Health Affairs’ December issue includes a variety of articles investigating mental health and substance misuse, including:
- A Veterans Affairs study showing that programs that provided legal services for civil matters such as housing, family, and consumer issues in conjunction with medical services are linked to improvements in mental health and wellbeing.
- A study revealing that between 1993-2014, for opioid-related hospitalizations, the portion of those admitted for opioid dependence has decreased, while the portion of those admitted for the more life-threatening condition of opioid poisoning has increased. Those admitted for poisoning were most likely to be White men between the ages of 50-64 living in lower income areas.
- A study that shows that less than 5% of people referred by the criminal justice system to treatment for substance misuse receive the most effective treatments, vs. more than 40% of people referred by other sources.
Vox interviewed Deferred Action for Childhood Arrivals, or DACA, recipients on what happens when “a family has equal rights, and then loses them”: “In the meantime, thousands are living with a wrenching uncertainty. Uncertainty over whether their renewal applications will be accepted; uncertainty over whether they can sign leases or enroll for another school year; uncertainty in knowing that their days working legally and living securely in the US are numbered; uncertainty that their US-born children could find out how tenuous their parents’ presence is.”
People working in agriculture die by suicide more than in any other occupation, The Guardian reports. Crop-ravaging disasters, financial stress, isolation, lack of access to mental health supports, and a culture that discourages farmers from voicing distress and seeking help all contribute to the problem, says Mike Rossman, an Iowa farmer and therapist. The same passions that draw people to farming—a desire to provide sustenance and be linked to the land—make them especially vulnerable to threats to their livelihoods.
US Surgeon General Jerome Adams speaks with STAT about his younger brother Phillip’s struggles with substance misuse, which the family believes are the result of untreated mental health issues. Phillip, who is currently serving a sentence in state prison for burglary, has been in and out of jails and prison. “My substance abuse has been the key factor for my history of incarcerations and I’m very tired of the road I have been on with my drug use,” Phillip wrote in a letter to STAT. His brother Jerome said, “One of the most frustrating things is being surgeon general of the United States and feeling like you can’t help your own brother.” The experience has given him a heightened awareness of some of the challenges people face when attempting to address substance misuse, particularly during and after incarceration. He suggests that addressing these challenges will require bringing together law enforcement, public health and others to develop a more comprehensive response that recognizes substance misuse as a chronic disease.
New research published in Science Advances sheds light on the health effects of fracking, finding that mothers who live within two miles of fracking sites are more likely to deliver low-birth weight babies, which can lead to reduced health throughout the lifespan: “The researchers don’t yet know why this link between fracking and low birth weight exists, though they suggest that air pollution could be a possible contributor. The process of fracking may release chemicals into the air, for one, but many wells also run multiple diesel engines at once, and they can be a hub of local activity, with trucks regularly commuting to the sites.”
On Wednesday night, the House Appropriations Committee released a proposed continuing resolution that would fund the government through January 19, 2018, including reauthorizing the Children's Health Insurance Program for five years. This would be paid for, in part, by cutting $6.35 billion from the Prevention and Public Health Fund.
Wisconsin governor Scott Walker is renewing his push to drug-test food assistance recipients. The Obama administration previously blocked Walker’s drug-testing proposal, but he believes the Trump administration will be more supportive. Drug-testing policies have proven costly and ineffective in other states, misunderstands substance misuse struggles that a few recipients may have, and increases the stigma surrounding public assistance. When Kansas introduced a drug-testing regime, applications for public assistance dropped. “These policies are based on an idea that drug use is prevalent among welfare recipients, and that harmful stereotype is simply not true,” [Scott] Anglemyer [of Kansas Association of Community Action Programs] said, “It drives people, whether or not they are using drugs, away from a safety net and into deeper poverty.”
Vox reports on the failures of the legal system in addressing sexual harassment: “One reason women are accusing men of sexual harassment in the press, rather than the courts: The legal system that’s supposed to investigate, address, and prevent sexual harassment has failed them for decades. That’s the conclusion from a review of more than 1,000 job discrimination cases by two law professors: Sandra Sperino at the University of Cincinnati, and Suja Thomas at the University of Illinois. Sperino and Thomas set out to understand how judges view discrimination cases. Their results are summarized in their new book, Unequal: How American Courts Undermine Discrimination Law. Sexual harassment is illegal in all workplaces and in every state. It's a form of gender discrimination prohibited by the Civil Rights Act of 1964, and it's illegal whether the alleged perpetrator is a person's co-worker or supervisor. But Sperino and Thomas argue that federal court judges frequently dismiss sexual harassment cases that likely meet the requirements under the law. In the past 40 years, they say federal judges across the country (who are mostly men) have developed an extremely narrow interpretation of what sexual harassment is under the law, and which behaviors create a hostile work environment. Repeated groping, sexual propositions, and sexualized comments at work usually don't meet that high standard.”
STAT’s Lev Facher looks at Kellyanne Conway’s role in advancing the Trump Administration’s response to the opioid epidemic. With leadership vacancies at the Drug Enforcement Administration and Department of Health and Human Services, the presidential counselor is not only leading communication and coordination among the federal departments involved in the effort and urging Congress to supply funding, but also helping to shape policy. While she lacks expertise and experience in addressing substance misuse, she has the trust of the president. Experts say Conway has noted the importance of understanding substance misuse as a community issue, and as an illness rather than a moral failing… for the most part.
Children born with microcephaly after being exposed to the Zika virus in the womb continue to struggle – with children who are most severely affected even losing ground compared to developmental delays present at birth, according to a new CDC study. “At about 22 months old, these children had the cognitive and physical development of babies younger than 6 months. They could not sit up or chew, and they had virtually no language… In Brazil, the future of Zika babies is complicated by poverty and strained resources. “Most of these babies are from low socioeconomic status and rely on the public health system to provide care,” Dr. Marques said. “It’s very difficult to manage those children because they need multiple types of specialists.”’