Juul Labs reached a $40 million settlement with North Carolina Attorney General Josh Stein this week, agreeing to limit its sales and marketing practices to quell underage use of its potent e-cigarettes. The settlement is also part of an “ongoing effort to reset our company and its relationship with our stakeholders” and “earn trust through action,” as a Juul spokesperson put it in a statement. In other words: Juul is trying to shed its reputation as the company that fueled a youth vaping epidemic, and it’s willing to pay $40 million to do it. But is it too late? Juul “developed a brand identity and style that is durable,” says Dr. Robert Jackler, a tobacco-marketing researcher at Stanford University who was set to be an expert witness for the state in the North Carolina trial before the settlement. “No matter what Juul has done—and it’s done many things in the face of withering regulatory attention and public scrutiny,” he says, “it is too tarnished of a brand” to come back from that. Juul was conceived as a cigarette alternative for adult smokers. E-cigarettes deliver nicotine but are generally considered less dangerous than traditional cigarettes, making them a potentially useful tool for adults trying to stop smoking. But by the time Juul took off, around 2017, it was popular with another demographic: teenagers. By 2019, 27.5% of U.S. high school students had vaped in the last 30 days. Many experts blamed Juul, with its sleek, techy devices and appealing flavors like mango. Stein—and many others—have argued that the company’s marketing targeted teenagers, an allegation Juul has repeatedly denied. Among other claims, Stein’s complaint noted that Juul launched in 2015 with a bright, colorful ad campaign that many compared to youth-friendly cigarette marketing; worked with influencers; and offered free samples at trendy launch parties. He also argued that Juul downplayed the amount of nicotine in its pods, causing some consumers to accidentally become addicted. Juul’s business has been more restrained in recent years, after vocal criticism from lawmakers, regulators and health groups. From 2018 to 2019, it discontinued popular flavors like mango and mint, shut down its U.S. social media pages and halted most advertising. It also implemented new age-verification practices and, in 2020, moved its headquarters from San Francisco to Washington, D.C., in an apparent effort to leave behind the “move fast and break things” culture of Silicon Valley. Juul’s corporate website now looks “like an AARP website,” plastered with images of older customers, says Chris Allieri, founder of the New York City-based public relations firm Mulberry & Astor who previously worked with the anti-smoking Truth Initiative. While Juul still reportedly controls about half of the e-cigarette market, the tobacco company Altria—which in 2018 paid $12.8 billion for a 35% stake in Juul—has slashed the valuation of its stake to around $1.5 billion. The Federal Trade Commission argues that investment violated antitrust law and is currently trying to unwind it. The North Carolina settlement codifies some policies Juul adopted voluntarily under pressure from regulators, like not advertising on social media or near schools. Under the agreement—through which Juul did not admit any wrongdoing—Juul is also forbidden from marketing to anyone in the state younger than 21, in keeping with recent legislation that raised the minimum age of tobacco purchase from 18 to 21. It can also only sell its products behind the counter at North Carolina retailers that ID-scan shoppers and will pay secret shoppers to test these practices. The $40 million will help fund vaping cessation and prevention programs, as well as e-cigarette-focused research. That’s a bargain for a rich company like Juul, Allieri argues. “This wasn’t a bad day for them,” Allieri says. “This is all part of business. Now they think they can turn the page with this” by appearing to take responsibility for their actions. Whether they actually can is another story. Juul’s early marketing missteps, popularity among teenagers and relationship with Big Tobacco could make it difficult to ever come across as a responsible company, Allieri says. Juul was “operating very egregiously in terms of their own marketing tactics,” he says, but it’s also paying for “the track record and mistakes and business practices of tobacco companies over the years.” Traditional tobacco companies were harshly criticized for marketing to young people. In a 1990s settlement known as the Master Settlement Agreement, the country’s largest tobacco companies agreed to pay billions of dollars to U.S. states after downplaying the health risks and addictive properties of cigarettes. They also agreed to stop marketing to teenagers. As of 2020, fewer than 5% of U.S. high school students said they regularly smoked cigarettes, compared to 28.5% in 1999, the year after the Master Settlement Agreement. There are echoes of that deal in Juul’s settlement, which could be the first of many. States including Massachusetts, New York, California and Hawaii have also sued Juul, and a group of 39 state attorneys general began investigating the company’s marketing practices in 2020. Hundreds of complaints from customers and school districts have also been consolidated before a judge in California; trials are set to begin in 2022. But Juul’s largest test may happen outside the courtroom. The U.S. Food and Drug Administration is currently reviewing applications that Juul and other e-cigarette makers filed to stay on the market, and decisions are expected by September. If Juul cannot prove that it provides a net benefit to public health—that its benefits for adult smokers outweigh issues like teen addiction and recreational use—it could be removed from the U.S. market entirely. Then, of course, there’s the test of public opinion. The company’s revenue fell dramatically in 2020, fueled by a mixture of public scrutiny, the discontinuation of flavored products, the coronavirus pandemic and the aftermath of a dramatic vaping-related lung disease outbreak (which was ultimately linked to THC, not nicotine, products). Its revenue in the third quarter of 2020 stood around $360 million, compared to $745 million in the second quarter of 2019. Generally, Allieri says, consumers are “quick to outrage and quick to forget.” But when asked to think of another company that has pulled off an image rehabilitation of the scale Juul is attempting, Allieri says, none immediately come to mind. from https://ift.tt/3y6XkVL Check out https://takiaisfobia.blogspot.com/
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Walmart Inc. will offer its own brand of analog insulin for people with diabetes, an effort to boost its pharmacy business and counter Amazon.com Inc.’s recent push to sell more medications. The world’s largest retailer will begin selling ReliOn NovoLog this week in its U.S. pharmacies with a prescription, Walmart said in a statement Tuesday. The medicine will cost between 58% and 75% less than the current cash price of branded insulin products for uninsured patients, Walmart said. More than 3 million Walmart customers are diabetic, and the retailer already offers human insulin to them for about $25. But that type is inferior to analog insulin, a man-made variety that’s designed to better mimic the body’s own blood-sugar production and regulation. While widely considered the preferred option, analog insulin is expensive, prompting pleas from patients and Congressional investigations to lower the cost of the lifesaving drug. “Diabetes is one of the most rapidly growing diseases in the country,” Cheryl Pegus, executive vice president and head of Walmart’s health and wellness business, said on a conference call. “We know from our customers that cost is a major factor in how you manage health care.” The medicine is being manufactured by drugmaker Novo Nordisk A/S as part of a partnership than took 2 1/2 years to finalize. It can be used by those with Type 1 or Type 2 diabetes. Walmart’s insulin launch comes 15 years after it disrupted drugmakers and pharmacy chains by introducing a range of generic drugs for common ailments like allergies and high cholesterol, with the treatments costing just $4 per prescription. The retailer expanded the generic offering in 2008, claiming then that it had saved consumers more than $1 billion. Amazon’s PushMore recently, Amazon has moved aggressively into the $465 billion U.S. prescription-drug market by opening an online pharmacy in November and by offering six-month prescriptions starting at $6 earlier this month. Price is a big barrier for diabetics who must take insulin to manage glucose levels and prevent complications. Approximately 34 million people have diabetes in the U.S., according to the American Diabetes Association, and 1.5 million Americans get diagnosed with the disease each year. Walmart’s product will cost $72.88 if administered through vials and $85.88 for a FlexPen version. It’s available in pharmacies inside Walmart stores this week and will be available in Sam’s Club warehouse locations in mid-July. The move could be “a really big deal” for people with diabetes, said Dawn Davis, an associate professor and endocrinologist at the University of Wisconsin at Madison. Walmart’s $25 insulin has provided a lifeline for some patients, particularly those who are uninsured, she said. Introducing an analog version will give people a less expensive way to access modern insulin. However, patients using Walmart’s brands will likely still need to use the older type since most people need both a rapid-acting and a longer-action version, she said. A Walmart representative said that “treatments vary by patient and provider.” Brand-name insulin under Novo Nordisk’s NovoLog and Eli Lilly & Co.’s Humalog labels can run more than $300 a vial, according to a 2020 review of cash prices from GoodRx Holdings Inc., a company that offers coupons and publishes research on prescription drugs. Novo and Lilly, the top insulin manufacturers, have introduced generic versions in recent years. These typically sell for less than half of the branded formulations, according to GoodRx. The amount of insulin that the average person with diabetes needs can vary widely, Davis said. Even if a person requires only five vials a month, the cost for the rapid-acting insulin alone would total $375. Patients also need all the other supplies like glucose test strips and needles. Walmart’s PharmaciesWalmart opened its first pharmacy in 1978, and drug sales make up the bulk of its health and wellness business. In 2020, it had 4.7% of U.S. prescription revenue, behind CVS Health Corp. and Walgreens Boots Alliance Inc., according to the Drug Channels Institute. Over the past two years, the company has also opened 20 low-priced medical clinics in states like Georgia and Illinois in an effort to grab a bigger slice of the nation’s $3.6 trillion in health spending. The idea is to harness its greatest asset: the 150 million people coming through Walmart’s 4,743 U.S. stores each week. The chain also acquired MeMD, a telehealth company, in a deal that Pegus said closed Monday. Even so, the company’s push into health care has been hobbled by a revolving door of executives, each with different approaches. Pegus, who joined in December, is the sixth person to run the business since 2014. Walmart’s health and wellness unit increased sales more than 5% in the last fiscal year to $38.5 billion, but its growth rate lagged behind those of its grocery and general-merchandise departments, which combined, account for the majority of its U.S. revenue. from https://ift.tt/3hmqSIj Check out https://takiaisfobia.blogspot.com/ (DURHAM N.C.) — Electronic cigarette giant Juul Labs Inc. will pay $40 million to North Carolina and take more action to prevent underage use and sales, according to a landmark legal settlement announced Monday after years of accusations that the company had fueled an explosion in teen vaping. A state judge accepted the first-of-its-kind agreement with a state. North Carolina Attorney General Josh Stein had sued Juul, accusing it of employing unfair and deceptive practices that targeted young people to use its vaping products, which deliver addictive nicotine. The lawsuit had been scheduled for trial next month. [time-brightcove not-tgx=”true”] As part of the agreement, Juul will not advertise to anyone under 21 in North Carolina, including through social media, and will limit sales amounts of Juul products online to any state residents. It will also sell its products only behind counters at retailers that have ID scanners to ensure customers are of age. Teen use of e-cigarettes skyrocketed more than 70% after Juul’s launch in 2015, leading the U.S. Food and Drug Administration to declare an “epidemic” of underage vaping among teenagers. Health experts said the unprecedented increase risked hooking a generation of young people on nicotine, an addictive chemical that is harmful to the developing brain. “Juul sparked and spread a disease — the disease of nicotine addiction. They did it to teenagers across North Carolina and this country simply to make money,” Stein, a Democrat, said after a brief court hearing. “Today’s court order will go a long way towards ensuring that their e-cigarettes product is not in kids’ hands, its chemical vapor is out of their lungs, and that the nicotine does not poison or addict their brains.” Read more: How Juul Got Vaporized Juul, which is partially owned by Altria Group Inc., has seen sales fall after already halting all advertising and social media promotion and pulling most of its flavors except for menthol. “This settlement is consistent with our ongoing effort to reset our company and its relationship with our stakeholders, as we continue to combat underage usage and advance the opportunity for harm reduction for adult smokers,” Juul said in a statement after the court hearing. “We seek to continue to earn trust through action.” Several states have filed their own lawsuits against Juul. A group of 39 state attorneys general have been cooperatively investigating the company’s marketing and products since February 2020. Juul also faces hundreds of personal injury lawsuits from customers and families of young people who said they were hurt or addicted by the company’s products. Those have been consolidated in a California federal case. Juul already had taken a legal beating this spring in the North Carolina case. Superior Court Judge Orlando Hudson declared in May that the company had destroyed documents and ignored court orders, leading to possible massive monetary sanctions. Teen vaping dropped significantly last year, according to the federal Centers for Disease Control and Prevention. In a national survey, just under 20% of high school students said they were recent users of electronic cigarettes and other vaping products, down from about 28% in 2019. Experts point to restrictions on flavors along with a new federal law that raised the age limit for all tobacco and vaping sales to 21. Anti-vaping advocates welcomed the decision. But they said more restrictions are needed to curb teen use, including banning menthol from Juul and all other e-cigarettes. Stein also urged the FDA to step in. “The evidence is clear that Juul’s high-dose nicotine products caused the youth e-cigarette epidemic,” said a statement from Matthew Myers of the Campaign for Tobacco-Free Kids. “The evidence is also clear that menthol flavor appeals to kids and kids shifted to menthol products.” Monday’s settlement, which Hudson signed, also directs “secret shopper’ visits to stores by young people to ensure the restrictions are being carried out. The $40 million, to be paid over six years, will be earmarked by the state for vaping cessation and prevention programs, and for e-cigarette research. Stein filed the lawsuit in state court in Durham, a central North Carolina city that is home to Duke University. Both the city and the school grew substantially in the 20th century thanks to tobacco production. North Carolina still remains the No. 1 producer of flue-cured tobacco in the country. The connection to Durham wasn’t lost on Stein, who said he recalls traveling to the city to tour the now-shuttered Liggett & Myers cigarette manufacturing facility when he was in elementary school. “The whole town smelled of tobacco,” Stein told reporters after the hearing. “When we thought about bringing this case, we thought that there was some symbolism to bring it here.” ___ AP health writer Matthew Perrone in Washington contributed to this report. from https://ift.tt/3jnb5vf Check out https://takiaisfobia.blogspot.com/ The So-Called Delta Plus Variant of COVID-19 Is Dangerous But Appears Unlikely to Be a Game-Changer6/25/2021 As if the already worrisome Delta variant, first identified in India, wasn’t concerning enough, now there’s