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Unconscious Bias Crops Up In Health Care, Even During A Pandemic : Shots

Karla Monterroso says after going to Alameda Hospital in May with a very accelerated heart rate, very low blood pressure and cycling oxygen levels, her entire experience was one of being punished for being ‘insubordinate.’

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Karla Monterroso says after going to Alameda Hospital in May with a very accelerated heart rate, very low blood pressure and cycling oxygen levels, her entire experience was one of being punished for being ‘insubordinate.’

Kenneth Eke/Code2040

In mid-March, Karla Monterroso flew home to Alameda, Calif. after a hiking trip in Utah’s Zion National Park. Four days later she began to develop a bad, dry cough. Her lungs felt sticky.

The fevers that persisted for the next nine weeks grew so high — 100.4, 101.2, 101.7, 102.3 — that on the worst night, she was in the shower on all fours, ice cold water running down her back, willing her temperature to go down.

“That night I had written down in a journal, letters to everyone I’m close to, the things I wanted them to know in case I died,” she remembers.

Then came a new batch of symptoms in the second month, headaches and shooting pains in her legs and abdomen that made her worry she could be at risk for the blood clots and strokes that other COVID-19 patients in their thirties were starting to report.

But still, she wasn’t sure if she should go to the hospital.

“As women of color, you get questioned a lot about your emotions and the truth of your physical state. You get called an exaggerator a lot throughout the course of your life,” says Monterroso, who is Latina. “So there was this weird, ‘I don’t want to go and use resources for nothing’ feeling.”

It took four friends to convince her that she needed to call 911.

But what happened in the emergency room at Alameda Hospital only confirmed her worst fears.

At nearly every turn during her emergency room visit, providers dismissed her symptoms and concerns, Monterroso says. Her low blood pressure? That’s a false reading. Her cycling oxygen levels? The machine’s wrong. The shooting pains in her leg? Probably just a cyst.

“The doctor came in and said, ‘I don’t think that much is happening here. I think we can send you home,'” Monterroso recalls.

Her experiences in the medical system, she reasons, are part of why people of color are disproportionately affected by the coronavirus. She says it is not just because they’re more likely to have front-line jobs that expose them to the virus, and the underlying health conditions that can lead to a more serious COVID-19 infection.

“That is certainly part of it, but the other part is the lack of value people see in our lives,” Monterroso wrote in a Twitter thread detailing her experience.

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health

Nearly 8 in 10 report pandemic is causing mental health strain, poll shows

COVID-19, health care, the economy, systemic racism and the presidential election are a threat to the nation’s mental health, according to an American Psychological Association poll.

Seventy-eight percent of adults polled said the pandemic is causing major stress and 60% called the array of issues facing the country overwhelming.

And younger adults are really struggling, the poll revealed.
Respondents from Generation Z — those born since 1996 — pegged their stress level in the past month at a 6 on 10-point scale in which 1 represented “little to no stress” and 10 was “a great deal of stress.” That compared with an average stress level of 5 among all adults.

Nineteen percent of adults said their mental health is worse than it was a year ago.

That included 34% of Gen Z adults, 19% of millennials, who were born between 1977 and 1995, 21% of Gen Xers, who were born between 1965 and 1976, 12% of baby boomers, who were born between 1946 and 1964, and 8% of those born before 1946.

Gen Z adults were the most likely to report common signs of depression.
More than 7 in 10 said that in the last two weeks they were so tired that they sat around and did nothing, felt very restless, found it hard to think or concentrate, felt lonely, or felt miserable or unhappy.

“This survey confirms what many mental health experts have been saying since the start of the pandemic: Our mental health is suffering from the compounding stressors in our lives,” said Arthur Evans Jr., chief executive officer of the APA.
“This compounding stress will have serious health and social consequences if we don’t act now to reduce it,” he said in an association news release.

Evans noted that the youngest Americans are showing signs of serious mental health issues, including depression and anxiety.

The poll found that changes to school are a big stressor for Gen Zers. More than 8 of 10 teens said they have had negative impacts of school closures, and 51% said planning for the future seems impossible.

Among college students, 67% feel the same way about planning for the future. And 87% of Gen Z members in college said school is a significant source of stress.

“Loneliness and uncertainly about the future are major stressors for adolescents and young adults, who are striving to find their places in the world, both socially, and in terms of education and work. The pandemic and its economic consequences are upending youths’ social lives and their visions for their futures,” said survey researcher Emma Adam, a professor of education and social policy at Northwestern University in Evanston, Ill.

