage on the federally-facilitated marketplace, with 302,000 individuals (20 percent of enrollees).

By comparison, 14 percent of the enrollees, or roughly 100,000 were children aged 0-18, according to the most recent marketplace data reported  by the U.S. Department of Health and Human Services.

Are young adults in your state obtaining dental benefits? Are they satisfied with their coverage? Why aren’t more parents in your state purchasing dental coverage for their children?

Joseph Burns

Writing about a new report from the Health Care Pricing Project (HCCP), Dan Gorenstein made the case that researchers now have compelling data showing that hospital consolidations drive up prices. Coverage of the HCPP report by Gorenstein and others raises an interesting question: Do we finally have game-changing data on hospital price variation?

The fact that hospital mergers drive up prices is certainly not new. But the HCPP researchers used newly released data from three large health insurers — Aetna, Humana, and UnitedHealthcare — and they controlled for factors that hospital administrators usually cite when explaining why their facilities charge more than others. It was, as Gorenstein described in his Marketplace article, “an unprecedented look at medical costs nationwide.”

Tara Haelle

You run across a fascinating study that seems newsworthy – but it’s published in a medical journal you’ve never heard of. How do you make sure it’s a legitimate, reasonably high-quality publication?

Often some of the most interesting findings can come from a smaller journal, especially in an emerging area of science that isn’t widely studied or accepted, yet remains scientifically sound.

You want to watch out for predatory journals, those that charge scientists to publish their work without adequate quality controls, and those that are just low in quality or affiliated with an advocacy organization.

So, how do you vet a journal before moving forward on reporting a study published in it? Here are some guidelines on performing due diligence on the journal’s quality.

Trudy Lieberman

Veteran health care journalist Trudy Lieberman says that she's long observed that U.S. health reporters are reluctant to reach out globally to inform their reporting. She points out that the health stories we’re asked to report are the same ones our counterparts abroad are writing and that this "reportorial parochialism results in poor understanding of foreign health care and makes it easy to report misleading or false claims because we have no knowledge to judge their correctness or to give context so audiences can judge for themselves."

 She has gathered nine journalists from seven countries, representing the United States, Australia, Canada, the United Kingdom, The Netherlands, Italy and Portugal. The panelists represent different areas of expertise ranging from hospital safety practices and insurance systems to antibiotics, overtreatment, and conflicts of interest in medicine.

In this article, she suggests some ways to add an international perspective to your health care reporting and why it might be important to your readers, listeners and viewers.

As federal officials recommend that Americans limit their sugar intake to help prevent systemic and oral disease, researchers continue to explore how the relationship between diet and tooth decay works.

Mary Otto, AHCJ's core topic leader on oral health, runs down some of the latest research on the relationship between sugar and tooth decay and suggests some questions that could guide your reporting on this topic.

At first, a story by Roni Caryn Rabin for The New York Times seemed like another article about a shooting gone wrong. But reading the full story showed there was much more to it, involving a little-known loophole in health insurance plans that leaves some health plan members without coverage or recourse.

The story shows that journalists might find a number of stories if they look into whether health insurers routinely deny coverage to victims of violent crimes if the insurers believe the victims are at fault.

A growing subset of the senior tidal wave known as the “gray tsunami” are those who identify as gay, lesbian, bisexual or transgender.

LGBT seniors increasingly are living out of the closet, yet remain largely invisible in government statistics. Few national health surveys include questions about sexual orientation or gender identity, leaving researchers to only guess at the true size of the nation’s LGBT older adult population.

In this tip sheet, Matthew S. Bajko explains some of the unique health issues that LGBT seniors face, such as social isolation and housing issues. He also offers stories ideas, contact information for sources and some relevant research. 

If you are wondering if the year-end spending and tax bills approved by Congress undid some of the funding for the Affordable Care Act – they did.

The bipartisan deal contained four major ACA provisions – rolling back three taxes which raised money to pay for the ACA, as well as renewing for another year a limitation the Republicans put in last year limiting the risk corridor payments to insurers. The Democrats backed the tax changes, and haven’t been able to stop the risk corridor change. The tax changes are worth $35 billion (if you count some related deductibility provisions, $32 billion if you don’t.)

This tip sheet will give you some understanding of what happened – and the questions about what comes next.

My story for The Atlantic, Into the Body of Another, looked at how mothers in many states were receiving lengthy prison sentences for abusing their fetuses by using drugs while they were pregnant. Leaving aside the life-at-conception issue, among the things I learned was that drugs differ in the levels of harm, if any, they can cause fetuses. What’s more, many states simply do not have the rehabilitation beds necessary to treat all the drug addicts within their borders, pregnant or otherwise.

Health and science journalism today is a complex ecosystem of journals and their publicity machines, public information/press officers at universities, scientists, talking heads that function as quote machines, and the journalists, bloggers and freelance writers who cover the enterprise.  None of these parts of the ecosystem really can get along without the others in our complex sound-bite driven part of the world. Yet the relationship between institutional press officers and the reporters who cover their scientists and research findings can sometimes become strained, partly because of changes in the university research occurs in recent years.

There are a lot of posts and stories out there focused on how public information officers (PIOs) can work more effectively with journalists, or that highlight extremely bad pitches aimed at reporters. I’ve written a few of them myself. But there are also things that reporters can do to work more effectively with PIOs. You don’t see many posts about that.

A couple years ago, I ran a guest post by Lauren Rugani – a PIO at the National Academy of Sciences – on nine things that drive PIOs nuts. Here I revisit the subject, reiterating some of Rugani’s posts but expanding on them too.

Malissa Savage, a community health worker who works with people in need of dental care, notes that variations in physical ability, mental capacity and behavior often call for flexibility and creativity by the individual and their caregivers.

Savage works for Allegany Health Right, a Cumberland, Maryland-based safety-net dental care provider for low-income, uninsured/underinsured adults. During a recent opportunity to observe Savage in action teaching, I learned about a number of resources will be useful to you in writing about the challenges and benefits of good home dental care for vulnerable adults.

Family gatherings during the holidays are an ideal time for adult children to assess the wellbeing of aging parents and other older relatives. This is especially important for those who may visit just a few times a year, since changes in mental or physical health and safety issues in the home may be more noticeable. Holiday visits are a good time to ensure that aging parents can still care for themselves.

The time between Thanksgiving and New Year’s Day is also an optimal time for journalists to cover these issues. Media from Maine to Rochester to Chicago report annually on how to take advantage of family visits to look for signs that aging parents may need help. It is a story which bears repeating – because this year might just be the year of a significant change.

There are a variety of risk behaviors and inherent health risks that LGBTQ young people experience. LGBTQ youths often are marginalized by family or friends, and we know that marginalized populations in general are at a higher risk for mental health and substance abuse issues. This group also is less likely to get care, especially care in which they may need to acknowledge their status to a provider.

In this tip sheet, Lawrence D’Angelo M.D., M.P.H., division chief of adolescent and young adult medicine at Children’s National Health System in Washington, D.C and director of the Youth Pride Clinic at Children’s, offers some advice on talking with LGBTQ youth, some of the special health and privacy concerns they face and resources for journalists.

When the U.S. Supreme Court ruled in February that the North Carolina State Board of Dental Examiners lacked the authority to regulate teeth-whitening businesses, experts observed that the decision might have impact far beyond the world of dentistry.

Licensing boards regulate hundreds of occupations across the country, everything from medicine and law to bee-keeping and fortune telling. Often the boards are comprised of members of the profession they are regulating. And as in the North Carolina case, there are times when these regulatory bodies run afoul of federal antitrust laws intended to ensure consumer choice and greater access to services.

Most journalists do a great job of writing for their audience. However, sometimes it’s easy to forget that part of the audience may include older adults – who often struggle with issues of health literacy, cognitive impairment or language problems.

As Medicare Open Enrollment season gets underway, this is a good time to consider story structure and how the information seniors may rely on is framed. While most of these tips probably are more applicable to journalists at consumer media, writers for more specialized journals and outlets can also benefit.

The media has a role in helping to prevent overdiagnosis and excessive care in medicine. I write a popular blog and can empathize with how hard it can be to resist the “catchy” headline or teaser to help drive readers to your article. The problem is that while evidence advances our understanding, more often than not articles are shared without being read. A short headline becomes fact and misrepresents the science.

Ray Moynihan and colleagues discussed specific drivers of overdiagnosis in an article published a few years ago in the British Medical Journal (BMJ 2012;344:e3502 doi: 10.1136/bmj.e3502; 29 May 2012):

The traditional sense of a hospital is fading.

Advances in technology, changes in how doctors and hospitals are paid, and a big push toward outpatient care mean patients aren’t spending as much time in hospital beds as they used to. In Chicago in particular, huge population shifts have gutted many minority communities anchored by hospitals.

The result? A lot of empty beds. I found quite the increase in vacancy rates while analyzing state records and interviewing dozens of people for my project, Running on Empty, which included this database that readers could search for information on every hospital in Illinois.

In 2016, the definition of “small business” or “small group” market was supposed to change under the Affordable Care Act. Instead of covering businesses with up to 50 workers, the small group market would encompass businesses with up to 100.

But in a rare bipartisan move on ACA-related legislation this week, the House of Representatives, followed by the Senate, swiftly and quietly voted to make this change optional for states as part of what has become known as the Protecting Affordable Coverage for Employees Act (PACE). The House voted on September 29 and the Senate on October 1.

Lisa Zamosky

For nearly two years, Lisa Zamosky has been writing a weekly health care column for the Los Angeles Times, called Healthcare Watch, which features the personal story of one consumer dealing with the issue she is writing about.

She says that finding a consumer each week remains, by far, her greatest challenge. While she wishes she had a brilliant, simplified process for finding the right person, she says that, "In all honesty, it can be an ugly, stressful ride right up until deadline." But she says things do almost always work out, and each week she finds someone to talk with her for the story. Here she shares some of her strategies to find patients and consumers for her stories.

Alan Cassels

There seems to be no end of news reports about promising therapies for Alzheimer’s disease and Parkinson’s disease. With the aging of the population having become one of the more serious and complicated aspects of modern American health care, these typically age-associated conditions are driving a lot of research into new drug and other treatment approaches.

With millions of school athletes headed back to playing fields across the country, protecting teeth from loss and damage should be on the minds of parents, coaches, teachers and players, too.

Mary Otto has compiled some informationa and resources to help reporters who might be covering sports-related injuries or risks.

How did we get here? Scientific discoveries that began in the 1920s, and continue today, gave birth to the longevity revolution, changing the nature of health care from acute to episodic/chronic care, where care is provided, who is providing that care and the costs associated. Some of these issues – and where they intersect – are easy to spot: Alzheimer’s impact on long-term care, family finances, nursing homes and the effect of new drugs on the treatment of chronic conditions, survival rates and the insurance industry come immediately to mind.

Others, including the issues in this tip sheet, take a bit more digging.

There’s a lot to unpack from day-long conferences and AHCJ’s Rural Health Journalism Workshop this summer was no exception. About one dozen presenters offered their expertise on everything from the impact of cultural barriers on mental health to luring doctors to work in sparsely populated areas.

For those already covering rural health, it provided some new angles and expertise for future stories. For reporters new to the beat, the workshop provided a wide view of issues particular to the health of those living outside urban America.

Fred Schulte’s investigation, for the Center of Public Integrity, into problems with Medicare Advantage plans took a lot of digging, filing of FOIA requests and ultimately a lawsuit to force CMS to turn over certain documents. We asked him, “At what point should a reporter consider filing an FOIA request or even suing a government agency to obtain information?”

Not only did he answer that question, but he shared some important tips and reminders for reporters trying to obtain public records.

I earlier wrote about a story by Sara Schilling of the Tri-City Herald in Kennewick, Washington, that offered her readers a glimpse into world of a local “adventure dentist.”

When dentist Bart Roach isn’t taking care of his own patients or helping at a local clinic serving the poor, he is traveling to faraway places such as Cambodia or Guatemala to help people who are suffering from oral disease. “You have an obligation to give back to your community and your global community,” Roach explained.

One agency created by the Affordable Care Act is the Center for Medicare & Medicaid Innovation (CMMI). As the name implies, its task is to innovate: trying new ways of delivering health care and testing new incentives and payment models. Some ideas are likely, even expected, to fail. Others may lead to new ways of delivering higher quality care for less money.

CMMI also is supposed to help spread new ideas so they’ll take root in the real world. The U.S. Department of Health and Human Services has the authority to expand approaches that reduce spending – and halt those that do not. This is a more flexible approach than officials had with “demonstration projects” prior to the ACA.

When it comes to organ transplants, where people live has a lot to do with when they receive care.

I explored geographic disparities in access to kidney and liver transplants in May in the first part of an ongoing series, “Living On: Improving The Odds of Organ Transplants,” supported by an AHCJ Fellowship on Health Care Performance.

As an interactive map with the series shows, the median wait time for a kidney transplant is more than six years in much of Texas and Pennsylvania but less than 18 months in Mississippi and Nevada.

Elder abuse was a key agenda item at this year’s White House Conference on Aging (WHCoA). While much of that panel discussion focused on financial exploitation, this is only one type of abuse that an older person might suffer.

It’s estimated that between 1 million and 5 million older adults (or 1 in 10 people age 60 years or older) has suffered from physical, emotional, or sexual abuse, are neglected or abandoned. If financial abuse is included, the figure is closer to two in 10. Major financial exploitation was self-reported at a rate of 41 per 1,000 surveyed, higher than self-reported rates of other types of abuse, according to the Administration on Aging.

Dental care and medical care have long been provided separately in America. New research and evolving models of care are challenging that traditional gap.

Chronic diseases are responsible for billions of dollars in health care costs and millions of deaths each year. Dental office screenings for diabetes, as well as other common conditions such as high cholesterol and hypertension could save the nation’s health care system as much as $102.6 million annually, researchers from the American Dental Association’s Health Policy Resources Center concluded in a study published in the American Journal of Public Health.

Mary Otto explains some of the screenings and interventions that may be coming to a dentist's chair near you, as well as some of the questions around providing such care.

The months-long controversy between Florida and the federal Medicaid program over funding for hospitals and clinics that serve uninsured low-income people drew attention to these uncompensated care pools. In Florida the arrangement is called the Low-Income Pool – better known as “LIP” (a gift to headline writers).

So what are these payments? And how do they differ from a Disproportionate Share Hospital (DSH) arrangement?

At least nine states, including Florida, have some kind of Medicaid waiver arrangement with the federal government that involves payments to safety net hospitals and, in at least some states, community health centers.

The 50th anniversary of Medicare and Medicaid is July 30. Over the years, these programs have evolved from basic safety nets to comprehensive care models designed to improve quality and offer affordable health care for millions. According to the Centers for Medicare and Medicaid Services, about 55 million Americans have Medicare this year and more than 70 million have Medicaid in any given month

Here is some background on the Medicare program and some ideas to consider as you plan coverage of the anniversary.

Health insurers focus so closely on the cost of care that they sometimes face charges that they discriminate against members with chronic costly conditions. Over the past year, patient advocates have complained to state and federal regulators that health insurers have failed to provide adequate insurance coverage to patients with cancer, HIV, mental health conditions and other illnesses (pdf).

For journalists covering insurance discrimination, the HIV cases offer important lessons about how insurers have used pharmacy benefit pricing strategies to shift the cost of medications to members. Health policy researchers and patient advocates contend that these pricing policies, including one called adverse tiering, are discriminatory.

This tip sheet explains issues and resources journalists will find valuable when covering pharmacy benefit discrimination cases.

List of panels for which there are tip sheets or presentations available from Health Journalism 2015.

Millions of Americans are going without dental care. Some lack insurance or money to pay for services. Others are too young or old or disabled to get themselves to a dentist’s office. Still others live in poor or isolated places where providers are in short supply. Dental hygienists who gathered in Nashville June 17-23 for the 92nd annual session of the American Dental Hygienists Association (ADHA), stress they are ready and willing to help get care to people who now lack it.

