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A Strategy To Support Perinatal Mental Health By Collaborating With Tribal Communities In Montana. 通过与蒙大拿州部落社区合作支持围产期心理健康的战略。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-04-01 DOI: 10.1377/hlthaff.2023.01449
Amy Stiffarm, Stephanie Morton, Dawn Gunderson, Brie MacLaurin, Nicole Redvers, Maridee Shogren, Terri Wright, Andrew Williams
{"title":"A Strategy To Support Perinatal Mental Health By Collaborating With Tribal Communities In Montana.","authors":"Amy Stiffarm, Stephanie Morton, Dawn Gunderson, Brie MacLaurin, Nicole Redvers, Maridee Shogren, Terri Wright, Andrew Williams","doi":"10.1377/hlthaff.2023.01449","DOIUrl":"10.1377/hlthaff.2023.01449","url":null,"abstract":"<p><p>Among Indigenous women and birthing people, reported rates of perinatal mental health complications are consistently higher than in the general US population. However, perinatal mental health programs and interventions tend to focus on the general population and do not account for the unique experiences and worldviews of Indigenous Peoples. We highlight a collaborative strategy employed by a Montana nonprofit to engage Tribal communities in completing a statewide online resource guide designed to help pregnant and parenting families find resources, including mental health and substance use treatment options, within and beyond their local communities. Based on this strategy, cultural resources relevant to Tribal communities were added to the resource guide. Agencies committed to addressing perinatal mental health disparities among Indigenous populations should consider similar strategies to share power with Tribal communities and collaboratively create culturally congruent programs and interventions.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice. 为围产期健康和持续致力于生殖公正创造重要条件。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-04-01 DOI: 10.1377/hlthaff.2023.01452
Alison Stuebe, Anna Creegan, Francoise Knox-Kazimierczuk, Meredith C Smith, Sabia Wade, Kristin Tully
{"title":"Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice.","authors":"Alison Stuebe, Anna Creegan, Francoise Knox-Kazimierczuk, Meredith C Smith, Sabia Wade, Kristin Tully","doi":"10.1377/hlthaff.2023.01452","DOIUrl":"10.1377/hlthaff.2023.01452","url":null,"abstract":"<p><p>Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, \"the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.\" To support reproductive justice for pregnant and birthing people, the Rippel Foundation's Vital Conditions for Health and Well-Being framework offers a holistic approach comprising seven domains: a thriving natural world; basic needs for health and safety; humane housing; meaningful work and wealth; lifelong learning; reliable transportation; and, central to all of these, belonging and civic muscle. Here we review the evidence for each of the vital conditions as key drivers of perinatal mental health, and we outline how this public health approach can advance well-being across generations.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perinatal Mental Health: The Need For Broader Understanding And Policies That Meet The Challenges. 围产期心理健康：需要更广泛的理解和应对挑战的政策。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-04-01 DOI: 10.1377/hlthaff.2023.01455
Emily C Dossett, Alison Stuebe, Twylla Dillion, Karen M Tabb
{"title":"Perinatal Mental Health: The Need For Broader Understanding And Policies That Meet The Challenges.","authors":"Emily C Dossett, Alison Stuebe, Twylla Dillion, Karen M Tabb","doi":"10.1377/hlthaff.2023.01455","DOIUrl":"10.1377/hlthaff.2023.01455","url":null,"abstract":"<p><p>Perinatal mental health is gaining recognition as a key antecedent of adverse maternal and child outcomes as the United States experiences a maternal mortality and morbidity crisis. Recent policy efforts have attempted to mitigate adverse outcomes through legislation such as the Taskforce Recommending Improvements for Unaddressed Mental Perinatal and Postpartum Health (TRIUMPH) for New Moms Act of 2021 and postpartum coverage through Medicaid expansion. Even with progress, perinatal mental health policy continues to grapple with a basic truth: The United States lacks an overarching health care system capable of meeting the mental health care needs of perinatal people and their families.  Moreover, the burden of undiagnosed and untreated perinatal mental health challenges remains greatest among racially minoritized populations, such as Black, Asian, and multiracial people. A broader understanding of perinatal mental health is needed, grounded in the tenets of reproductive justice. From this perspective, we articulate specific policies to meet perinatal mental health challenges and promote thriving for birthing people and their families.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