Adam said public policy must address this generation’s need for social, emotional and mental health supports as well as financial assistance and educational and work opportunities. “Both comfort now and hope for the future are essential for the long-term well-being of this generation,” she said.

But most Americans aren’t getting the support they need. Among adults, 61% said

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health

Older adults using marijuana for common health problems, survey shows

Marijuana is fast becoming a favorite medication among older Americans, a new study finds.

Cannabis is being used to ease problems such as pain, sleep disturbances and psychiatric conditions like anxiety and depression, researchers say.

Among more than 550 patients surveyed, 15% had used cannabis within the past three years, and 50% of users said they used it regularly and mostly for medical purposes.

“Pain, insomnia and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain,” said researcher Christopher Kaufmann. He’s an assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at the University of California, San Diego.

Also, 61% of the patients who used cannabis had started using it after age 60.

“Surprisingly, we found that nearly three-fifths of cannabis users reported using cannabis for the first time as older adults. These individuals were a unique group compared to those who used cannabis in the past,” said researcher Kevin Yang, a third-year medical student at UCSD.

“New users were more likely to use cannabis for medical reasons than for recreation. The route of cannabis use also differed with new users more likely to use it topically as a lotion rather than by smoking or ingesting as edibles. Also, they were more likely to inform their doctor about their cannabis use, which reflects that cannabis use is no longer as stigmatized as it was previously,” Yang said in a university news release.

The report was published online recently in the Journal of the American Geriatrics Society.

“There seems to be potential with cannabis, but we need more evidence-based research,” Kaufmann added. “We want to find out how cannabis compares to current medications available. Could cannabis be a safer alternative to treatments, such as opioids and benzodiazepines? Could cannabis help reduce the simultaneous use of multiple medications in older persons?

“We want to find out which conditions cannabis is most effective in treating,” Kaufmann said in the release. “Only then can we better counsel older adults on cannabis use.”

More information

Harvard University has more on medical marijuana.

Copyright 2020 HealthDay. All rights reserved.

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health

For Latino voters, health care is a top issue as Obamacare gains reverse under Trump

SAN ANTONIO — Larisa Alvarado, 36, feared she had the coronavirus when she woke up last week feeling an itch and pain in her leg that later advanced to swelling. She began running a fever and became nauseous.

A friend and poison control expert suggested her symptoms could be from a spider bite, and advised her to see a doctor. But before she went to an urgent care clinic, Alvarado first had to research the cost of a visit and of the medicine a doctor was likely to prescribe—to see if she could afford them.

That’s because she doesn’t have health insurance. Alvarado lost her job as a patient resource specialist with the American Cancer Society after the organization’s fundraising was hit due to the pandemic.

Alvarado is just one of more than 11.2 million Latinos in the United States who don’t have health insurance—in 2019, almost 17 percent of Hispanics didn’t have health coverage, the highest of any group. That was the figure from before the pandemic, which was already up from 10.22 million in 2016.

Now experts say that number is likely even higher given the pandemic’s disproportionate toll on the community.

As people lose work and health care benefits, it’s become an even tougher task to ensure residents get health coverage access, said Joe Ibarra, co-chair of EnrollSA, a coalition of organizations trying to boost insurance enrollment in the San Antonio area.

“In Texas, there is no expanded Medicaid. The rules are really harsh. Folks are losing coverage as a result of losing their jobs and they are left without good options,” Ibarra told NBC News.

Latinos gained the most under the Affordable Care Act after it was enacted in 2010, with about 4 million adults and 600,000 children obtaining health care coverage by 2016.

As more people lose health insurance, the cost and the availability of coverage are top-tier issues for Hispanics this election cycle. Latinos rank it even ahead of jobs and the economy and place more importance on it than they did about this time in 2016.

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“Latinos are going to the polls keeping health care in mind and their experience with Covid in mind and voting for change for their health and well-being,” Alberto Gonzalez, senior policy strategist at UnidosUS, a Latino civil rights organization, said.

Early in the election cycle, the GOP was pointing to record low unemployment rates Latinos were experiencing as reason to re-elect Trump, while Democrats countered that Hispanics were not economically stable if many had to work more than one job to make ends meet.

But the pandemic’s disproportionate effect on Latinos has forced a reckoning of the gaps in health care coverage, especially in states like Texas with a huge Hispanic population.

Fears of Covid-19 — without health insurance

Before Alvarado lost her job, she was already skimping on her health, forgoing therapy for carpal tunnel to save on the steep copay and deductibles. Now

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health

Pregnancy care is dangerously distant for women in maternity care ‘deserts’ | Health care/Hospitals

Each week, Ashley Landreneau, a mom of two with another little one on the way, jumps in her car and heads to her doctor’s office in Lafayette.

