More deaths from ozone predicted without action
As the world’s temperatures continue to rise with climate change and air pollution worsens, ozone-related deaths could increase significantly, a new study predicts.
Unless climate and air quality regulations substantially change, as many as 6,200 more people could die each year from ozone-related causes in 400 cities around the globe in coming decades, said the study, which was published Jan. 23 in One Earth.
The Yale University-led research team modeled a range of scenarios in which global climate policies and air quality regulations were strengthened. If both strong climate and air quality controls are put in place, deaths from ground-level ozone would increase by 0.7%, they found. But with both weak climate and air pollution controls, deaths would increase by 94%.
The only scenario in which deaths would drop would be in line with goals set nearly decade ago under the 2015 Paris climate agreement. Adopted by 196 parties at a United Nations climate conference, the Paris agreement calls for actions that will keep global temperature increases to less than 2 degrees Celsius above pre-industrial levels. As climate change has posed a growing threat to human health in recent years, global leaders have called to limit the rise by the end of this century to 1.5 degrees Celsius above pre-industrial levels.
About 6,600 ozone-related deaths already occur each year in the studied cities, which include highly populated regions of the U.S., Europe, Japan, Australia and Mexico that already experience elevated ozone levels. Ground-level ozone, which is the main component of smog, is created when emissions from cars, power plants, industries and other sources react with sunlight. Levels tend to be highest on hot, sunny days in urban areas, though winds can spread them to other regions.
Climate and air quality standards in most countries, including the U.S., currently fall short of what is needed to mitigate the threat of ground-level ozone, the new study said.
Minorities receive poorer dementia care
More than 5.8 million Americans have dementia, and numbers are expected to rise as the nation’s population ages. But how those people weather the condition may vary widely based on their race and ethnicity, as people of color are less likely to receive optimal care, a new study finds.
Published Jan. 24 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the research reviewed findings from more than 70 dementia studies conducted from 2000 to 2002. From how quickly and accurately patients are diagnosed to how they die, the researchers found widespread disparities in dementia care between people of color and white patients.
Higher rates of misdiagnosis and delayed diagnosis are more common among people of color, with one study finding that took it 11% longer for Black people and 40% longer for Hispanic people with dementia to be diagnosed than white people, the review found.
Once they have a dementia diagnosis, people of color are less likely than white people to be prescribed drugs that can help with the condition. If they do receive them, Black and Hispanic patients are more likely than white patients to discontinue their medications. Black dementia patients are also more likely to have increased hospital admission rates, longer hospital stays and higher medical costs.
As they live with their condition, people of color with dementia are less likely than white patients to reside in long-term care facilities with special memory care units. And as they approach the end of their lives, patients of color with dementia are less likely to have hospice care and more likely to receive aggressive life-sustaining treatments such as feeding tubes and mechanical ventilation.
The researchers called for better training on bias and culturally competent care for clinicians as well as working to empower people with dementia and their caregivers as they navigate the health care system.
New hazmat rule aimed at protecting train workers
A new federal rule is requiring better breathing protection for workers on trains that are transporting hazardous materials.
As of March 26, railroad companies that operate in the U.S. will be required to provide emergency escape breathing apparatuses for all workers who could be exposed to dangerous fumes when hazardous materials are released. Companies also will be required to train employees how to use the equipment and ensure it is maintained, according to the rule, which was published Jan. 26 in the Federal Register. The Federal Railroad Administration estimates that at least three sets of the new safety equipment will be required on each of the 24,000 locomotives impacted by the new rule.
The rule comes almost one year after a Norfolk Southern train derailed in East Palestine, Ohio, releasing thousands of pounds of vinyl chloride and other chemicals. While no one was killed in that incident, both workers and residents in Graniteville, South Carolina, and Macdona, Texas, died of chlorine gas inhalation following separate train crashes in those communities about a decade ago.
Chlorine, which is used for water purification to produce plastics, and anhydrous ammonia, which is used mainly as a fertilizer, make up the majority of poisonous-by-inhalation hazard materials shipped via railroad in the U.S., according to the U.S. Department of Homeland Security. While the chemicals comprise only about 1% of hazardous materials transported via trains each year, they account for more than 100,000 shipments.
Preventable hospitalizations higher for Black Medicaid users
Black people with Medicaid have higher rates of preventable hospitalizations than white people who are covered by the low-income insurance program, a new analysis shows.
Researchers with the Urban Institute examined 2019 Medicaid data, finding that Black enrollees were more likely than white users to be admitted for asthma, chronic obstructive pulmonary disease, diabetes and heart failure — the most common causes of preventable hospitalizations.
People with the conditions generally can avoid being hospitalized through high-quality outpatient care that includes medication and monitoring, the researchers said in a Jan. 23 brief. Nevertheless, millions of people with Medicaid are admitted to hospitals because of the conditions each year, raising stress for patients and costs for the federal program.
The gap in hospitalization rates was particularly wide for heart failure complications, with Black Medicaid enrollees who had been previously diagnosed with the condition hospitalized at nearly twice the rate of white enrollees.
People with Medicaid who have a disability also experienced preventable hospitalizations at unequal rates, the brief found. Compared to other people under age 65 with Medicaid, people with a disability that qualified them for the program were three times as likely to be hospitalized for asthma and COPD, almost twice as likely for heart failure and one-and-a-half times for diabetes.
Previous research has found that people with disabilities are more likely to experience low-quality care, report unfair treatment at a doctor’s office and to encounter discrimination because of their Medicaid coverage.
Preventable hospitalizations varied widely by state. While just 0.2% of Medicaid enrollees in Alabama were hospitalized for asthma and COPD, 4% were admitted in Wyoming. For diabetes, 1.5% of enrollees were hospitalized in New Jersey, compared to 9.2% in Alabama. Washington, D.C., had the highest rate of Medicaid users hospitalized for heart failure, at 13.3%, compared to 0.7% in Alabama.
About 53 million adults were covered by Medicaid in 2019, including 10 million people with disabilities.
The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.