Old equipment, aging facilities threaten care at IHS 

Outdated medical equipment, aging infrastructure and insufficient space at Indian Health Service facilities are hindering care and threatening patient health, a federal review finds. 

Part of the U.S. Department of Health and Human Services, IHS provides health care to more than 2.8 million American Indian and Alaska Native people in the U.S. Care is provided through federal or tribal-operated facilities, which include hospitals, health centers, dental clinics and behavioral health offices. More than 4,500 health clinicians work in the system.

Inspectors with the Government Accountability Office examined more than 200 buildings at federally operated IHS facilities, finding that 61% were in poor or fair condition, with missing floor tiles, sewage leaks, heating problems and uneven walkways.

Incomplete data prevented a full assessment of medical equipment, but inspectors found broken sterilization equipment, outdated mammography machines and optometry devices too old to be repaired. Medical equipment at the facilities is generally used twice as long as it is recommended to be, an IHS official testified in 2021.

The facility problems can lead to delays in care for patients as well as challenges for health workers, the report said. Inspectors called for IHS to improve recordkeeping on its medical equipment so repairs and replacements can be budgeted for and addressed more quickly.

Racism linked to stroke in Black women

Racism against Black women may be raising their risk of stroke, a new study says.

Researchers examined data on nearly 50,000 U.S. Black women who have been followed for more than 20 years as part of a long-term health study. Women who said they had personally experienced racism in employment, housing and police interactions had a 38% higher risk of stroke than those without those experiences, found the study, which was published Nov. 10 in JAMA Network Open. 

Employment was the most common setting where women reported experiencing racism, at 59%; followed by housing, at 35%; and police interactions, at 24%.

Black women who said they had personally experienced racism were more likely to live neighborhoods with higher socioeconomic status, less likely to live in the Southern U.S. and more likely to have a higher level of education, the researchers said.

About 795,000 people in the U.S. suffer a stroke each year. Black people have a higher rate of strokes than other Americans and are more likely to die from them at a younger age. Black women are twice as likely to have a stroke than white women. 

Prior research has linked racism to high blood pressure, inflammation and unhealthy behavior.

Workplace injuries, illness increase in U.S.

Serious injuries and illnesses in U.S. workplaces jumped 7.5% in 2022, according to new federal data.

The U.S. Bureau of Labor Statistics reported Nov. 8 that more than 2.8 million cases of injury and illness occurred at private industry workplaces in 2022. Injuries — which rose 4.5% from 2021 to 2022 — accounted for 82% of the cases. 

Industries with the highest combined injury and illness rates included veterinary services, hog farming, poultry and egg production, department stores, air transportation and animal slaughter.

More than 1 million employees had to miss work, be restricted from their duties or transferred to another job in 2022 because of overexertion, such as lifting or carrying, or bodily reaction, the bureau said.

While occupational-related illnesses trailed injuries in 2022, they experienced the biggest jump: Cases of illness rose 26% in a single year, with respiratory illness accounting for a third of them. The data was collected during the third year of the COVID-19 pandemic, when fewer employees were working from home and safety measures such as masking and distancing had waned.

The new findings, which are based on the BLS Survey of Occupational Injuries and Illnesses, only cover non-fatal injuries and illness. A December report from the bureau is slated to share data on workplace-related fatalities.

World temperatures, health-related deaths to rise in wake of climate inaction

Heat-related deaths around the world could rise 370% by mid-century if leaders around the world do not take urgent action to address climate change, a new report predicts. 

The 8th annual report of The Lancet Countdown on Health and Climate Change, released Nov. 14, documents the growing dangers to human health caused by climate change, including water shortages, infectious disease, hunger and displacement.

While climate experts have called for actions that could limit global temperature increases to 1.5°C above pre-industrial levels, or to 2°C at most, the world is currently on track for 2.7°C by 2100, according to The Lancet Commission report. 

Even if world leaders are able to meet the 2°C goal, it would mean a 4.7-fold increase in heat-related deaths by 2050, the report said. As many as 525 million people would experience food insecurity, and the potential for transmission of dengue, a viral infection spread by mosquitoes, would increase up to 37%.

Threats to human health are already occurring, with extreme weather events, droughts and food insecurity becoming more common. Heat-related deaths of people older than 65 years have increased by 85%, for example. According to a recent assessment from Climate Central, the Earth experienced its warmest 12-month stretch ever recorded in October.

Without human-caused climate change, people would be expected to experience about 60 days a year with health-threatening temperatures, the report said. Between 2018 and 2022, the average number of such days was 86. 

Commission members took companies and banks to task for their roles, citing continued investments in the oil and gas industry and “collective inertia.” Global fossil fuel investment increased by 10% in 2022, totaling more than $1 trillion. Governments are also lagging, with only four countries developing or updating health national adaption plans from 2020 to 2022.

The commission called for a swifter transition to clean energy, better energy efficiency in low-income countries, an increase in electric transportation and a shift to low-carbon diets, among other steps.

On the positive side, the report noted that deaths from fossil-fuel related air pollution have fallen more than 15% since 2005, with most of the reduction coming from reduced pollution from coal. Global investment in clean energy is growing, and renewable energy made up 90% of growth in global electricity capacity in 2022.

The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.