Illinois leaders are correct to focus on stepping up mental health services in schools in the wake of COVID-19, as our surveys demonstrate how dealing with the pandemic negatively affected students. But not all Illinoisans were disrupted the same way, and state leaders need to ensure that resources reach the children who were hardest hit. It is clear that the city of Chicago itself is the epicenter of this crisis. [Crain's]

“The last few years have been challenging for all of us and this is especially true for our children,” Gov. J.B. Pritzker observed in August in announcing that the state is making $10 million in federal money available as grants. He understated.

The need is clear. In a recent Harris Poll survey of Chicago-area parents of school-age children (ages 5-17), 90% said that the local, state and/or federal governments need to provide more aid to support students’ mental health, and 92% said that school districts ought to prioritize offering mental health services. Pluralities of these parents said that the pandemic harmed their child’s social health (42%) and emotional development (36%), while significant numbers also reported negative effects on behavioral development (35%) and academics (33%).

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Importance  In the US, the prevalence of hepatitis C virus (HCV) is 1.8% among people who are Black and 0.8% among people who are not Black. Mortality rates due to HCV are 5.01/100 000 among people who are Black and 2.98/100 000 among people who are White.

Hepatitis C virus (HCV) is the most common chronic bloodborne infection in the US and a leading cause of mortality from infectious disease, primarily through progression to cirrhosis, liver failure, and hepatocellular carcinoma (HCC).^1-3 From 2013 to 2016, approximately 4.1 million people in the US had a positive HCV antibody test result, indicating past or current HCV infection, of whom approximately 2.4 million had current HCV infection with HCV RNA detected in their blood.¹ Among approximately 29 065 800 Black individuals in the US between 2013 and 2016, the prevalence of HCV infection was 1.8% compared with 0.8% among approximately 215 615 900 individuals of other races and ethnicities combined (prevalence ratio [PR], 2.2) (Table 1).⁴ Black individuals comprise 23% of all HCV-infected individuals in the US, but represent approximately 12% of the population.⁴ Among US residents in 2021, those who were non-Hispanic Black had an HCV mortality rate of 5.01/100 000 compared with 9.99/100 000 for American Indian/Alaska Native individuals, 1.32/100 000 for Asian/Pacific Islander individuals, 3.67/100 000 for Hispanic individuals, and 2.98/100 000 for non-Hispanic White individuals (Table 2).³ Of the approximately 13 895 HCV-related deaths in 2021, an estimated 279 were among American Indian/Alaska Native people, 293 among Asian/Pacific Islander people, 2442 among Black people, and 1901 among Hispanic people.

Because of the high prevalence and absolute number of annual HCV-related deaths in Black populations relative to other racial and ethnic minority groups, this review summarizes evidence regarding Black race and inequities in outcomes of HCV infection.

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             Mental healthcare access and treatment was down by 24% and no change was detected for PRO's after ACO enrollment. 

Being enrolled in an accountable care organization (ACO) won’t do much to improve a patient’s mental healthcare access or symptom burden; in fact, ACO enrollment has proven to hamper access to care and decrease patient-reported outcomes for folks with depression and anxiety disorders, a new Health Affairs study says. [Patient Engagement HIT] 

The data, obtained via email, shows that Medicare beneficiaries newly enrolled in Medicare ACOs see a 24 percent drop in mental healthcare treatment during the year, plus no relative improvement in their anxiety and depression symptoms.

These findings come as the United States healthcare system looks to ACOs as the gold standard in chronic disease management.

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On November 1, the CDC released sobering new data that showed a 3% increase in infant mortality in 2022. This is critical as infant mortality has steadily decreased over the last several years and this data shows the largest year-to-year increase in more than 20 years. Maternal and infant health is fundamental to all health. Read our statement. [CDC and March of Dimes]

One of the leading factors in infant mortality is preterm birth. Now, more than ever, it's critical that we do all we can towards ending preventable preterm birth. This November is the 20th anniversary of Prematurity Awareness Month. Please join us to raise awareness of the maternal and infant health crisis our country is facing.

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Opioid use during pregnancy has greatly increased in the past 3 decades.¹ Medications for opioid use disorder (MOUD) are an effective treatment, but use of MOUD remains low.¹ Little is known about the association between MOUD use in pregnancy and improved outcomes for children of pregnant people with opioid use disorder (OUD).^2-5 This omission from the literature is important, as treatment during the prenatal period may have long-term implications for infant health by ameliorating the harm caused by untreated OUD. Using a multistate Medicaid claims database on mother-infant dyads, we examined the association between receipt of prenatal MOUD and health services use (recommended number of well-child visits, emergency department [ED] visits, and rehospitalization) during the first year of life. [JAMA Network]

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On April 10, 2023, U.S. President Joe Biden signed a resolution officially terminating the Covid-19 national emergency in the United States. The public health emergency ended 1 month later. In September 2022, Biden had stated that “the pandemic is over,” when during that month, there were more than 10,000 deaths involving Covid-19 nationwide. [The New England Journal of Medicine]

The United States is, of course, not the only country to have made such pronouncements. Several European countries declared an end to the emergency associated with the pandemic in 2022, lifting restrictions and starting to manage Covid-19 more like influenza. What insights can be derived from past declarations of this sort?