Organization leaders are determined to further expand hygienists’ freedom to work in the field. And they say that efforts to enable hygienists to become mid-level dental providers trained to drill and extract teeth are gaining momentum nationwide.

When the Blue Cross Blue Shield Association published a report in January 2015 about the wide variation in the cost of hip and knee surgery nationwide, it was a national story. Many journalists treated it that way.

But the report also offered journalists a way to localize the story because it offered so much detail on individual insurance markets. One good example came from journalist Bill Toland of the Pittsburgh Post-Gazette (@btoland_pg) who wrote about how the city’s hospitals ranked versus hospitals in other markets.

In the U.S. there are frequent appeals for people to submit to regular cancer screening—whether it’s for colon, cervical, prostate, lung or breast cancer screening—but when is it too much of a good thing? When should older people, perhaps those with limited life expectancy, stop getting periodic screening?

At study published in JAMA Medicine in 2014 found that “large numbers of elderly U.S. people with limited life expectancy continue to be screened for cancer even though such tests are of little benefit and can pose substantial harms.”

Having trouble talking to “real” people about their experiences under the Affordable Care Act?

This tip sheet by Shannon Muchmore, health care reporter at the Tulsa World, gives some hints. She shares ideas on finding people, what to ask them about their insurance coverage and some story ideas, as well as some important reminders for reporters.

She also shares some of the stories she's written that include consumers' experiences and perceptions.

In an excellent article for The New York Times’ Upshot blog, Margot Sanger-Katz explained what happens when a hospital or health system buys a physician’s group. As she points out, doctors’ fees often rise sharply when hospitals acquire doctors’ practices.

In her reporting, Sanger-Katz provides a good example of how payment strategies cause hospitals to buy physician groups. Find out why the discrepancy exists, learn about the proposal to eliminate it and find out where hospital and physician groups stand on the recommendation.

In this tip sheet, prepared for Health Journalism 2015, investigative reporter Peter Eisler (@byPeterEisler) offers some resources for reporting on medical devices. In January 2015 Eisler reported that a deadly, antibiotic-resistant bacteria was being spread by the use of a type of hard-to-clean endoscope. 

Medical devices are regulated by the FDA’s Center for Devices and Radiologic Health (CDRH). Oversight breaks into two general categories: pre-market review and approval, and post-market surveillance and control. 

With the trove of data out from everything from Medicare payments to data tracking relations between providers and drug companies, understanding the data to find stories can be overwhelming. At Health Journalism 2015, panelists shared their experiences with health data and gave attendees tips for avoiding potential potholes in the data.

Notes from a panel discussion on freelancing and working for trade publications at Health Journalism 2015, featuring Bob Finn, Daniel M. Keller, Ph.D., Peggy Peck and Rabiya Tuma, Ph.D.

Tips and information from this panel at Health Journalism 2015.

Materials related to the March 24, 2015, news conference with Robert McDonald, U.S. Secretary of Veterans Affairs.

Lucas, associate director, accident and forensic investigation for the ECRI Institute, has provided a number of online resources related to medical device adverse events that reporters may find useful.

Arthritis is the most common cause of disability in the United States, affecting about 52.5 million people, or one in five adults, according to the Centers for Disease Control and Prevention. It is projected that 67 million adults will develop some form of arthritis by 2030, yet the condition often is overlooked when it comes to public awareness of chronic diseases.

Arthritis causes pain, fatigue and sleep deprivation. It affects a person’s ability to conduct activities of daily living, such as walking or bending. It also complicates other chronic diseases, such as heart disease and diabetes. Roughly $128 billion in total arthritis-related health costs in 2003 (the most recent year available) included $80.8 billion in medical care spending and $47 billion in lost earnings, the CDC said.

The term arthritis is an umbrella for more than 100 conditions affecting the joints, surrounding tissues and other connective tissue. Symptoms vary but generally include aches, pains and stiffness in and around joints. Certain rheumatic conditions can affect the immune system and internal organs. Symptoms can either develop gradually or appear suddenly. Among the most common types of arthritis are osteoarthritis, rheumatoid arthritis, gout, lupus, and fibromyalgia.

The most recent National Health and Nutrition Examination Survey (NHANES) combines face-to-face interviews and physical examinations of a nationally representative sample of about 5,000 people each year. This tip sheet offers highlights from the new NHANES assessments, which provide a fresh look at the status of the oral health of over 40 million American children and 32 million adolescents and teens.

They also offer insights gleaned from a recent webinar hosted by the National Institute of Dental and Craniofacial Research (NIDCR) and the Centers for Disease Control and Prevention’s Division of Oral Health. The program features NIDCR dental epidemiology officer Bruce A. Dye, D.D.S., M.P.H., lead author of the new report, as well as previous reports on the NHANES.

Across the country, health systems are getting larger, gobbling up community hospitals or smaller chains. Some of this has to do with payment incentives in Obamacare, but just as much has to do with changes to Medicare, Medicaid and providers’ desire for leverage as they negotiate payments with insurance companies.

The recent HHS announcement that Medicare would tie 30 percent of payments to alternative models, such as accountable care organizations or bundled payment arrangements by the end of 2016, and 50 percent by the end of 2018, furthered many health system executives' beliefs that the key to survival is the ability to manage population health. And that is best done with large populations. That's a big reason why we see so much consolidation, but in crowded markets, such as New York, New Jersey and California, it's only a part of the story. (In smaller markets, such as Idaho, the FTC 's view of whether a merger will create an anti-competitive environment is the most important question.)

In the February issue of Capital Magazine, I looked at New York's five large health systems and the strategies they were employing to diversify their revenue base while preparing to play in a post-ACA, value-based world.

Each year, the release of new datasets makes it more exciting to cover health care. No longer are we limited to comparing states to one another to look for differences. No longer are doctors’ practice patterns protected by outdated privacy rules. We have entered an era in which we can compare one doctor to another. And what we’re learning is that there are huge, seemingly unexplainable, differences among them.

This tip sheet offers both very broad data sources, as well as more granular ones. None of the data sets cover individual claims-level data, which require special permissions and often cost a lot of money.

Probably in late June, the Supreme Court will rule in King v. Burwell. The case challenges whether subsidies, in the form of tax credits, can go to people in states using the federal exchange, or only to those in the states running their own health insurance marketplaces. After the state cases and 2012 National Federation of Independent Business case, it is the third case that poses an existential threat to the Affordable Care Act. (Hobby Lobby and other contraception-related cases wouldn’t unspool the structure of the whole ACA, only that aspect of women’s preventive health care.)

This case isn’t about whether the Affordable Care Act is constitutional. (The 2012 case was.) This is about interpreting the text, and whether the language of the law allows the subsidies in the federal exchange states.

The age boom – the 77 million boomers reaching old age together – is already straining national, local and personal resources as the country tries to manage health care and services for the millions who are living longer, dealing with multiple chronic conditions or who require a continuum of care – beginning with assistance with the tasks of daily living and ending with palliative care and end-of-life services.

As stakeholders experiment with how best to redesign and deliver care that supports and engages older adults they also must account for changing demographics. According to the Census Bureau, the majority of aging boomers (72 percent) are white. Their experiences may prove less instructive in understanding the particular needs of racial and ethnic minorities, whose numbers will surge when today’s millenials reach retirement age. Today, Latinos are just 11 percent of the boomer generation, but comprise one-fifth of the millennial generation, and one in four of today’s children under the age of 18. 

Mid-level dental providers are at work in countries from the United Kingdom to Malaysia. Here in the United States, advocates are pushing hard to get states to enact laws that would open the way for dental therapists to get care to people who might otherwise go without it.

Organized dental groups, including the American Dental Association have fought the model, contending that only dentists have the training to perform what are termed irreversible procedures such as drilling and extracting teeth.

Even so, dental therapists, who provide care under the general supervision of dentists, are now treating patients in tribal areas of Alaska as well as in poor communities in the state of Minnesota. Maine has also passed legislation and is moving forward with therapists.

It started small, as a single day in Cleveland.

Feb. 3, 1941, was dedicated to spotlighting the dental needs of children. It turned out there was lots more to say and do.

Over the years, February has evolved into National Children’s Dental Health Month.

Maybe a story related to the oral health of children is unfolding in your community. And February is a good time to tell it.

To help you get started on your reporting, here is a tip sheet that draws upon insights and information exchanged during a Jan 23 AHCJ webinar.

Science recently revealed a fascinating new fact about romantic intimacy: a couple exchanges 80 million bacteria during the average French kiss.

The Dutch study “Shaping the Oral Microbiota Through Intimate Kissing,” which was published in the journal Microbiome, suggests that a shared microbiota is able to develop in the mouths of partners.

The study got quite a bit of attention from the press. And there will be plenty of other tales to tell, as researchers delve deeper into the intricate workings of the microbial communities that inhabit various regions of our bodies, including our mouths.

Debate about the government’s 340B Drug Pricing Program continues to build as the program expands. Like all good controversies, this one has enthusiastic advocates and wild-eyed opponents, and it’s easy to get snagged by the passion of the partisans.

340B is a discount program that requires pharmaceutical companies to sell outpatient drugs – both branded and generic – to eligible health care organizations at significantly reduced prices, up to half off in some cases. The program was created in 1992 to help provider organizations that serve a lot of poor people stretch their resources.

Over the years, the eligibility criteria to participate has expanded repeatedly. Currently, safety-net hospitals, children’s hospitals, critical access hospitals, federal health centers and other organizations are eligible; organizations that fall into those categories must register and enroll in the 340B program.

Outbreaks and infectious diseases can be difficult topics to cover. Stories need to be informative, sensitive and scientifically sound - all without inducing panic. When Ebola hit home in fall 2014 with a few cases on U.S. soil, it was easy to feed the public fear frenzy with inflammatory coverage. But how can journalists avoid sensationalism while still respecting the public's right to know? The following resources and websites provide some useful tips for reporting on Ebola or other outbreaks. 

 Lisa Chedekel’s article on infection rates in Connecticut could serve as a template for any health care journalist writing about hospital infections.

Her story, “Half of State Hospitals Exceed Infection Rates New Data Show,” is important because hospitals with the worst infection rates in 2012 and 2013 will lose 1 percent of their Medicare reimbursements in fiscal 2015. It’s also important because she names 11 of Connecticut’s 30 hospitals that will likely be penalized.

A senior writer for the non-profit Connecticut Health Investigative Team, Chedekel puts the Connecticut numbers in perspective, reporting that more than 50 percent of hospitals in the Nutmeg State had infection rates in 2012 and 2013 for at least one type of hospital-acquired infection that were worse than the rates cited in federal benchmarks.

How can journalists make the most of their time and energy when covering a scientific or professional conference?

Mark Taylor recently attended the annual Scientific Meeting of the Gerontological Society of America, which featured more than 500 presentations, symposia and poster sessions. He has covered other scientific conferences in his two decades as health care journalist, and he shares hard-earned wisdom on successfully covering such massive events. 

About 75,000 people a year die from nosocomial infections - infections they contracted while in the hospital. This seems like a high number, but these infections don't get a lot of coverage.

Every 15 seconds, an older adult falls. According to the American College of Sports Medicine, falls are the leading cause of injury-related death among adults age 65 and over. Additionally, the ACSM says that one in every three older adults takes a serious fall each year – resulting in more than 20,000 fatalities.

In 2012, 2.4 million nonfatal falls among older adults were treated in emergency departments, with some 722,000 of these patients hospitalized, according to statistics from the CDC. These falls resulted in direct medical costs of more than $30 billion, and those costs are expected to skyrocket to between $44 and $54 billion by 2020 as the population ages.

Image: Rex Sorgatz via flickr.

Is there a soda tax debate coming to your community? The potential for such taxes address problems with obesity, diabetes and cardiovascular disease are important angles to explore, but don’t forget the oral health aspect of the soda tax story.

In the November 2014 elections, Berkeley, Calif., voters approved a 1-cent per ounce tax on sugar-sweetened beverages, a measure strongly opposed by the American Beverage Association but supported by a wide range of health groups.

While Berkeley is the first city in the country to approve such a “sin” tax, it might have opened the door for other communities to do so. Mary Otto has collected relevant research and resources for reporters who might be called on to cover soda taxes.

Recently Julie Drizin, who directs the Journalism Center on Children & Families (JCCF), gathered a team of student reporters to cover a free two-day dental clinic sponsored by the University of Maryland School of Public Health.  The dental clinic, which was held on the university’s basketball court with support from organizations including Mission of Mercy, aimed to provide $1 million in dental care to poor and uninsured adults. The student’s coverage of the 100-chair clinic resulted in a compelling assortment of stories that are packaged together on JCCF’s website as part of the regular “On The Beat” feature.

As Drizin observed in a Q & A on the project, covering these events can be challenging.  

The hours can be long. The crowds can be large. And many of the patients waiting in the long lines for care are tired and hurting. Some are frightened and ashamed.

"Be a human being," Drizin counseled her students. "You are going there as a journalist trying to get a story on deadline, but connect with people on a human level. That’s how you can make the most of this experience. Just keep your mind, your eyes, your ears and your heart open. Stories are everywhere."

Price transparency is supposed to be one of the keys to controlling the cost of health care. But as journalist Michael Chang reported in The Miami Herald, getting insurers to release the figures on what they pay for health care and getting providers to release the figures on what they receive for delivering care can be difficult if not impossible.

In his article, Chang reported on the struggle a consultant for a local union had in determining what Miami-Dade County paid to doctors and hospitals caring for county employees, their family members and retirees. The numbers could not be released, he reported, because data in contracts between insurers and providers are proprietary. In fact, most contracts between health plans and providers include “gag” clauses that prohibit either side from releasing price information.

Even a public employer, such as Miami-Dade County, could not get the data due to gag clauses. Chang quoted Duane Fitch, the consultant for Local 1991 of the Service Employees International Union, saying, “We really need to understand where the money is being spent in order to be insightful about benefit design changes.’’ Local 1991 represents physicians and nurses at the Jackson Health System, which is a county-owned hospital.

 The term “frailty” seems to be practically synonymous with aging. And while it’s true that adults naturally have a gradual physical decline as they age, not every older adult is frail and not every frail person is old.

Aging, also called senescence, refers to the biological process of growing older. As people age, it becomes more difficult for the body to repair itself and maintain optimal health, according to Neal S. Fedarko, Ph.D., professor of medicine, division of geriatric medicine and gerontology, Johns Hopkins University. People age differently based on both genetics and lifestyle factors.

Frailty is considered a chronic and progressive condition, categorized by at least three of five criteria: muscle weakness, unintentional weight loss, low physical activity levels, fatigue and slow walking speed. The body loses its ability to cope with everyday or acute stress, becoming more vulnerable to disease and death, as Samuel Durso, M.D., director of geriatric medicine and gerontology at Johns Hopkins School of Medicine explained in a recent AHCJ webcast.

Hospital consolidations – mergers and acquisitions – are increasing, as this chart illustrates. There have been several hundred hospital deals since 2009, and from 2009-13 one-third of all cases investigated by the FTC were hospital-related.

Is this trend a wise and inevitable path to a more efficient health care system? Can big systems wring out waste and overlap and inefficiencies and better deploy data, telemedicine and EHRs? Or are we just empowering bigger, more powerful hospital systems that will be able to demand higher prices from insurers and other payers as they come to dominate the market?

Barak Richman, Ph.D., a Duke law professor whose doctorate is in business administration, is an expert on (and a worrier about) hospital consolidation. This tip sheet helps explain an area that has an outsize impact on our communities but which we as health journalists may neglect or not understand. This lightly edited email interview with Richman includes information about policy and regulation at the federal and state levels.

Is there a teeth-whitening story in your state?

Now might be a good time to take a look at this widely-contentious issue.

A long feud between North Carolina’s state dental board and a group of non-dentists who provide teeth-whitening services is headed for the U.S. Supreme Court. Oral arguments in the case, North Carolina Board of Dental Examiners v. Federal Trade Commission, are scheduled for Oct. 14.

