Emergency departments trying to help patients with social problems such as food insecurity and housing insecurity are meeting with varying degrees of success, according to reports from researchers here at the annual meeting of the American College of Emergency Physicians. [MedPage Today]

Although screening in the emergency department for food insecurity is becoming more common, "many patients experience difficulty in connecting to the resources that we refer them to," Alex Ulintz, MD, of the Ohio State University in Columbus and formerly a resident at Indiana University in Bloomington, said Tuesday.

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Illinois ranks 15th nationally when it comes to the health of women and children, according to a report released by the United Health Foundation last week. [Health News Illinois]

The report from America's Health Rankings placed Illinois atop the country for its prevalence of neighborhood amenities and second-best for low prevalence of frequent mental distress among women. Other strengths include Illinois placing 8th for high enrollment in early childhood education and 9th for its low percentage of uninsured children.

Download report here>

However, the state received low marks for having a low prevalence of cervical cancer screening, which was the 4th worst in the country. 

Illinois also placed 45th for Special Supplemental Nutrition Program for Women, Infants, and Children coverage among children 4 and younger, 41st for employment among women and 40th for fruit and vegetable consumption among women.

Illinois finished 16th for women’s health and 17th for children’s health.

Minnesota was ranked the healthiest state for women and children in the country, while Mississippi finished last.

Overall, the report found that rates of maternal mortality increased 29 percent between 2014-2018 and 2017-2021, with non-white women being disproportionately affected. The rate of drug deaths among women increased 27 percent from 2016-2018 to 2019-2022.

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As professionals working closely with child protective services (CPS) for many years, we are well aware of its shortcomings, particularly undertrained and overwhelmed staff who may inadequately protect children and serve families as mandated by states’ laws. Some professionals and media have highlighted the problems, feeding into a popular narrative that damns CPS as a dangerous, damaging structure.¹ Missing from this picture are data and stories of when children are protected and families are helped. We think a balanced perspective is much needed, recognizing both CPS’ strengths and shortcomings, to move forward constructively. [JAMA}

The history of CPS in the United States clearly points to a broad concern for vulnerable children.² A seminal article on the “battered child” in 1962 in JAMA³ galvanized enormous attention and quickly led to civil laws in all 50 states to protect abused and neglected children. The primary intent has been and remains to help families, not to punish parents; in a small minority of instances, accountability does lead to criminal prosecution.

Despite the above goals, some argue that mandated reporting of suspected child maltreatment to CPS is implemented in a racist and paternalistic manner.¹ There is some dated support for this position, although recent research clarifies that the association is confounded by poverty.⁴ Indeed, after analyses control for sociodemographic variables, Black newborns exposed to illicit drugs appear less likely to be reported than White newborns. Similarly, others found that racial disproportionality in CPS’ overall statistics is largely confounded by poverty,⁵ with further support by a recent analysis.⁶ Reported Black children were less likely to have maltreatment substantiated and less likely to be placed out of home than White children.⁶ Clearly, child poverty and its many associated burdens are strongly linked to a lengthy list of problems.

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When Sukky Bleck’s infant son was diagnosed last year with bilateral hydronephrosis, a condition preventing urine from draining from the kidney into the bladder, she started questioning herself. [Chicago Tribune]

“Was it something I did? What did I do wrong? How can I fix it,” the 27-year-old Southeast Side resident said.

Bleck said she soon became haunted by whether lead-contaminated drinking water might have contributed to his condition. While kidney damage from lead exposure is uncommon in the United States, according to the National Kidney Foundation, lead found in drinking water has been proven to cause kidney damage on rare occasions, usually after many years of exposure.

“I shouldn’t have to stockpile cases of water for my children’s home. No parent should,” she said. “The lead pipe crisis is not just a statistic. It’s a harsh reality we’re facing daily. Our children, our future are at risk.”

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Crisis in Black communities: Black residents in Cook County are the only racial group whose suicide rates are higher now than before the pandemic. The problem is even worse for men, whose suicide rates are more than three times higher than women in Cook County. Advocates say there isn’t much encouragement for men — particularly Black men— to discuss mental health. [Chicago Sun-Times]

Chicagoans want help: While grassroots mental health organizations and groups have popped up in the Chicago area, city-run resources haven’t done enough outreach in suicide prevention, say families who have lost loved ones. Also, a lack of messaging directly to communities in need — in addition to well-documented clinic closures — could have been a factor in higher suicide rates for Black residents, mental health advocates say.

Pain into purpose: Rafiah Maxie-Cole, 48, was inspired to start her own organization after her son, Jamal Clay, 20, died by suicide May 27, 2020, two days after George Floyd’s death. Soul Survivors of Chicago provides financial support through donations to those struggling with trauma, as well as mental health education centering specifically on Black, Indigenous and People of Color communities.

