A weekly roundup of public health news
Medicaid requirements may force hospitals to cut services
As new Medicaid work requirements cause millions of people to lose coverage, U.S. hospitals may be forced to cut services or close, researchers warn in a new issue brief.
Hospitals across the U.S. could see their operating margins fall an average of 13% as more people become uninsured, according to the Sept. 18 brief from The Commonwealth Fund. Community safety net hospitals, which serve a higher proportion of low-income people, could see a loss of nearly 30%, the brief said. The shortfalls could force hospitals to reduce their staff and eliminate clinical services.
Under a new law passed this year, Medicaid users who gained coverage under expanded eligibility will be required to work, volunteer or take part in educational programs at least 80 hours a month. Researchers have estimated that as many as 6.3 million people across 40 states could lose coverage once the new requirements take effect, in part because of problems reporting hours, difficulties finding jobs and other barriers.
The new issue brief estimates that as many as 5.8 million people who are kicked off Medicaid because of the new work requirements would become uninsured. As hospitals often are a source of care for people without insurance, the facilities would lose income and have higher uncompensated costs for care.
The losses in revenue could cause major concerns for hospitals that are already struggling to stay open. Nearly 200 rural hospitals have either closed or converted to outpatient-only services in the past two decades, and a third of all rural hospitals are at risk of closing. An additional major loss in revenue could force many more to close their doors, the brief said.
Hispanic, Black workers have higher rates of serious job injuries
On-the-job injuries that force people to take time off from work are nearly twice as common among Hispanic workers than white ones, a new study in JAMA Health Forum finds.
Researchers examined 15 years of data on California workers, finding that lost-time injury rates were 90% higher for Hispanic workers and 74% higher for Black workers as compared to white workers. About 2.6 million injuries that caused laborers to lose at least one day of work occurred during the study period, with 63% of them among males.
Much, but not all, of the disparities in injury rates could be explained by differences in occupations and their risks, the researchers said. For example, 95% of California’s agriculture workers, 88% of landscaping and groundskeeping workers, and 83% of construction laborers are Hispanic, according to the Public Policy Institute of California. Black workers in California are more likely to be overrepresented in occupations such as security, transit and food preparation.
On the flip side, Asian and Pacific Islander workers were 37% less likely to lose work time because of a job injury than white workers, the study found. In California, Asian and white workers are overrepresented in the management, professional and business occupations.
Nationally, U.S. workers reported 2.6 million occupationally related injuries and illness that caused them to lose at least a day of work in 2023, according to the U.S. Bureau of Labor Statistics. Occupational categories with high incidence rates for injury and illness included transportation and warehousing; arts, entertainment, and recreation; and agriculture, forestry, fishing and hunting.
Plastics, pesticides present in produce
Diners may be taking in more than just nutrients when they chomp down on their favorite fruits and vegetables. New studies find pesticides and plastics could also be present in their produce.
For the first time, researchers found evidence that nanoplastics — tiny pieces of plastic that are up to 1,000 times smaller than a speck of dust — can build up in the edible parts of vegetables. In a study in Environmental Research, they found nanoplastics can be absorbed through roots and spread to other parts of plants.
Previous research has shown microplastics can hinder plant growth and lower nutritional content. The small pieces of plastic, which are created as larger plastic materials break down, can enter agriculture through sources such as sludge-based fertilizers and irrigation with contaminated water.
The potential threat to human health from microplastics in produce is unclear, the researchers noted. The average American consumes as many as 150,000 microplastic particles a year through their diet, equating to about 12 plastic shopping bags, according to the Environmental Working Group.
Researchers are also turning their attention to another potential type of produce contaminant. A new study from the Environmental Working Group finds some fruits and vegetables Americans consume have more pesticide residue than others. People who eat fruits and vegetables that have greater levels of pesticide residue — such as grapes, kale and strawberries — have higher levels of pesticide markers in their urine, according to the study in the International Journal of Hygiene and Environmental Health.
Rather than skip fruits and vegetables, the researchers encouraged consumers to choose organic produce when they can. Very small amounts of pesticide residue on food are not unsafe, according to the U.S. Environmental Protection Agency, which sets limits for the residue.
Other recent public health news of note:
• Economies around the world may be significantly harmed by climate change if the problem continues to worsen, new research in PLOS Climate finds. Researchers said hotter, low-income countries could face losses that are 60% higher the global average.
• U.S. agricultural workers spend long hours working outdoors, exposing them to both high heat and farm-related chemicals. Those combined exposures are putting the workers — who are often immigrants with low access to care — at high risk for kidney damage, a new study in Environmental Research finds.
• By the time U.S. children reach age 18, more than 60% of them have been covered by Medicaid or the Children’s Health Insurance Program sometime during their lifetimes. And by the same age, 40% of kids have at some time been uninsured, according to new findings published in the Journal of the American Medical Association.
• Air pollution is hurting children’s eyesight, a new study in PNAS Nexus says. Researchers found exposure to nitrogen dioxide and fine-particle pollution — which are commonly linked to fossil fuel burning sources such as vehicles, power plants and industries — worsens short-sightedness, also known as myopia, among kids.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
