Archive for the ‘health and health care’ Category

Association of Improved Air Quality with Lung Development in Children

April 20, 2015 Comments off

Association of Improved Air Quality with Lung Development in Children
Source: New England Journal of Medicine

Air-pollution levels have been trending downward progressively over the past several decades in southern California, as a result of the implementation of air quality–control policies. We assessed whether long-term reductions in pollution were associated with improvements in respiratory health among children.

As part of the Children’s Health Study, we measured lung function annually in 2120 children from three separate cohorts corresponding to three separate calendar periods: 1994–1998, 1997–2001, and 2007–2011. Mean ages of the children within each cohort were 11 years at the beginning of the period and 15 years at the end. Linear-regression models were used to examine the relationship between declining pollution levels over time and lung-function development from 11 to 15 years of age, measured as the increases in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) during that period (referred to as 4-year growth in FEV1 and FVC).

Over the 13 years spanned by the three cohorts, improvements in 4-year growth of both FEV1 and FVC were associated with declining levels of nitrogen dioxide (P<0.001 for FEV1 and FVC) and of particulate matter with an aerodynamic diameter of less than 2.5 μm (P= 0.008 for FEV1 and P<0.001 for FVC) and less than 10 μm (P<0.001 for FEV1 and FVC). These associations persisted after adjustment for several potential confounders. Significant improvements in lung-function development were observed in both boys and girls and in children with asthma and children without asthma. The proportions of children with clinically low FEV1 (defined as <80% of the predicted value) at 15 years of age declined significantly, from 7.9% to 6.3% to 3.6% across the three periods, as the air quality improved (P=0.001).

We found that long-term improvements in air quality were associated with statistically and clinically significant positive effects on lung-function growth in children. (Funded by the Health Effects Institute and others.)

Measuring the Risks and Causes of Premature Death: Summary of a Workshop (2015)

April 20, 2015 Comments off

Measuring the Risks and Causes of Premature Death: Summary of a Workshop (2015)
Source: Institute of Medicine

Measuring the Risks and Causes of Premature Death is the summary of two workshops conducted by The Committee on Population of the National Research Council at the National Academies to address the data sources, science and future research needs to understand the causes of premature mortality in the United States. The workshops reviewed previous work in the field in light of new data generated as part of the work of the NRC Panel on Understanding Divergent Trends in Longevity in High-Income Countries (NRC, 2011) and the NRC/IOM Panel on Understanding Cross-National Differences Among High-Income Countries (NRC/IOM, 2013). The workshop presentations considered the state of the science of measuring the determinants of the causes of premature death, assessed the availability and quality of data sources, and charted future courses of action to improve the understanding of the causes of premature death. Presenters shared their approaches to and results of measuring premature mortality and specific risk factors, with a particular focus on those factors most amenable to improvement through public health policy. This report summarizes the presentations and discussion of both workshops.

New Report: Disparities in Child and Adolescent Mental Health and Mental Health Services in the U.S.

April 20, 2015 Comments off

New Report: Disparities in Child and Adolescent Mental Health and Mental Health Services in the U.S.
Source: William T. Grant Foundation

Mental health is recognized as a central determinant of individual well-being, family relationships, and engagement in society, yet there are considerable variations in mental health and mental health care according to race and ethnicity among youth in the U.S.

In their new report, Margarita Alegría and colleagues investigate disparities in mental health and mental health services for minority youth. Taking a developmental perspective, the authors explore four areas that may give rise to inequalities in mental health outcomes, highlight specific protective factors and barriers to care, and, finally, outline an agenda for future research.

The authors write, “Over the past decade, the study of inequality in health and mental health has grown rapidly, with researchers seeking to quantify the extent of the problem, identify causal mechanisms, and develop interventions to eliminate specific disparities. Even so, inequity persists, and in most areas of health care progress has been limited and incremental in nature. There is good reason to believe that a renewed focus on prevention of youth mental health problems among minorities could not only yield more rapid results, but could also drastically reduce overall inequality in the long-term.”

