The Connection
A roundup of recent Fund publications, charts, multimedia, and other timely content.
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October 29, 2024
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Maternity Care Providers Are Fleeing States with Abortion Restrictions
Even prior to the Supreme Court decision ending the national right to abortion, more than a third of U.S. counties were maternity care deserts — areas without any obstetric providers or maternity care facilities. Since states began banning or severely restricting access to abortion, things have been getting worse. On To the Point, the Commonwealth Fund’s Kristen Kolb reports that states with restrictions are seeing a drop in ob/gyn residency applications and an increase in mental health issues among practicing physicians.
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Health Equity for People with Disabilities Requires New Data
Nearly a third of adults with disabilities experience unfair treatment in health care settings, as well as high rates of discrimination in hiring. Acknowledging these disparities and the detrimental effects of systemic discrimination is essential to developing a more accurate picture of the disabled population in all its diversity, write the Urban Institute’s Sarah Morriss and Nina Russell on To the Point. They say new measures are needed to estimate the disabled population — and these must be developed with input from members of the community.
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FEATURED CHART
Global Models Can Support Indigenous Peoples’ Health
Indigenous people experience among the lowest life expectancies in the United States, a consequence of both historical and ongoing oppression, missing and incomplete health data, and persistent underfunding of institutions like the Indian Health Service. Brazil and Norway have taken steps to improve health outcomes for their Indigenous populations. To learn more about their efforts — and what the U.S. can learn — stay tuned for the next International Insights, coming November 11 on LinkedIn.
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Improving Access in Rural and Tribal Communities
The Harris–Walz campaign recently announced a proposal to expand access to health care services in rural and tribal communities ([link removed] ) , including recruitment of 10,000 additional health care professionals to underserved areas. Last year, Commonwealth Fund researchers described other strategies ([link removed] ) rural hospitals are pursuing to avoid closure.
QUIZ
Since the Affordable Care Act was signed into law, the uninsured rate for Latino Americans has decreased from . . .?
- 13% to 8%
- 25% to 12%
- 33% to 18%
- 45% to 26%
Scroll down to see if you got it right.
Opportunity Costs of Medicare Advantage Plan Rebates
Federal payments to Medicare Advantage plans should be reviewed to ensure that all Medicare beneficiaries receive the care and coverage they need, say the Commonwealth Fund’s Gretchen Jacobson and colleagues in the New England Journal of Medicine. “Rebates” paid to these plans to cover extra benefits like dental, vision, and hearing care, which are not covered by traditional Medicare, have increased fivefold over the past decade. Moreover, the rebates increase premiums for people in traditional Medicare, say the authors, who point out the opportunity costs of providing extra benefits in this way.
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Equity and Medicare Advantage Supplemental Benefits
Do supplemental dental, vision, and hearing benefits offered at low or no premiums, available through most Medicare Advantage plans, close the access gap for high-need, low-income beneficiaries? In a new episode of the Health Affairs podcast A Health Podyssey, editor-in-chief Alan Weil interviews the Commonwealth Fund’s Avni Gupta about the costs associated with unmet needs.
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Climate Change as a Public Health Issue
As climate change intensifies and New Yorkers face record-breaking heat, the city is taking new measures to protect residents. Landlords will soon have to provide air conditioning to tenants, school bus fleets are going electric, and efforts are underway to make housing more affordable. On The Dose podcast, recorded during Climate Week NYC in September, host Joel Bervell talks to Cameron Clarke about the push to build a healthier New York City while advancing health and environmental justice.
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Climate Change Is Already Disrupting Health Care
The planet is getting hotter, tropical storms are growing fiercer than ever, and the Arctic is melting — but what’s that got to do with health care? On The Dose podcast, host Joel Bervell explores the intersection of climate change and public health with Admiral Rachel L. Levine, M.D., the U.S. Assistant Secretary for Health. Levine, who oversees the federal Office of Climate Change and Health Equity, talks about how weather-related events are already having a serious impact on our fragile health system supply chain, even though those effects can go unnoticed by the broader public.
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States Respond to Private Equity’s Push into Health Care
Over the past decade, private investors have been buying health care facilities, with the aim of maximizing profits. This has raised lawmakers’ concerns about the consequences for the cost, quality, and equity of health services. On To the Point, David Blumenthal, M.D., explains that without congressional action, managing private equity in health care will fall to the states. He fears that private equity could become yet “another factor dividing health care systems in conservative and progressive states.”
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Pakistani Program Boosts Maternal and Infant Outcomes
In Pakistan, where there are 186 maternal deaths per 100,000 live births, two provinces have implemented conditional cash transfers, or CCTs, to incentivize actions linked to better maternal and child health outcomes. Reporting in International Insights, the Commonwealth Fund’s Evan Gumas writes that the promising initial results — particularly an increase in hospital visits during pregnancy — may be of interest to U.S. policymakers seeking to address America’s high maternal mortality rates. Still, he cautions that CCTs must be viewed as a stopgap rather than a solution.
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Inaugural Health Equity Fellows Announced
Eight emerging health equity changemakers from across New York City have been selected to join the inaugural cohort for the Health Equity Fellowship, an initiative funded by United Hospital Fund with support from the JPB Foundation and the Commonwealth Fund. The program provides fellows with the opportunity to deepen their leadership capacities while developing and implementing action learning projects that tackle pressing health equity challenges.
The 2024–2026 fellows are: Omega Augustus, R.N. (One Brooklyn Health); Micaela Bayard, M.D. (Mount Sinai/Mount Sinai Queens); Joshua Amit Budhu, M.D. (Memorial Sloan Kettering Cancer Center); Chanelle M. Diaz, M.D. (New York-Presbyterian/Columbia University Medical Center); Gwendolyne Anyanate Jack, M.D. (New York-Presbyterian/Weill Cornell Department of Medicine); Monique Collier Nickles, M.D. (NYC Health + Hospitals/Lincoln Medical Center); Fehintola Orisamolu, D.N.P. (New York-Presbyterian/Brooklyn Methodist Hospital); and Pascale M. White, M.D. (Mount Sinai Hospital). For more information on the fellows and their work, visit [link removed] ([link removed] ) .
QUIZ: Answer
The answer is C. Since the ACA was signed into law in 2010, the uninsured rate for U.S. Latinos has decreased from 33 percent to 18 percent — meaning 9 million more have insurance coverage.
With the election just around the corner, Commonwealth Fund President Joseph Betancourt, M.D., considers what’s at stake for Latino health ([link removed] ) on To the Point. In his essay, originally published in Spanish by El Tiempo Latino and El Planeta, Betancourt draws upon his decades as a primary care doctor treating a diverse group of patients as well as his experience as a health system leader. He writes about how policies implemented by the president and Congress — whether it’s different approaches to Medicaid, the Affordable Care Act, women’s health, or health equity — could impact Latinos and their families, and all Americans who share the same hopes for health, happiness, and a promising future.
Affordable, quality health care. For everyone.
The Commonwealth Fund, 1 East 75th Street, New York, NY 10021
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