Dental whitening has grown into a multi-billion dollar business and the struggle over whether non-dentists should be allowed to bleach teeth has been playing out across the country in recent years.

 One factor that makes health care costs difficult to manage is the system the federal government and health insurers use to decide how to pay physicians for the various services they deliver. In an article in The Washington Post, “How a secretive panel uses data that distorts doctors pay,” journalists Peter Whoriskey and Dan Keating explain that a committee of the American Medical Association meets in private every year to develop values for most of the services doctors perform. The AMA is the chief lobbying group for doctors.

Hispanics are the fastest growing segment of the U.S. population, and they face a measurable disadvantage when it comes to oral health. They experience more oral disease than white Americans and often face barriers in getting care. Yet dentally speaking, they are far from a homogeneous group.  

New research , including a paper published in the August issue of the Journal of the American Dental Association (JADA) finds a remarkable variety in the oral health status of American Hispanics from differing national and regional backgrounds. The August JADA paper, which examines periodontal (gum) disease, reveals significant differences in disease incidence among Americans identifying as Cuban, Dominican, Mexican, Puerto Rican Central American and South American.

Mary Otto shares some tips on covering oral health issues in the Hispanic community.

Unlike problems in vision and hearing, age-related losses to smell and taste have only recently gained attention. Like declines in the other senses, losing the ability to smell different odors and scents and to taste food can lead to serious quality-of-life and safety issues.

When the sense of smell or taste diminishes, the world becomes a different place. Adults who have trouble smelling and tasting often have poor appetites, which can lead to weight loss, malnutrition and weakened immune systems. Losing the ability to enjoy food can also contribute to emotional problems such as anxiety and depression.

Barbara Bein shares tips on how to cover smell and taste disorders in older adults.

Older Americans have been misusing, abusing and becoming addicted to alcohol, tobacco and herbal “substances” for decades. Now they are also abusing drugs – both prescription and illegal – in increasing numbers, according to this NIA/NIH update. The most prevalent abuse is in the age 50 to 59 (trailing-edge boomer) cohort, where abuse of illicit drugs and non-medical use of prescription drugs rose from 2.7 percent to 5.8 percent between 2002 and 2010.

A CASA Columbia study found that substance abuse was an especially serious issue for older and aging women, who “get addicted faster, using smaller amounts of a substance, than any other demographic group.” The report also found that when older women show signs and symptoms of alcohol and/or prescription drug abuse, most physicians “don’t even consider an addiction diagnosis.”

Why now?

The ties between smokeless tobacco and baseball run deep. The immortal Babe Ruth claimed Pinch Hit was his chew of choice (as this short film from the U.S. Centers for Disease Control and Prevention reminds us), but the news that well-known baseball player Curt Schilling blames his oral cancer on chewing tobacco, as well as the June death of Hall-of-Famer Tony Gwynn serves as a reminder of the dangers posed by the habit. Gwynn said he believed the salivary gland cancer that killed him was caused by his longtime use of chewing tobacco.

National, state and local health organizations used the story of Gwynn’s passing to talk about the dangers of smokeless tobacco and likely will use Schilling’s news to raise awareness. Is there an angle in this that you could explore in your own state or community?

Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing. This tip sheet includes key stories to pursue and critical insights on the housing-as-health-care trend.

Sandel, an associate professor at the Boston University School of Medicine and Public Health and former pediatric medical director of Boston’s Healthcare for the Homeless program, offers suggestions on questions reporters should ask and encourages more exploration of the relationship between housing and health.

Dual eligibles are low-income elderly or disabled people jointly enrolled in both Medicare and Medicaid. The distinctions are sometimes bewildering. It’s easy to confuse which program pays for what, what each agency considers “appropriate” care, what factors go into measuring outcomes and how the separate structures of Medicare and Medicaid affect costs and quality.

There is growing concern about the high costs of dual eligibles and the type of care they receive. The CBO points out that these separate programs, with different payment and approval procedures increases the likelihood that full duals – especially those who have many chronic conditions and functional limitations – will be treated by a variety of health care providers who are not coordinating their care, potentially increasing costs and worsening outcomes.

Health care costs lack transparency and are wildly variable, not just from region to region but sometimes from block to block within the same city.

It is a complex topic, with chargemaster prices, what insurers paid and what consumers pay (if anything). Then there are the administrative rules set by Medicare and Medicaid and the negotiated rates between insurers and providers.

It's daunting, but three reporters have teamed up to offer guidance for reporting on health care costs.

Have you visited a school-based dental sealant program in your state or community? There may be a good story there.

Can’t find one to visit? That may be another worthwhile story.

Dental sealants are thin, plastic coatings that are applied to children’s permanent back teeth to seal the narrow grooves on the chewing surfaces and keep out decay-causing bacteria and food particles. Studies show that the procedure can reduce the incidence of tooth decay by 60 percent.

But poor and high-risk kids who could benefit the most from sealants are not always receiving them. 

As part of the Robert Wood Johnson Foundation’s efforts to monitor the impact of the Affordable Care Act (ACA) on coverage, utilization and affordability, the organization is working with others to acquire and analyze timely and unique data. They have developed a website, entitled Reform by the Numbers, which will house downloadable data, tables and graphs, in addition to policy briefs, blogs and other content that highlights key findings.

Cardiovascular disease (CVD) is the leading cause of death in the U.S. As with many other chronic conditions, age is the greatest risk factor. In 2013, someone in the U.S. died from cardiovascular disease every 40 seconds.

The average annual rates for first cardiovascular event rise drastically with age – from three per 1,000 men from 33 to 44 years old, to 74 per 1,000 men in the 85-to-94 age group. For women, comparable rate rises occur 10 years later than men.

Of the estimated 82.6 million Americans who have one or more types of cardiovascular disease, the American Heart Association says about 40 million are age 60 or older. Liz Seegert provides resources and information for reporters covering cardiovascular disease and older adults. 

Joseph Burns

As the nation’s health insurers file rate requests with state insurance departments, the news about health insurance premium increases is coming out almost daily now. The deadline for submitting rate requests on the marketplaces is June 27.

Premium rate review is an important story, obviously, because it begins to answer the question of what consumers will pay for insurance next year. But it’s a complex story because what health insurers propose now is not necessarily what consumers will pay next year, and, in fact, insurance rate requests are only part of the story, as Trudy Lieberman reported last week in the Columbia Journalism Review.

Here's some background on the process of premium rate review, as well as tools, resources and tips for doing the most nuanced and accurate reporting on this important topic.

Mark A. Richardson, M.D., MScB, M.B.A., dean, School of Medicine, Oregon Health & Science University, spoke on the panel, "The aging of rural physicians and the next generation of care."

Phillip T. Marucha, D.M.D., Ph.D., dean, School of Dentistry, Oregon Health & Science University, spoke on the panel "Poor oral health: What's the cost?"

David Jordan, project director, Dental Access Project, Community Catalyst, spoke on the panel "Poor oral health: What's the cost?"

Timothy D. McBride, professor, Brown School, Washington University, spoke on the panel "How the ACA impacts rural health care."

Tina Castañares, M.D., consultant on health care for special populations, was the spotlight speaker at the luncheon session "Upstream of the rapids: Rural health leadership in a changing countryside."

Andrew Bazemore, M.D., M.P.H., director, Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians, spoke on the panel "The aging of rural physicians and the next generation of care."

Mario Gutierrez, executive director, Center for Connected Health Policy, The National Telehealth Resource Center, spoke on the panel "Telemedicine: Technology triumphs and regulation challenges."

Miles Ellenby, M.D., medical director, Telemedicine Network, Oregon Health & Science University, spoke on the panel "Telemedicine: Technology triumphs and regulation challenges."

Mark O’Hollaren, M.D., vice president of strategic outreach, Oregon Science & Health University, spoke on the panel "Rural health landscape: Meeting the people, meeting the challenges."

John Green, Ph.D., director, Center for Population Studies, The University of Mississippi, spoke on the panel "Rural health landscape: Meeting the people, meeting the challenges."

Some reporters have inquired about whether “essential coverage” and “essential benefits” are one and the same. They aren't and it's important for health care reporters to understand the terms. Here, Joanne Kenen explains each of them and reviews some other important concepts, such as the employer mandate and actuarial value.

Getting oral health care services to elders in nursing homes is a crucial task, yet one that is often overlooked. Untreated oral disease can have a devastating impact on the lives of these frail patients, leading to suffering and tooth loss, poor nutrition and serious, even fatal infections.

While federal law requires nursing homes to assist patients in obtaining routine and emergency dental care, state laws vary. In addition, nursing home directors, staff and family members may overlook the importance of oral health care, not only for the increasing number of seniors who have kept their teeth into old age, but for those who use dentures.

Recently, Dr. Ben Goldacre, a prominent critic of drug studies, embarked on a research project of his own. He wanted to find out how often side effects reported by users of cholesterol-lowering drugs called statins were genuinely caused by the medications.

The study he co-authored concluded that most reported side effects of statins aren't often due to the drugs themselves, but to other causes—perhaps an unhealthy lifestyle that contributes to heart disease in the first place, or even the nocebo effect, which occurs when people experience side effects because they expect a drug will cause them.  Brenda Goodman reports on Goldacre's study, and gives health reporters some helpful hints on covering drug side effects.

Palliative care is specialized medical care for people with serious illnesses. This type of care is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness - whatever the diagnosis.

The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work with a patient's other doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided together with curative treatment.  Here, Daniel Johnson discusses the relevant issues and provides tips for better coverage of palliative care.

Richard Cauchi, health program director, National Conference of State Legislatures, spoke on the panel "ACA: An interim report card."

Hilda Bastian, editor, PubMed Health, spoke on the panel "Statistics: Basic tips for better stories."

J. Michael Bostwick, M.D., professor of psychiatry, Mayo Clinic; Michael Elliott, executive director, Marijuana Industry Group; Kari L. Franson, Pharm.D., Ph.D., associate dean for professional education, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; Larry Wolk, M.D., M.S.P.H., executive director, Colorado Department of Public Health and Environment; and Michael Booth (moderator), editor, Health Elevations, The Colorado Health Foundation, spoke on the panel "Medical Ramifications of legal marijuana."

Award-winner Alison Young, reporter, USA Today, spoke on the panel "Award winners share their techniques."

Tony Leys, health care reporter, Des Moines Register, spoke on the panel "Plunging into health care: How to master the beat."

Susan E. Birch, M.B.A., B.S.N., R.N., executive director, Colorado Department of Health Care Policy and Financing, spoke on the panel "Transforming Medicaid: What it means for states and your audience."

Rosemary Gibson, senior adviser, The Hastings Center, spoke on the panel "Medicare changes: Impact on hospitals and patients."

Robert Logan, Ph.D., communication scientist, National Library of Medicine spoke on the panel "Finding great stories using public clinical research databases."

Randall Reves, M.D., professor, University of Colorado School of Medicine, spoke on the panel "The advance of drug-resistant TB and our minimal tools to fight it."

Peter Speyer, director of data development, Institute for Health Metrics and Evaluation, spoke on the panel "Big data: What's in it for us?"

Paul A. Offit, M.D., chief of the division of infectious diseases and director of the Vaccine Education Center at Children's Hospital of Philadelphia, spoke at the Awards Luncheon, in which journalists who did the best work of 2013 were recognized with Awards for Excellence in Health Care Journalism. 

Susan Chimonas, Ph.D., research scholar, Center on Medicine as a Profession, Columbia University, spoke on the panel "Spotting conflicts of interest in studies and treatment."

Kevin Unger, president/CEO, Poudre Valley Hospital, spoke on the panel "Medicare changes: Impact on hospitals and patients."

Paul Levy, author and blogger, former hospital chief executive officer, spoke on the panel "Spotting conflicts of interests in studies and treatment."

Steven M. Southwick, M.D., Glenn H. Greenberg professor of psychiatry, PTSD and resilience, Yale University School of Medicine, spoke on the panel "Grappling with PTSD across society."

Paula Schnurr, Ph.D., acting executive director, National Center for PTSD, U.S. Department of Veterans Affairs, spoke on the panel "Grappling with PTSD across society."

Alan Meisel, J.D., director, Center for Bioethics and Health Law; Mildred Solomon, Ed.D., president and chief executive officer, The Hastings Center; and Judith Graham (moderator), independent journalist, Denver, spoke on the panel "Separating fact from fiction: End-of-life decisions in the United States."

Paul Melinkovich, M.D., director, community health services, Denver Health and Hospital Authority, and Tracy L. Johnson, Ph.D., M.A., director, health care reform initiatives, Denver Health and Hospital Authority, spoke on the panel "Experiments in reducing ER loads."

Marshall Allen, reporter, ProPublica, spoke on the panel "Hospital grading: Reporting on quality report cards."

Marisa Bunning, Ph.D., associate professor and extension specialist, Colorado State University, spoke on the panel "From product to plate: Food security and safety."

Margo Wootan, Ph.D., director of nutrition policy, Center for Science in the Public Interest, spoke on the panel "From food to plate: Food security and safety."

Lynne M. Picard, director, Workforce Development and Community Initiatives, Denver Housing Authority, spoke on the panel "What's ahead in efforts to 'build healthy places?'"

Lois A. Brink, executive director, Learning Landscapes, spoke on the panel "What's ahead in efforts to 'build healthy places?'" 

Randy Capps, Ph.D., director of research, U.S. Programs at the Migration Policy Institute, spoke on the panel "Immigrant health care: National politics, local challenges."

Lisa Cacari Stone, Ph.D., assistant professor of health policy, University of New Mexico Health Sciences Center, spoke on the panel "Immigrant health care: National politics, local challenges."

John Arensmeyer, founder and chief executive officer, Small Business Majority, spoke on the panel "Marketplaces' effects on small businesses."

Neal Henderson, M.S., C.S.C.S., founder and owner, APEX Coaching & Consulting, spoke on the panel "Cutting-edge sports science: From elites to everyone."

Jennifer Gibson, M.Sc., R.D., C.S.S.D., registered dietitian, United States Olympic Committee, spoke on the panel "Cutting-edge sports science: From elites to everyone."

Jeffrey Swanson, Ph.D., professor in psychiatry and behavioral sciences, Duke University School of Medicine, spoke on the panel "Covering mental illness and violence."

Cindy Uken, health care reporter, Billings (Mont.) Gazette, spoke on the panel "Suicide: Prevention, repercussions and survivors."

Matt Vogl, M.P.H., deputy director, University of Colorado Depression Center, spoke on the panel "Suicide: Covering prevention, repercussions and survivors."

Marian Betz, M.D., M.P.H., assistant professor of emergency medicine, University of Colorado School of Medicine, spoke on the panel "Suicide: Covering prevention, repercussions and survivors."

Marjie Grazi Harbrecht, M.D., chief executive officer, HealthTeamWorks, spoke on the panel "Is technology speeding coordinated medicine?"

Greg Smith, independent journalist; board member, National Press Photographers Association, spoke on the panel "Freelance: Contracts 101."

Jean Kutner, M.D., M.S.P.H., Gordon Meiklejohn endowed professor of medicine, University of Colorado School of Medicine, spoke on the panel "Spotting the gaps in evidence, ethics and practice."

Lewis Cohen, M.D., professor, Tufts University School of Medicine, spoke on the panel "Spotting the gaps in evidence, ethics and practice."

Gil Asakawa, manager of student media, University of Colorado-Boulder, spoke on the panel "The art of the tweet."

Ivan Oransky, M.D., vice president and global editorial director, MedPage Today, spoke on the panel "How to read medical studies - and write smarter stories."

Gary Schwitzer, publisher, HealthNewsReview.org, spoke on the panel "How to read medical stories - and write smarter stories."

Deborah Schoch, senior writer, CHCF Center for Health Reporting, moderated the panel "Investigating senior care."

Jules Rosen, M.D., chief medical officer, Mind Springs Health/Colorado West Inc., spoke on the panel "New realities in aging."