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Join us for the 9th State of Health of Chicago! The Institute of Medicine of Chicago, hosts this biannual event to discuss the critical issues impacting healthcare and public health from this convening with thought leaders.  The State of Health of Chicago is a pivotal event as diverse leaders discuss and define imperative challenges that are barriers to advancing healthcare equity and reducing healthcare disparities. The purpose is to identify areas that demand attention for action and initiatives to drive a path to reduce healthcare disparities. 

We are honored that Dr. Bechara Choucair, MD, SVP and Chief Health Officer of Kaiser Permanente- Kaiser Foundation Health Plan & Hospitals will join us.  In addition, a diverse panel of speakers will discuss key issues facing the healthcare and public health community.  Health  News Illinois is the moderator of the panel discussion. The educational forum will be followed by a networking reception.

More details and to register more> 

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IOMC join Dr. Georges Benjamin, Executive Director of The American Public Health Association, in this webinar to discuss the role of public health practitioners as chief health strategists and how to build modernized public health system. The webinar is open to all- Nov. 28th at 830 AM CT. 

The American Public Health Association champions the health of all people and all communities. They are the only organization that combines a 150-year perspective, a broad-based member community and the ability to influence policy to improve the public's health. www.apha.org

Dr. Georges C. Benjamin, MD is known as one of the nation’s most influential physician leaders because he speaks passionately and eloquently about the health issues having the most impact on our nation today. From his firsthand experience as a physician, he knows what happens when preventive care is not available and when the healthy choice is not the easy choice. As executive director of APHA since 2002, he is leading the Association’s push to make America the healthiest nation.

More details and to register here>

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Illinois Attorney General Kwame Raoul joined colleagues this week to urge a federal court to uphold an initiative of the Biden administration intended to make it easier for legal immigrants to access Medicaid and other federal programs. [Health News Illinois] 

The 17 attorneys general wrote in a brief to the Southern District of Texas that the administration’s changes to the so-called “public charge” rules will support states in their efforts to get immigrants and their families to enroll in and access health and nutrition programs for which they are eligible.

They said it will help improve immunization rates and reduce the financial and administrative burden on states’ public health agencies, health systems and safety-net providers.

“Everyone, regardless of where they are born, deserves the right to critical healthcare and housing programs,” Raoul said in a statement. “I urge the court to uphold these policy changes to ensure hardworking immigrants and their families have access to the programs that protect their well-being.”

The Biden administration announced the rule in 2022, restoring the public charge policy to what it was before former President Donald Trump, whose administration moved to make it easier for the federal government to deny immigrants green cards if they receive government benefits.

 Texas has sued over the Biden administration’s rule, requesting the court block its enforcement.

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The federal government must do more to address maternal health outcomes, specifically among Black women, Sen. Tammy Duckworth, D-Ill., and Rep. Robin Kelly, D-Matteson, said this weekend. [Health News Illinois]

The lawmakers and officials from the United States Health Resources and Services Administration participated in a roundtable discussion in Chicago on maternal health disparities and ways to provide resources and support for women at risk.

Kelly noted that Illinois has taken several steps to address the issue, including extending the Medicaid postpartum period to a full year, but “there is so much more that needs to be done.”

“In the richest country in the world, it is unacceptable that the United States continues to fail moms and babies,” she said. “Black and Native women, especially, are most likely to die from pregnancy-related complications because of systemic racism.”

Kelly noted Congress has passed several proposals to address the matter, including one that tasks the Department of Health and Human Services with identifying, developing and disseminating best practices to improve maternal healthcare.

A report earlier this month from the Department of Public Health found Black Illinois women continue to die at disparately higher rates from medical causes, while substance use disorder is the leading cause of pregnancy-related death.

“This isn’t some Catch-22," Duckworth said. "There are real — and easy-to-implement — solutions, and I’m going to keep pushing on the federal level to help end this crisis once and for all."

The senator reintroduced a plan last week to grant paid leave to individuals who have experienced pregnancy loss.

The Health Resources and Services Administration has held events across the country in the past month to raise awareness of the issue.

 "We stand with the families of Chicago and are committed to the work of supporting safer pregnancies, eliminating health disparities and helping families to thrive,” agency Administrator Carole Johnson said in a statement.

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