A weekly roundup of public health news
Health care, social workers have high rates of depression
Depression is more common for workers in the health care and social assistance field than in almost any other U.S. profession, a new study finds.
Released June 6 in JAMA Network Open, the research looked at mental health issues by occupational group. Food service and accommodation workers, such as those who work in restaurants, hotels and housekeeping, had the highest rate of depression, with 18.4% of staff reporting that they had ever been told by a health worker that they had the illness. Health care and social assistance staff were a close second, with 18.2% of workers reporting depression.
Other industries with high rates of depression included retail, education, arts, entertainment and recreation. On the low end, workers in mining, agriculture, forestry, fishing and hunting were least likely to say they have had been told they had depression sometime in their lifetimes.
Extreme distress — in which people suffered from stress, depression or emotional problems every day over the past month — was also a problem for some workers, with the highest rates reported among workers in the mining, oil and gas, and arts, entertainment and recreation industries.
Common contributors to work-related mental health stress include heavy workloads, shift work, long hours, lack of control, harassment and interpersonal conflict, previous research has shown.
States with abortion bans also have barriers to pregnancy care
Pregnant women who live in states with strict abortion policies are more likely to have poorer access to medical care, a new study reports.
Published June 4 in the American Journal of Preventive Medicine, the study found rates of pregnant women who were uninsured, lacked a regular health provider or couldn’t afford a needed doctor visit during the past year were higher in states that banned or significantly restricted abortion than those that did not.
Of the nearly 260,000 pregnant women who lacked health insurance in 2022, 62% lived in states with abortion bans. Texas had the highest rate of uninsured pregnant women, at 21%, followed by Arkansas and Florida, at about 19% each, researchers found.
The findings held true even for pregnant women with chronic diseases that could be harmful for them or their fetus, such as diabetes. Women who had diabetes before they were pregnant were less likely to have a personal doctor in states with strict abortion policies, and those who developed diabetes while pregnant were more likely to lack insurance or go without needed care.
Researchers linked the poorer access to care to state Medicaid policies. Failure to expand Medicaid eligibility to more people, banning Medicaid coverage for some pregnant immigrants and setting a high income threshold for eligibility among pregnant women accounted for the differences in access, they said.
Poorer Medicare Advantage users hit harder by insurance denials
Medicare Advantage users who are poorer or people of color experience the highest burden from claim denials, a new study in the June issue of Health Affairs finds.
Researchers looked at three years of insurance claims handled by Medicare Advantage plans, which are optional health insurance plans for older adults provided through private companies. About half of U.S. Medicare users are enrolled in the plans, which have been criticized for high out-of-pocket costs, restrictive provider networks and prior authorization requirements.
Only about 26% of claims denied for Medicare Advantage users were contested, the study found. Patients who made less than $50,000 a year were least likely to have their denials contested or reversed. People of color were less likely than white people to have their claims contested, and if a denial was reversed, they saw lower savings than white patients did.
About 26% of denials were linked to a specific benefit, 33% were due to billing errors, and the remainder were attributed to lapsed coverage or other issues. The average cost of denied charges were $150 for preventive services and $700 for other services.
Besides costing patients money, claim denials can erode trust in the health system and discourage people from seeking care, study researchers said.
About 17% of all initial health insurance claims are denied for Medicare Advantage users, according to a second study in the same issue of Health Affairs.
Other recent public health news of note includes:
• Air pollution can harm pregnant women at the molecular level, new research in Environmental Science & Technology shows. Researchers found exposure to fine-particle air pollution, also known as PM2.5, during pregnancy can disrupt maternal metabolism, increasing risks for premature birth and other harms.
• Many Americans found it harder to pay their energy bills after an expanded tax credit put into place during the height of the COVID-19 pandemic ended, new research in the American Journal of Public Health finds. The credit, which was created by Congress to relieve financial pressures during the pandemic, allowed families to claim as much as $3,600 per child during the 2021 tax year. Previous research has credited the tax credit with lifting more than 4 million children out of poverty.
• Staffing shortages, high workloads and a greater focus on profit are hindering the ability of nurses to provide quality care for all patients, according to new research in JAMA Network Open. The lack of adequate technology or interpreters to help with language translation is also a barrier, nurses told researchers.
• Patients in need of inpatient hospital rooms are often left “boarding” in emergency department spaces, a new study in Health Affairs finds. Researchers reviewed nine years of records on more than 46 million U.S. hospitalizations, finding that the practice — in which patients in beds wait in ED hallways, aisles and other areas — has been growing. In January 2022, 40% of patients were boarded for more than four hours, and more than 6% boarded for more than 24 hours. The practice can put strain on ED staff and jeopardize patient safety.
• The impacts of poverty show up in the blood cells of children and can threaten their future health, a new study in The Lancet eBioMedicine finds. Compared to their more affluent peers, kids from lower socioeconomic backgrounds have shorter telomeres, DNA sequences that protect chromosomes from damage. That could put poorer children at greater risk of disease in adulthood and earlier death, researchers said.
• New findings in the Journal of the American Heart Association show children exposed to high levels of “forever chemicals” while in utero are more likely to have high blood pressure in teens. Risks were higher for boys and Black children whose mothers had high levels of per- and polyfluoroalkyl substances in their blood around the time of delivery. PFAS, which don’t break down in the human body or environments, are used to make products resistant to water, grease and stains.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.