A weekly roundup of public health news
Federal policy changes could strain hospitals nationwide
Recent federal policy changes will stress U.S. hospital and health systems, making it harder for them to provide care, a new Urban Institute report predicts.
New limits on Medicaid financing, work requirements for Medicaid users, the end of health insurance tax credits and other recent health-related policies put into place by Congress and the Trump administration will have a negative impact across the country, according to the July 29 report.
Together, the policies are expected to increase the number of uninsured people, reduce hospital revenue and overburden the healthcare workforce. Financial strain could force some hospitals to reduce services, cut staff or close, especially in already struggling rural and low-income communities. As of 2025, about 40% of hospitals were already operating with negative margins, the report noted.
Growing numbers of uninsured and underinsured patients are expected to increase uncompensated care, leaving hospitals with more unpaid bills. An additional 5.3 million people are expected to become uninsured under the new Medicaid work requirements alone, according to estimates from the Congressional Budget Office.
New limits on state Medicaid financing could also reduce payments to hospitals, making it harder for them to stay financially stable. Safety net, rural, academic and children’s hospitals are expected to face greater financial challenges because of their reliance on Medicaid funding.
Changes to immigration policies also are expected to worsen existing workforce shortages by making it harder to recruit and retain healthcare staff. Foreign-born workers accounted for 18% of the U.S. healthcare workforce and 27% of hospital physicians in 2023. New Trump administration restrictions on who can enter and stay in the U.S. are expected to squeeze the workforce supply.
Discrimination tied to fewer screenings, more emergency care
People who routinely experience discrimination are less likely to receive regular healthcare and more likely to rely on emergency care, according to a new study.
The research, published July 28 in JAMA Network Open, linked everyday discrimination with delayed medical care, financial barriers to treatment and lower use of preventive healthcare.
Everyday discrimination — defined as repeated exposure to subtle slights, disrespect and unfair treatment — was also linked to greater difficulty affording healthcare. People who reported discrimination were more likely to delay or skip medical care, mental healthcare, dental care and prescription medications because of cost. They also were less likely to receive cholesterol and diabetes screenings.
The findings were based on a 2023 survey that asked how often people experienced everyday discrimination, such as being treated with less courtesy or respect, receiving poorer service than others, being treated as though they were not intelligent, having people act afraid of them or experiencing threats or harassment.
Nearly half of respondents, 45%, said they had been treated with less courtesy or respect. About 14% said people acted as though they were afraid of them, the least commonly reported experience.
Some people reported more everyday discrimination than others. Scores were highest among American Indian and Alaska Native people, Black people and multiracial people. Younger adults also reported more discrimination than older adults.
Researchers said discrimination may discourage people from seeking routine care by eroding trust in healthcare providers and institutions. Previous research has linked long-term exposure to discrimination to cardiovascular disease, mental health disorders, premature death and other health harms.
Lithium exposure widespread in tribal communities
People living in tribal communities in the Western U.S. may be regularly exposed to high levels of lithium in their drinking water.
A new study, published July 23 in Nature: Journal of Exposure Science & Environmental Epidemiology, examined drinking water in American Indian communities in four states, finding lithium levels often exceeded benchmarks used in health screenings.
The study analyzed household tap water samples collected between 2022 and 2024 and paired them with urine samples from participants in the long-running Strong Heart Family Study, which includes tribal communities in Arizona, Oklahoma, North Dakota and South Dakota.
Nearly three-quarters of household tap water samples contained lithium above the U.S. Geological Survey’s health-based screening level of 10 micrograms per liter. Urine samples collected from participants over 15 years also showed lithium exposure remained largely steady.
Lithium concentrations varied by region. Every household water sample collected in Arizona exceeded the screening level, as did 93% of samples from North Dakota and South Dakota. In Oklahoma, 35% of samples exceeded the screening level. Overall, the median lithium concentration in household drinking water was more than three times the screening level.
Lithium occurs naturally in some groundwater and surface water, but researchers said growing demand for lithium used in rechargeable batteries has raised concerns about the ways mining and processing could affect environmental exposure.
U.S. demand for lithium is expected to rise sharply as production expands to support electric vehicles and renewable energy storage. Previous research estimated 79% of U.S. lithium reserves are within 35 miles of tribal reservations. In Nevada, home to most of America’s lithium reserves, more than 23,500 active lithium mining claims have been registered, according to a May report from Amnesty International.
Although lithium is used safely as a prescription medication for mental health disorders at higher doses than those found in drinking water, previous research has linked environmental exposure to possible thyroid, kidney, pregnancy and developmental effects. Lithium is not currently regulated under the Safe Drinking Water Act, and researchers said additional monitoring is warranted as production expands.
Other recent public health news of note includes:
• New research warns 6.5 million Americans live in areas that are prone to landslides, a danger that is growing worse with climate change. Published July 29 in Earth’s Future, the study found most people at risk live in Appalachia and along the West Coast. The analysis also found that while nearly 20% of U.S. land is susceptible to landslides, only about 2% of the population lives in those areas. A May study in Natural Hazards found heavier rainfall linked to climate change is expected to increase landslide risk in parts of the U.S., including regions that have not historically faced the hazard.
• Wildfires can have lasting mental health impacts, especially for less-wealthy people, a July 29 analysis in JAMA Network Open finds. After the January 2025 wildfires in Los Angeles County, residents who lived in evacuation or warning zones reported higher levels of anxiety and depression for nearly a year. The increase was greatest among people with lower incomes, heavy housing costs, preexisting mental health issues or limited social support, researchers found.
• Workers who are middle-aged and older often have problems with sleep, which can interfere with their health and well-being, new findings show. A year-long study published July 29 in Scientific Reports that focused on workers ages 50 to 66 found that nearly 70% of them had ongoing sleep problems, and about 92% showed signs of a sleep disorder at least once. Many sleep problems were tied to stress at work rather than too little sleep, researchers found. People who said they had a better work-life balance and were happier with their jobs also reported better well-being. Wearable devices showed that waking up often during the night was common, even among people who slept up to eight hours.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.wo decades of experience as a public health journalist.