Ernestine Kotthoff-Burrell, Ph.D., A.P.R.N., F.A.A.N.P., assistant professor, University of Colorado, spoke on the panel "New realities of aging."

Jordan Rau, senior correspondent, Kaiser Health News, moderated the panel "Hospital grading: Reporting on quality report cards."

John Santa, M.D., M.P.H., medical director, Consumer Reports Health Ratings Center, spoke on the panel "Hospital grading: Reporting on quality report cards."

Evan Marks, executive vice president, informatics and strategy, Healthgrades, spoke on the panel "Hospital grading: Reporting on quality report cards."

Kenneth L. Tyler, M.D., Reuler-Lewin family professor and chairman, Department of Neurology, University of Colorado School of Medicine, spoke on the panel "What promise does the BRAIN initiative hold?"

John R. Sladek Jr., Ph.D., professor of neurology, pediatrics and neuroscience, University of Colorado School of Medicine, spoke on the panel "What promise does the BRAIN initiative hold?"

Erik Parens, senior research scholar, The Hastings Center, spoke on the panel "What promise does the BRAIN initiative hold?"

William E. Heisel, contributing editor, Institute for Health Metrics and Evaluation, spoke on the panel "Transparent reporting: Investigating in the open."

Emily Bazar, senior writer, CHCF Center for Health Reporting, spoke on the panel "Transparent reporting: Investigating in the open."

Jonathan M. Bowser, M.S., assistant professor, University of Colorado School of Medicine, spoke on the panel "Covering disparities in oral health."

Terry Batliner, D.D.S., associate director, Center of Native Oral Health Research, University of Colorado, spoke on the presentation "Covering disparities in oral health."

Diane Brunson, R.D.H., M.P.H., director of public health and interprofessional education, University of Colorado School of Dental Medicine, spoke on the panel "Covering disparities in oral health."

Lee S. Newman, M.A., M.D., professor of environmental and occupational health, Colorado School of Public Health, spoke on the panel "Fracking, drilling and other environmental health concerns." 

Lisa McKenzie, Ph.D., research associate, Colorado School of Public Health, spoke on the panel "Fracking, drilling and other environmental health concerns."

David O. Williams, founder and editor,Rocky Mountain Post, spoke on the panel "Fracking, drilling and other environmental health concerns."

Sidney Wolfe, M.D., director, Health Research Group, Public Citizen, spoke on the panel "Regulating health professionals."

David A. Swankin, president and chief executive officer, Citizen Advocacy Center, spoke on the panel "Regulating health professionals."

Paul D. Biddinger, M.D., F.A.C.E.P., medical director for emergency preparedness, Massachusetts General Hospital and Partners HealthCare, spoke on the panel "Is your local hospital ready for a disaster?"

Richard D. Zane, M.D., professor and chair, University of Colorado School of Medicine, spoke on the panel "Is your local hospital ready for a disaster?"

Deborah Schoch, senior writer, CHCF Center for Health Reporting, spoke on the panel "Is your local hospital ready for a disaster?"

David Gifford, M.D., M.P.H., senior vice president of quality & regulatory affairs, American Health Care Association, spoke on the panel "Investigating senior care."

David Corcoran, editor, Science Times, The New York Times, spoke on the panel "Freelancers: Editors give the inside story."

Timm Edell, M.D., regional department chief of infectious disease, Kaiser Permanente Colorado, spoke on the panel "Vector-borne disease growth."

Lyle R. Petersen, M.D., M.P.H., director, Division of Vector-borne Infectious Diseases, Centers for Disease Control and Prevention, spoke on the panel "Vector-borne disease growth." 

Dan Stinchcomb, Ph.D., senior scientific advisor, Takeda Vaccines Inc., spoke on the panel "Vector-borne disease growth."

Nancy Berlinger, Ph.D., research scholar, The Hastings Center, spoke on the panel "A journalist's guide to clearer writing."

Daniel Johnson, M.D., F.A.A.H.P.M., clinical lead for palliative care, Care Management Institute, Kaiser Permanente, spoke on the panel "A journalist's guide to clearer writing."

Eric G. Campbell, Ph.D., professor of medicine-health policy, Harvard Medical School, spoke on the panel "Covering prescription drug data."

Kendra Martello, deputy vice president of strategic operations, Pharmaceutical Research and Manufacturers of America, spoke on the panel "Covering prescription drug data." 

Charles Ornstein, senior reporter, ProPublica, moderated the panel "Covering prescription drug data."

Gideon Lack, M.D., professor of paediatric allergy, King's College London, spoke on the panel "The dirt on the allergy epidemic."

Mark Holbreich, M.D., physician, Allergy and Asthma Consultants, spoke on the panel "The dirt on the allergy epidemic." 

Erwin Gelfand, M.D., chair of pediatrics, National Jewish Health, spoke on the panel "The dirt on the allergy epidemic."

Dan Atkins, M.D., associate professor, Children's Hospital Colorado, spoke on the panel "The dirt on the allergy epidemic."

Jack Westfall, M.D., M.P.H., chief medical officer, Colorado HealthOP, spoke on the panel "Health access in the wide-open spaces."

Dean W. Bartholomew, M.D., F.A.A.F.P., owner/physician, Platte Valley Medical Clinic, Saratoga, Wyo., spoke on the panel "Health access in the wide-open spaces." 

Chrysanne Grund, project director, Greeley County (Kan.) Health Services, spoke on the panel "Health access in the wide open spaces."

Health care is but one element of what makes the biggest difference in health outcomes – social factors play a far more significant role. Income and its distribution, education, employment, social supports, housing, nutrition, and the wider environment — what we have come to know as the social determinants of health – are the most powerful predictors of wellness and longevity. This has been understood for centuries, and empirically validated in recent decades with study after study demonstrating significant inequalities in health outcomes between wealthy and disadvantaged populations.

Why is it that, when we talk about health promotion, we still get stuck talking about the "Trinity Trap" of smoking, diet and exercise when we know that social factors have the biggest influence on health outcomes?

Family doctor and medical professor Ryan Meili discusses the importance of understanding the social determinants of health. 

Christopher B. Colwell, M.D., chief of emergency medicine, Denver Health Medical Center, spoke on the panel "Covering mental illness and violence."

Christopher Alban, M.D., M.B.A., clinical informatics specialist, Epic Systems Corp., spoke on the panel "What happens when your medical records are digitized?"

Robin Shandas, Ph.D., chair, Department of Bioengineering, University of Colorado spoke on the panel "Commercializing research: Bringing ideas to the market."

Lauren C Costantini, Ph.D., vice president of therapeutics and device development, Colorado Institute for Drug, Device and Diagnostic Development, spoke on the panel "Commercializing research: Bringing ideas to the market."

Carol Gentry, editor, Health News Florida, spoke on the panel "New journalism business models."

Michelle Barron, M.D., associate professor of medicine, University of Colorado, spoke on the panel "Patient safety: New efforts to address human error."

Leah Binder, M.A., M.G.A., president and chief executive officer, The Leapfrog Group, spoke on the panel "Patient safety: New efforts to address human error."

Camille Haycock, R.N., vice president of Care Continuum, Catholic Health Initiative, spoke on the panel "Patient safety: New efforts to address human error."

Lisa Cicutto, R.N., Ph.D., C.A.E., director of community outreach and research, National Jewish Health, spoke on the panel "The Asthma Crisis: Keeping kids out of the ER."

Stanley J. Szefler, M.D., director, Pediatric Asthma Research Program, The Breathing Institute, Children's Hospital Colorado, spoke on the panel "The asthma crisis: Keeping kids out of the ER."

Bruce Bender, Ph.D., co-director of the Center for Health Promotion, National Jewish Health, spoke on the panel "The asthma crisis: Keeping kids out of the ER."

David Casarett, M.D., M.A., director, hospice and palliative care, Penn Medicine, spoke on the panel "Crisis, cost and quality: New angles on end-of-life care."

Bronwyn Long, R.N., D.N.P., M.B.A., palliative care and oncology clinical nurse specialist, National Jewish Health, spoke on the panel "Crisis, cost and quality: New angles on end-of-life care."

Brandon Stahl, data/watchdog reporter, Star Tribune, Minneapolis-St. Paul, spoke on the panel "Investigating senior care."

Tyghe Trimble, senior editor, Men's Journal, spoke on the panel "Freelancers: Editors give the inside story."

Betsy Agnvall, features editor, health, AARP Media, spoke on the panel "Freelancers: Editors give the inside story."

Arlen Meyers, M.D., M.B.A., professor of otolaryngology, dentistry and engineering, University of Colorado, spoke on the panel "Commercializing research: Bringing ideas to the market."

Olga Pierce, reporter, ProPublica, and Marshall Allen (moderator), reporter, ProPublica, spoke on the panel "Transparent reporting: Investigating in the open."

Bryan R. Haugen, M.D., professor of medicine and pathology, University of Colorado School of Medicine spoke on the panel "Getting personal: The medical and ethical challenges of using genetic information."

Rebecca D. Pentz, Ph.D., professor of research ethics, Emory School of Medicine, spoke on the panel "Getting personal: The medical and ethical challenges of using genetic information."

Eric T. Rosenthal, special correspondent, Oncology Times, spoke on the panel "Getting personal: The medical and ethical challenges of using genetic information."

Carl Morrison, M.D., D.V.M., executive director, Center for Personalized Medicine, Roswell Park Cancer Institute, spoke on the panel "Getting personal: The medical and ethical challenges of using genetic information."

Four experienced reporters provide some tips on how to get started in health care reporting.

These reading suggestions and links to helpful national organizations will keep health reporters in the loop. 

Experts say many thousands of Americans are now going abroad for dental care. The growing phenomenon of dental tourism is believed to make up a sizable portion of the worldwide multibillion-dollar medical tourism market.

While exact numbers are impossible to find, and even estimates are scarce, the Deloitte Center for Health Solutions estimated that 1.6 million Americans would traveled abroad for all types of medical care in 2012 with dental treatments heading the list of procedures sought. Mary Otto reports on the growing market in dental tourism. 

Hospital-ratings agencies portray themselves as champions of transparency when it comes to information about health-care quality. But some clam up if you ask for details of their business arrangements.

Consumers should know that hospitals pay substantial fees for permission to run ads about awards they receive from services such as Healthgrades, U.S. News & World Report and the Leapfrog Group. That fact could explain why the services offer awards in so many categories.

Tony Leys explains the arrangements, including how much some hospitals pay to use the rankings in their marketing efforts and how to find out what hospitals in your area are paying. It just might change how you cover hospital awards and ratings.

With the new sign-up numbers coming out of the state and federal exchanges, Politico health care reporter Kyle Cheney reports on what the numbers mean.

Loose characterizations by allies and enemies of how many people have signed up, (more than 7 million as of April 1) have led to rampant – often verifiably incorrect – interpretations in the press. That matters.  The way news reports characterize enrollment could  tilt the national narrative about the health law in a tense election year.

There are subtle but significant differences between the number of people “signed up” for ACA plans and the number actually “enrolled.” And there’s an even greater difference,  for the short term, between the number of enrollees and the number of people who have “coverage.”

Enrolled? Selected? Covered? The semantics matter.

Here’s a tip sheet about what to watch – and listen – for.

With more data on relationships between doctors and drug companies soon to be released,  Charles Ornstein reports on some ways journalists can use this information. From the Health Journalism 2014 session “Covering prescription drug data."

This tip sheet features freelance reporting tools for productivity, writing, editing, and research. These tools were the focus of a panel discussion that took place March 30 at Health Journalism 2014, AHCJ's conference.  Panelists included: 

• Jill Adams, independent journalist, Delmar, N.Y.
  jilluadams@gmail.com, @juadams

• Amy Gahran, independent journalist and editor, Boulder, Colo. 
  amy@gahran.com, @agahran

• Moderator:Kit Seeborg, digital media producer, Boulder, Colo.

• Panel organized by Catherine Dold, freelance writer and editor, Boulder, Colo. catherinedold@gmail.com; @catherinedold; @TheRecoveryBook

Joy Robertson of The Food Channel offers some tips for shooting great video solo and on a deadline.

Links to research and resources, compiled by Eileen Beal,  from a panel at Health Journalism 2014. It includes information about frailty, senior mental health and coordinated care.

There are more than 300,000 dental assistants at work across America and their ranks are expected to increase 25 percent in the next decade, as a result of the recognition of the link between oral health and overall health. Their work often includes helping dentists with procedures, taking and developing X-rays, preparing and sterilizing  instruments, making appointments, keeping records, and giving patients post-operative instructions.

But from state to state, duties, credentialing, and training standards vary widely.

Oral health topic leader Mary Otto provides some background, the latest news on what's happening in various states and links to help reporters learn what changes may be in the works in their state – just in time for Dental Assistants Recognition Week, March 2-8.

Remember the burger grown from stem cells? It might be a great idea, except a single patty grown using today's technology, at least, cost a whopping $332,000.

Here, Jonathan Latham, Ph.D., the executive director of the Bioscience Resource Project, asks whether discoveries like that are breakthroughs or "fakethroughs" – scientific advances that will never progress to new treatments or beneficial products.

He also talks about his brand of investigative science journalism and why reporting on new discoveries should probably be more muted.

A 3-year old Hawaiian girl died in January, a month after she lapsed into a coma while undergoing a dental procedure. The Hawaii Department of Commerce and Consumer Affairs is investigating what went wrong and the child's parents are suing. Questions have been raised about the level of sedatives administered to the 38-pound girl.

An increasing number of children are being placed under sedation or anesthesia for dental care, experts say. Children with diagnoses of extensive decay who may not be able to sit still for care are sometimes placed under general anesthesia before undergoing treatment.

But how often is this done, what kinds of sedatives and anesthesia are used, what's the training for dentists who use sedatives and what are the risks involved? We get some answers from the American Academy of Pediatric Dentistry.

ProPublica reporter Charles Ornstein is often asked by colleagues how he stays abreast of health news and developments across the country. Here, he shares a list of email subscriptions he finds most valuable. The emails summarize and aggregate health news from around the country, each with a different bent.

The CDC estimate that 636,000 people have died from AIDS in the United States since the virus was first identified in the early 1980s. Today, more than a million people live with HIV – however, nearly 20 percent do not know they are infected. Those over age 50 represent approximately 15 percent of the 50,000 new diagnoses annually, nearly one-fourth of all existing cases of HIV, and nearly 30 percent of those with AIDS.

What do you need to know about AIDS in the older population?

Janice Lynch Schuster runs down the facts and figures for reporters, as well as the public health challenges to preventing the disease and the ramifications for those living with it. She also lists story ideas and sources for your reporting

Gout is a devastating disease at any age, but can hit older adults especially hard. It is the most common inflammatory arthritis seen in the elderly and researchers report an escalating incidence and prevalence of gout. As this tip sheet by Eileen Beal describes, gout is very painful, manifesting with pain, swelling, heat, tenderness, and stiffness in the joints.

Elderly gout patients have higher health care utilization and costs than those without the disease. Gout represents about six percent of total health costs for seniors with this condition. By proactively managing the condition, it’s possible to avoid or minimize painful gout attacks. 

The Mental Health Parity and Addiction Equity Act of 2008 required health plans that offer mental health and substance use disorder benefits to cover them to the same extent that they cover medical/surgical benefits. Among other things, it prohibits having treatment limits or financial coverage requirements such as copayments or deductibles that are more restrictive than a plan’s medical coverage. Interim regulations issued in 2010 clarified some issues about implementing the law.

The final rules, issued in November by federal officials, spell out more specifics. Michelle Andrews, writing for Kaiser Health News, spoke with Jennifer Mathis of the Judge David L. Bazelon Center for Mental Health Law and provides some background and clarification on how the rules affect consumers.

Image by ktpupp via flickr.

One of the major dental dramas of 2013 was a story followed closely by Tulsa World reporter Shannon Muchmore.

