Disparities in Youth Mortality

Health Disparities

A new study in JAMA reported that as pediatric mortality increases, American Indian/Alaska Native and Black youth die at increasingly higher rates than White youth. The difference was more drastic for injuries, with Black youth dying by homicide at more than 10 times the rate of White youth. Additionally, an analysis by the U.S. Department of Agriculture’s Economic Research Service team demonstrated a widening mortality gap between rural and urban Americans, which grew from 6% to 43% from 1999 to 2019 for the working-age population.

• Racial & Ethnic Disparities: A recent report from the Commonwealth Fund identifies substantial health and health care disparities between White and Black, Hispanic, and American Indian/Alaska Native communities in most states.
• Rural Health: Data from the Centers for Disease Control and Prevention (CDC) found that preventable and early deaths are more common among people living in rural communities. Experts suggest the increased mortality rates in rural areas may be linked to care that is unaffordable, low-quality, and inaccessible.
• SDOH: A report from the CDC found that mammography screening decreased among women ages 50 to 74 who experienced adverse social determinants of health (SDOH) and had health-related social needs. SDOH also contribute to racial health disparities, with Native Americans experiencing shorter life spans, which experts say can be attributed to social and economic factors.

Resources & Initiatives

• See NIHCM’s latest resources on health equity, rural health, and SDOH, including an infographic on addressing barriers to care in rural areas.
• The CDC has public health resources on SDOH and health equity.
• The Rural Health Information Hub provides resources to support population health in rural areas.
• Blue Cross Blue Shield of Michigan is making funds available to improve health equity by supporting comprehensive clinical services.
• The U.S. Preventive Services Task Force updated their mammography recommendations to start screening women at age 40.

Long-Term Care & Caregiving

More Americans are in need of long-term care, but the cost can be prohibitive. Nursing homes may charge $100,000 a year or more and paid caregivers may cost more than $5,000 a month, as home health care prices increase.

• Caregiving: People providing care for aging parents are subject to financial strain, as the costs of caregiving may not be covered by their parent’s personal funds. State programs may also fall short. Many in-home caregivers paid through California’s state program, for example, still experience financial hardship.
• Federal Efforts: The White House recently announced its commitment to support long-term care by addressing inadequate nursing home care and improving home care. A new rule from the Centers for Medicare and Medicaid Services will increase caregiver compensation.

Resources & Initiatives

• Harvard Public Health Magazine published an op-ed on the PEARLS program, a tool for assessing caregiver burnout.
• Forbes Health released a compilation of facts and statistics on aging in place.
• Blue Cross Blue Shield of North Carolina partnered with Appalachian State University to expand outreach programs for aging adults.
• Sarah Walsh, a NIHCM research grantee, published a new study in Health Affairs on the likelihood of aging in place or being hospitalized among Meals on Wheels clients.

Health Care Costs & Quality

A recent study from Blue Cross Blue Shield of Massachusetts found that 40% of the people surveyed put off seeing a doctor or going to a hospital due to the cost of care. There is also increasing attention to how health care provider consolidation impacts costs.

• Chronic Illness Management: Medicare offers a program to coordinate care for people with a chronic illness while boosting physician pay. However, only 4% of potentially eligible beneficiaries are enrolled. Barriers to doctors joining the program include lack of capacity, as most doctors’ offices are not set up for monitoring patients at home.
• Provider Consolidation: Recent research published in the American Economic Review reveals that from 2002 to 2020, 20% of hospital mergers could have been flagged by the Federal Trade Commission (FTC) for their potential to diminish competition and inflate prices. Mergers that were overlooked by the FTC between 2010 and 2015 resulted in an overall price increase of 5% or more.

Resources & Initiatives

• The CDC has resources on the health and economic impact of chronic diseases.
• NIHCM offers a wide range of resources on costs and quality and provider consolidation. View our affordability webinar series to explore the topic.
• Elevance Health released a progress report on their 2023 metrics, detailing their improvement in health care through value-based payment.
• Independence Blue Cross recognizes local hospitals working towards delivering higher-quality maternity care at a lower cost.

In Other Public Health News…

Food-Borne Infections

While the scope of the presence of the bird flu virus in cattle remains unclear, recent federal testing did not detect any signs of the virus in retail dairy products. Researchers suggest there is minimal risk to consumers drinking pasteurized milk, but a higher risk for people consuming raw milk.

Measles

As of May 2nd, the nation's total for measles cases reached 131, with 44% of cases occurring in children younger than 5 years old. The West Virginia Department of Health has detected the state’s first case of measles since 2009. The spread of measles is tied to an increase in viral activity globally and low vaccination rates.

COVID

More than 7 million people have lost their lives to COVID as of 2024. Yet, global collaboration to proactively address the next public health crisis has stalled. Expiring COVID mandates have resulted in hospitals halting their collection of data on respiratory diseases. Research continues to emerge on the impact of COVID on public health, highlighting disparities in vulnerable populations. A new analysis from the Marshall Project sheds light on the high COVID death rate among the incarcerated from 2019 to 2020, which was 3x higher than the general population.

Weight Loss Drugs

Wegovy, the anti-obesity drug, is now approved to prevent cardiovascular complications in people who are overweight or obese. This new approval means Medicare can now cover the drug when it is prescribed to reduce heart disease risks and other insurers are also beginning to provide coverage. However, challenges remain as the cost of these drugs begins to climb. Health experts are also raising concerns that the lack of equal access to weight-loss drugs may exacerbate obesity-related health risks in certain populations.