{"title":"Racial And Ethnic Inequalities In COVID-19 Mortality Within Carceral Settings: An Analysis Of Texas Prisons.","authors":"Neal Marquez, Destiny Moreno, Amanda Klonsky, Sharon Dolovich","doi":"10.1377/hlthaff.2022.00390","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00390","url":null,"abstract":"<p><p>The COVID-19 pandemic has taken a heightened toll on people incarcerated in prisons in the United States, with those incarcerated experiencing a higher rate of infection and mortality than the US population more generally. What is less well known is the degree to which COVID-19 outcomes differ among incarcerated populations, especially by race and ethnicity, where significant differences have been found among the US population as a whole. This knowledge gap is, in part, due to a lack of reporting of COVID-19 outcomes by race and ethnicity by most state prison systems. To shed light on this topic, we analyzed mortality patterns of the population incarcerated in Texas state prison facilities during both the year before (beginning April 1, 2019) and the first year of (beginning April 1, 2020) the COVID-19 pandemic. We used a unique data set of roster information from the Texas Department of Criminal Justice and medical examiner records. COVID-19 mortality was 1.61 and 2.12 times higher for Black and Hispanic populations, respectively, when compared with the White population in Texas prisons. Strategies for COVID-19 mitigation in carceral settings, such as vaccination and decarceration, should include an equity component to minimize disparities.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1626-1634"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Confronting Racism In Pediatric Care.","authors":"Benjamin Danielson","doi":"10.1377/hlthaff.2022.01157","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.01157","url":null,"abstract":"<p><p>A primary care pediatrician calls on his profession to address racism in pediatric care.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1681-1685"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40472431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pandemic And Recession Effects On Mortality In The US During The First Year Of COVID-19.","authors":"Christopher J Ruhm","doi":"10.1377/hlthaff.2022.00364","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00364","url":null,"abstract":"<p><p>There were almost 700,000 excess deaths in the US from March 1, 2020, through February 28, 2021, resulting from two often counterbalancing mechanisms: those predicted by changes in unemployment rates occurring during this period, referred to here as the \"recession effect,\" and those predicted by the \"pandemic effect,\" which reflects direct consequences of SARS-CoV-2 infections and COVID-19, accompanying impacts on health and medical care, and other changes in mortality not caused by greater joblessness. Using data from the Centers for Disease Control and Prevention, this study decomposed total mortality in this period into pandemic and recession effects, with additional estimates by sex, race and ethnicity, age, and fourteen causes. Although the pandemic effect increased many types of mortality, the recession effect reduced most types of mortality. Without the recession effect, there would have been nearly 40,000 more deaths than actually occurred. However, there were disparate impacts, particularly for external causes. Vehicular and alcohol-related fatalities and homicides rose because of strong pandemic effects. In contrast, the recession effect accounted for a greater share of the rise in drug mortality. Offsetting pandemic and recession effects resulted in a decrease in the number of suicides. Understanding these diverse impacts provides useful lessons for policy efforts to mitigate the current and future health pandemics.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1550-1558"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Glasner, Oscar Jiménez-Solomon, Sophie M Collyer, Irwin Garfinkel, Christopher T Wimer
{"title":"No Evidence The Child Tax Credit Expansion Had An Effect On The Well-Being And Mental Health Of Parents.","authors":"Benjamin Glasner, Oscar Jiménez-Solomon, Sophie M Collyer, Irwin Garfinkel, Christopher T Wimer","doi":"10.1377/hlthaff.2022.00730","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00730","url":null,"abstract":"<p><p>In 1997 the US established the Child Tax Credit (CTC), which offers payments to parents of dependent children to help defray child-rearing costs. In 2021 a temporary expansion to the CTC increased the size of payments, extended payments to families with low or no earnings, and distributed payments monthly instead of annually. Quasi-experimental evidence from the US and experimental evidence from low- and middle-income countries shows that moderate-to-large cash transfers improve subjective well-being and mental health. We estimated the CTC's expansion's effects on the subjective well-being and mental health of adult recipients, using data from the Understanding America Study, a nationally representative survey with more than 7,000 respondents and more than 2,700 unique respondents with children. We found no evidence that the CTC expansion had a significant short-term impact on measures of life satisfaction, anxiety, and depression symptomology among adult recipients. We speculate that the null effects may be due to the expansion's temporary nature.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1607-1615"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"State Eviction Moratoriums During The COVID-19 Pandemic Were Associated With Improved Mental Health Among People Who Rent.","authors":"Abdinasir K Ali, George L Wehby","doi":"10.1377/hlthaff.2022.00750","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00750","url":null,"abstract":"<p><p>In response to the COVID-19 pandemic, many US states implemented eviction moratoriums in 2020. Evidence from eviction filings from that year shows short-term declines in eviction filings. This study examined the short-term effects of these state eviction moratoriums in 2020 on the mental health status of renters. It employed nationally representative data from the Behavioral Risk Factor Surveillance System and a triple-difference design that compared renters with homeowners while leveraging state differences in moratoriums over time. During 2020 forty-three states and Washington, D.C., implemented eviction moratoriums of varying scope and enforcement. Some moratoriums targeted the whole eviction process, including early stages, whereas others focused on the later stages of eviction. We found that state moratoriums were associated with an improvement in mental health, including fewer days not in good mental health in the past thirty days and a lower likelihood of frequent mental distress (fourteen or more days not in good mental health in the past thirty days). Overall, there is some evidence from this study pointing to potential short-term benefits from state eviction moratoriums in 2020 to the mental health and well-being of renters, which would be important to consider when formulating policies that affect residential stability.