Early in the year, an inspection at the office of a local oral surgeon, W. Scott Harrington, raised concerns that lax sanitation practices had put patients at risk. Widespread testing followed and health officials announced that a former patient had contracted hepatitis C while receiving care at his office.

Muchmore stayed in constant contact with local and state health officials  and her reports also came as a reminder of the important role that the U.S. Centers for Disease Control and Prevention often plays in such major investigations.

The CDC is just one of the federal bodies charged with overseeing and regulating the safety of America’s dental care system. Here is a look at a few of these agencies, with links to information about how their work relates to dental care. You might want to use them as resources to expand the focus of your local stories.

Some 45 percent of older adults struggle with two or more chronic conditions and the health ramifications of those with multiple conditions are vast. People coping with several chronic illnesses have more difficulty with activities of daily living and may struggle to complete simple physical activities.

Many are taking multiple medications, often prescribed by multiple providers, who may or may not communicate with each other. Medication management and adherence may be a key component to allowing older adults to age in place.

This tip sheet provides more background on the impact of medication management, as well as story ideas and the resources to help you do more informed reporting on the topic.

Depending on the source, the home health care industry is either a boon to older adults or an industry rife with fraud and abuse. The truth, as always, lies somewhere in-between. For most part, home health care can be a cost-effective alternative to hospital or facility care, providing many clinical and skilled nursing services in a non-institutional setting. Hospitals are under intense pressure to reduce or avoid re-admissions within 30 days of patient discharge, clinicians want alternatives to institutionalized care, and insurers – especially Medicare – realize cost-savings through home-based short-term nursing and therapy services.

Here are some of the things to be aware of when covering home health care.

A new scientific measure was introduced at this year’s annual meeting of the Gerontological Society of America (GSA) that may have serious implications for how Americans are going to pay for long-term care. It’s called, “Not going to happen.”

At a symposium on the topic, Marc A. Cohen, chief executive officer of LifePlans, Inc., a research organization for private insurance companies selling long-term care insurance, painted a bleak picture for the role of the private sector in this field. He said there are only 11 companies now selling a meaningful number of long-term care policies while there were 102 in 2002.

As more health insurers begin covering the uninsured under the Affordable Care Act, they will assume the financial risk of covering the most costly patients in any health system: the 1 percent who run up the biggest bills. A recent report from the federal Agency for Healthcare Research and Quality shows that these 1 percent of patients account for 21.4 percent of all spending. Writing for Kaiser Health News and The Washington Post, Sandra G. Boodman covered this issue thoroughly and her article serves as a tip sheet for any health care journalist covering this segment of the population.

The Department of Health and Human Services recently reported the first set of enrollment numbers from the state and federal insurance marketplaces. There were a lot of numbers and Joanne Kenen, AHCJ's health reform topic leader breaks them down and helps reporters understanding what they do and do not tell us.

As of July 1, 2011, baby boomers in the U.S. numbered 41.4 million, representing 13.3 percent of the population. By 2060, that figure is expected to skyrocket to 92 million. This generation has exerted significant influence on the social, cultural, political and economic aspects of life and now, as it moves into and beyond the 65-year mark, is targeting health care.

The average 65-year old American is diagnosed with multiple medical issues that may include hypertension, arthritis, heart disease, cancer and diabetes, according to an infographic assembled by Concordia University.

While many boomers still rely on traditional Western medicine, a greater number are looking for complementary and alternative solutions to address these issues.

With age and the advance of illness, depression often strikes older adults. How often? Estimates vary. The Centers for Disease Control and Prevention suggests that up to 5 percent of adults age 65 and older have major depression. Other experts believe that figure hovers around 7 percent to 9 percent.

The numbers are much higher for seniors who are hospitalized (11.5 percent are clinically depressed) or who require home healthcare services (13.5 percent), according to the CDC. Again, estimates from other sources are higher. The take-home point is that depression is even more common in seniors who need institutional care or nursing care in their homes.

When it comes to the new health insurance exchanges, every state has its own pediatric dental benefits story.

In the next five years, an estimated 3 million children are expected to become eligible to receive private dental benefits through the insurance marketplaces set up by the states. They will be among the approximately 8.7 million children who stand to gain extensive dental coverage through the ACA.

How is your state coping with the challenges of offering them? And will the benefits result in getting more kids the dental care they need? Oral health topic leader Mary Otto explains the issues and why states could be making some controversial decisions in implementing this part of the law.

You have a great medical study to cover – interesting topic, compelling results. All you need is an interview with the study authors to help bring the research home to readers. But scoring an interview with a scientist who works for a government agency can be frustrating and full of dead ends. It shouldn't be. AHCJ's Right to Know Committee is working on improving reporters' access to a number of government agencies.

But change is slow. And your deadlines won't wait. What can you do today for a story that's due tomorrow? Brenda Goodman, AHCJ's medical studies topic leader, offers a set of strategies that recently helped her through an impasse with the FDA.

Good oral health is a strong indicator of good overall health in older adults. It makes sense that nutritional intake is better when a person has all or most of their teeth. Poor oral health, on the other hand, is negatively linked to obesity, sleep apnea, poorer chronic disease management, higher LDL or “bad” cholesterol levels, malnutrition, low self esteem, and other physiological problems.

Eating “well” is critical throughout the lifecycle to prevent chronic disease, and support both physical and mental health. Each stage of life presents unique nutritional needs and challenges; however, dietitians who work with seniors, or adults, aged 65 and older, consistently identify the following nutrition-related concerns specific to aging, many of which are interrelated and influence a senior’s ability to live independently.

Reporters should be aware of these concerns and explore how the community and those who support seniors are addressing these needs.

Ronald Campbell, of The Orange County Register, offers a number of story ideas and tips on reporting them.

Among the thousands of topics that the Census covers, there are a few obvious gems for healthcare reporters and many that will require deeper digging. The obvious targets: health insurance and disabilities. Not only can you explore these topics geographically, but you can get insanely detailed information about each of them. How about the number of visually impaired people in your local workforce – employed vs. unemployed? Or look at part-timers and see how many buy health insurance on their own, through their employers or not at all.

Katie Kerwin McCrimmon, a reporter for HealthPolicySolutions.org in Colorado, shares some important story ideas and questions, as well as background on each, to help reporters explain the rollout of the health insurance exchanges or marketplaces.

She suggests, among other things, taking a good look at whether the technology will work, who will be left uninsured and what plans people are choosing.

Seeking to avoid the employer mandate of the Affordable Care Act, many small employers are pursuing self-funded health insurance.

Under this strategy, employers set aside enough funds to insure themselves, eliminating the traditional health insurance although these employers still use traditional insurers or health plans to enroll employees, process claims and establish networks of providers.

California journalists are lucky to have the Office of Statewide Health Planning and Development. Despite its bureaucratic and jargony name, it is a terrific resource for facts and figures about health care (particularly hospital care) in the state.

This tipsheet will focus on the hospital financial data on OSHPD's website and provide tips on how best to use the information.

There’s been a lot of interest lately in how much it will cost to buy a health plan through the exchanges created by the Affordable Care Act. But equally important, and often overlooked, is what those premiums will buy.

In fact, many consumer advocates are worried that people buying coverage through the exchanges will choose plans based solely on premiums and buy plans with such high deductibles and co-insurance they’ll be unable to afford care.

Arielle Levin Becker, who covers health care for The Connecticut Mirror, breaks down the the tiers of coverage, how subsidies will be calculated, out-of-pockets costs and other critical components that your readers, listeners and viewers are depending on you to explain.

Navigators. In-person assisters. Volunteers.

Who are they and what do they do?

Getting people to sign up for health coverage under the Affordable Care Act will take more than a few public service ads and some brochures. So the law envisioned having “navigators” and other community organizations and trained individuals help them. Various advocacy groups also will mount volunteer efforts.

Understanding the role of these people and organizations will be important as the federal government is set to announce on Aug. 15 who will get navigator grants from a pool of $54 million. 

Health reform topic leader Joanne Kenen breaks it down and identifies some local stories that reporters should be working on.

Periodontal (gum) disease is a recognized complication of diabetes.

Beyond the fact that people with diabetes are more likely to suffer from periodontal disease, some studies point to a bi-directional relationship between the two diseases. They suggest that the presence of periodontal disease makes diabetes harder to control.

Oral health topic leader Mary Otto provides some background on the relationship between the diseases, the body's response and other conditions that research is pursuing.

Self-insurance has been called an Obamacare loophole because the arrangement is immune to taxes, benefit requirements, profit limits and other rules set by the Affordable Care Act. For small businesses with young, healthy workers, it’s a way to offer coverage while avoiding premiums that build in costs for older, sicker people in the ACA’s insurance marketplaces.

But some people fear that self-insuring companies could skim too many young folks out of the small-business exchanges and insurance company costs and losses could soar, insurers could exit and the exchanges could break down.

Jay Hancock of Kaiser Health News explains the issues and why this is a local story that reporters should be paying attention to.

In June dental hygienists celebrated the 100^th anniversary of their profession.

It was in 1913 that a Bridgeport, Conn., dentist, Dr. Alfred Fones, opened the world’s first dental hygiene school. The first dental hygienist was Fones’ cousin and chairside assistant Irene Newman.

Today, more than  181,000 dental hygienists are at work in the United States,  according to the Bureau of Labor Statistics.

The work of these dental auxiliaries has typically centered upon offering preventive services such as cleaning teeth, applying dental sealants and fluoride treatments, screening for oral cancer and offering oral health education. 

But much about this female-dominated profession has been changing in recent years.

Many older adults live with chronic pain. It may be related to arthritis, complications from diabetes, falls, surgery, or other causes, but aging and pain go hand-in-hand for an estimated 58 percent to 70 percent of community-dwelling adults over age 65 and up to 80 percent of nursing home residents. Although physiologic changes are inevitable as we get older, persistent pain is not part of a normal aging process.

An  International Association for the Study of Pain fact sheet said that nearly half (45 percent) of older adults admitted to hospitals report pain – 19 percent have moderate or severe pain and 12.9 percent are not satisfied with current pain management methods.

Chronic pain in older adults is often underassessed and undertreated, according to numerous studies.  If you plan to report on pain-related issues, here are some things to keep in mind.

The dramatic filibuster of Texas Senate Bill 5 has refocused the nation’s attention on abortion. The bill would have prohibited abortions after 20 weeks gestation and it would have mandated that the minimum standards for an abortion facility must be equivalent to the minimum standards adopted for ambulatory surgical centers.

Only five of the state’s 42 abortion providers would meet the new requirements without extensive upgrades, which could drive many out of business. Democrats say the new rules would limit women’s access to abortion providers. Republicans contend that the stricter requirements are necessary to protect women’s safety.

Politics and personal beliefs aside, this is an opportunity for health journalists everywhere to look into the safety of abortion providers and whether there is evidence that stricter requirements will protect women from adverse events.

AHCJ member Eileen Beal put together this useful compilation of resources, briefings and contact information for sources to help reporters cover seniors in rural areas.

Health policy these days is contentious, with those in favor of the Affordable Care Act saying one thing while opponents insist other things are true. Carol Eisenberg, a senior editor at Kaiser Health News, offers some helpful tips for understanding health policy and communicating it accurately to your readers, viewers and listeners.

When writing about medical studies, drugs, devices, medical procedures and other health stories, social media can help you find real patients, not the ones groomed by pharmaceutical companies, to round out your coverage of research and treatments. In this helpful tip sheet, Liz Szabo, an award-winning medical reporter for USA Today passes on some of her best tricks for using social media to cultivate sources.

If you're planning to cover the American Society of Clinical Oncology meeting, this advice comes just in time for you to set up a network of potential sources in advance.

Primary care is where the rubber meets the road when it comes to health-system changes. Whether you want to reduce emergency room use, better manage chronic illness or boost immunization rates, primary care providers must be the driving force.  And yet what the wonks call “the primary care infrastructure” has never been more fragile. For reporters, this means a rich trove of stories on issues affecting the lives of everyone.

Providence Journal medical writer Felice J. Freyer lays out the key issues and a rich supply of story ideas and resources for local health reporters to pursue.

“The aging population is a significant driver of the diabetes epidemic,” according to a consensus report from the American Diabetes Association and American Geriatrics Society. Patients, providers, and the entire health system must grapple with the impact of the disease as more boomers enter their senior years.

When covering health trends or researching statistics, bear in mind that diabetes in older adults impacts many facets of health care, including hospitalizations, costs, population health, access, quality of life years and policy, for starters. Here are some facts, important story ideas and resources to get you started on reporting on diabetes in the aging community.

As a writer covering health for Angie's List Magazine, a consumer publication that goes to more than 1 million members around the country, Michael Schroeder is required to include meaningful medical pricing information in his stories. But as any health reporter knows, this is no simple task.

Schroeder says he is constantly fine-tuning his strategy. In an era in which high-deductible plans are on the rise, with patients paying more out of pocket and increasing pressure — public and private — for health organizations to share pricing information with the rest of us, he sees no other choice but to press on. In this tip sheet he reveals what questions he asks to get that very important information.

Shuka Kalantari, health outreach coordinator, KQED-San Francisco, spoke on the panel "Tech tools to diversify your sources."

Dany Adams, Ph.D., research associate professor, Tufts University, spoke on the panel "Promises of replacement medicine."

If you've interviewed anyone with an M.D., Ph.D., M.P.H. or Sc.D. after his or her name, you know: It's often no easy feat to get your sources to speak in everyday language.

Freelance journalist Kathleen Doheny has come up with some strategies to coax more usable language out of sources. Find out what the "java approach" is, ways to suggest to your source that they use more reader-friendly words and how to coach them through the interview.

Rich Siegel, M.D., co-director, Tufts Medical Center's Diabetes Clinic, spoke on the panel "Diabetes: Latest in diagnosis, treatment, prevention."

Gary Schwitzer, publisher, HealthNewsReview.org, spoke on the panel "Reporting on medical studies."

Karl Stark, assistant managing editor, health and science, The Philadelphia Inquirer, spoke on the panel "Diving into documents: Using 990s and more to cover hospital finances."

Walter Kaufmann, M.D., director and professor, Rett Syndrome Program, Boston Children's Hospital, spoke on the panel "Latest research into the mysteries of autism."

This tip sheet, courtesy of the National Immigration Law Center, breaks down how the Affordable Care Act covers various groups of immigrants, including naturalized citizens, lawfully present immigrants and undocumented immigrants. It also explains how the status of immigrants will be verified.

Ali Khademhosseini, Ph.D., M.A.Sc., associate professor, Harvard Medical School; Division of Bioengineering, Brigham and Women’s Hospital, spoke on the panel "Promises of replacement medicine."

David Corcoran, editor, Science Times, The New York Times, spoke on the panel "Freelance: Ideas that editors buy."

Scott Turner, M.D., Ph.D., director, memory disorders program, Georgetown University, spoke on the panel "The drive toward earlier Alzheimer’s treatment."

Manish Sethi, M.D., director, Orthopaedic Institute Center for Health Policy, Vanderbilt University, spoke on the panel "The nanny state: Can government change our behavior?"

John Walczyk, pharmacy manager, Johnson Compounding and Wellness Center, spoke on the panel "From compounders to drug shortages: Covering pharmacies and pharmacists."

Lisa Girion, staff writer, Los Angeles Times, spoke on the panel "Tracking, exposing prescription drug abuse in your state."

John L. Eadie, director, Prescription Drug Monitoring Program, Center of Excellence at Brandeis University, spoke on the panel "Tracking, exposing prescription drug abuse in your state."

Jerome Groopman, M.D., Dina and Raphael Recanati Chair of Medicine, Harvard Medical School; chief of experimental medicine, Beth Israel Deaconess Medical Center, and Pamela Hartzband, M.D., assistant professor, Harvard Medical School; attending physician, Division of Endocrinology, Beth Israel Deaconess Medical Center, spoke on the panel "When experts disagree: The art of medical decision making."

Giridhar Mallya, M.D., M.H.S.P., director of policy and planning, Philadelphia Department of Public Health, spoke on the panel "The nanny state: Can government change our behavior?"

