Loss of Medicaid coverage hurts access to care
Scores of people who lost Medicaid coverage during the program’s recent “unwinding” ended up uninsured and missing out on needed health care, a new study of four states finds.
Researchers surveyed Medicaid users in Arkansas, Kentucky, Louisiana and Texas, finding 12.5% of them had lost coverage as of late 2023. Of those, nearly half still lacked health insurance, according to the study, which was published June 29 in JAMA Health Forum.
Disenrollment rates varied by state. Among people who been enrolled in Medicaid at some point since March 2020, 16% of program users in Arkansas, 15% in Texas, 8% in Louisiana and 7% in Kentucky lost coverage. People who were disenrolled were more likely to live in rural areas, be younger, female and employed.
The disenrollments came in the four states and across the U.S. as a federal policy mandating automatic reenrollment in Medicaid came to an end beginning in April 2023. The policy was put into place near the start of the COVID-19 pandemic to ensure that people had access to care but expired as the outbreak ebbed. More than 23 million people lost Medicaid coverage during the unwinding.
People who were disenrolled from the program experienced significantly worse access to care than those who did not lose coverage, the new study found. Disenrolled low-income adults were more likely to skip doses of their medications or miss their annual checkups, for example.
Toxic substances linked to depression symptoms
A range of common environmental toxicants are associated with symptoms of depression, a new study in JAMA Network Open finds.
Researchers examined thousands of blood and urine samples for nearly 90 toxicants — including arsenic, perchlorate and volatile organic compounds — finding 27 of them are linked to symptoms of depression.
Environmental toxicants are potentially harmful substances created by humans or introduced through human activities, such as chemicals, pharmaceuticals and metals.
The more than two dozen toxicants that were linked to depressive symptoms included common substances such as acrylamide, ethylene oxide, metals and nicotine metabolites. Acrylamide is a chemical formed by cooking starchy foods such as potatoes at high temperatures while ethylene oxide is used to produce a range of chemicals, including antifreeze.
Men and younger people were more vulnerable to experiencing depressive symptoms via exposure to environmental toxicants, the study found. Depressive symptoms, assessed via a patient questionnaire, include hopelessness, thoughts of self-harm, sleep problems and poor appetite.
Exposure to environmental toxicants can trigger systemic inflammation in the body, which contributes to depressive symptoms, the researchers concluded.
Cool roofs can help lower city temperatures
Painting building rooftops white or using a reflective coating can significantly help reduce heat in urban areas, a new study shows.
Published July 4 in Geophysical Research Letters, the research found that if such measures were widely used across a city such as London, they could lower outdoor temperatures on average about 1.2 degrees Celsius, and as much as 2 degrees Celsius in some neighborhoods.
While measures such as installing solar panels on buildings and planting trees and other vegetation at street level offer environmental benefits for cities, they don’t go as far to provide cooling, only lowering temperatures about 0.3 degrees Celsius on average across a city, the study said. Roofs that are planted with vegetation, also known as green roofs, have negligible effect on city-wide cooling, as they reduced temperatures during the day but retained heat at night.
The study also looked at the impact of air conditioning on city temperatures. Because the process transfers heat from the inside of buildings to their exteriors, widespread use of AC would warm outdoor city temperatures by about 0.15 degrees Celsius overall and as much as 1 degree Celsius in densely populated areas.
The researchers based their analysis on conditions during two days of record-setting temperatures experienced in London in summer 2018. Because of human-caused climate change, urban temperatures are increasing across the globe in a process known as the heat island effect.
Air pollution in childhood connected to bronchitis
Kids who are exposed to ongoing air pollution are at high risk for experiencing symptoms of bronchitis once they’re adults.
A new study, published in the American Journal of Respiratory and Clinical Care Medicine, finds a direct link between childhood air pollution exposure and adult lung health.
Researchers asked adult participants in a long-term health study in Southern California about their bronchitis symptoms — such as chronic cough, congestion or phlegm production — and compared it to their childhood air pollution exposure.
The study found a strong link between adult bronchitis symptoms and childhood exposure to both nitrogen oxide and fine-particle pollution, also known as NO2 and PM2.5. NO2 is associated with emissions from sources such as vehicles and power plants, while PM2.5 is primarily linked to exhaust, wildfires and industrial facilities.
About 25% of study participants reported bronchitis symptoms. The association between symptoms and childhood exposure to air pollutants was strongest among people who had asthma as kids, according to the University of Southern California researchers.
Other public health news of interest this week includes:
• Exposure to respirable crystalline silica is a known health hazard for U.S. coal miners. A new study in Occupational & Environmental Medicine finds that exposure risks are higher in certain mines, including those that are smaller, have thinner coal seams and are located in Central Appalachia.
• Injuries result in significant economic losses to self-employed farm and ranch operators, with a total nationwide cost of $11.3 billion per year, finds new research in the American Journal of Industrial Medicine.
• People with high incomes are more likely to receive high-value care, such as beta blockers for heart failure or statins for high cholesterol, says a Health Affairs study. People with low incomes are more likely than those with high incomes to use opioids for back pain.
• Greener, less densely populated cities have lower mortality rates and lower air pollution levels. But they have a higher per capita carbon footprint, says a new study in The Lancet Planetary Health. In comparison, high-density cities have higher mortality rates and poorer air quality, but lower greenhouse gas emissions per capita.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