Delta Plus. The latest variant of SARS-CoV-2 was announced by Indian health officials in late June, and labelled by the Indian government as a variant of concern. By June 24, only about 40 cases of Delta Plus infections were reported by Indian health officials, based on genetic sequencing of the virus from positive patients. But given the original Delta strain’s ability to transmit more efficiently from person to person, and to potentially cause more severe disease, health authorities are rightly raising concern. Delta Plus contains an additional mutation called K417N, in the part of the spike protein of the virus that binds to cells to start infection. But, says Dr. Ravindra Gupta, professor of clinical microbiology at the Cambridge Institute for Therapeutic Immunology and Infectious Diseases who has been genetically sequencing SARS-CoV-2 and studying its genetic evolution, “I predict 417 is not an important enough mutation. Delta is bad enough as it is and I don’t think 417 will change [it] that much or become dominant.” That’s because the 417 mutation isn’t new. Gupta says he has also found it in other major variants of the virus, including the B.1.1.7, or Alpha, variant, that was first identified in the U.K., and the B.1.351 or Beta variant first reported in South Africa. “We’ve seen it come up in a number of Alpha isolates and it didn’t take off or anything,” he says. Health officials shouldn’t get distracted by Delta Plus and lose their focus on the original Delta, which is dangerous enough especially when only about 22% of the world has received at least one dose of the most common two-dose vaccines. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a White House briefing on June 22 that the Delta variant is the “greatest threat” in the world’s efforts to contain COVID-19. However, he noted that health officials already have the most powerful weapon to fight this variant: vaccines. Gupta’s lab has studied how well antibodies generated after natural infection or immunity provided by vaccines can protect against the Delta variant, and found that the protection is sufficient. However, it is lower than that generated against the Alpha variant. So it may only be a matter of time before vaccinated people need a booster shot with a new vaccine to enjoy long-term protection against Delta and Delta Plus. “We should be worried about the accumulation of mutations,” says Priyamvada Acharya, director of the division of structural biology at the Duke Human Vaccine Institute. “We should be worried about variants that are coming up that are more transmissible and resistant [to immune antibodies]. Should we be panicked yet? I don’t think so. But it’s important to get people vaccinated as fast as possible.” Given time, new variants of the virus could find ways of evading that protection, if the steady march of mutations that SARS-CoV-2 has developed so far is an indication. “Right now we are seeing evolution in real time,” says Sophie Gobeil, fellow in the division of structural biology in Acharya’s lab. “The virus is trying really hard to evade those vaccines.” That means staying ahead of the virus could require more, and different vaccines. “I would say we will need boosters for sure and I would even venture to say that the boosters won’t be the same [vaccines] we are getting now,” says Acharya. “From what we are seeing, the virus will likely evade vaccines at some point and we will need updated vaccines.” from https://ift.tt/3xUv8FG Check out https://takiaisfobia.blogspot.com/ On June 23, a group of scientists told the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices that mRNA vaccines (those made by Pfizer-BioNTech and Moderna) have a “likely association” with heart risks for younger people. Understandably, that’s still generating a lot of attention. Here’s what you should know about COVID-19 vaccines and heart problems. The heart issues in question are called myocarditis and pericarditisThose refer, respectively, to inflammation of the heart and the lining around it. While they sound scary, both tend to clear up on their own or with minimal treatment, particularly if caught early. They can come with symptoms like chest pain, shortness of breath, fatigue and abnormal heart rhythms, and can be caused by viruses and bacteria. They are a very rare vaccine side effectSince April, about 1,000 cases have been reported among people who got vaccinated with mRNA-based shots, the CDC says. That might sound like a lot, but, for context, more than 300 million mRNA vaccine doses have been administered so far in the U.S. A statement signed by influential physicians including CDC Director Dr. Rochelle Walensky notes that myocarditis and pericarditis are far more common among people who catch COVID-19 than among people who get the vaccine. Certain groups seem to be at higher riskAdolescent boys and young men seem to develop these side effects more often than other groups, according to the CDC, and it is more common after a second shot. In general—that is, separate from COVID-19 side effects—men are more likely than women to develop heart inflammation, and it is commonly diagnosed among younger adults. Experts still recommend vaccinationGiven the known benefits of COVID-19 vaccination, physicians still recommend the shots for people of all ages. “It is the best way to protect yourself, your loved ones, your community, and to return to a more normal lifestyle safely and quickly,” the group of physicians urged in their joint statement. This story originally ran in TIME’s Coronavirus Brief newsletter. from https://ift.tt/3xSoBLv Check out https://takiaisfobia.blogspot.com/ Although James Toussaint has never had COVID-19, the pandemic is taking a profound toll on his health. First, the 57-year-old lost his job delivering parts for a New Orleans auto dealership in spring 2020, when the local economy shut down. Then, he fell behind on his rent. Last month, Toussaint was forced out of his apartment when his landlord—who refused to accept federally funded rental assistance—found a loophole in the federal ban on evictions. Toussaint has recently had trouble controlling his blood pressure. Arthritis in his back and knees prevents him from lifting more than 20 pounds, a huge obstacle for a manual laborer. He worries about what will happen when his unemployment benefits from the federal government run out, which could come as early as July 31. “I’ve been homeless before,” says Toussaint, who found a room to rent nearby after his eviction. “I don’t want to be homeless again.” With coronavirus infections falling in the U.S., many people are eager to put the pandemic behind them. But it has inflicted wounds that won’t easily heal. In addition to killing 600,000 in the U.S. and afflicting an estimated 3.4 million or more with persistent symptoms, the pandemic threatens the health of vulnerable people devastated by the loss of jobs, homes and opportunities for the future. It will, almost certainly, cast a long shadow on American health, leading millions of people to live sicker and die younger due to increasing rates of poverty, hunger and housing insecurity. In particular, it will exacerbate the discrepancies already seen in the country between the wealth and health of Black and Hispanic Americans and those of white Americans. Indeed, new research published June 23 in BMJ, shows just how wide that gap has grown. Life expectancy across the country plummeted by nearly two years from 2018 to 2020, the largest decline since 1943, when American troops were dying in World War II, according to the study. But while white Americans lost 1.36 years, Black Americans lost 3.25 years and Hispanic Americans lost 3.88 years. Given that life expectancy typically varies only by a month or two from year to year, losses of this magnitude are “pretty catastrophic,” says Dr. Steven Woolf, a professor at Virginia Commonwealth University and lead author of the study. Over the two years included in the study, the average loss of life expectancy in the U.S. was nearly nine times greater than the average in 16 other developed nations, whose residents can now expect to live 4.7 years longer than Americans. Compared with their peers in other countries, Americans died not only in greater numbers but at younger ages during this time period. The U.S. mortality rate spiked by nearly 23% in 2020, when there were roughly 522,000 more deaths than expected. Not all of these deaths were directly attributable