Deaths from extreme temperatures to soar in US
Significantly more U.S. adults could die annually from extreme temperatures over the next 40 years, with Black and Hispanic people at disproportionate risk, a new study predicts.
Published Sept. 20 in JAMA Network Open, the research noted that as greenhouse gas emissions continue to increase around the world, the U.S. will experience longer and more frequent periods of extreme heat.
If those emissions increase at high rates, as many as 26,600 U.S. adults in the contiguous U.S. could die annually from extreme temperatures from 2036 to 2065 — more than triple the 8,250 annual deaths that occur today.
Even if greenhouse emissions don’t increase quite as much, 19,350 adults could die annually from extreme temperatures during that period, said study researchers, affiliated with the University of Pennsylvania.
While the study projected extreme temperature deaths could increase as much as 147% among white Americans, they could rise by 459% among Black Americans and 845% among Hispanic Americans.
Some of that disparity is attributed to changes in population makeup, with more people of color expected in the U.S. by mid-century, but it is also linked to where populations live. As rural areas are generally cooler than cities, they would have less of an increase than urban areas, which tend to be home to more people of color. By region, deaths would increase in southern areas of the U.S., which also have large populations of people of color.
Older adults, who are more physically sensitive to extreme temperatures, also would experience increased deaths, the study said.
Funding shortfalls could close community health centers
The nation’s community health centers, which served more than 31 million people last year, face a looming financial crisis that could harm their ability to provide care.
That’s the prediction of a new issue brief from George Washington University’s Milken Institute School of Public Health. As operational and service delivery costs continue to outpace revenue, the majority of the nation’s 1,400 health centers are likely to experience significant budget losses this year, according to the Sept. 17 brief.
Visits to community health centers have rebounded since the early years of the COVID-19 pandemic, with 1.5 million more people receiving care through the centers in 2023 than 2019. Almost 133 million visits were made last year, with patients receiving preventive, dental, medical and reproductive health care.
Revenue has not climbed with the increase in patients, however. The proportion of health centers with negative profit margins reached a high of 48% in 2023. For 2024, health centers overall will lose an estimated $1 billion, the brief predicts. That could force some centers to close.
Community health centers play an essential role in providing health care to the nation’s low-income population and to people who lack insurance in particular. The centers cared for 5.6 million uninsured patients in 2023, about one-fifth of the nation’s uninsured population.
Policies put in place during the emergency phase of the Covid-19 pandemic that automatically re-enrolled people in Medicaid helped millions of people stay covered. But now that the policies have ended, the number of uninsured Americans is rising, underscoring the need for community health centers.
Race, ethnicity of doctors linked to acceptance of patients with Medicaid
White and Asian doctors are less likely to see patients who are covered by Medicaid, according to a new study in the Annals of Family Medicine.
Researchers examined data from Medicaid claims and questionnaires provided to family medicine physicians. They found Hispanic and Black doctors were significantly more likely to participate in Medicaid and care for higher numbers of Medicaid patients that their white and Asian colleagues.
Only about half of the 13,000 physicians in the study “meaningfully” participated in Medicaid, which the study defined as seeing at least 150 patients covered by the program each year. Male or rural physicians were more likely to see Medicaid patients than female or urban ones.
Greater Medicaid reimbursement rates did not affect whether a doctor would see at least 150 program beneficiaries a year, the study said.
Only 5% of all U.S. physicians nationwide are Black and about 6% are Hispanic, according to the American Association of Medical Colleges. Nearly 57% are white and 19% are Asian.
About 74 million people are enrolled in Medicaid, accounting for almost a third of all U.S. adults. While almost all U.S. physicians accept new patients who are covered by private insurance, only about 70% accept those covered by Medicaid, previous research shows. A 2019 study found Medicaid beneficiaries have more difficulty scheduling health care visits than people with private insurance.
‘Forever chemicals’ linked to breast density
Women with higher exposure to certain “forever chemicals” may be more likely to have dense tissue in their breasts, a new study in Environmental Health Perspectives finds.
Researchers with the Washington University School of Medicine examined mammography data from hundreds of premenopausal women and compared it with blood levels of per- and polyfluoroalkyl chemicals. Also known as PFAS, the substances are often called forever chemicals because of their inability to break down in the human body.
Two types of PFAS, perfluorooctane sulfonate and perfluorohexane sulfonate, also referred to as PFOS and PFHxS, were linked to dense volume, a measure of how much fibrograndular tissue is in the breast. Women with a lot of fibroglandular tissue, which includes connective tissue as well as milk glands and ducts, are considered to have dense breasts, which puts them at higher risk of developing breast cancer.
Fibroglandular tissue can also be problematic because it appears white and opaque on a mammogram. As cancerous tumors also appear white, having a lot of the tissue can make it more difficult to diagnose breast cancer.
Previous science has shown that PFAS exposure can induce cell growth, study researchers noted. PFOA and PFHxS can also increase levels of progesterone, a hormone associated with dense breasts.
Other recent public health news of note includes:
• County-level air pollution is linked to stroke deaths in older adults, particularly among Black residents, a study in Frontiers in Public Health finds.
• New research in Eco-Environment & Health reports that low-income people who live in areas with high traffic visit emergency departments more often for asthma.
• Discrimination and other harmful social factors can impact cardiovascular health among Asian Americans, according to a new statement from the American Heart Association.
• Counties and states with higher levels of incarceration have increased rates of cancer deaths, says a study in the Journal of the National Cancer Institute.
• Campylobacter infections among humans can increase after rain and other precipitation, especially in counties with animal operations, according to a new study in Environmental Health Perspectives.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