The 33-year-old salon owner gets a regular weekly ultrasound because a history of seven previous miscarriages means her pregnancy is considered high risk.

And while everything has gone smoothly 19 weeks into her the current pregnancy, what makes it more dangerous is how far she has to trek. From her home in Bayou Chicot, the trip to her doctor’s office is an hour away.

“With my experience and everything I’ve been through, I can’t see just anyone,” said Landreneau. “The closest hospital to me is 45 minutes away. There’s not a specialist there that can deliver. There’s no NICU.”

When Elizabeth O’Brien Brown found out she was pregnant, she knew it would be expensive. So she chose a hospital in her insurance network and …

Louisiana has among the highest rate of death for pregnant women in the U.S. One of the reasons, according to new research, is the lack of maternal care in many areas of the state, which forces women to travel long distances for routine checkups, emergency visits and deliveries.

Twenty-two parishes in the state are without a hospital offering obstetric care, a birth center or any OB/GYNs or certified nurse-midwives, according to an analysis of 2018 federal workforce data released last month by the March of Dimes, a national nonprofit focused on improving health care for mothers and their babies.

In Evangeline Parish, where Landreneau lives, there is just a single OB/GYN in a population of over 33,000 people. That puts the parish among the 35 out of Louisiana’s 64 parishes that have little to no access to maternal care, according to the report.

Due to that scarcity, researchers estimate that one in four pregnant women in Louisiana may need to travel outside of their parish for the many appointments necessary to monitor a pregnancy: ultrasounds, blood tests, glucose screenings, specialist appointments and delivery.

Dr. Rahul Gupta, the nonprofit’s chief medical officer, said that the inconveniences of distance can make it hard for expectant mothers to get the care needed to keep them healthy.

“Transportation becomes an issue,” said Dr. Gupta. “Time becomes an issue, it becomes a money issue. You have to take a day off, go and wait in a practitioner’s office. A lot of times pregnant people have other kids they need to take care of. They have to then find child care. These things accumulate in maternity care deserts.”

According to a study published in the journal Women’s Health Issues last week, a lack of nearby providers is impacting the state’s maternal mortality rate, which was the worst in the country in 2019.



Pregnancy during pandemic: How providers are rewriting birthing care standards amid coronavirus

At this point, the medical procedure that Lacy Smith has scheduled for Friday at Ochsner Medical Center in New Orleans could hardly be put off…

Study author and Tulane University epidemiologist Maeve Wallace compared the geographic data from the March

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fitness

Listen to the Men’s Health Minute for the Latest News in Fitness and Health

Whether you’re pounding the weights, cooking up dinner, or doing anything else with your hands, there are lots of times when you can’t sit back and read Men’s Health. Now, you can listen to it, no matter what else is going on.



a man flying through the air on top of a mountain: The Men's Health Minute gives you up-to-date content about health, fitness, and more on Alexa, Google Assistant, Spotify, iTunes, and other platforms.


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The Men’s Health Minute gives you up-to-date content about health, fitness, and more on Alexa, Google Assistant, Spotify, iTunes, and other platforms.

Introducing the brand new Men’s Health Minute. It’s a daily briefing that brings our authoritative advice and info for healthy living into your speakers and earbuds. Here’s how to access it:

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Alexa Flash Briefing

Go to Alexa app and search for Men’s Health Minute. Click enable and say to your device, “Alexa, what’s my flash briefing?”

Alexa Skill

Go to the Alexa app and search for Men’s Health Minute. Click enable and say, “Alexa, open Men’s Health Minute” or “Alexa, launch Men’s Health minute” or “Alexa, what’s the latest from Men’s Health Minute?”

Google Play

Android users, subscribe here or search Men’s Health to start listening.

Google Narrative News

Say to your device, “OK Google, play Men’s Health Minute” or “OK Google, open Men’s Health Minute” or “OK Google, what’s the latest from Men’s Health Minute?” You can also say “Men’s Health Minute” to access content on Google Narrative News.

Google Action

Simply say to your device, “OK Google, talk to Men’s Health.”

Spotify

To listen on Spotify, follow here or search simply Men’s Health.

iTunes/Apple Podcasts

To listen on your Apple device, subscribe here or search Men’s Health on iTunes.

iHeartRadio

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health

N.Y. Accuses Religious Health Cost-Sharing Group of Misleading Consumers

New York State accused a major Christian group on Tuesday of deceiving customers by illegally offering health insurance to as many as 40,000 residents since 2016.