Ellen Goodman, co-founder and director, The Conversation Project, spoke on the panel "Covering end-of-life issues."

David Swankin, president and chief exectutive officer, Citizen Advocacy Center, spoke on the panel "How to spot troubled health care workers."

Bill D. Marler, managing partner, Marler Clark, spoke on the panel "Why is food still making us sick in the 21st century?"

Sharon A. Levine, M.D., professor of medicine, Boston University; Geriatrics Section, Boston Medical Center, spoke on the panel "The growing complication of coordinating senior care."

Susan Reinhard, Ph.D., R.N., senior vice president, AARP Public Policy Institute, spoke on the panel "The growing complication of coordinating senior care."

Bert Rahl, L.I.S.W.-S., director, Mental Health, Eldercare Services Institute LLC, Benjamin Rose Institute on Aging, spoke on the panel "The growing complication of coordinating senior care."

Julius Yang, M.D., Ph.D., hospitalist and director of clinical operations, Beth Israel Deaconess Medical Center, spoke on the panel "Local hospitals start paying price for readmissions."

Karen Joynt, M.D., M.P.H., instructor, Harvard Medical School and Harvard School of Public Health; staff cardiologist, Boston VA Healthcare System, spoke on the panel "Local hospitals start paying price for readmissions."

Susannah Bernheim, M.D., M.H.S., acting director of quality measurement, Centers for Outcomes Research and Evaluation, Yale School of Medicine, spoke on the panel "Local hospitals start paying price for readmissions."

William Churchill, M.S., R.P.H., chief of pharmacy services, Brigham and Women’s Hospital, spoke on the panel "From compounders to drug shortages: Covering pharmacies and pharmacists."

Will Daniels, senior vice president, operations and organic integrity, Earthbound Farm, spoke on the panel "Why is food still making us sick in the 21st century?"

Paul Dreyer, Ph.D., principal, Dreyer Consulting, spoke on the panel "Deciphering inspection reports to cover hospital quality."

Michael R. Cohen, R.Ph., M.S., president, Institute for Safe Medication Practices, spoke on the panel "From compounders to drug shortages: Covering pharmacies and pharmacists."

Kate Walsh, president & chief executive officer, Boston Medical Center, spoke on the panel "Rich hospital, poor hospital: Stories of business survival."

Ilise Benun, founder & director, Marketing-Mentor.com, spoke on the panel "Freelance: Road to security."

David M. Nathan, M.D., director, MGH Diabetes Center and Clinical Research Center; professor of medicine, Harvard Medical School, spoke on the panel "Diabetes: Latest in diagnosis, treatment, prevention."

K. Vish Viswanath, Ph.D., associate professor, Harvard School of Public Health, spoke on the panel "Can technology-consumer interaction improve health behaviors?"

Brian Jack, M.D., professor and chair, Department of Family Medicine, Boston University School of Medicine / Boston Medical Center, spoke on the panel "Can technology-consumer interaction improve health behaviors?"

David Seltz, executive director, Massachusetts Health Policy Commission, spoke on the panel "Lessons from Massachusetts in handling health care costs."

Tim Ferris, vice president, Population Health Management, Massachusetts General Hospital and Partners HealthCare, spoke on the panel "Lessons from Massachusetts in handling health care costs."

While employment in many industries tanked and weakly recovered, jobs in the health care sector have grown at a steady clip. But ever-growing health employment may be coming to an end, as National Journal reporter Margot Sanger-Katz learned when she reported on the health sector’s impact on the Pittsburgh economy.

Deficit reductions out of Washington will squeeze the dollars fueling health care jobs. That means cuts from Medicare and Medicaid, as well as grants from the National Institutes of Health and the Centers for Disease Control and Prevention and other agencies. The recent across-the-board budget cuts known as the sequester hit medical research and public health particularly hard. Hundreds of billions of dollars likely will be cut from future Medicare spending, cuts that come on top of Affordable Care Act reductions that already have many hospitals tightening their belts.

Sanger-Katz urges reporters to cover the health care workforce in their own communities and, in this tip sheet, she points out potential stories, asks key questions and offers some essential resources. The changing health workforce is a key part of the story of health reform, and it hasn’t yet been well told.

Andrew Dreyfus, president and chief executive officer of Blue Cross Blue Shield of Massachusetts, spoke on the panel "Lessons from Massachusettes in handling health care costs."

For Dr. John W. Rowe and Robert L. Kahn, authors of “Successful Aging,” the book that got the nation thinking about healthy aging, it’s a goal: “[L]ow probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life.” For the quick-read version of the book, see Rowe and Kahn’s article in The Gerontologist.

For other thought leaders, it’s a public policy issue. And for those who are actively promoting healthy aging, it’s the outcome of the life-long interaction of various “dimensions” of health (genetic, physical, emotional, intellectual, social, spiritual, occupational, environmental).

Health journalist Eileen Beal explains the concept of healthy aging, what it involves and suggests a number of story ideas and points reporters to good sources to help in telling the stories of their communities.

The challenges of caregiving are getting new attention from AARP and the federal government as baby boomers struggle to assist their aging, ailing parents.

AARP and the Ad Council turned a spotlight on the issue in an advertising campaign that began  last August, featuring caregivers screaming silently in frustration over responsibilities such as taking a parent to the doctor or dealing with medical bills.

At the same time, AARP premiered an expanded resource center on caregiving on its website with experts who respond to readers’ questions and tips on everything from legal and financial matters to end-of-life concerns.

If caregivers walked away from their responsibilities, who would step in to care for older adults and at what cost? The government doesn’t especially want to pay for the many services caregivers supply. Free labor is a better and much cheaper alternative, from a budgetary standpoint.

Now, Judith Graham and Eileen Beal share facts, studies, story ideas and lots of resources for reporters to cover caregiving issues. This is a topic that will only continue to grow in importance as the baby boomers age.

We don’t normally think about local hospitals as cutthroat competitors seeking to put rivals out of business or operating monopolies that can charge whatever they wish because they’ve bought, intimidated or frightened away competition. But anticompetitive behavior can exert real impact on health care pricing, access and quality of care. Organizations with market power often do charge higher prices. And when they raise prices, their competitors frequently do as well. Some researchers have suggested that it may also reduce the quality of care.

As Mark Taylor tells us in this comprehensive tip sheet, antitrust issues are among the most underreported stories in health care. And that’s a shame because, at their core, health care antitrust stories often include classic elements of conflict, greed, conspiracies, collusion and intense rivalry. Millions, even billions, of dollars are at stake. Find out what stories you might find in your community.

Critical access hospitals are supposed to be small, rural facilities that receive a higher Medicare reimbursement rate to help keep them afloat. But not all of them fit that description, and they’re not always “critical.” More than 1,300 facilities – nearly one in four acute care hospitals – have been designated as critical access, and some are neither rural nor isolated.

Recently, several proposals floating around Washington, including one from President Obama, recommend narrowing the definition to help weed out some of the spending from the program.

Jenny Gold, of Kaiser Health News, has written about critical access hospitals and offers background, questions reporters should be asking and resources to support their reporting.

Cost is an important aspect of covering research, especially if you’re covering a study of a drug or medical device. But pricing information can also be tough to find, especially if you’re on a tight deadline. Brenda Goodman, AHCJ's topic leader on covering medical studies, runs down some of the best sources for finding costs of drugs, tests and devices, as well as finding information on trends in the nutrition market.

Entitlement reform. Everyone seems to think that it’s inevitable, now that the elections are over.

Two big targets of reform are programs that serve seniors: Medicare and Social Security.

In a new tip sheet, Bob Rosenblatt, one of the most experienced aging reporters around, explains the ins and outs of the Social Security and how essential it is, financially, to many older adults. Without Social Security, large numbers of seniors would be poor and unable to afford health care bills, as well as other expenses.

Rosenblatt’s tip sheet gives the background needed to understand why Social Security is at a crossroads, as well as numerous resources and story ideas for reporters on the aging beat. Also, you’ll learn details about how benefits are calculated that sheds light on why many older women find themselves unexpectedly impoverished after divorce or the death of a spouse.

While immigrants often bring with them some health-related disadvantages, such as poverty and a lack of health insurance, plenty of data suggests that Hispanics, at least, have an advantage when it comes to lifespan — a phenomenon known as the Hispanic paradox. While experts have debated its existence, the Hispanic paradox got the backing of the federal government two years ago with the publication of the Hispanic life tables. But what happens when those immigrants — or their children — begin to adopt the sedentary habits and fast-food lifestyle Americans are famous for? And are those extra years of life necessarily healthy ones?

Immigrants face untold dangers on the job. They are more likely than native-born Americans to work in hazardous occupations, such as agriculture and construction, and may perform riskier tasks. Especially if they're undocumented, their employers may be cutting corners on safety. A reporter who has written about immigrants who suffered horrendous workplace injuries, a lawyer for an agency dedicated to protecting workers, and an organizer who's seen firsthand what happens in the construction industry talk about the rights of immigrants in the workplace, the hazards they face on the job, and how you can track down good stories on this under-recognized public safety issue.

The San Antonio workshop keynote presentation covering population change and racial/ethnic diversity, immigrants and immigrant diversity and the immigrant health advantage.

The rich collection of Census data include key geographic information ideal for mapping. Combine Google tools with data to create online maps and charts you can tailor.  Learn how to create a map you can use with your online project with a combination of a spreadsheet, Google Fusion Tables and some basic data work.

The wide-ranging Affordable Care Act has many provisions that touch on issues important to immigrants, both documented and undocumented. Many immigrants and their families rely on safety-net hospitals, along with community clinics, Medicaid and other programs if they don’t have insurance through work. How will the federal health care law play out? Will safety net hospitals get adequate funding to care for the people who remain uninsured? How will community health centers fare? What happens if states like Texas don’t expand Medicaid eligibility? Where will undocumented immigrants turn to for care? Understand the issues involved as the law moves into final implementation in 2014.

This hands-on session showcased data sources on the demographics of immigrants, both nationally and in your community, and walked through how to access the numbers you need. It touched on a variety of information available from the Census Bureau, Department of Homeland Security and other sources. Learn how to build a portrait of foreign-born Americans that includes the basics such as race, ethnicity and birth country, as well as find information on specialized topics such as immigrants in health-care occupations, immigrants without health insurance and unauthorized immigration.

The term “anti-aging” often conjures up visions of L’Oréal face creams and Botox, but today’s anti-aging industry encompasses much more than that. Most anti-aging doctors promote a regimen that includes dietary supplements like resveratrol, plus a host of hormone products, such as estrogen, progesterone, testosterone and human growth hormone (HGH). The scientific validity of claims attached to these substances is highly questionable, yet the anti-aging industry continues to bring in an estimated $88 billion a year in sales.

The seemingly endless search for the fountain of youth offers a host of story ideas for enterprising health journalists. Arlene Weintraub, who has covered health and science for 15 years and is the author of “Selling the Fountain of Youth: How the Anti-Aging Industry Made a Disease out of Getting Old — And Made Billions,” offers useful background on the anti-aging movement as well as hot topics, potential story ideas and sources.

Joanne Kenen, AHCJ's health reform topic leader and deputy health editor at Politico, and Stacey Singer, of  The Palm Beach (Fla.) Post, presented a session at the Excellence in Journalism 2012 conference. Here are their story ideas and tips for covering health reform on the local level.

There are ample resources for covering health policy at the state and federal level. Here are some particularly useful ones – but they will lead you to other ones.

We have compiled tip sheets, articles about covering the public health angle of disasters, award-winning stories about health and past hurricanes, as well as links to resources and academic research that should help you report on Tropical Storm Isaac. You should be able to find story ideas and sources to help you evaluate and cover the health response before, during and after the storm.

Don’t look only to Washington policymakers for strategies to control medical costs and improve care for our aging population. New pilot projects that could accomplish these goals, which are at the heart of health reform, are being tested in communities across the country. In this tip sheet, reporter Susan Jaffe provides an overview of projects sponsored by the Center for Medicare and Medicaid Innovation, directs journalists to helpful resources, and supplies an extensive list of potential story ideas.

This story will have many dimensions – policy and political – to keep us busy for months to come but here is a quick guide to help you get started on reporting the ruling’s impact on your community.

The ruling is expected on Thursday, June 28. It will be handed down live, from the bench, in sessions that begin at 10 a.m. ET.  The ruling will go up on the court website fairly quickly, and many news organizations will post as well. As most of you know, there is no TV or radio feed, and reporters can’t have cell phones or laptops in the courtroom.

Aging-in-place is a broad term for arrangements that allow seniors to remain at home rather than relocate as frailty or disability increases their need for help with daily activities. However, aging-in-place is not easy to achieve. Health care journalist Lani Luciano introduces major resources, information and questions to help reporters explain aging-in-place and examine the issues and trends surrounding the concept.

Presentation from Mark S. Gold, M.D., distinguished professor and chair of psychiatry, University of Florida College of Medicine, who spoke on the panel "New understandings in the science of addiction and treatment."

Presentation from Stephanie Walsh, M.D., medical director of child wellness, Children’s Healthcare of Atlanta; associate professor at Emory School of Medicine, who spoke on the panel "Overcoming 'fat fatigue' in our reporting."

Presentation from Lance Williams, senior reporter, California Watch and the Center for Investigative Reporting, who spoke on the panel "Working with geeks to tell new stories."

Presentation from Kathleen Adams, Ph.D., professor, Rollins School of Public Health, Emory University; health economist, Division of Reproductive Health, Centers for Disease Control and Prevention, who spoke on the panel "Economic determinants of child health."

Presentation from panel "Freelance: Mapping successful business plans and models."

As 10,000 baby boomers turn 65 every day, Medicare spending will skyrocket. About 30 percent of Medicare’s costs are for care in the last year of life. Research has shown that many people nearing the end of life are not informed of their treatment options and their doctors are unaware of their preferences for treatment, which contributes to a lower quality of life at the end of life.

Every family is touched by the end of life of a loved one. Every reporter who covers Medicare policy and health and aging issues will want to know about hospice and palliative care.

Remarks from Enid Borden, president and CEO of Meals on Wheels Association of America, at the 2012 Rural Health Journalism Workshop. She focuses on the health and social implications for seniors living in rural America.

Presentation from Barry Silverman, M.D., Mark Silverman chair of cardiac education, the Piedmont Heart Institute, who spoke on the panel "How will citizen scientists impact medicine?"

Presentation from Robert A. Logan, Ph.D., communication research scientist, National Library of Medicine, who spoke on the panel "From story ideas to sources: Finding hidden gems in PubMed."

Presentation from James MacKillop, Ph.D., director, Experimental and Clinical Psychopharmacology Laboratory; associate professor, Department of Psychology; associate director, Owens Institute for Behavioral Research, University of Georgia, who spoke on the panel "New understandings in the science of addiction and treatment."

Presentation from Vladimir N. Cadet, M.P.H., clinical writer/analyst, ECRI Institute, who spoke on the panel "Identifying disparities in diagnosis and treatment."

Presentation from Theresa Gillespie, Ph.D., associate professor, Department of Surgery, Emory University School of Medicine and Winship Cancer Institute, who spoke on the panel "Identifying disparities in diagnosis and treatment."

Presentation from John Ward, M.D., director, Viral Hepatitis Program, CDC, who spoke on the panel "Hepatitis: New battle lines in war on silent killer."

Presentation from Sarah R. Callahan, M.H.S.A., project director, NAPH Safety Network National Association of Public Hospitals and Health Systems, who spoke on the panel "Are your local hospitals targeting health care-acquired conditions?"

Presentation from Bridget Catlin, Ph.D., M.H.S.A., senior scientist, program director, Mobilizing Action Toward Community Health, University of Wisconsin, who spoke on the panel "Online health data to tap for project ideas."

Presentation from Rishi Manchanda, M.D., M.P.H., founder, HealthBegins, who spoke on the panel "Economic determinants of child health."