to COVID-19. Fatal heart attacks and strokes both increased in 2020, at least partly fueled by delayed treatment or lack of access to medical care, Woolf says. More than 40% of Americans put off treatment during the early months of the pandemic, when hospitals were stretched thin and going into a medical facility seemed risky. Without prompt medical attention, heart attacks can cause congestive heart failure; delaying treatment of strokes raises the risk of long-term disability. Much of the devastating public health impact during the pandemic can be chalked up to economic disparity. Although stock prices have recovered from last year’s decline—and have recently hit all-time highs--many people are still suffering financially, especially Black and Hispanic Americans. In a February report, economic analysts at McKinsey & Co. predicted that, on average, Black and Hispanic workers won’t recover their pre-pandemic employment and salaries until 2024. The lowest-paid workers and those with less than a high school education may not recover even by then. And while federal and state relief programs have cushioned the impact of pandemic job losses, 11.3% of Americans today live in poverty—compared to 10.7% in January 2020. According to U.S. Census data from late May through early June 2021, 20 million U.S. adults reported having had trouble putting food on the table. Families with a limited food budget typically choose the cheapest food, rather than the healthiest, a trade-off that causes short- and long-term harm. In the short term, for example, people with low incomes are more likely to be hospitalized for low blood sugar toward the end of the month, when they run out of money for food. In the long term, food insecurity is associated with an increased risk of diabetes, high cholesterol, hypertension, depression, anxiety and other chronic diseases, especially in children. “Once the acute phase of this crisis has passed, we will face an enormous wave of death and disability,” says Dr. Robert Califf, former commissioner of the U.S. Food and Drug Administration, who wrote about post-pandemic health risks in an April editorial in Circulation, a medical journal. “These will be the aftershocks of COVID-19.” More illness, and faster deathsAmerican health was poor even before the pandemic, with 60% of the population suffering from at least one chronic condition. Four of the most common of these health issues—obesity, diabetes, high blood pressure and heart failure—were associated with nearly two-thirds of hospitalizations from COVID-19, according to a February study in the Journal of the American Heart Association. Deaths from some chronic diseases began rising in lower-income Americans in the 1990s, says Woolf. That trend was exacerbated by the Great Recession of 2007-2009, which undermined the health not just of those who lost their homes or jobs but the population as a whole. Still, the Great Recession, and its resultant health effects, did not affect all Americans equally. Black people in the U.S. today control less wealth than they did before that recession, while the gap in financial security between Black and white Americans has widened, according to a Nonprofit Quarterly article published last year. And the unemployment rate among Black workers did not recover to pre-recession levels until 2016. Across the board, life expectancy in the U.S. began falling in 2014, largely due to early deaths in working-age adults suffering the corrosive effects of stagnant wages, the disappearance of manufacturing jobs, unemployment, socioeconomic inequality and deteriorating neighborhoods, Woolf says. Based on what we know about how chronic stress—such as that caused by poverty, job loss and homelessness—leads to disease (for example, stress-related inflammation has been show to damage blood vessels, the heart and other organs), we can surmise that the most vulnerable suffered the most. People who are poor tend to smoke more, have higher risks of chronic illnesses such as cardiovascular disease, diabetes, kidney disease and mental illness, and are more likely to become victims of violence. And research shows that people with low incomes live an average of seven to eight years less than those who are financially secure. The richest 1% of Americans live nearly 15 years longer than the poorest 1%. “Poverty causes a lot of cancer and chronic disease, and this pandemic has caused a lot more poverty,” says Dr. Otis Brawley, a professor at Johns Hopkins University who studies health disparities. “The effect of this pandemic on chronic diseases, such as cardiovascular disease and diabetes, will be measured decades from now.” Life-altering evictions during COVID-19Being evicted, too, erodes a person’s health in multiple ways, and once the federal eviction moratorium, which has helped an estimated 2.2 million people remain in their homes, expires June 30, many people could find themselves homeless. Without protection from evictions, “millions of Americans could fall off the cliff,” says Vangela Wade, president and CEO of the Mississippi Center for Justice, a nonprofit advocacy group. Some landlords have found ways to evict tenants despite the federal ban. James Toussaint’s annual lease expired during the pandemic, leaving him to rent on a month-to-month basis. While some states require landlords to show “just cause” for eviction, Louisiana landlords can evict tenants for any reason once their annual lease has expired. In May, a judge ordered Toussaint—who is Black—evicted from his New Orleans home, giving him just two weeks to vacate the premises. His family was unable to take him in. “I’ve got family, but everybody has their own issues and problems,” Toussaint says. “Everyone is trying their best to help themselves.” Toussaint is now renting a room in a boarding house with no kitchen and a shared bathroom for $160 a week. Although he’s fully immunized, he bought cleaning supplies with his own money to sanitize the bathroom, which he says is often too dirty to use. Sharing communal space is often unsanitary and increases the risk of being exposed to the coronavirus, says Emily Benfer, a visiting professor at Wake Forest University School of Law. Even moving in with family poses risks, she says, because it’s impossible to isolate or quarantine in crowded homes—and while some 65.6% of U.S. adults are vaccinated, that still leaves a huge portion of the 18-plus population that is not. Benfer co-wrote a November study that found COVID-19 infection rates grew twice as high in states that lifted moratoriums on evictions, compared with states that continued to ban them. People who are evicted often move into substandard housing in neighborhoods with higher crime rates. These homes are sometimes plagued by mold and roaches, lack sufficient heating or have plumbing that doesn’t work. Landlords have no incentive to make repairs for tenants who are behind on their rent, Benfer says. In fact, tenants who request repairs or report safety hazards risk eviction. A growing body of evidence shows that eviction is toxic to health, causing immediate and long-term damage that increases the risk of death. Studies show that evicted people are more likely to be in poor general health or have mental health concerns even years later. About 14% of tenants in the U.S. have fallen behind on rent—double the rate before the pandemic. Rates are even higher among minorities; nearly a quarter of Black tenants and 16% of Hispanic renters are behind on rent. “This singular event alters the course of one’s life for the worse,” Benfer says. Without intervention to prevent mass evictions when the moratorium ends, “it will be catastrophic for generations to come.” Even before last year, tenants with children were more likely to be evicted than others, but the pandemic has made life especially difficult for women and families with kids. With schools and nearly half of child care centers closed, many women have struggled to hold a job while taking care of children; some have found it impossible. More than 2.3 million women dropped out of the labor force between February 2020 and February 2021, compared to 1.8 million men, according to the National Women’s Law Center. As a result of this exit and the loss of income, households with children are more likely to have trouble affording food and paying rent than other households, according to an analysis of U.S. Census data by the Center on Budget and Policy Priorities. The