NIHCM Newsletter / March 2024
How Housing Impacts Health
Overview: Garcia C, Doran K, Kushel M. Homelessness And Health: Factors, Evidence, Innovations That Work, And Policy Recommendations. Health Affairs. 2024.
Overdoses: Bradford D, Lozano-Rojas F. Higher Rates Of Homelessness Are Associated With Increases In Mortality From Accidental Drug And Alcohol Poisonings. Health Affairs. 2024.
Pandemic Evictions: Graetz N, Hepburn P, Gershenson C, et al. Examining Excess Mortality Associated With the COVID-19 Pandemic for Renters Threatened With Eviction. JAMA. 2024.
How Housing Impacts Health
Renters who faced eviction during the COVID-19 pandemic experienced excessively high mortality rates compared to other groups, according to a recent study. Additionally, mortality rates are increasing rapidly for people experiencing homelessness, particularly in terms of drug and alcohol-related deaths. Housing impacts health outcomes and can further exacerbate health disparities, particularly as it becomes more expensive amidst America’s housing shortage.
- Impact on Health: Health Affairs’ Housing and Health issue includes research on a range of issues, including homelessness, gentrification, and the impact of housing on cancer outcomes. The issue also includes strategies to support health through housing, such as through primary care and financial assistance interventions.
- Medicaid Efforts: New guidance expands the use of Medicaid funds to address social determinants of health, with at least 19 states utilizing Medicaid to support people experiencing homelessness and prevent eviction. The Departments of Health and Human Services (HHS) and Housing and Urban Development (HUD) announced the Housing and Services Partnership Accelerator will support eight states and Washington, D.C., in efforts towards stable housing.
Resources & Initiatives
- The National Governor’s Alliance convened governors to discuss housing affordability and availability in their states.
- The National Academy for State Health Policy released a report on how state Medicaid programs are leveraging managed care contracts for housing-related interventions.
- Blue Cross and Blue Shield of Illinois funds efforts to provide housing for people experiencing homelessness in the state.
- NIHCM has a range of resources on social determinants of health, including infographics and webinars on homelessness.
- Florida Blue Foundation is supporting programs to improve health equity for homeless individuals in downtown Orlando.
Long COVID & Chronic Fatigue
Despite federal investment, understanding of and treatment options for long COVID remain limited. However, researchers have recently gained a better understanding of myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS and its overlapping symptoms with long COVID.
- Chronic Fatigue: A study in Nature highlights the biological abnormalities that have helped researchers classify ME/CFS as a disorder spanning the brain, gut, immune and nervous systems. Researchers from the Centers for Disease Control and Prevention (CDC) report patients that had COVID are 4.3 times more likely to develop chronic fatigue compared to non-COVID-19 patients.
- Long COVID: New research reveals long COVID may lead to cognitive impairment, decreasing IQ by about 6 points, however these symptoms may not be permanent. Even patients with mild and resolved symptoms demonstrated a 3 point loss in IQ. Another study found that COVID-19 vaccines are effective in reducing the risks of long COVID.
Resources & Initiatives
- The CDC has developed a toolkit for discussing chronic fatigue syndrome with patients.
- States are monitoring long COVID surveillance data to identify geographic disparities to learn more about the condition.
- The Administration for Community Living has a list of resources for people with long COVID.
Chronic Diseases & Disparities
Chronic diseases remain of significant public health concern, particularly due to health disparities and the policies that perpetuate them. These disparities are further compounded by environmental factors. Centers for Disease Control and Prevention (CDC) research highlights links between discriminatory policies, inadequate environmental conditions, and rates of chronic disease.
- Environmental Exposures: A Harvard study reports chronic exposure to fine particulate matter (PM2.5) may increase hospitalization for seniors with certain cardiovascular conditions. Their findings suggest PM2.5 disproportionately affects people living in neighborhoods with lower high school graduation levels, limited access to health care, and socioeconomically deprived neighborhoods.
- Race & Health Disparities: Black women with high blood pressure before age 35 may have a 3.1 times higher risk of having a stroke. As diabetic amputations increase, medical experts express concern and push for earlier treatment for Black and Latino patients, who have a higher likelihood of diagnosis.
Resources & Initiatives
- The CDC shares resources on chronic diseases, including prevention and health equity.
- The University of Pennsylvania and Independence Blue Cross Blue Shield partner to monitor high blood pressure for maternity patients, which can develop into preeclampsia.
- Some medical experts are recommending testing blood pressure levels at home rather than in a clinic to obtain accurate readings.
- Blue Cross Blue Shield of Tennessee highlights care disparities and improvement areas in their new health equity report.
Prescription Drugs: Accessibility & Weight-Loss Drugs
The landscape of prescription drugs is continually evolving with continued shortages and trends in use, such those related to weight-loss drugs. The growing popularity of weight-loss drugs also sheds light on their extensive impact.
- Accessibility: Targeted cyber attacks are creating additional accessibility challenges for patients by disrupting prescription orders. Concurrently, patients with ADHD are expressing frustration as a drug shortage continues to increase the wait times for medication. The Federal Trade Commission is investigating generic drug shortages at hospitals.
- Expected Impact of Weight-Loss Drugs: A new Pew Research Center survey shows 53% of Americans think Ozempic, Wegovy, and similar drugs are good options to lose weight. Eating disorder experts remain cautious about the impact of these medications and their potential to worsen eating disorder symptoms.
- Teen Use of Weight-Loss Drugs: There was a notable uptick amongst U.S. teens in the use of Wegovy from 2022 to 2023. Teens are also taking risky non-prescription weight-loss drugs. A JAMA study reveals 1 in 10 teens globally have used ineffective and potentially harmful non-prescribed weight-loss products like diuretics, laxatives, and diet pills.
Resources & Initiatives
- Under a NIHCM grant, FREOPP authored a report comparing startups’ ability to lead pharmaceutical innovation and address drug prices.
- The University of California San Francisco offers tips for dealing with ADHD medication shortages.
- Some employers are considering covering the new blockbuster weight-loss drugs, while others are hesitant.
- The American Medical Association provides answers for common questions people may have about weight-loss drugs.