Presentation from David Radley, Ph.D., M.P.H., senior analyst, The Commonwealth Fund, who spoke on the panel "Online health data to tap for project ideas."

Presentation from Karen Adams, Ph.D., vice president, National Quality Forum, who spoke on the panel "Are your local hospitals targeting health care-acquired conditions?"

Presentation from Clarissa Hsu, Ph.D., research associate, Center for Community Health and Evaluation, Group Health Research Institute, who spoke on the panel "A reporter's guide to medical decision making."

Presentation from Nikhil Khushalani, M.D., associate professor of oncology, Roswell Park Cancer Institute, who spoke on the panel "Translational research: Tracking a drug or therapy through the process."

Presentation from John Rother, president, National Coalition on Health Care, who spoke on the panel "Seeing through the rhetoric in health reform debates ."

Presentation from Michael W. Wagner, assistant professor, Department of Political Science and College of Journalism and Mass Communications, University of Nebraska, who spoke on the panel "Seeing through the rhetoric in health reform debates."

Presentation from Donald Stein, Ph.D., Asa G. Candler Professor, Department of Emergency Medicine, Emory University School of Medicine, who spoke on the panel "Translational research: Tracking a drug or therapy through the process."

Presentation from Allan Levey, M.D., Ph.D., chair, Department of Neurology, Emory University School of Medicine; director, Emory Center for Neurodegenerative Disease, who spoke on the panel "Is earlier diagnosis of Alzheimer's around the corner?"

Presentation from William Hu, M.D., Ph.D., assistant professor, Department of Neurology, Emory University School of Medicine, who spoke on the panel "Is earlier diagnosis of Alzheimer's around the corner?"

Presentation from Neil Buckholtz, Ph.D., chief, Dementias of Aging Branch, National Institute on Aging, who spoke on the panel "Is earlier diagnosis of Alzheimer's around the corner?"

Presentation from Beatrice Gee, M.D., F.A.A.P., associate professor, clinical pediatrics, Morehouse School of Medicine; medical director, Sickle Cell and Hematology Program, Children’s Healthcare of Atlanta, who spoke on the panel "Identifying disparities in diagnosis and treatment."

Presentation from Cathrin Buetefisch, M.D., Ph.D., associate professor, Department of Neurology, Emory University School of Medicine, who spoke on the panel "Neuroplasticity 101: It really is all in your head."

Presentation from Janice P. Lea, M.D., M.Sc., F.A.S.N., professor, Department of Medicine, Division of Renal Medicine, Emory University School of Medicine, who spoke on the panel "Diabetes' impact on diverse populations."

Presentation from Scott Standifer, Ph.D., assistant director, Region 7 Technical Assistance and Continuing Education Center; organizer, Autism Works National Conference; clinical associate professor, School of Health Professions, University of Missouri, who spoke on the panel "Is the workplace prepared for an increase in adults with autism?"

Presentation from Parinda Khatri, Ph.D., director of integrated care, Cherokee Health Systems, who spoke on the panel "Mental health: Integrating behavioral health with primary care."

Presentation from Marjorie Funk, Ph.D., R.N., F.A.H.A., F.A.A.N., professor, Yale University School of Nursing, who spoke on the panel "Health technology hazards to watch for in your community this year."

Presentation from Rita J. Louard M.D., F.A.C.P., F.A.C.E., director, Clinical Diabetes Program - Moses Campus, Montefiore Medical Center; associate professor of clinical medicine, Division of Endocrinology, Albert Einstein College of Medicine, who spoke on the panel "Diabetes' impact on diverse populations."

Presentation from Paul J. Nussbaum, Ph.D., adjunct professor of neurological surgery; University of Pittsburgh School of Medicine, who spoke on the panel "Neuroplasticity 101: It really is all in your head."

Presentation from Michael J. Kuhar, Ph.D., researcher, Yerkes National Primate Research Center; Candler professor of neuropharmacology, Emory University School of Medicine, who spoke on the panel "Neuroplasticity 101: It really is all in your head."

Presentation from Paul Spearman, M.D., chief research officer, Children’s Healthcare of Atlanta; professor, Department of Pediatrics, Emory University School of Medicine, who spoke on the panel "Health technology hazards to watch for in your community this year."

Presentation from John Bartlett, M.D., M.P.H., senior project adviser, Primary Care Initiative, Carter Center Mental Health Program, who spoke on the panel "Mental health: Integrating behavioral health with primary care."

Presentation from Connie Crawley, M.S., R.D., L.D., nutrition and health specialist, The University of Georgia Cooperative Extension, who spoke on the panel "Helping the Woman with Gestational Diabetes."

Presentation from Eric S. Sacks, director, Healthcare Product Alerts, ECRI Institute, who spoke on the panel "Health technology hazards to watch for in your community this year."

Presentation from Bryan McCullick, Ph.D., professor of kinesiology, University of Georgia, who spoke on the panel "Overcoming 'fat fatigue' in our reporting."

Presentation from Aaron Wernham, M.D., director, Health Impact Project, Pew Health Group, who spoke on the panel "Health in all policies."

Presentation from Caroline Smith DeWaal, J.D., food safety director, Center for Science in the Public Interest, who spoke on the panel "Food safety: Getting beyond the annual scare."

Presentation from Janet Woodcock, M.D., director, FDA Center for Drug Research and Evaluation, who spoke on the panel "Newsmaker briefing: Advances in how FDA monitors drug safety after approval."

Presentation from Barbara L. Schuster, M.D., campus dean, Georgia Health Sciences University, University of Georgia Medical Partnership, who spoke on the panel "What's the future for primary care?"

Presentation from Gale Prince, president, Sage Food Safety Consultants, who spoke on the panel "Food safety: Getting beyond the annual scare."

Presentation from David Satcher, M.D., Ph.D., director, The Satcher Health Leadership Institute, Morehouse School of Medicine, who spoke on the panel "What's the future for primary care?"

Presentation from Christopher Braden, M.D., director, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, who spoke on the panel "Food safety: Getting beyond the annual scare."

Presentation from Michael A. Covington, Ph.D., associate director, Institute for Artificial Intelligence, University of Georgia, who spoke on the panel "Future of artificial intelligence in patient care."

Presentation from Jonathan Mermin, M.D., M.P.H., director, HIV/AIDS Prevention Program, Centers for Disease Control and Prevention, who spoke on the panel "Global effort on HIV/AIDS: Lessons learned."

Presentation from Sonal Ambegaokar, health policy attorney, National Immigration Law Center, who spoke on the panel "State crackdowns: Who is caring for undocumented immigrants?"

Presentation from Frank Don Diego, M.D., family practitioner; academic chair, combined Floyd Medical Center Allopathic and Osteopathic Family Medicine Residencies, who spoke on the panel "What's the future for primary care?"

Presentation from Martin S. Kohn, M.D., chief medical scientist, IBM, who spoke
on the panel "Future of artificial intelligence in patient care."

This is the presentation from Brandon Stahl, a winner of the Awards for Excellence in Health Care Journalism, who spoke on the panel "Award winners speak". 

Some information about African-American organizations with health programs. 

This tip sheet is based on the presentation from Maryn McKenna, independent journalist, Atlanta, who spoke on the panel "Global health: How a shrinking world means increasing threats."

Most health journalists know that the U.S. population is rapidly aging thanks to 78 million Baby Boomers who started turning 65 years old in 2011. What’s not as well appreciated is the increasing diversity of our aging population. By mid-century, the proportion of elders from ethnic and racial communities will double.

For health care journalists, the graying of the American rainbow presents a kaleidoscope of story possibilities. Paul Kleyman has contributed this tip sheet to help health reporters cover our increasingly diverse older population. It includes four key concepts and helpful links intended to point the way toward more ethnically representative – and interesting – stories.

The tip sheet offers useful information of neuroplasticity from a variety of sources. 

Presentation from Michael Helgeson, D.D.S., chief executive officer, Apple Tree Dental, who spoke on the panel "Moves to address access to dental care."

Ivan Oransky, M.D., executive editor of Reuters Health and blogger at Retraction Watch and Embargo Watch, offers advice to journalists on reading studies and reseach, evaluating it and translating it for your readers, viewers and listeners.

This tip sheet is developed by Charles Ornstein, senior reporter, ProPublica, who spoke on the panel "Handling the explosion of hospital quality data."

Presentation from Ashish K. Jha, M.D., M.P.H., C. Boyden Gray Associate Professor, Harvard School of Public Health; staff physician, Veterans Health Administration, who spoke on the panel "Handling the explosion of hospital quality data."

Presentation from Venkat Narayan, M.D., Hubert professor, Department of Global Health, Rollins School of Public Health, Emory University, who spoke on the panel "Global health: How a shrinking world means increasing threats."

Presentation from Paul Emerson, Ph.D., director, Trachoma Control Program; co-director, Malaria Control Program, The Carter Center, who spoke on the panel "Global health: How a shrinking world means increasing threats."

Presentation from Harry Heiman, M.D., M.P.H., director, health policy, The Satcher Health Leadership Institute, Morehouse School of Medicine, who spoke on the panel "Health in all policies."

Presentation from Heather Howard, director, State Health Reform Assistance Network; CHW affiliate, Center for Health & Wellbeing, Princeton University, who spoke on the panel "The politics of state insurance exchanges."

Charles Ornstein, a senior reporter from ProPublica, has compiled tips on obtaining public records from all levels of government, with a focus on how to get the most useful documents and data most efficiently.

Presentation from Pamela H. Wescott, MPP, Director, Patient Perspective, who spoke on the panel "A reporter's guide to medical decision making."

Presentation from Michael J. Barry, M.D., president, Informed Medical Decisions Foundation, who spoke on the panel "A reporter's guide to medical decision making."

Presentation from Christina Jewett, health and welfare reporter, California Watch and the Center for Investigative Reporting, who spoke on the panel "The working  journalist's guide to using FOI laws."

Presentation from Eugene Litvak, Ph.D., president and chief executive officer, Institute for Healthcare Optimization, who spoke on the panel "Are your local hospitals targeting health care-acquired conditions?"

Presentation from Sandra Heikkinen, global communications and public affairs manager, Google Inc., who spoke on the panel "Google tools for health reporters."

Presentation from Shelly Gehshan, M.P.P., director, Pew Children’s Dental Campaign, Pew Center on the States, who spoke on the panel "Moves to address access to dental care."

Presentation from Nora Volkow, , M.D., director, National Institute on Drug Abuse, who spoke on the panel "New understandings in the science of addiction and treatment."

Presentation from Charles Davis, Executive Director of National Freedom of Information Coalition at University of Missouri School of Journalism, who spoke on the panel "The working  journalist's guide to using FOI laws."

This tip sheet is based on the presentation of Charles Davis, Executive Director of National Freedom of Information Coalition at University of Missouri School of Journalism, who spoke on the panel "The working  journalist's guide to using FOI laws."

Presentation from Samantha Artiga, Kaiser Commission on Medicaid and the Uninsured Kaiser Family Foundation, who spoke on the panel "State crackdowns: Who is caring for undocumented immigrants?"

The nexus between housing and health is evident in assisted-living centers or nursing homes, which take care of people with minor or substantial physical limitations who require regular assistance.

But even when older people are independent, housing arrangements can affect health by influencing their access to medical care, engagement in activities, social connections and other components of well-being.

Senior housing options have proliferated over the past several decades and it’s important to understand what’s available or being planned in your community. Richard Peck, who has covered aging-related topics for 30 years as editor of Geriatrics and editor-in-chief/contributing editor of Long-Term Living, offers a general description of the choices available, as well as story ideas and links to useful resources.

Charles Ornstein, of ProPublica, and Jeff Porter, AHCJ's special projects director, compiled this tip sheet to help reporters find and use data about Medicare, Medicaid, nursing homes and disciplinary actions against health professionals. The tip sheet includes links to the data sets, examples of how they are used in other reporters' stories and advanced tips.

Shuka Kalantari of KQED Public Radio introduces the basics of using Twitter and how journalists can use it to stay on top of health news and use it to disseminate their own stories.

Marian Liu, community manager at Storify.com, introduces ways of telling stories using Storify, a useful tool for health care journalists. It also offers some successful examples of using Storify.

On March 26, the Supreme Court starts six hours of oral arguments over three days – its longest case in years – on four separate legal questions arising from the Affordable Care Act. A decision is expected in late June. We talked to T.R. Goldman, a longtime legal journalist who has written about the case.

We asked Goldman to address five questions for journalists:

1. Is the individual mandate’s “minimum coverage provision” that requires most people to obtain health insurance constitutional?

2. If not – will the court strike the whole law down, or just certain sections (“severability”)?

3. What role does Medicaid expansion play in the legal case?

4. Can the court decide on the constitutionality of the mandate now, or under the Anti-injunction Act does it have to wait until mandate penalties are imposed in 2015?

5. What are some tips for health reporters trying to cover this – particularly those covering from afar?

Along with his answers, we are including some links to further reading, webcasts and health and legal blogs that may be useful.

Joanne Kenen, AHCJ's topic leader on health reform, has compiled a list of books about health reform in the United States. The list is organized by topics, such as understanding the law, politics and history, criticism of the law and value versus volume.

The list includes resources and information that are about the discussions of challenges, rules and approches to implement health reform in the United States.

AHCJ member Maia Szalavitz compiled a reference guide on how to get access to a number of publications that health journalists will find useful. It includes web links, e-mails and phone numbers of relevant contacts for publications that include EurekAlert!, Science magazine, Nature, the New England Journal of Medicine, the Journal of Neuroscience, Wiley Journals, Science Direct (Elsevier), the American Psychological Association Journals and the Association for Psychological Science Journals. Also included is information on how to get free access to a number of other journals and databases that are included as benefits of being a member of AHCJ.

Over the next 20 years, the percentage of Americans age 65 and older will rise from around 13 percent of the population to approximately 20 percent. Along with this increase, there will be a jump in the number of people with Alzheimer’s or related dementias (ADRDs). Estimates vary, but it’s been suggested that as many as 13.2 million Americans could be diagnosed with Alzheimer’s disease by 2050 – almost a three-fold increase from 4.5 million in 2000. 

Eileen Beal covers this issue that touches every community and is important to every reporter covering aging and health.

Long-term care has been in the news with the October 2011 demise of the CLASS Act – the first attempt by the government to establish a national long-term care insurance program. Now, the question is how the long-term care needs of people with chronic conditions such as arthritis, diabetes or heart disease will be addressed going forward as the Baby Boomers enter later years.

This has actually been a pressing, unresolved question for a long time. Although few people realize it, Medicare doesn’t cover long-term care, for the most part. To be more precise, Medicare doesn’t pay for custodial care; it only pays for medically necessary care at home or in a skilled nursing facility, under limited circumstances.

That leaves middle class seniors having to pick up the tab for long-term care services out of their own pockets. Few people appear to have prepared adequately for this eventuality or to appreciate just how expensive it can be.

Judith Graham, AHCJ's topic leader on aging sorts out the options, the statistics and offers resources to help reporters cover long-term care for their readers and viewers.

You’d think that advance directives signed by people with serious, life-threatening illnesses would ensure their treatment preferences or end-of-life wishes would be carried out. Too often this isn’t the case. One solution lies in Physician Orders for Life-Sustaining Treatment (POLSTs), which are summaries of a patient’s advance directives related to their current medical situation. When signed by the patient’s physician (and increasingly, the patient), these summaries become physician’s orders. They are medically and legally recognized documents that are placed up front in the patient’s written and electronic medical records.

Medicare is one of the largest government programs in the United States. Health reporters are bound to hear about it every day. Judith Graham, AHCJ's topic leader on aging, has assembled a quick guide for reporters that nails down the basics of the program, the politics and changing landscape of the program, as well as essential resources and the questions that reporters should be asking and writing about for their news outlets.