EU — Radio Spectrum: A Key Resource For The Digital Single Market

April 20, 2015 Comments off

Radio Spectrum: A Key Resource For The Digital Single Market
Source: European Parliamentary Research Service

Radio spectrum refers to a specific range of frequencies of electromagnetic energy that is used to communicate information. Applications important for society such as radio and television broadcasting, civil aviation, satellites, defence and emergency services depend on specific allocations of radio frequency. Recently the demand for spectrum has increased dramatically, driven by growing quantities of data transmitted over the internet and rapidly increasing numbers of wireless devices, including smartphones and tablets, Wi-Fi networks and everyday objects connected to the internet.

Radio spectrum is a finite natural resource that needs to be managed to realise the maximum economic and social benefits. Countries have traditionally regulated radio spectrum within their territories. However despite the increasing involvement of the European Union (EU) in radio spectrum policy over the past 10 to 15 years, many observers feel that the management of radio spectrum in the EU is fragmented in ways which makes the internal market inefficient, restrains economic development, and hinders the achievement of certain goals of the Digital Agenda for Europe.

In 2013, the European Commission proposed legislation on electronic communications that among other measures, provided for greater coordination in spectrum management in the EU, but this has stalled in the face of opposition within the Council. In setting out his political priorities, Commission President Jean-Claude Juncker has indicated that ambitious telecommunication reforms, to break down national silos in the management of radio spectrum, are an important step in the creation of a Digital Single Market. The Commission plans to propose a Digital Single Market package in May 2015, which may again address this issue.

Employee Assistance Programs in Private Health Plans: What Do They Offer?

April 19, 2015 Comments off

Employee Assistance Programs in Private Health Plans: What Do They Offer?
Source: Psychiatric Services

Employee assistance programs (EAPs) address issues affecting work performance and well-being. Studies show positive EAP outcomes, although methodological limitations necessitate additional research (1). Health plans are among the vendors selling EAPs to employers, but data on these EAPs are sparse. Data are from a 2010 survey of private health plans in 60 markets. A total of 389 market area–specific plans (89% response) reported on behavioral health services in 939 insurance products. The analysis included 200 products (from 72 plans) reporting EAPs.

Most products (57%) required that purchasers pay additional fees rather than including the EAP without charge in standard packages (Figure 1). Only 12% of products contracted with an EAP vendor outside the plan. Although 36% recommended that enrollees use the EAP before accessing behavioral health benefits, only 4% required this. Forty-five percent of products with EAPs covered clinical assessment. Nearly all covered in-person and telephone counseling. All products reporting per-year limits reported eight-session limits. Of products with per-problem limits, 78% had a five-session limit, and the remainder had a six-session limit.

Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011

April 18, 2015 Comments off

Progress With Electronic Health Record Adoption Among Emergency and Outpatient Departments: United States, 2006–2011
Source: National Center for Health Statistics

Key findings

Data from the 2006–2011 National Hospital Ambulatory Medical Care Survey

  • In 2011, 84% of hospital emergency departments (EDs) used an electronic health record (EHR) system.
  • Adoption of a basic EHR system with a specific set of functionalities by EDs increased from 19% in 2007 to 54% in 2011.
  • In 2011, 73% of hospital outpatient departments (OPDs) used an EHR system, up from 29% in 2006.
  • Adoption of a basic EHR system with a specific set of functionalities by OPDs increased from 9% in 2007 to 57% in 2011.
  • From 2007 through 2011, adoption of Stage 1 Meaningful Use objectives by EDs and OPDs increased.In 2011, 14% of EDs and 16% of OPDs had EHR technology able to support nine Stage 1 Meaningful Use objectives.

State Discretion Over Medicaid Coverage for Mental Health and Addiction Services

April 17, 2015 Comments off

State Discretion Over Medicaid Coverage for Mental Health and Addiction Services
Source: Psychiatric Services

Approximately one-third of adults who enroll in Medicaid because of a disability have a serious mental illness. Arguably, this population stands to benefit from insurance coverage that complies with the Mental Health Parity and Addiction Equity Act (MHPAEA). The MHPAEA and the Affordable Care Act (ACA) do not guarantee such coverage for this beneficiary group; however, they provide a variety of mechanisms by which states may provide parity-compliant coverage for mental health and substance use disorder treatment. This column explains key interactions between the MHPAEA, the ACA, and the Medicaid program that permit states to determine whether and how to provide parity-consistent coverage to beneficiaries with disabilities.


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