A Health Podyssey

Racism is a social phenomenon. Even though the medical research community has historically relied heavily on racism that treated Black bodies as property that could be experimented upon, clinical medicine has actually been pretty slow to accept racism as a legitimate topic of examination. Health services, with its ties to the social sciences, has been somewhat more accepting of the notion that rac...

There are more than 22 million people of Asian descent living in the United States. In the aggregate, Asian Americans have mostly better economic and health outcomes than other groups, including White Americans. Yet within the broad category of Asian Americans, there are dozens of subgroups often with quite different health outcomes and lived experiences. This within-group heterogeneity is often l...

In a bonus episode of A Health Podyssey, Harriet Washington discusses the history of racism in medicine and research with Vabren Watts, Health Affairs’ director of health equity, and Aletha Maybank, chief health equity officer and senior vice president of the American Medical Association. Washington is the author of several books on medical ethics, including Medical Apartheid: The Dark History of...

Racism manifests in different ways for different people in different environments. For many Black women, experiences with sexual and reproductive health reveal cross-cutting themes of racism, sexism, and classism, all expressed in the context of strong social norms and prejudices regarding Black women and reproduction.  Attention to poor health outcomes for Black women has grown recently in part d...

Listen to this bonus episode from Health Affairs' Narrative Matters podcast, which highlights personal stories from the front lines of care.  In this episode, host Jessica Bylander interviews Wanda Irving, chair of the board of Dr. Shalon’s Maternal Action Project, before Irving reads an essay from the February 2022 issue of Health Affairs, dedicated to the theme of racism and health. This essay r...

"Members of racial and ethnic minority groups have long suffered from health inequities in the United States. These inequities result, in large part, from racial and ethnic minority populations' inequitable access to health care, which persists because of structural racism in health care policy. Racism includes a complex array of social structures, interpersonal interactions, and beliefs by which...

The February 2022 issue of Health Affairs focuses entirely on racism and health .  It includes papers that trace the long history of racism to present day policies and practices that are the reasons for large and sustained health disparities. Racism and bias come in many forms and given the social stigma associated with them, they can be difficult to study. When a study comes along that provides n...

The COVID-19 pandemic has made the relationship among research, policy, and public health strikingly clear. People who may have given little thought to health policy and research began following the latest study results to guide their own behavior and push governments and businesses to make decisions that reflect a combination of science and their own values and risk tolerance. Health journals lik...

Precision medicine is built on a platform of big data, or large data bases that permit analysis of correlations among environmental and personal factors, treatments, and health outcomes. Data bases that once included only paper records now include tissue samples, air and water samples, and more. There's vast potential for significant advances in health care from precision medicine. But existing la...

Advance care planning is a term used to describe when a person prepares for future management of serious or terminal illness, including developing an advance care directive or what is sometimes is called a living will. Beginning in January of 2016, Medicare made it possible for certain clinicians to bill for their work for patients to develop advance care plans. Despite the new billing option, upt...

"Let us hope that this is a one in a hundred years pandemic. We don't want to build our health care system to operate at all times as if tomorrow will be COVID." - Sherry Glied On December 15, Health Affairs published ahead-of-print, “ National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic , ” the annual national health expenditures article pr...

When you think of the health care workforce, nurses and physicians are probably the first professions which come to mind. But there are actually more personal care aides in the US than physicians. Together with home health aides and nursing assistants, personal care aides comprise one-fifth of the US health care workforce. These workers provide essential supports to people who face limitations in...

The availability of pharmacist-administered vaccination has grown in recent decades. Proximity to a pharmacy has found to be predictive of vaccine use. In Florida, Publix grocery stores were the first retail pharmacies to provide COVID-19 vaccinations to eligible members of the public. For more than a month after the initial rollout, Publix remained the sole retail pharmacy authorized to administe...

This episode originally aired on November 10, 2020. The U.S. health policy community recognizes that fee-for-service models incentivize physicians and health systems to perform more tasks than may be needed. And, these models can contribute to industry fragmentation as organizations chase revenue. But is fee-for-service really the smoking gun when it comes to the high levels of U.S. health care sp...

Medical advances have enabled many people to be cared for appropriately in an outpatient setting rather than being admitted to a hospital. Yet, since Medicare payment rates are generally lower for outpatient visits than inpatient hospital stays, hospitals have a financial incentive to admit patients. Observing what were believed to be inappropriate admissions, in 2013 Medicare adopted the "two-mid...

When we launched A Health Podyssey in 2020, our goal was to take listeners beyond the research published in Health Affairs . For A Health Podyssey 's one-year anniversary, we wanted to take listeners on an Excursion and speak with someone who epitomizes so much of what brings professionals into the fields of health policy and health services.     Ashish Jha from the Brown University School of Publ...

With about 700 pregnancy-related deaths every year, the United States has the worst maternal mortality rates among developed countries. One response to this crisis has been the creation of state and local maternal mortality review committees (MMRCs), which are multidisciplinary committees that examine the context in which maternal deaths occur. The October 2021 issue of Health Affairs is focused o...

Postpartum depression is a common condition among people who give birth. Within four weeks of childbirth, 13% of women experience postpartum depression with as many as 19% of women affected three months postpartum. Mothers who experienced postpartum depression are more likely to experience impaired mother-infant bonding, which has been linked to increased risk for infant maltreatment and socio-emo...

Systems of oppression like racism, sexism, and classism lead to poor health outcomes. These factors are a source of poor mental health and have particular implications for pregnant and birthing people. Black women who face multiple axes of oppression experience higher rates of maternal mental health conditions than the population as a whole. Yet maternal mental health issues among black women are...

Mental health conditions, such as mood and anxiety disorders are diagnosed in one of every five pregnant or postpartum people. Despite this high burden of morbidity and mortality and economic costs, perinatal mental illness is poorly addressed by the current US healthcare system. Jennifer Moore, founding executive director of the Institute for Medicaid Innovation , joins A Health Podyssey to discu...

Most office workers think of paid sick leave as a benefit for them and their family members, but there are societal benefits to paid sick leave as well. Since 1993, the United States has guaranteed access to unpaid sick leave through the Family and Medical Leave Act (FMLA) but that guarantee leaves out a large number of workers. A growing number of US states and localities have sought to fill-in s...

Roughly 6 million adults ages 65 and older in the United States have dementia. That number is projected to more than double by 2050. Family caregivers play an essential role in caring for people with dementia, including help with dressing to eating assistance and more. In 2020, it's estimated that more than 11 million family members and other unpaid caregivers provided care to people with dementia...

Recent reports suggest about six-tenths of a percent of the United States population, or 1.4 million people, identify as transgender. Transgender individuals are people whose personal and gender identity are different from the gender they were thought to be at birth. Good information about the health status of this group has been hard to come by although research is growing. Some data come from Me...

The US government reports that the total spending on hospital care in 2019 was almost $1.2 trillion. High and highly variable hospital prices have been in the news recently in part due to new information made available under the price transparency rules implemented by the Trump administration. Competitive markets are supposed to constrain prices, but in much of the US, there's little competition a...

The quality-adjusted life-year (QALY) combines the expected effects on longevity and the expected effects on quality-of-life into a single standard measure. QALYs are often used as part of cost effectiveness analysis, particularly when analyzing the effectiveness of drugs. QALY as a measurement has received a lot of criticism. It's been criticized in concept or in the specifics of how it's defined...