Electronic medical record systems have been touted for years as the way to fix health care. Proponents say electronic prescribing would warn against dangerous drug interactions and electronic access to patient medical information could reduce unnecessary procedures. States and the federal government, particuarly in the Affordable Care Act, are pursuing plans to link hospitals, doctors and patients electronically, dangling incentives for medical providers. Meanwhile, privacy problems continue to surface with information breaches such as occurred at Stanford Hospital, where data for 20,000 emergency room patients was posted on a commercial Web site, including names and diagnosis codes.

Lee Tien, senior staff attorney at the Electronic Frontier Foundation, discussed privacy and security concerns, as well as suggesting some possible story ideas for reporters.

How profitable is your local hospital? How much charity care does it provide? Do doctors there implant a disproportionate number of cardiac stents? Is the ER turning a high number of ambulances? This session will show you how to answer these questions and more. Using data from California’s Office of Statewide Health Planning and Development (OSHPD), this session introduced data sets that journalists can request in other states.

As our media world changes, journalists who have traditionally worked for print outlets are finding themselves with the opportunity to appear on television or the radio to help explain complex health issues to a different audience.

Bruce Japsen, a longtime Chicago Tribune reporter who now contributes to The New York Times, has some tips to help his fellow ink-stained journalists best convey their information and even embrace appearing on on other outlets.

He provides ideas on how to explain complex topics in nuggets of information that are short and sweet enough to get your message across but not so simple that you are insulting an audience.

Handouts and presentations from the October 2011 workshop held in San Francisco.

Topics include hospital data, insurance battles that lie ahead, the future of health care, what to expect of Medicare in the coming months and years, information about the future of pharmaceutical manufacturing and what remains to be seen about how electronic medical records can be used.

Investigative reporter Christina Jewett explains how she and other journalists have analyzed data from California's Office of Statewide Health Planning and Development to look at how health care services are being utilized, the profitability of local hospitals, how much charity care they provide and more. This tip sheet is from a presentation at the Business of Health Workshop in October 2011.

California journalists are lucky to have the Office of Statewide Health Planning and Development. Despite its bureaucratic and jargony name, it is a terrific resource for facts and figures about health care (particularly hospital care) in the state. A look through its website  can help you discover which hospitals in your community are most profitable, how much they charge for specific procedures, which perform the most C-sections and which are at the greatest risk of collapsing in powerful earthquakes. OSHPD keeps track of data from every region of California – the most urban and most rural.

This tip sheet, a companion to the webinar of the same name, will focus on the hospital utilization data on OSHPD's website and provide tips on how best to use the information.

Just as with other aspects of health care, children, older adults, and people who live in rural areas are affected by economic, structural, geographic and cultural factors that limit access to dental health care. A report this week from the Institute of Medicine and the National Research Council looks at the consequences of inadequate access to oral health care and recommends ways to improve access.

AHCJ has a number of resources, including taped panel discussions, tip sheets, articles and contest questionnaires on reporting on dental health.

It's likely you've read some of the stories about health professionals gone wrong in recent months. They include reports by Blythe Bernhard and Jeremy Kohler of the St. Louis Post-Dispatch that patients are kept in the dark about problems with their doctors and hospitals and that Missouri's disciplinary system seems geared toward protecting doctors’ livelihoods; a series of articles from Charles Ornstein and Tracy Weber of ProPublica showing that patients suffered as problem nurses were kept on the job in California and state agencies have failed to report disciplined caregivers to a federal database; and Bill Heisel's chronicles of "Doctors Behaving Badly" at ReportingOnHealth.org.

Now we have some tips from a number of AHCJ members who have checked up on the medical professionals in their area – and the boards that regulate them.

AHCJ now has an up-to-date list of the senior media officials at each division of the U.S. Department of Health and Human Services. These are the people reporters should contact when they are not getting meaningful and timely responses from lower-level media officials at the U.S. Department of Health and Human Services. If your deadline is approaching and you still don’t have what you need, call a contact on this list.

The HHS public affairs office provided the names, email addresses and direct phone lines in response to AHCJ’s continuing efforts to improve reporters’ access to information from the federal government.

William D. Hacker, M.D., F.A.A.P., C.P.E.; commissioner, Kentucky Department for Public Health discusses the role of public health in response to disaster and disease.

Timothy D. McBride, Ph.D., professor and associate dean for public health at Brown School of Washington University offers an abundance of information on health coverage in rural areas, payment differentials, the health status of chronic disease.

Tom Dean, M.D., family practice physician Avera Weskota Memorial Medical discusses rural health challenges such as professional recruiting, maintaining services and physical distances.

Joel Halverson, assistant professor, School of Pharmacy and Mary Babb Randolph Cancer Center, West Virginia University analyze the nation by county for food insecurity, food availability and health outcomes.

Sarah Gehlert, Ph.D., E. Desmond Lee Professor of Racial and Ethnic Diversity, Brown School, Washington University discusses determinants of health disparities such as genetic predisposition, social circumstances, behavioral patterns and shortfalls in medical care and more.

Ellen Barnidge, Ph.D., M.P.H., assistant professor in behavioral science and health education at St. Louis University offers this information on the shortage of physicians, shortage of mental health providers, limited health insurance coverage and poorer health status of rural residents in the U.S. Between one in four and one in five Americans live in rural areas.

Speakers at this workshop provided handouts, tip sheets and links to relevant information related to their panels.

Resources for reporting on health care workforce shortages from speakers at the 2011 Rural Health Journalism Workshop.

Handouts and a presentation from Robert V. Tauxe, M.D., M.P.H., deputy director, Division of Foodborne, Bacterial and Mycotic Diseases National Center for Zoonotic, Vectorborne and Enteric Diseases, Centers for Disease Control and Prevention, from the AHCJ-CDC Fellowship program in 2009. Tauxe details the stages of an investigation and offers useful statistics.

Tips and resources about covering prescription use and abuse, especially in rural areas, from panelists at the 2011 Rural Health Journalism Workshop.

As quick-striking tornadoes and slowly rising flood waters affect part of the United States, public health becomes a life and death issue. Water systems fail, leaving no clean drinking water. Roads and bridges are blocked, adding hours to emergency transport times. Floods can contaminate the environment with hazardous chemicals.

Even if you aren't in one of the affected areas, this collection of resources will help you prepare for reporting on future crises. Find out how to prepare ahead of time for a disaster, how to organize coverage of a long-term story, how to evaluate whether your city or region is adequately prepared to handle emergencies and more.

Medicaid doesn't get anywhere as much attention as Medicare. That's nothing new – it's been that way pretty much since the twin programs were enacted in 1965. But reporters should pay attention to Medicaid right now, for a lot of reasons:

• It's smack in the middle of the debt/spending/entitlement debate going on in Washington.
• It's a lynchpin for the insurance coverage expansion starting in 2014.
• Keep in mind, too, that the federal stimulus package gave the states a lot of extra Medicaid money – and that runs out at the end of June. States know that's coming, but it doesn't mean they like it or that they are as prepared as they might be.

If it seems like the Medicaid headlines are going in several directions at once – that's because they are. Expand, contract, reinvent, blow up, save, destroy ... What's really going on?

Dennis H. Novack, M.D., professor of medicine and associate dean of medical education at Drexel University College of Medicine, lays out ways to advance clinical skills education including specific teaching and assessment strategies.

St. Louis Post-Dispatch staffers Jeremy Kohler and Blythe Bernhard share tips for researching doctors' malpractice histories and hospital actions against employees.

Linda Dahlstrom, of MSNBC.com and Today.com, share tips for freelancers on how to approach editors and get assignments.

Politico's Sarah Kliff offers story ideas about health exchanges, insurance rate hikes, medical loss ratio waivers and points readers to some resources to help with those stories in this tip sheet from "Health reform: Repeal, replace or implement?" at Health Journalism 2011.

A sample timeline of the editorial process from a special panel for freelancers called "What editors wish writers knew" at Health Journalism 2011.

Timothy Stoltzfus Jost, of Washington and Lee University, compiled this tip sheet for the Health Journalism 2011 panel "Health insurance: Changes that are coming fast." It outlines how coverage will be expanded, the five categories of coverage, plan requirements as well as pros and cons, and information about enforcement of the Affordable Care Act.

Tips from Karen Brown, of WFCR Public Radio in Amherst, Mass., compiled for the Health Journalism 2011 panel "What we've learned from the Massachusetts experiment." Brown suggests the people you should be talking to and how to find the stories your audience will appreciate.

In this tip sheet compiled for Health Journalism 2011, Julie Appleby offers a list of useful websites for covering health reform.

The team physician and director of athletic medicine at Princeton University offers information about concussions in young athletes.

These are handouts that were available at the panel "From pee-wees to pros: Head injuries in sports" at Health Journalism 2011.

Frank Bass, a reporter/analyst at Bloomberg, offers a set of data-related websites to help report on health care in this tip sheet from the workshop "Mapping and charting health in your area" at Health Journalism 2011.

Douglas Wiebe presents research about the activities of 15-19 year-old subjects, finding that in most instances, four types of locations constituted the place along a subject’s path that was the farthest point from their home: school, work, places of recreation, and food stores and restaurants. He also presents research into alcohol outlet prevalence in subjects’ areas and a survey about children's exposure to gun violence. His conclusion includes key points and questions that researchers and journalists should keep in mind.

ProPublica's Tracy Weber presented information from the long-running investigation she and Charles Ornstein have conducted into nurses and other caregivers who are disciplined but still caring for patients while the public is largely unaware of their past problems.

Nursing boards - and agencies that oversee such professionals as pharmacists, dentists and psychologists - do not get nearly enough scrutiny. These boards are charged with protecting consumers from unscrupulous or incompetent professionals, but some provide almost no public information about what they do or how they're run. They are sometimes led by ill-qualified political appointees and lack sufficient personnel. But should these boring bureaucracies fail; the implications for patients can be dire.

It's important to remember that nurses, not doctors, provide the bulk of the care patients receive in hospitals and nursing homes. Ensuring that regulators properly oversee nurses is crucial for ensuring quality patient care.

ProPublica's Tracy Weber offers suggestions for how to look into medical professionals and the boards that oversee them.

"Premium support" is one of those quintessential Washington phrases. What on earth does it mean?

It's in the news now because House Budget chairman Paul Ryan wants to turn Medicare into a "premium support" program. It's not a totally new idea – House Republicans, including former Speaker Newt Gingrich and former House Ways and Means chairman Bill Thomas, had somewhat similar ideas that began circulating in the mid-1990s. But the Ryan idea is starker - or bolder, depending on your perspective.

AHCJ's health reform topic leader Joanne Kenen explains what it really means and points members to some resources to help sort it out for readers, listeners and viewers.

Dan Taylor of St. Christopher's Hospital for Children presented studies and data on the effects of stress on young brains, food insecurity, the likelihood that the children of incarcerated parents will later be incarcerated and more.

Maurice Tamman, of The Wall Street Journal, shares information from that paper's "Secrets of the System" series and the closed federal database it was based upon: Under a three-decade-old court order, Medicare can't publish the billings of individual physicians who participate in the program. His presentation shows what's in the data, how they went about standardizing and analyzing it and more.

Rebecca Sudore, M.D., assistant professor of medicine, Division of Geriatrics, University of California, San Francisco; staff physician, San Francisco VA Medical Center discusses several problems with advance care planning and what she calls a "new paradigm" of advance care planning.

Karl Stark, health & science editor of The Philadelphia Inquirer, discusses five key documents in exploring hospital finances and recent trends.

Alison Singer, president of the Autism Science Foundation, offers this presentation on influences on treatment options.

Dorie Seavey, Ph.D., director of policy research at the Paraprofessional Healthcare Institute, offers key facts on America's direct-care workforce and eldercare and disability services industry.

Gary Schwitzer, publisher, HealthNewsReview.org offers information on intelligently challenging claims, types of claims to look out for and how patients can be harmed by poor reporting.

Karen Schoelles, M.D., S.M., F.A.C.P., director, ECRI Institute Evidence-based Practice Center, offers this presentation on what "counts" as evidence, what bias is, factors that contribute to health outcomes and more.

Katherine A. Schneider, M.D., senior vice president of health engagement at AtlantiCare, explains the accountable care organization model and the focus on outcomes for special care centers.

Emily Saltz, executive director of Elder Resources, explains the function of geriatric care managers, who exactly their clients are, how services are paid for and their challenges.

This panel presentation covers nanotechnology, what it is and its role in fighting cancer.

Jeff Porter, AHCJ special projects director, offers this guide on how to use this user-friendly web-based demographic, consumer and business data exploration tool.

John Novack, director of communications of online health and wellness community Inspire, offers this presentation on online patient communities and their definition, impact, and quick tips for journalists looking for stories.

Andrew Newberg, M.D., director of research, Myrna Brind Center for Integrative Medicine, Thomas Jefferson University Hospital and Medical College offers this presentation on how the brain is related to religious and spiritual practices and experiences, including studies on changes in the brain.

Jacob Nelson, director of traffic safety policy & research, American Automobile Association, offers this presentation on looking at traffic safety as a public health issue and 10 things that can be done to save lives.

Mary Naylor, Ph.D, F.A.A.N., R.N., Marian S. Ware professor in Gerontology, University of Pennsylvania School of Nursing, offers this information on core components of the transitional care model and its relevance to the Affordable Care Act provisions.

Adam Marcus, managing editor, Anesthesiology News; blogger, Retraction Watch, offers this presentation on what constitutes research fraud and tips on how to cover it.

Robert A. Logan, Ph.D., communication research scientist, National Library of Medicine shares step-by-step techniques for using PubMed, Clinicaltrials.gov and MedlinePlus.gov.

Steven M. Lieberman, president, Lieberman Consulting; visiting scholar, Brookings Institution, offers an overview on accountable care organization goals, key innovations and challenges.

Susan E. Levy, M.D., FAAP, at The Children's Hospital of Philadelphia, offers this information on complementary and alternative medicine (CAM) treatments, with some interesting findings on placebos.

Michael S. Weingarten, professor of surgery and chief of vascular surgery at Drexel University College of Medicine, offers this presentation on Operation Iraqi Freedom and Operation Enduring Freedom damage control surgery, transportation for critically ill patients and reducing the "footprint" of hospitals "down range."

Judy Klickstein, of the Cambridge Health Alliance, offers this overview of the organization's integrated health care and electronic records system.

Joseph Kim, vice president of medical affairs and technology at Medical Communications Media and founder of MedicalSmartphones.com, MobileHealthComputing.com, MedicineandTechnology.com, NonClinicalJobs.com, offers information on medicine-related apps.

Kathleen Kelly, executive director of the National Center on Caregiving, offers this presentation on family caregivers, the challenges of caregiving and take-away information on policy.

Jeffrey Jacobson, chief of the Division of Infectious Diseases and HIV Medicine at Drexel University College of Medicine, explains viral characteristics that make developing an HIV vaccine such a challenge.

Lorraine Iacovitti, associate director and laboratory head of Farber Institute for Neurosciences, gives an overview of the state of stem cell research.

Jennifer F. Culhane, associate professor in the department of pediatrics at The Children's Hospital of Philadelphia, offers this presentation on the impacts of infant and child health on adult health.

Gail Hansen, senior officer for Human Health and Industrial Farming, Pew Health Group, offers this presentation on the effects of industrial-scale animal antibiotics on human health.

Rosemary Gibson, author of The Treatment Trap and Wall of Silence, offers 10 points on end-of-life care and health reform.

Thomas Getzen, professor of risk, insurance and health management, Fox School of Business, Temple University and previous member of a 35-hospital system board offers brief information on health care finance.

Patricia Gerrity, professor, associate dean for community programs, Division of Graduate Nursing, Drexel University’s College of Nursing and Health Professions, offers this presentation explaining how the future of nursing will likely make significant changes in health care, and what journalists need to know to cover the story.

Steven Douglas, professor and associate chair, Department of Pediatrics, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, offers this overview of the current state of the search for a vaccine for HIV. 

Harold DeMonaco, director of the Innovation Support Center at Massachusetts General Hospital, offers a presentation on the 10 criteria used by HealthNewsReview.org to evaluate research and reporting on research.