Texas abortion restrictions harmful for OB-GYNs
Most Texas OB-GYNs say the state’s restrictive abortion policies are hindering them from practicing medicine that’s based on evidence — and some say it may drive them to leave, a new report finds.
Released Oct. 1 by Manatt Health, the report was based on surveys with about 500 Texas physicians working in obstetrics and gynecology.
More than 70% of the OB-GYNs said state abortion laws have had a negative impact on their practice, and 60% said they feared legal repercussions if they followed scientific evidence or best practices for reproductive health care.
The Texas laws may drive some physicians to leave the field or the state, the report found. About 21% of survey participants said they had thought about or are planning to depart Texas to practice elsewhere, and 13% said they are going to retire early.
Among resident physicians — medical school graduates who work in a clinical setting to gain experience and training — 57% said Texas abortion laws factored into their decision whether to stay in the state after their residencies end. Half of those respondents said they are planning to leave the state.
Except for rare exceptions in which the life of a pregnant woman is at risk, all abortions in Texas were banned following the June 2022 Supreme Court decision overturning Roe v. Wade. But restrictions were in place in the state long before then.
A September 2021 law known as S.B. 8, for example, banned abortions as early as five weeks into pregnancy. Research on the impact of that law has shown a range of harms, including significant increases in deaths among infants and pregnant women.
A 2021 federal analysis projected there will be a 10% nationwide shortage of OB-GYNs by 2030, with a 15% shortage in Texas.
Death rates stay higher years after hurricanes
People in Florida may be feeling the health impacts of Hurricane Milton long after the hurricane left the state.
Tropical cyclones, which include both hurricanes and tropical storms, can lead to higher death rates in communities for nearly 15 years after a storm hits, new research in Nature finds.
On average, U.S. tropical cyclones are responsible for about 24 deaths each storm from direct causes such as trauma or drowning. But because indirect impacts — such as population displacement, lower access to health care services, crop damage and job losses — can continue long after a storm ends, so do elevated death rates.
When those and other health impacts are taken into account, each U.S. tropical cyclone indirectly causes as many as 11,000 excess deaths, the University of California-Berkeley researchers said. They estimated tropical storms have led to as many as 5.2 million deaths in the U.S. since 1930 — much higher than official government counts, which number about 10,000 deaths.
About 33% of deaths nationwide are related to tropical cyclones, researchers concluded, with the storms accounting for 25% of infant deaths and 15% of deaths among people ages 1 to 44. Black people were three times more likely than white residents to die after a hurricane.
By state, Florida had the highest proportion of deaths from tropical cyclones, accounting for about 13% of its total. North Carolina, which was recently devastated by flooding and winds from Hurricane Helene, came in second at 11%.
Medicaid auto-enrollment boosted uptake of mental health care
A recent federal policy that allowed Medicaid users to continuously stay enrolled in the program boosted access to mental health care, a new analysis shows.
To ensure that low-income people were able to obtain health care during the height of the COVID-19 pandemic and help stem spread of disease, the federal government adopted a policy in 2020 that automatically reenrolled Medicaid users into the program. As a result, the number of people covered by Medicaid reached new highs — swelling by 23 million — and U.S. uninsured rates fell.
Access to mental health care also grew, according to the new analysis, which was published Oct. 3 as a working paper from George Washington University’s Milken Institute School of Public Health. The probability that someone covered by Medicaid received mental health care or related medications grew from about 21% in 2018-2019 to over 28% in 2022. In comparison, people with private insurance had a 23% probability rate of receiving services or medications in 2022 and uninsured people had a rate of about 11%.
But even with the increase in access, many people struggled to gain care. About half of adults with Medicaid or private insurance who had moderate or serious mental illness did not receive any care for it, the paper said. About two-thirds of uninsured people with moderate or serious mental illness went without care.
Mental health access varied by race and ethnicity for all types of coverage, the paper found. Whether insured under Medicaid, privately or not at all, white people with moderate or serious mental illness were more likely to receive the care they needed, followed by Hispanic and Black people.
Medicaid’s continuous enrollment policy expired with the end of the COVID-19 public health emergency in the U.S. in 2023, with about 25 million people losing Medicaid coverage as result. As of April, about 70% of those who lost coverage said they were at least temporarily uninsured as a result.
Warming temperatures mean more income will go toward AC costs
As U.S. temperatures warm with climate change and the need for air conditioning rises, more people in the South and Southwest may struggle with energy costs, a new study warns.
In past decades in the U.S., heating bills accounted for much of the cost Americans pay for energy, particularly in northern states with significantly cold winters. But as the nation has warmed, the energy burden — which reflects the percentage of household income needed to pay for energy — has shifted, according to the research in Science Advances.
In 2015, the five states with the highest energy burden, in descending order, were Maine, Mississippi, Arkansas, Vermont and Alabama. Maine dropped to fifth place in 2020, however, with
four southern states at the top — Mississippi, Arkansas, Alabama and West Virginia.
The findings point to a trend in which less fuel for heating is needed for milder winters in the North, Northwest and Mountain West, while more air conditioning is required to survive extreme temperatures in southern parts of the U.S., the researchers said.
The changing climate also is altering where households are most likely to be suffering from energy poverty, with more than 6% of income is used for energy costs. In 2015, 23% of census tracts where the average household experienced energy poverty were urban, but that percentage fell to 14% in 2020.
Other recent public health news of note includes:
• Consumer skin products containing topical benzoyl peroxide can contain potentially hazardous levels of benzene, according to new research in the Journal of Investigative Dermatology.
• Exposure to four types of per- and polyfluoroalkyl substances, chemicals also known as PFAS, is linked to sleep disruptions in young adults, says a study in Environmental Advances. Another study, published in Environment International, links prenatal PFAS exposure with higher BMI in childhood.
• State abortion bans can be an occupational health hazard for workers, contributing to burnout and harming mental and physical health, says a study in BMJ Occupational Health and Medicine.
• New research in Environmental Research finds people may be routinely exposed to plasticizer chemicals through the air. Study participants, who wore wrist monitors to measure ambient exposure, were exposed to a range of polyvinyl chloride chemicals as they went about their daily lives.
• AI programs can absorb and perpetuate mistruths about race-based pain tolerance, potentially leading to undertreatment of Black patients, says a study in JAMA Network Open.
• New research in Transportation Research Part D says low-income people — who are more likely to work outdoors and use public transportation or walk to their destinations — suffer more harm from extreme heat days.
• Black plastic used in cooking and food storage can contain chemicals harmful to human health. A study in Chemosphere found fire retardant-treated plastic from electronics is being recycled into takeout containers, spatulas and more.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