health harms that result from evictions can be measured at every stage of life: Kids who are evicted are at greater risk of lead poisoning from substandard housing. They’re also more likely than others to be hospitalized. When pregnant women are evicted, their newborns are more likely to be born early or very small and have a higher risk of dying in the first year. Women who are evicted are more likely to suffer sexual assault. Evicted adults in general report worse mental health and are more likely to be hospitalized for a mental health crisis, studies show. They also have higher mortality rates from suicide. Although the causes of addiction are complex, research shows that counties with higher eviction rates have significantly higher rates of drug- and alcohol-related deaths. And during the pandemic, so-called deaths of despair increased significantly. Fatal drug overdoses spiked 30% from October 2019 to October 2020. And the bad habits that many Americans developed during lockdowns and their aftermath--smoking more, drinking more and gaining weight—increase the risk of chronic disease in the future. Jennifer Drury, 40, has struggled with substance abuse, particularly prescription painkillers, since her 20s. In recent years, she was the mend and managed to stay sober. She blames the isolation and stress of the pandemic for causing her to relapse—and leading several of her friends to fatally overdose. “Idle time is not good for addiction,” says Drury, who fell behind on rent and was evicted from her previous home. She says drug dealers are never far away, especially at the New Orleans motel where she and her husband are now staying. “Drug dealers don’t care about pandemics.” Don’t forget recent historyToussaint, who in the past spent a two-year stretch living on the street, says he’s determined not to return there. He hopes to apply for disability insurance, which would provide him with an income if his arthritis prevents him from finding steady work. Woolf says he hope that Americans won’t forget about the suffering of people like Toussaint as cases of COVID-19 decline. “My worry is that people will feel the crisis is behind us and it’s all good,” Woolf says. His research connecting four decades of declining economic opportunity with falling life expectancy shows “we are in really big trouble, and that was true before we knew a pandemic was coming.” The pandemic doesn’t have to doom a generation of Americans to disease and early death, says Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation. By addressing issues such as poverty, racial inequality and the lack of affordable housing, the country can improve American health and reverse the trends that caused communities of color to suffer. “How the pandemic will affect people’s future health depends on what we do coming out of this,” Besser says. “It will take an intentional effort to make up for the losses that have occurred over the past year.” KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation. from https://ift.tt/3j8iYEM Check out https://takiaisfobia.blogspot.com/ In many places across the United States, COVID-19 feels over. Unmasked citizens run rampant. New York City is planning an August mega-concert in Central Park. I’m as hopeful as the rest of us, but I think we may be suffering from memory loss. Let’s start from this time last year, when many Americans were exuberantly returning to newly reopened beaches, parks and restaurants after a seemingly eternal three months—three whole months!—of quarantine. Universal observance of safety guidelines was surely going to be sufficient to limit viral spread. We know how that turned out. By mid-June 2020, there were already signs that our bleary-eyed re-emergence was premature. On June 22, 2020, the number of new daily cases of COVID-19 (33,485) surpassed the high-water mark hit on the worst day of the horrific first surge, when that figure peaked at just over 32,000. A year later, the daily case count is not as foreboding—nor is it nearly as low it may appear. If you look at a graph of new daily cases of COVID-19 since March 1, 2021, averaged over seven days, you’ll see that the slope of the curve was in steep decline until the beginning of June. Since then, progress has nearly flatlined at a figure that stubbornly refuses to dip below 10,000 people per day. You’ll notice that this graph covers only the past 12 weeks, while virtually every chart you’ll find (including the one on TIME’s dashboard) graphs COVID-19 cases from the beginning of the outbreak. This is intentional. The toll of the pandemic in the U.S. has persisted for so long, and reached such catastrophic heights in the first weeks of 2021, that patterns such as this one are nearly impossible to see on the typical chart. Here’s what the same graph looks like against that backdrop: My fear is that the pandemic remains much more deadly than how it looks on the page. Yes, deaths remain on a steady decline, having recently sunk below 300 people a day on average for the first time since March 24, 2020, right around the time that many offices were shuttering. But a surge in cases, particularly among the large number of unvaccinated Americans, could quickly reverse that decline. For context, let’s look at just the figures since March 1, 2021 against the same period last year (the blue portion above): As you can see, it has been less than a month since the 2021 case count sunk below the year-over-year figure, on May 26. The massive nationwide vaccine rollout is undoubtedly a major factor, but it’s difficult to quantify the impact of vaccination on the currently low case and death figures. There are only weak correlations between states’ vaccination rates and some key indicators, like the rate at which cases have risen or fallen in recent weeks. What we can quantify is that, in the 27 days since the lines crossed, the vaccination rate in the U.S. has only crawled upward, from 39.7% to 45.3% of Americans who have received a complete dosage. While the official vaccination rate applies to the entire population, data from the U.S. Centers for Disease Control and Prevention (CDC) also includes percentages for several age groups. By TIME’s calculations, there are 97.4 million adults age 18 and over who have been eligible for vaccination for two months but who have not yet received even a first dose. This group trends heavily younger, with those 65 and over representing only 7.8% of the unvaccinated population. (These figures do no include those under 18, who constitute a small portion of the eligible population.) On May 13, two weeks before daily case numbers in 2021 fell below the year-over-year figures from the same day in 2020, the CDC issued guidance liberating fully vaccinated individuals from wearing masks in many scenarios. I do not have conclusive proof that any of the country’s 97.4 million unvaccinated adults have abused this privilege. All I can state with confidence is that, based on the number of people I’ve seen not wearing a mask in stores places like stores, which often have signs imploring those who are not fully vaccinated to continue to mask up, it is mathematically almost certain that more than a few have done so. Which is to say: the situation today, if one can momentarily rewind to Memorial Day of 2020, feels very familiar. There appears to be a lambent light at the end of the tunnel, yet cavalier attitudes towards the pandemic, particularly among younger people who, as a group, are under-vaccinated, resembles what we saw last summer just before the second wave. Watching these trends, I grow more concerned every day that the country is positioned for yet another surge in cases, despite our defensive upgrades in the off-season. I hope I’m wrong, but the numbers are not nearly as comforting as they first look. That the Delta variant, which is both more transmissible and appears to cause more severe disease, is on pace to become the dominant form of COVID-19 in the U.S. in the coming months is further reason for alarm. Moreover, some states have significantly higher vaccination rates than others, leaving those with less protection more vulnerable to future spikes. Forgive me for being a buzzkill, but unless we can institute a functional vaccine passport system, which appears unlikely, I do not think it is wise to assume that every unmasked individual is fully dosed. Short of a passport system, and with dangerous variants competing for dominance and the