The state filed civil charges against Trinity Healthshare, the Christian group, and Aliera, a for-profit company that markets the plans.

The state insurance regulators’ complaint included a list of charges, which said Trinity and Aliera “aggressively marketed and sold their products to consumers in the health insurance marketplace, preying on people who were uninsured and deceiving consumers into paying hundreds of dollars per month for what they were led to believe was comprehensive health coverage.”

New York regulators said patients were often left with thousands of dollars in unpaid medical bills. A woman with leukemia was denied coverage for an emergency hospital stay that cost thousands of dollars because she was told she had a pre-existing condition. Aliera denied a $15,000 claim for breast cancer treatment, according to regulators, while another patient said even routine doctor’s visits were not covered by Trinity.

State officials said the cases of financial hardship were exacerbated by the coronavirus pandemic, which has spawned high unemployment and resulted in the loss of health insurance for millions of Americans.

“New Yorkers should not have to worry whether a trip to a medical professional could lead them to bankruptcy, a factor that has been compounded by this unprecedented global health crisis,” Linda A. Lacewell, the state’s superintendent of financial services, said in a statement.

The state said it would seek civil penalties and other relief on behalf of consumers, and had issued a cease-and-desist letter in April that prevented the group from enrolling new customers.

Both Trinity and Aliera have been the targets of actions by other states, including Connecticut and Washington. They say they are not selling health insurance and that there is no confusion about their plans. They say customers are expressly told there is no guarantee that their medical bills will be covered.

Customers “must acknowledge either on a recorded line or by signature that the program is not insurance,” Aliera said in a statement on Tuesday. It said plans would not be affordable if all pre-existing conditions were eligible for sharing but they “are a legitimate option for people of faith who maintain a healthy lifestyle.”

Given the health crisis, “it’s deeply concerning to see New York State regulators working to deny their residents access to more affordable alternatives to traditional health insurance,” Aliera said.

Trinity disputed the claims made by state regulators. “The vast majority of Trinity’s members around the country are very pleased and satisfied with Trinity’s health care sharing ministry and continue to choose to participate in Trinity’s ministry as a cost-effective arrangement,” it said in a statement on Tuesday.

In New Hampshire, where Trinity and Aliera are suing to block the state’s efforts to regulate their activities, a Superior Court judge in Merrimack County halted an administrative hearing to be held by regulators until their court case is resolved.

With the economic downturn’s

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medicine

Does Your Health Insurance Cover Alternative Medicine?

It’s still known as alternative medicine, but services like chiropractic care, acupuncture and therapeutic massage are not that alternative anymore. According to the National Center for Complementary and Integrative Health, almost 40% of adults and 12% of children use complementary or alternative medicine, or CAM, to stay healthy and treat chronic or severe conditions.

Many more would likely use some kind of complementary or alternative treatment if it were covered by their insurance company. While many carriers cover a few services under certain circumstances, most CAM treatments are not covered, forcing patients to pay for it out of their own pocket.

Data from a 2016 study led by the NCCIH suggest that Americans are more and more willing to pay those out-of-pocket charges. Between 2002 and 2012, those who saw a chiropractor rose from 7.5% to 8.3%. The numbers were 1.1% to 1.5% for acupuncture and 5% to 6.9% for massage. Interestingly, usage rates stayed the same for those who had at least some insurance covering the care, but they went up among those who lacked coverage.

For those looking to have complementary or alternative treatments covered, here is what you should know.

[Read: 5 Places to Get Health Care That Aren’t a Clinic.]

CAM Coverage Varies

The NCCIH says that Americans spend about $30.2 billion each year out-of-pocket on complementary health products and practices beyond what their insurance covers. This includes:

— $14.7 billion for visits to such practitioners as chiropractors, acupuncturists and massage therapists.

— $12.8 billion on natural products.

— About $2.7 billion on self-care approaches, including homeopathic medicines and self-help materials, such as books or CDs, related to complementary health topics.

The 2016 study found that 60% of the respondents who had chiropractic care had at least some insurance coverage for it in 2012, but those rates were much lower for acupuncture (25%) and massage (15%). Partial insurance coverage was more common than complete coverage. For chiropractic, nearly 40% of respondents had no coverage, 41.4% had partial and 18.7% had complete coverage. For acupuncture, the breakdown was 75%, 16.5% and 8.55%, and for massage, it was 84.7%, 8.35% and 7%.

The NCCIH says the following complementary or alternative treatments are most often covered to some degree:

Chiropractic: 91% of big insurance companies cover prescribed chiropractic care, most limited to between 15 to 25 prescribed visits with a $20 to $30 copay.