My Story Of Trauma And Reproductive Health. 我的创伤与生殖健康故事
IF 9.7 1区 医学
Health Affairs Pub Date : 2024-04-01 DOI: 10.1377/hlthaff.2023.01444
Angelica L Al Janabi
{"title":"My Story Of Trauma And Reproductive Health.","authors":"Angelica L Al Janabi","doi":"10.1377/hlthaff.2023.01444","DOIUrl":"10.1377/hlthaff.2023.01444","url":null,"abstract":"<p><p>Trauma-informed care is essential-and currently lacking-in reproductive health care.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":9.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nursing Homes, Medicaid, Physicians, And More. 养老院、医疗补助、医生等。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2024.00221
Alan R Weil
{"title":"Nursing Homes, Medicaid, Physicians, And More.","authors":"Alan R Weil","doi":"10.1377/hlthaff.2024.00221","DOIUrl":"10.1377/hlthaff.2024.00221","url":null,"abstract":"","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PrEP Discontinuation In A US National Cohort Of Sexual And Gender Minority Populations, 2017-22. 2017-22 年美国全国性与性别少数群体队列中的 PrEP 停用情况。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.00867
Yan Guo, Drew A Westmoreland, Alexa D'Angelo, Chloe Mirzayi, Michelle Dearolf, Pedro B Carneiro, Meredith Ray, David W Pantalone, Adam W Carrico, Viraj V Patel, Sarit A Golub, Sabina Hirshfield, Donald Hoover, Denis Nash, Christian Grov
{"title":"PrEP Discontinuation In A US National Cohort Of Sexual And Gender Minority Populations, 2017-22.","authors":"Yan Guo, Drew A Westmoreland, Alexa D'Angelo, Chloe Mirzayi, Michelle Dearolf, Pedro B Carneiro, Meredith Ray, David W Pantalone, Adam W Carrico, Viraj V Patel, Sarit A Golub, Sabina Hirshfield, Donald Hoover, Denis Nash, Christian Grov","doi":"10.1377/hlthaff.2023.00867","DOIUrl":"10.1377/hlthaff.2023.00867","url":null,"abstract":"<p><p>In the US, sexual and gender minority populations are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a key prevention method, but its effectiveness relies on consistent usage. Our four-year national cohort study explored PrEP discontinuation among sexual and gender minority people who initiated PrEP. We found a high annual rate of discontinuation (35-40 percent) after PrEP initiation. Multivariable analysis with 6,410 person-years identified housing instability and prior history of PrEP discontinuation as predictors of discontinuation. Conversely, older age, clinical indication for PrEP, and having health insurance were associated with ongoing PrEP use. To promote sustained PrEP use, strategies should focus on supporting those at high risk for discontinuation, such as younger people, those without stable housing or health insurance, and prior PrEP discontinuers.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Losing Our Way In A Rare Disease Diagnostic Odyssey. 在罕见病诊断奥德赛中迷失方向
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.01001
Kara A Ayik
{"title":"Losing Our Way In A Rare Disease Diagnostic Odyssey.","authors":"Kara A Ayik","doi":"10.1377/hlthaff.2023.01001","DOIUrl":"10.1377/hlthaff.2023.01001","url":null,"abstract":"<p><p>A mother shares the story of her son's rare disease diagnostic journey and how providers failed them both along the way.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meals On Wheels Clients: Measurable Differences In The Likelihood Of Aging In Place Or Being Hospitalized. 轮餐服务对象：居家养老或住院可能性的显著差异。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.00822
Sarah E Walsh, France Marie Weaver, Jennifer Chubinski