duration of vaccine protection still unclear, we ought to continue to ration physical space in public areas—a policy that is hastily being relaxed at places like Major League Baseball parks. I love baseball and eagerly look forward to buzzing up to Philadelphia to take in a game at Citizen’s Bank Park, which is operating at full capacity. But not while the policy is that “Unvaccinated fans are strongly encouraged to wear their masks in all indoor and outdoor areas in and around the ballpark.” I also think there might be a backdoor to a digital passport system. Based on polling data, it appears there is a substantial population of people who aren’t categorically opposed to vaccination, just unmotivated to get around to it—what we’ve termed vaccine “meh-sitance,” not hesitance. My proposal is that bars, restaurants and other popular venues merely require each person who enters to verbally affirm that they are fully vaccinated. This might sound about as effective as asking passengers in the exit row to individually verify that they listened to the instructions. But while it’s one thing ignore a sign at the grocery store, it’s another to lie in front of your friends. Peer pressure is a powerful motivator, and if even a fraction of the unvaccinated would take the time to resolve that dissonance, or risk missing out on trivia night, it could substantially push up the percentages. I call this the “FOMO method,” and though we are still a long, long way from eliminating the disease altogether, it could help us avert a fourth wave this summer. from https://ift.tt/3xNIGT6 Check out https://takiaisfobia.blogspot.com/ When Malone Mukwende, 21, started medical school in London, he identified a fundamental problem: almost all the images and data used in its teaching were based on studies of white patients. But medical symptoms can present very differently on Black and brown skin, leading to misdiagnosis, suffering and even death. Still a student, he has recently launched both a handbook, Mind the Gap, and Hutano, a new online platform intended to empower people with knowledge about their health. I asked him what he hoped to achieve and the wider lessons for all of us. AJ: For people who don’t know your work, would you explain Mind the Gap? MM: I got to medical school and noticed there was a gap in our teaching. If we learned about a particular type of rash or disease that manifests on skin, it would always have white skin as the reference. I would ask “what does this look like on other skin tones?” just for my own learning. Often people told me that they didn’t know. I decided that something needed to be done. Some members of staff at the university and I then started collating pictures and descriptions of different conditions on darker skin, and we compiled them all into a handbook that we called Mind the Gap. AJ: The gap isn’t just because there haven’t been studies on Black and brown skin. It’s because it wasn’t considered important, right? MM: Yes, that’s right. After the publication of Mind the Gap, someone reached out to me who is a student in Zimbabwe. They said that all the books and reference images they use are also from white skin, even though the population [is] predominantly of darker skin. It really shows you that the legacies of colonialism are still living in 2021. A lot of the textbooks that they get are the ones we in the Western world have discarded, after a new edition has come out. It makes you question and wonder how come in the continent of Africa—I would assume the same thing is happening in much of Asia—there isn’t an established [local] source or resource.There are so many people locally on the ground who know this stuff. But from a wider perspective and a teaching perspective, it’s not being transitioned from individual knowledge into textbooks and resources to help to teach people. AJ: I have children from different backgrounds, and I know when there was a rash that everybody got, it looked drastically different depending on their skin color. But whenever I looked at medical charts, the reference point was always white skin. Recently my daughter Zahara, whom I adopted from Ethiopia, had surgery, and afterward a nurse told me to call them if her skin “turned pink.” MM: That’s the kind of thing I started to notice very early on. Almost the entirety of medicine is taught in that way. There’s a language and a culture that exists in the medical profession, because it’s been done for so many years and because we are still doing it so many years later it doesn’t seem like it’s a problem. However, like you’ve just illustrated, that’s a very problematic statement for some groups of the population because it’s just not going to happen in that way and if you’re unaware you probably won’t call the doctor. AJ: Now that there is so much online, it should be so much easier. So what is your new digital platform, and why is it called Hutano? MM: Hutano, in my native language, Shona, translates directly to ‘health’. It’s a health social platform, where people from all over the world can connect to form communities and really discuss these different conditions. AJ: What do you hope it will achieve? MM: We want people who are living with these conditions to have a platform to be seen and empower their health care literacy. For example, someone who has been struggling with eczema can come onto Hutano and join or even create an awareness group around their condition, and other people from all over the world who have that condition can join in and maybe discuss, “oh I’ve recently been diagnosed with eczema, does anyone know how I can find some clothes which won’t irritate my eczema?” or “I’ve used this cream, does anyone have any experience in how it has worked?” We want to give people the platform to be able to discuss these things. We need to start empowering the individual, and that, I hope, will start to reduce some of the health care disparities that exist. AJ: Do you have some examples of the consequences of these disparities? MM: In the U.K. there was a case in the early 2000s, and even though it was a while ago now it shows how serious these things can get. There was a little girl, Victoria Climbié, and she was undergoing abuse from her great aunt and her boyfriend. She presented to the hospital, and she had visible injuries on her skin. A doctor concluded that she was suffering from scabies and accepted her guardians’ story that she had inflicted the wounds herself by scratching the scars. Eventually they realized that this was a potential social-services case and a case of neglect. Unfortunately she did end up dying due to abuse at the hands of her guardians. From a health care perspective there had been an opportunity to be able to intervene and alert social services quicker. In the report on her death it said she had 128 different injuries. We missed that many different signs on darker skin to be able to identify that this was actually a problem. This is a common problem with bruising and injury in domestic violence and abuse cases. AJ: And this goes beyond just looking at skin, doesn’t it? There are wider problems with our medical knowledge and our evidence and our measurements? MM: It’s the politics of medicine, for so long. For instance if you read an old medical textbook it will tell you from a European perspective that a 70 kg (154 lb.) 25-year-old male is the reference point, and if you are above that you are obese, if you are below that you are malnourished, and who came up with this scale? We like to say medicine is evidence-based, but we need to question where our evidence is coming from. A lot of the studies only included people from Europe and America. We’ve got all these data sets but actually we only tested 30% or 40% of the world. AJ: So how do we recalculate? MM: I can’t say I have a solution because if we decide to group by age that will also open a can of worms; [the same is true] if we group by race, if we group by income. It just depends on individual circumstances a lot of the time. If [individual] people are empowered they will have an adequate amount of information or an adequate ability to ask the right questions about their health care. AJ: What amazes me is that you’ve managed to publish this handbook and created this new platform while you’re still a medical student. MM: I’m a big believer that age shouldn’t be a barrier. If there is a problem that needs to be fixed it doesn’t matter if you’re a doctor who has been qualified for 25 years or if you’re somebody who has just walked into the doors of medical school, as long as you are committed to the cause.