Acupuncture: 32% of big insurance firms cover acupuncture, usually limited to about 20 visits annually.

Massage: Roughly 17% of large insurance firms cover massage therapy, typically if physical therapy and medication hasn’t helped.

Homeopathy: Only 11% of major insurers cover homeopathic remedies.

Hypnosis: Insurers that cover hypnosis require physician authorization, and they typically cover only 50% to 70% of costs.

Biofeedback: Only a few insurers cover the mind-body technique biofeedback, and when they do it’s only for a documented condition like migraines or fibromyalgia.

Naturopathy: Insurers are more likely to cover a licensed naturopath, but only 19

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health

Pandemic Putting Americans Under Great Mental Strain: Poll | Health News

By Steven Reinberg, HealthDay Reporter

(HealthDay)

TUESDAY, Oct. 20, 2020 (HealthDay News) — COVID-19, health care, the economy, systemic racism and the presidential election are a threat to the nation’s mental health, according to an American Psychological Association (APA) poll.

Seventy-eight percent of adults polled said the pandemic is causing major stress and 60% called the array of issues facing the country overwhelming.

And younger adults are really struggling, the poll revealed.

Respondents from Generation Z (those born since 1996), pegged their stress level in the past month at a 6 on 10-point scale in which 1 represented “little to no stress” and 10 was “a great deal of stress.” That compared with an average stress level of 5 among all adults.

Nineteen percent of adults said their mental health is worse than it was a year ago.

That included 34% of Gen Z adults; 19% of millennials (born 1977-1995); 21% of Gen Xers (born 1965-1976); 12% of baby boomers (born 1946-1964); and 8% of those born before 1946.

Gen Z adults were the most likely to report common signs of depression.

More than 7 in 10 said that in the last two weeks they were so tired that they sat around and did nothing, felt very restless, found it hard to think or concentrate, felt lonely, or felt miserable or unhappy.

“This survey confirms what many mental health experts have been saying since the start of the pandemic: Our mental health is suffering from the compounding stressors in our lives,” said Arthur Evans Jr., chief executive officer of the APA.

“This compounding stress will have serious health and social consequences if we don’t act now to reduce it,” he said in an association news release.

Evans noted that the youngest Americans are showing signs of serious mental health issues, including depression and anxiety.

The poll found that changes to school are a big stressor for Gen Zers. More than 8 of 10 teens said they have had negative impacts of school closures, and 51% said planning for the future seems impossible.

Among college students, 67% feel the same way about planning for the future. And 87% of Gen Z members in college said school is a significant source of stress.

“Loneliness and uncertainly about the future are major stressors for adolescents and young adults, who are striving to find their places in the world, both socially, and in terms of education and work. The pandemic and its economic consequences are upending youths’ social lives and their visions for their futures,” said survey researcher Emma Adam, a professor of education and social policy at Northwestern University in Evanston, Ill.

Adam said public policy must address this generation’s need for social, emotional and mental health supports as well as financial assistance and educational and work opportunities. “Both comfort now and hope for the future are essential for the long-term well-being of this generation,” she said.

But most Americans aren’t getting the support they need. Among adults, 61% said they could use

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health

Presidential Elections May Be Bad for Your Health

The stress of presidential elections may increase the incidence of heart attacks and strokes, researchers report.

Scientists tracked hospitalizations for acute cardiovascular disease in the weeks before and after the 2016 presidential election among about three million adults who were enrolled in the Kaiser Permanente Southern California health care system.

The study, in PNAS, found that hospitalizations for cardiovascular disease in the two days following the election were 61 percent higher than in the same two days of the preceding week. The rate of heart attack increased by 67 percent and of stroke by 59 percent in the two days following the election. The results were similar regardless of the age, race or sex of the patients.

The exact physiological mechanism is unknown, but previous studies have found similar increases in cardiovascular disease risk after traumatic public events, including earthquakes, industrial accidents and terrorist incidents like the World Trade Center attack of 2001 and the Charlie Hebdo shootings in 2015.

Psychological stressors such as anger, anxiety and depression have also been associated with sudden increases in the risk for cardiovascular events in the days, or even hours, following such events. The authors suggest that the stress of elections may provoke similar emotions.

“These are important findings,” said the lead author, Matthew T. Mefford, a postdoctoral research fellow at Kaiser Permanente Southern California. “This should really encourage health care providers to pay more attention to the ways that stress is linked to political campaigns and how election outcomes may directly impact health.”

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