A weekly roundup of public health news
Americans cut health care as it becomes less affordable
Americans are cutting back — sometimes in ways that endanger their health — to afford care, new national polls show.
Rising costs are forcing people to make trade-offs that affect both daily living and access to care, according to new surveys from KFF and the West Health-Gallup Center on Healthcare in America. Millions of Americans report they are worried about affording care, including emergency services, routine visits and prescription drugs.
A third of U.S. adults — more than 82 million people — made at least one trade-off in the past year to pay for health care, according to the March 12 West Health-Gallup survey findings.
Americans said they were borrowing money, cutting back on utilities or driving less to save money for care. About 26% of adults said they delayed medical or surgical treatment because of cost. Nearly a quarter of uninsured people said they had stretched out doses of their prescription drugs, a tactic that could lead to severe health consequences.
Costs are also a major concern for people enrolled in health insurance plans purchased through the Affordable Care Act Marketplace. Most returning enrollees said their costs have increased, according to KFF survey findings released March 19.
About 9% of marketplace enrollees dropped their plans and are now uninsured, while 28% switched plans, most citing costs, the survey found.
About 80% of marketplace participants reported increased health care costs this year, including 51% who said costs were “a lot higher.” Nearly 17% said they were not confident they could afford their monthly premiums for the full year. Although state and federal insurance marketplace plans were created to allow Americans to access affordable, comprehensive coverage, prices have soared this year because of an end to federal tax credits, rising hospital and drug costs and other barriers.
To keep their coverage, many people said they are cutting back on essentials. More than half of marketplace enrollees said they had cut or plan to cut spending on food or basic household items, the KFF poll found.
About 43% said they were working more or taking on extra jobs, while 23% reported skipping or delaying bill payments and 20% said they were taking on debt through loans or credit cards. Among people with chronic health conditions, the financial strain was even greater.
Physical activity could fall with increasing temperatures
Climate change could drive millions of people around the world to become physically inactive by 2050, leading to as many as 700,000 early deaths annually, a new study finds.
Published March 16 in The Lancet Global Health, the research predicts rising temperatures will make it harder for people to stay active, particularly in already-hot regions.
Analyzing data from 156 countries from 2000 to 2022, researchers found that each additional month with average temperatures above 82 degrees Fahrenheit was linked to a roughly 1.5 percentage-point increase in physical inactivity worldwide. Physical inactivity is already a major global health issue, with about a third of adults not meeting recommended activity levels.
The largest increases in inactivity are expected in hotter regions, including Central America, the Caribbean, eastern sub-Saharan Africa and equatorial Southeast Asia. In some areas, inactivity could rise by more than 4 percentage points during periods of extreme heat.
The burden is expected to fall disproportionately on lower-income populations, who may lack access to cooling, indoor exercise spaces or flexible schedules that allow activity during cooler times of day, researchers said.
Heat can limit physical activity by increasing cardiovascular strain, dehydration risk and overall discomfort, making outdoor exercise more difficult. Extreme weather and poor air quality can further reduce opportunities for safe activity.
Nearly half of U.S. primary care physicians burned out
U.S. primary care physicians are more likely to report burnout than those in most comparable countries, according to new findings in Health Affairs.
About 44% of U.S. primary care physicians reported burnout in 2022, among the highest rates across 10 high-income countries, the study found. Only New Zealand and Canada had higher levels, while countries such as Switzerland and the Netherlands had far lower rates, with 18% and 12% of primary care doctors, respectively, reporting burnout.
Across countries, U.S. physicians consistently reported higher dissatisfaction, stress and burnout than many of their peers. Female physicians were more likely to report burnout than male physicians across nearly all countries studied.
Burnout and declining well-being among primary care physicians have raised concerns among health care experts in the U.S., where growing work demands and limited capacity are straining the workforce. Burnout has been linked to lower job satisfaction, increased medical errors and reduced patient satisfaction, as well as higher physician turnover, particularly in underserved areas. The U.S. is already facing a shortage of physicians, with a shortfall of as many as 40,000 primary care doctors expected by 2036, according to the Association of American Medical Colleges.
The differences between countries suggest that policy and workplace changes could help reduce burnout in the U.S., particularly by improving working conditions and support systems for physicians, study researchers said.
Other recent public health news of note:
• More than a quarter of federal health advisory committees have been terminated or altered under the Trump administration, raising concerns about impacts on public health, according to a March 18 report from Public Citizen. Nearly a third of 273 committees across the U.S. Department of Health and Human Services were cut, including many at the National Institutes of Health, Food and Drug Administration and Centers for Disease Control and Prevention. Affected panels advised on topics such as vaccines, infectious diseases, Alzheimer’s care, rural health and substance use prevention.
• Flushed wet wipes may be a significant source of microplastics in waterways, according to a recent study in ACS ES&T Water. Researchers sampling a Toronto river found wipes were one of the most common types of litter, making up about a quarter of collected waste. Nearly all wipes contained plastic, primarily polypropylene and polyester. All types shed microscopic plastic fibers, including “flushable” wipes, which broke down fastest.
• Living near petroleum and biofuel refineries is linked to a range of health risks for children and adults, according to a new review of nearly five decades of studies. People living closest — especially within about three miles downwind — faced higher risks of cancer, heart disease, stroke and asthma attacks, according to the analysis in Current Environmental Health Reports. Risks declined with distance but remained elevated up to about six miles. Longer-term exposure was also associated with higher cancer risk.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist. decades of experience as a public health journalist.