from https://ift.tt/3gMEaPa Check out https://takiaisfobia.blogspot.com/ On April 8, more than 4.3 million people in the U.S. received a COVID-19 vaccine dose. But after that peak, the numbers began to fall. By June 3, the national seven-day average for daily shots given had dropped to 850,000. But after that—with weeks to go before the Fourth of July, the date by which President Joe Biden wanted 70% of U.S. adults to have gotten at least one shot—the numbers began to creep back up. On June 7, according to U.S. Centers for Disease Control and Prevention (CDC) data, the seven-day average for daily vaccinations again broke a million. It shrank a bit after that, but was still close to 900,000 on June 15. While it’s common for daily numbers to go up and down, it’s somewhat surprising that this uptick would happen months after COVID-19 shots became widely available to U.S. adults. Vaccine supply now far outpaces demand. To keep shots going into arms, many states have done away with appointment requirements; opened mobile clinics and partnered with community organizations in areas with low vaccine uptake; and dangled incentives and cash prizes for those who get vaccinated. But Loren Lipworth-Elliot, the associate director of Vanderbilt University Medical Center’s epidemiology division, says there may be a partial explanation that has nothing to do with those efforts: In mid-May, kids ages 12 to 15 became eligible to receive Pfizer-BioNTech’s shot. There are about 17 million U.S. adolescents in that age group, according to the Kaiser Family Foundation. As of June 21, 28% of them had received at least one dose of a COVID-19 vaccine and almost 18% were fully vaccinated. That means almost 8 million shots have been given in that age group alone over the last six weeks. “That’s definitely accounting for some of what we’ve been seeing,” Lipworth-Elliot says. Dr. Mark Roberts, director of the Public Health Dynamics Lab at the University of Pittsburgh’s Graduate School of Public Health, agrees that childhood vaccinations are part of the explanation—but they’re probably not all of it, he says. “You’re seeing a fulfilling of that pent-up demand [for pediatric immunizations], but it’s not going to be huge,” he says, because 12- to 15-year-olds make up only about 5% of the U.S. population. It’s hard to say exactly what else has been driving the recent uptick, but Roberts says it may have something to do with recent state-run incentive programs, like lottery drawings for vaccinated people. Ohio, for example, reported a 28% increase in vaccinations during the two weeks after it announced its Vax-a-Million lottery in May, compared to the week before the announcement. Trends vary widely from state to state, Lipworth-Elliot adds. States with relatively low vaccination rates, like Florida, Tennessee and Alabama, are among those seeing recent increases in vaccinations, while daily tallies are logically dropping off in areas where most eligible people are already protected. And while vaccination rates are still lower among Black and Hispanic/Latino people than among white people in the U.S., federal data suggest the gap is narrowing slightly, driven particularly by the Hispanic/Latino population. Both trends, Lipworth-Elliot says, suggest health officials are getting better at bringing vaccines to populations that need them and chipping away at vaccine hesitancy by building trust within communities. The fact that the CDC now says fully vaccinated people can safely go mask-free, socialize indoors and travel may also be encouraging some holdouts to get vaccinated, Lipworth-Elliot says. “People are seeing that there’s a lot of leeway and freedom given to people who are vaccinated, for good reason,” she says. TIME/Harris Poll data also suggest the CDC’s mask guidance encouraged some people to get vaccinated because they were concerned about the risks of others going mask-free in public. It’s too soon to say if the positive momentum will continue; both Lipworth-Elliot and Roberts caution that variations in the vaccination data are common, and that it will take time to see how the trends play out. Already, daily averages are lower than they were a couple weeks ago. But there are reasons for optimism. Shots may become available to kids even younger than 12 by the fall, which would open up a whole new swath of the population to vaccination. And in a recent Gallup poll, about a fifth of adult respondents who said they do not plan to be vaccinated—a group equivalent to about 5% of the U.S. adult population—said they were open to changing their minds. With about 65% of U.S. adults already vaccinated with at least one dose, building trust even within that small group could be the difference between making or missing Biden’s Independence Day goal. from https://ift.tt/3wPSyM3 Check out https://takiaisfobia.blogspot.com/ Alfredo “Freddy” Valles was an accomplished trumpeter and a beloved music teacher for nearly four decades at one of the poorest middle schools in El Paso, Texas. He was known for buying his students shoes and bow ties for their band concerts, his effortlessly positive demeanor and his suave personal style—“he looked like he stepped out of a different era, the 1950s,” says his niece, Ruby Montana. While Valles was singular in life, his death at age 60 in February 2021 was part of a devastating statistic: He was one of thousands of deaths in Texas border counties—where coronavirus mortality rates far outpaced state and national averages. In the state’s border communities, including El Paso, people not only died of COVID-19 at significantly higher rates than elsewhere, but people under age 65 were also more likely to die, according to a KHN-El Paso Matters analysis of COVID-19 death data through January. More than 7,700 people died of COVID-19 in the border area through January. In Texas, COVID-19 death rates for border residents younger than 65 were nearly three times the national average for that age group and more than twice the state average. And those ages 18-49 were nearly four times more likely to die than those in the same age range across the U.S. “This was like a perfect storm,” says Heide Castañeda, an anthropology professor at the University of South Florida who studies the health of U.S.-Mexico border residents. She says a higher-than-normal prevalence of underlying health issues combined with high uninsurance rates and flagging access to care likely made the pandemic especially lethal for those living along the border. That pattern was not as stark in neighboring New Mexico. Border counties there recorded COVID-19 death rates 41% lower than those in Texas, although the latter were still well above the national average as of January, the KHN-El Paso Matters analysis found. Texas border counties tallied 282 deaths per 100,000, compared with 166 per 100,000 in New Mexico. That stark divide could be seen even when looking at the neighboring counties of El Paso County, Texas, and Doña Ana, New Mexico. The death rate for residents under 65 was 70% higher in El Paso County. Health experts say Texas’ refusal to expand Medicaid under the Affordable Care Act, a shortage of health care options and its lax strategy toward the pandemic also contributed to a higher death rate at the border. Texas GOP leaders have opposed Medicaid expansion for a litany of economic and political reasons, though largely because they object to expanding the role or size of government. New Mexico, on the other hand, expanded Medicaid, and as a result has a much lower uninsured rate than Texas for people under 65—12% compared with Texas’ 21%, according to Census figures. And New Mexico had aggressive rules for face masks and public gatherings. Still, that didn’t spare New Mexico from the crisis. Outbreaks in and around the Navajo reservation hit hard. Overall, its state death rate exceeded the state rate for Texas, but along the border New Mexico’s rates were lower in all age groups. “Having no Medicaid expansion and an area that is already underserved by primary care and preventive care set the stage for a serious situation,” Castañeda says. “A lot of this is caused by state politics.” Texas was one of the first states to reopen following the nationwide coronavirus shutdowns in March and April last year. Last June—even as cases were