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1583-1589"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Little To No Correlation Found Between Immigrant Entry And COVID-19 Infection Rates In The United States.","authors":"Joseph Nwadiuko, Arturo Vargas Bustamante","doi":"10.1377/hlthaff.2021.01955","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01955","url":null,"abstract":"<p><p>The relationship between immigrant entry and COVID-19 spread in the United States has driven much political discussion and policy, including the implementation of Title 42 by the Centers for Disease Control and Prevention. To examine the relationship between COVID-19 spread and immigrant entry, we compared 2020-21 immigrant flows with local COVID-19 rates, using estimates of border crossings from the Border Patrol and visas issued through the Department of Labor's seasonal guest worker program. Our analysis capturing seasonal guest worker entry at the national level showed no statistically significant relationship with COVID-19 rates. Our analyses of Southwest border crossings showed a small, statistically significant relationship between immigrant flows and COVID-19 rates in border counties (0.14 percent increase in local cases per 100,000 residents for each additional 100 immigrants). However, this estimate is modest compared with the fact that half of all month-to-month changes in case rates were greater than 59 percent. Furthermore, the modest increase became nonsignificant with increasing local vaccination rates. Estimates also did not maintain their statistical significance when analyzed with some alternative approaches. Our findings support existing evidence that the short-term impacts of immigrant flow on local COVID-19 rates were minimal.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1635-1644"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily C Dore, Melvin D Livingston Iii, Paul R Shafer
{"title":"Easing Cash Assistance Rules During COVID-19 Was Associated With Reduced Days Of Poor Physical And Mental Health.","authors":"Emily C Dore, Melvin D Livingston Iii, Paul R Shafer","doi":"10.1377/hlthaff.2022.00740","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00740","url":null,"abstract":"<p><p>Unemployment rates soared at the beginning of the COVID-19 pandemic in the US, increasing financial stress that can affect physical and mental health. Temporary Assistance for Needy Families (TANF) is the primary cash assistance program for low-income families in the US, with benefits conditional on work activities and subject to suspension. However, many states loosened requirements during the pandemic. Using TANF policy data and data from the Behavioral Risk Factor Surveillance System from the period January 2017-December 2020 with a triple-difference design, we found a general protective effect of supportive changes to TANF on poor physical and mental health days and binge drinking during the COVID-19 pandemic for likely TANF participants. For example, providing emergency cash benefits to those not already participating in TANF, waiving work requirements, waiving or pausing sanctions, and automatically recertifying benefits were associated with reductions in the number of mentally unhealthy days. This study provides support for increasing generosity and easing administrative burdens in safety-net programs to buffer against negative impacts of public health and economic crises.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1590-1597"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Financial Coaching Offers New Paths To A Healthy Future.","authors":"Michele Cohen Marill","doi":"10.1377/hlthaff.2022.01232","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.01232","url":null,"abstract":"<p><p>With tax assistance, financial literacy education, and other programs, Boston Medical Center helps families rise out of poverty.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1544-1549"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gary Claxton, Matthew Rae, Anthony Damico, Emma Wager, Gregory Young, Heidi Whitmore
{"title":"Health Benefits In 2022: Premiums Remain Steady, Many Employers Report Limited Provider Networks For Behavioral Health.","authors":"Gary Claxton, Matthew Rae, Anthony Damico, Emma Wager, Gregory Young, Heidi Whitmore","doi":"10.1377/hlthaff.2022.01139","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.01139","url":null,"abstract":"<p><p>In 2022 the average annual premium for family health insurance coverage was $22,463, which is similar to the $22,221 reported in 2021. On average, covered workers contributed $1,327 for single coverage and $6,106 for family coverage. Among covered workers enrolled in a plan with a general annual deductible, the average deductible for single coverage was $1,763. Almost half of large employers reported an increase from 2021 in the share of employees using mental health services. The 2022 survey asked employers about the breadth of their provider networks, especially for those using services for mental health and substance use disorders. Employers were less likely to report that their plan with the largest enrollment was very broad for mental health services than for providers overall. Fewer employers thought that their plan had a sufficient number of behavioral health providers versus primary care providers to provide timely access to enrollees.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1670-1680"},"PeriodicalIF":9.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40428089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}