US mental health lags behind other high-income nations
Americans have some of the highest rates of mental health conditions compared with other high-income countries, but cost and other barriers often prevent them from receiving care, new research finds.
The Commonwealth Fund surveyed more than 21,000 people in 10 countries last year, finding that Australia and the U.S. have the highest rate of adults with mental health conditions such as depression and anxiety. About 37% of Americans overall reported mental health issues, compared with 39% of white people, 35% of Hispanic people and 34% of Black people.
Though they lower incidence, Black Americans with mental health conditions were most likely to have multiple chronic diseases, take several prescription drugs on a regular basis and have worries about money, food or employment. Hispanic people in the U.S. were more likely than Black or white Americans to forego treatment for mental health conditions because of cost.
The survey also found the U.S. had the highest suicide rate among the 10 countries, a trend that has been increasing during the past 20 years. U.S. and Canadian adults with mental health conditions were most likely to report that they lacked a regular doctor or source of health care.
People in Germany and Switzerland reported the lowest rate of mental health conditions, at 20%, followed by France, the Netherlands and Sweden. Other surveyed countries that fared better than the U.S. were Canada, New Zealand and the United Kingdom. Only Australia had higher rates of mental health conditions than the U.S., at 41%.
More than 28% of Americans with a mental health condition are not able to receive the care they need, many because they could not afford it, previous research has found. Nearly 11% of people with a metal health condition are uninsured.
Thunderstorms drive up emergency respiratory care visits
Severe thunderstorms — which are becoming more frequent with climate change — are making it harder for some people to breathe, new science in Environmental Health Perspectives shows.
Researchers looked at data on weather and hospital visits that occurred over more than a decade in in New York state, where thunderstorms account for a third of all severe weather events.
The study found that emergency department visits for asthma, bronchitis and chronic obstructive pulmonary disease increased immediately following thunderstorms and remained elevated for more than a week.
The impact was worse during grass weed, ragweed and tree pollen seasons, when storm winds can break up contaminants and spread them through the air. Cases of post-thunderstorm breathing problems were highest in spring and summer, concurrent with allergy season.
When thunderstorms occurred in conjunction with power outages — which are also becoming more common with climate change — the impact was even greater, particularly for bronchitis. Children, seniors, Hispanic people and those living in rural areas were most likely to experience serious breathing problems following concurrent thunderstorms and power outages.
Awareness of the dangers of thunderstorms on breathing problems has been growing, particularly in the wake of a 2016 storm in Melbourne, Australia, that led to 8,500 pediatric asthma visits and 10 deaths. Intense storms are becoming more frequent in the U.S., with damaging thunderstorms in the nation’s central region increasing fivefold in the past 40 years.
People of color disproportionately dropped from Medicaid for procedural issues
Hispanic and Black Americans were twice as likely than white people to lose Medicaid coverage because of procedural issues following the end of automatic reenrollment last year, a new study says.
After a federal policy that kept Medicaid users from losing health coverage during the COVID-19 pandemic expired in April 2023, more than 10 million people lost coverage. About three-quarters of those people were disenrolled because of process reasons, such as barriers to filling out paperwork, a lack of renewal notices or problems with other required steps.
The new study, published June 3 in JAMA Internal Medicine, found that about 34% of people who were disenrolled were Hispanic and 22% were Black. In comparison, about 23% of Medicaid enrollees were Hispanic and 16% were Black.
To avoid unintended disenrollment, researchers called for policymakers to auto-fill renewal forms, allow more time for forms to be returned and expand renewal assistance for at-risk Medicaid participants.
Automatic reenrollment in Medicaid, which began in March 2020, led to a record 94 million participants in the low-income insurance program and a drop in U.S. uninsurance rates. As of February 2024, about 76 million people were enrolled in Medicaid, according to the U.S. Centers for Medicare and Medicaid Services.
Health department hiring process needs revamp, experts say
Outdated application processes, lengthy hiring procedures and burdensome service exams are hindering new employment at U.S. health departments, a new analysis says.
The nation’s more than 3,000 state, county and local health departments have faced workforce challenges for decades, notes the article in the June issue of Health Affairs. To fill a shortage of an estimated 80,000 workers, the recruitment, hiring and incentivization processes for public health employees must change, according to authors from the Columbia University Mailman School of Public Health and Indiana University.
For example, while the hiring process in the public sector takes 12 to 49 days, government agencies spend an average of 204 days on hiring. Candidates may be required to take written or oral civil service exams, but the tests are not offered frequently enough. Salary disparities between the public and private sector are as high as 45% for nurses, managers and epidemiologists.
Coupled with poor opportunities for promotion, high student debt, increased levels of burnout and budget constraints, the hiring issues are keeping many public health graduates from seeking employment in the public sector, the article authors said.
To boost hiring at health departments, they called for public health workforce loan repayment, market-based salary adjustments, upgraded recruitment technology and other reforms.
Other public health news of note this week includes:
• Occupational exposure to airborne particles — such as wood dust, fibers and inorganic dust and fumes — increases risks for chronic kidney disease, a study in Occupational and Environmental Medicine finds.
• Nearly a third of U.S. adults know someone who has died of a drug overdose, according to new research in JAMA Health Forum.
• A New Jersey law that ended cash bail reduced the rates of people who were jailed pre-trial without increasing gun violence, says a study in JAMA Network Open.
• Chemical residue from car tires can be detected in leafy vegetables sold in supermarkets, researchers report in a new study in Frontiers in Environmental Science.
• A proposed rule from the U.S. Environmental Protection Agency would protect workers and consumers from exposure to n-methylpyrrolidone, a solvent linked to miscarriages and liver, kidney and nervous system damage.
• The U.S. Department of Health and Human Services has funded a new program to address high maternal death rates in the nation’s Delta region — located within Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri and Tennessee.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