{"title":"Meals On Wheels Clients: Measurable Differences In The Likelihood Of Aging In Place Or Being Hospitalized.","authors":"Sarah E Walsh, France Marie Weaver, Jennifer Chubinski","doi":"10.1377/hlthaff.2023.00822","DOIUrl":"10.1377/hlthaff.2023.00822","url":null,"abstract":"<p><p>Little is known about how participation in home-delivered meal programs (known as Meals on Wheels), financed in part through the Older Americans Act, relates to the use of health services and the ability to age in place for elder Medicare beneficiaries. Using 2013-20 data from the National Health and Aging Trends Study, we evaluated the relationship between Meals on Wheels use and two outcomes-likelihood of continued community residence and risk for hospitalization-in the following year for Medicare beneficiaries ages sixty-five and older, overall and by gender, race, Medicaid enrollment, and frailty. Overall, Meals on Wheels users and nonusers were equally likely to still reside in the community one year later; however, continued community residence was more likely among users than nonusers who were Black, were enrolled in Medicaid, or were frail. Program use was marginally associated with increased likelihood of hospitalization in the following year overall, but more strongly so among frail users. Our findings are consistent with the heterogeneity of Medicare-age Meals on Wheels users nationwide and suggest that program benefits differ among specific populations.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma Center Hospitals Charged Higher Prices For Some Nontrauma Care Than Non-Trauma Center Hospitals, 2012-18. 2012-18 年间，创伤中心医院的部分非创伤护理收费高于非创伤中心医院。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.00249
Daniel P Kessler, Richard Sweeney, Glenn A Melnick
{"title":"Trauma Center Hospitals Charged Higher Prices For Some Nontrauma Care Than Non-Trauma Center Hospitals, 2012-18.","authors":"Daniel P Kessler, Richard Sweeney, Glenn A Melnick","doi":"10.1377/hlthaff.2023.00249","DOIUrl":"10.1377/hlthaff.2023.00249","url":null,"abstract":"<p><p>Rising prices are a major cause of increased health care spending and health insurance premiums in the US. Hospital prices, specifically-for both inpatient and outpatient care-are the largest driver of rising health care spending in the commercial insurance market. As a result, policy makers and employers are increasingly interested in understanding the determinants of hospital prices. Hospitals serving as trauma centers are often endowed by regulators with monopoly power over trauma services in their geographic areas, and this monopoly power may spill over to nontrauma services. This study focused on the growing number of designated trauma centers and how trauma center status affects hospital prices for other, nontrauma services. We found that hospitals designated as trauma centers charged higher prices for nontrauma inpatient admissions and nontrauma emergency department visits when compared with hospitals that were not designated as trauma centers, even after controlling for potential confounders.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare Part D Plans Greatly Increased Utilization Restrictions On Prescription Drugs, 2011-20. 2011-20 年，医疗保险 D 部分计划大幅提高了对处方药的使用限制。
IF 8.6 1区 医学
Health Affairs Pub Date : 2024-03-01 DOI: 10.1377/hlthaff.2023.00999
Geoffrey Joyce, Barbara Blaylock, Jiafan Chen, Karen Van Nuys
{"title":"Medicare Part D Plans Greatly Increased Utilization Restrictions On Prescription Drugs, 2011-20.","authors":"Geoffrey Joyce, Barbara Blaylock, Jiafan Chen, Karen Van Nuys","doi":"10.1377/hlthaff.2023.00999","DOIUrl":"10.1377/hlthaff.2023.00999","url":null,"abstract":"<p><p>Drug utilization management tools can be employed to ensure that medicines are prescribed cost-effectively, but they can also be implemented in ways that reduce adherence and harm patient health. We examined trends in the prevalence of utilization restrictions on non-protected-class compounds in Medicare Part D plans during the period 2011-20, including prior authorization and step therapy requirements as well as formulary exclusions. Part D plans became significantly more restrictive over time, rising from an average of 31.9 percent of compounds restricted in 2011 to 44.4 percent restricted in 2020. The prevalence of formulary exclusions grew particularly fast: By 2020, plan formularies excluded an average of 44.7 percent of brand-name-only compounds. Formulary restrictions were more common among brand-name-only compared with generic-available compounds, among more expensive compounds, and in stand-alone compared with Medicare Advantage prescription drug plans.</p>","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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