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Six practices to improve the quality of perinatal care

The death of Olympic champion sprinter Tori Bowie from complications of childbirth cast a spotlight on the high rates of maternal mortality in the U.S., particularly among Black women. Far from an anomaly, her death highlights the fact that Black women in the U.S. are three times opens in a new tab or window more likely to die from pregnancy-related causes than white women. [MedPage Today]

Global data show that the U.S. maternal mortality rate continues to exceed that of other high-income countries. Even more striking, maternal mortality rates among the highest-income Black women are just as high as for low-income white women.

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Six municipalities will receive $41.5 million in state funds to help provide services like healthcare to asylum seekers, Gov. JB Pritzker announced Friday. [Health News Illinois] 

The majority of funds, nearly $30.3 million, will go to the city of Chicago. Other areas receiving funds include:

·    $8.6 million for Joliet

·    $1.3 million for Elgin

·    $1 million for Lake County

·    $250,000 for Urbana

·    $150,000 for Oak Park

Along with health services, the administration said the funds will be used for shelter, housing, food, wraparound services and legal support.

"Although we will still need significant federal support as this crisis continues, these grants will empower local governments to build out services and supports for new arrivals so we can successfully transition them into our state and give them the opportunity to complete their legal asylum process,” Pritzker said in a statement announcing the grants.

The funds are from a state budget allocation to the Department of Human Services. The agency will distribute the funds in partnership with the Metropolitan Mayors Caucus, which provides oversight on Notice of Funding Opportunity processes.

“Today's awards demonstrate our commitment to assisting recent arrivals from the southern border with the resources that they need to be successful,” said department Secretary Grace Hou.

The Pritzker administration said Illinois has received more than 15,000 new arrivals since last year.

The announcement came a day after Pritzker raised concerns over a plan by Chicago Mayor Brandon Johnson for a $29.4 million contract to build winter tent basecamps for asylum seekers.

Pritzker told reporters at an unrelated event that the city could instead create shelters in existing, unused buildings.

 “I have concerns about it, and we continue to have conversations about it,” Pritzker said.

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This paper is composed of three distinct but interrelated parts that together map the past, present, and future of addressing racial inequities in Maternal and Child Health. Part I recounts the history and achievements of a Centers for Disease for Control and Prevention initiative in the 1980–90’s, led by the Prematurity Research Group in the Division of Reproductive Health, Pregnancy and Infant Health Branch. [Maternal Child Health Journal]

This initiative stimulated a paradigm shift in how we understand and address black infant mortality and the inequities in this outcome. Part II illustrates examples of some exemplary programmatic and policy legacies that stemmed either directly or indirectly from the Centers for Disease for Control and Prevention paradigm shift. Part III provides a discussion of how efectively the current practice in Maternal and Child Health applies this paradigm to address inequities and proposes a path for accelerating Title V agencies’ progress toward birth equity. 

Download paper here>

Medical practice is about the human interaction between clinicians and patients, but what does it mean when a technology with human-like attributes such as AI enters the examination room? How does the dynamic between clinicians and patients change when AI is involved? [JAMA]

In a recent interview, Kirsten Bibbins-Domingo, PhD, MD, MAS, editor in chief of JAMA and the JAMA Network, discussed this aspect of AI with primary care physician Ida Sim, PhD, MD (Video). Sim is codirector of a joint program between the University of California, Berkeley, and the University of California, San Francisco (UCSF) in computational precision health. She is also an elected member of the National Academy of Medicine and the American College of Medical Informatics.

The following is an edited version of the interview.

Dr Bibbins-Domingo: I think of you as a physician who’s been in this informatics research space for a long time. You’ve also thought about how we create structures for sharing data and making data more accessible, and now all of us are talking about AI, and it’s transforming how we’re going to practice. It’s transforming how we’re going to do science. Why are we talking with a different urgency right now?

Dr Sim:I t is an urgency, absolutely. I think November 30, 2022, is going to go down in history. That was the day when ChatGPT came out. I had been talking to other people here in Silicon Valley about ChatGPT-2.0, about DALL-E, and it was just mind-blowing what was going on in the computer science world that we were not seeing publicly. But November 30 changed that.

That was an inflection point, and this is why I think it’s so transformative. AI and machine learning are 2 different terms, but we won’t dissect those. A lot of the work previous to what the public sees has been machine learning. You take a bunch of data, stick it in a black box and out comes something. And that something is usually a prediction.

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NIH-funded research sheds light on link between COVID-19 infection and increased risk of cardiovascular disease and stroke. [National Institutes of Health]

SARS-CoV-2, the virus that causes COVID-19, can directly infect the arteries of the heart and cause the fatty plaque inside arteries to become highly inflamed, increasing the risk of heart attack and stroke, according to a study funded by the National Institutes of Health. The findings(link is external), published in the journal Nature Cardiovascular Research, may help explain why certain people who get COVID-19 have a greater chance of developing cardiovascular disease, or if they already have it, develop more heart-related complications.

In the study, researchers focused on older people with fatty buildup, known as atherosclerotic plaque, who died from COVID-19. However, because the researchers found the virus infects and replicates in the arteries no matter the levels of plaque, the findings could have broader implications for anybody who gets COVID-19.

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