rising—Gov. Greg Abbott allowed all businesses, including restaurants, to operate at up to 50% capacity, with limited exceptions. And he refused to put any capacity restrictions on churches and other religious facilities or let local governments impose mask requirements. In November, Texas Attorney General Ken Paxton filed an injunction to stop a lockdown order implemented by the El Paso county judge, the top administrative officer, at a time when El Paso hospitals were so overwhelmed with COVID-19 patients that 10 mobile morgues had to be set up at an area hospital to accommodate the dead. For some border families, the immense toll of the pandemic meant multiple deaths among loved ones. Ruby Montana not only lost her uncle to COVID-19, but also her cousin Julieta “Julie” Apodaca, a former elementary school teacher and speech therapist. Montana says Valles’ death surprised the family. When he was diagnosed with COVID-19 in December, Montana and the family were not worried, not only because he had no preexisting health conditions, but also because they knew his lungs were so strong from practicing his trumpet daily over the course of decades. At the time, he was teaching remotely at Guillen Middle School in El Paso’s historical El Segundo Barrio neighborhood, an area known as “the other Ellis Island” because of its adjacency to the border and its history as an enclave for Mexican immigrant families. In early January, Valles went to a local urgent care after his condition deteriorated. He had pneumonia and was told to go straight to the emergency room. “When I took him to the [hospital], I dropped him off and went to go park,” says his wife, Elvira. “I never saw him again.” When she returned from parking, she says, the hospital staff did not let her inside. Valles, a father of three, had been teaching one of his three grandchildren, 5-year-old Aliq Valles, to play the trumpet. They “were joined at the hip,” Montana says. “That part has been really hard to deal with too. [Aliq] should have a whole lifetime with his grandpa.” Hispanic adults have been more than twice as likely to die from COVID-19 compared with white adults, according to the U.S. Centers for Disease Control and Prevention. In Texas, Hispanic residents died of COVID-19 at a rate four times higher than that of non-Hispanic white people, according to a December analysis by the Dallas Morning News. Ninety percent of residents under 65 in Texas border counties are Hispanic, compared with 37% in the rest of the state. Latinos have higher rates of chronic conditions like diabetes and obesity than the national averages, which increases their risks of COVID-19 complications and the risk of dying from the viral infection at earlier ages, health experts say. Coda Rayo-Garza, an advocate for policies to aid Hispanic populations and a professor of political science at the University of Texas-San Antonio, says expanding Medicaid would have aided the border communities in their fight against COVID-19 as they have some of the highest rates of residents without health coverage in the state. “There has been a disinvestment in border areas long before that led to this outcome,” she says. “The legislature did not end up passing Medicaid expansion, which would have largely benefited border towns.” The higher death rate among border communities are “unfortunately not surprising,” says Democratic congresswoman Veronica Escobar, who represents the district that includes El Paso. “It’s exactly what we warned about. People in Texas died at disproportionate rates because of a dereliction on behalf of the governor. He chose not to govern … and the results are deadly.” Renae Eze, a spokesperson for Governor Abbot says he mourns every life lost to COVID-19. “Throughout the entire pandemic, the state of Texas has worked diligently with local officials to quickly provide the resources needed to combat COVID-19 and keep Texans safe,” she says. Ernesto Castañeda, a sociology professor at American University in Washington, D.C. (unrelated to Heide Castañeda) says structural racism is integrally linked to poor health outcomes in border communities. Generations of institutional discrimination—through policing, educational and job opportunities, and health care—worsens the severity of crisis events for people of color, he argues. “We knew it was going to be bad in El Paso,” Castañeda says. “El Paso has relatively low socioeconomic status, relatively low education levels, high levels of diabetes and overweight [population].” In some Texas counties along the border, more than a third of workers are uninsured, according to an analysis by Georgetown University’s Center for Children and Families. “The border is a very troubled area in terms of high uninsured rates, and we see all of those are folks put at increased risk by the pandemic,” says Joan Alker, director of the center. In addition, because of a shortage of health workers along much of the border, the pandemic surge was all the more deadly, says Dr. Ogechika Alozie, an El Paso-based specialist in infectious diseases. “When you layer on top not having enough medical personnel with a sicker-on-average population, this is really what you find happens, unfortunately,” he said. The federal government has designated the entire Texas border region as both a “health professional shortage area” and a “medically underserved area. Jagdish Khubchandani, a professor of public health at New Mexico State University in Las Cruces, about 40 miles northwest of El Paso, says the two cities were like night and day in their response to the crisis. “Restrictions were far more rigid in New Mexico,” he said. “It almost felt like two different countries.” Doña Ana County and New Mexico mandated masks in public places and inside private businesses. Manny Sanchez, a commissioner in Doña Ana County, says the masking rules and messages urging residents to maintain physical distancing were critical to the effort to beat back the virus. “I would like to think we made a difference in saving lives,” Sanchez says. But, because containing a virus requires full community buy-in, even El Paso residents who understood the risks were susceptible to COVID-19. Julie Apodaca, who had recently retired, had been especially careful, in part because she knew her asthma and diabetes put her at increased risk. As the primary caregiver for her elderly mother, she was likely exposed to the virus through one of the nurse caretakers who came to her mother’s home and later tested positive, says her sister Ana Apodaca. Julie Apodaca had registered for a COVID-19 vaccine in December as soon as it was available but had not been able to get an appointment for a shot by the time she fell ill. Montana found out that Apodaca had been hospitalized the day after her uncle died. One month later, and after 16 days on a ventilator, she too died, on March 13. She was 56. This story was done in a partnership between KHN and El Paso Matters. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation. El Paso Matters is a member-supported, nonpartisan media organization that focuses on in-depth and investigative reporting about El Paso, Texas, Ciudad Juárez across the border in Mexico, and neighboring communities. MethodologyTo analyze COVID-19 deaths rates along the border with Mexico, KHN and El Paso Matters requested COVID-19-related death counts by age group and county from Texas, New Mexico, California and Arizona. California and Arizona were unable to fulfill the requests. The Texas Department of State Health Services and the New Mexico Department of Health provided death counts as of Jan. 31, 2021. Texas’ data included totals by age group for border counties as a group and for the state with no suppression of data. New Mexico provided data for individual counties, and small numbers were suppressed, totaling 1.6% of all deaths in the state. (Data on deaths is commonly suppressed when it involves very small numbers to protect individual identities.) National death counts by age group were calculated using provisional death data from the Centers for Disease Control and Prevention, and included deaths as of Jan. 31, 2021. Rates were calculated per 100,000 people using the 2019 American Community Survey. The ethnic breakdown in Texas’ border counties comes from the Census Bureau’s 2019 population estimates. from https://ift.tt/3vMyTvo Check out https://takiaisfobia.blogspot.com/ |
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