Institute of Medicine of Chicago

Durbin unveils roadmap to address rural healthcare workforce

24 May 2023 8:58 AM | Deborah Hodges (Administrator)

U.S. Sen. Dick Durbin, D-Ill., on Monday laid out a roadmap he says will prioritize recruitment and incentives for healthcare workers in rural areas, as well as expand educational programming at colleges and universities. [Health News Illinois]

The plan identifies three priorities for stakeholders to focus on over the next four years to address shortages of health professionals in rural areas.

That includes exploring new training partnerships between community colleges and medical facilities, the promotion of dual-credit options for high school students and increasing the number of medical residency programs operating in rural areas.

Durbin said during a stop in Lincoln that the roadmap “will help us address the root causes of these shortages by reaching into middle and high schools to attract young people into health careers, expanding the capacity of our education programs, and creating incentives for rural recruitment.”

Many of the initiatives will be funded through the federal Health Resources and Services Administration, with Durbin saying his office will convene regular meetings with hospitals, health centers, medical schools, nursing schools, community colleges and other stakeholders to disseminate federal funding opportunities and coordinate projects.

Eleven Illinois associations have signed on as partners in the work, including the Illinois Association of College of Nurses, the Illinois Health and Hospital Association and the Illinois State Medical Society.

As part of the announcement, Durbin said the Illinois State University will receive $2 million to expand its nursing school, and Southern Illinois University’s School of Medicine will receive $1 million to establish a Rural Health Institute.

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Using Modern Modalities to Improve Population Health and Advance Food and Health Equity

23 May 2023 5:37 PM | Deborah Hodges (Administrator)

I appreciated the recent Viewpoint by Virudachalam et al¹ highlighting the critical need to expand produce prescription programs to children as a means to advance food equity. As the principal investigator of Food for Health, a randomized clinical trial of a produce prescription program for children at New York City Health + Hospitals, the nation’s largest public health care system, I wholeheartedly agree with the authors’ sentiments. However, I regret that they overlooked the rapidly growing modality of home delivery of fruits and vegetables, which eliminates multiple barriers to inequitable fruit and vegetable access and stands to play an important role in advancing food and health equity. [JAMA Pediatrics}

Providing vouchers or on-site pickup for prescribed produce is often a substantial barrier to fruit and vegetable access among both rural and urban populations, who often face inequitable access to healthy foods. Studies of produce prescription programs have found that, in addition to limited proximity to prescription redemption locations, barriers to redeeming produce prescriptions include limited mobility, limited or unreliable transportation, and lack of childcare.² In recent years, produce prescription programs have begun to deliver fruits and vegetables to participants’ homes, but these have been pilot studies or serve adults.³^,4

To our knowledge, Food for Health is the first large study of a produce prescription program for children that delivers locally grown produce directly to participants’ homes.⁵ Our team chose home delivery to eliminate barriers to fruit and vegetable access, which we know are many among the population we serve, and to thereby advance food and health equity. Although this is more costly than vouchers or on-site pickup, we feel strongly that the benefit of overcoming barriers to fruit and vegetable access is worth the cost.

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Senate approves insurance coverage for mental health checkups, other proposals

22 May 2023 3:10 PM | Deborah Hodges (Administrator)

Senate approves insurance coverage for mental health checkups, other proposals

The Illinois Senate approved several healthcare proposals late last week, including one requiring insurance coverage for annual mental health checkups and wellness visits. [Health News Illinois]

The plan, sponsored by Sen. Laura Fine, D-Glenview, also encourages the Illinois Department of Public Health to work on an educational campaign for mental health and wellness.

The health insurance coverage provision would take effect in 2025.

“Normalizing annual mental health checkups will give people who may not have considered seeking support the strength to do so,” Fine said in a statement after the plan passed the chamber unanimously.

The Senate also approved a bill from Sen. Sara Feigenholtz, D-Chicago, that prohibits other states from using automatic license plate reader data gathered in Illinois to prosecute people seeking reproductive healthcare in the state or to detain people based on their immigration status.

“Illinois is one of the most health-accessible and welcoming states in the nation, so we need to make sure that residents and visitors alike are protected and their personal medical decisions are kept private,” Feigenholtz said.

It also approved a measure by Sen. Kimberly Lightford, D-Maywood, that requires the Illinois State Board of Education to create an index to measure community childhood trauma exposure among children between the ages of 3 and 18.

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House committee forwards legislation to cap insulin costs at $35 per month

19 May 2023 9:57 AM | Deborah Hodges (Administrator)

A House committee signed off Thursday on a proposal to lower the state’s cap on the out-of-pockets costs for insulin to $35. [Health News Illinois]

The House’s Prescription Drug Affordability & Accessibility Committee unanimously approved a bill by Rep. Jenn Ladisch Douglass, D-Elmhurst, that would update a 2020 law that caps out-of-pocket costs for insulin at $100 for a 30-day supply for patients who have commercial insurance plans regulated by the state.

Unlike the previously approved plan, the bill now tasks the Department of Central Management Services with providing participants with an identification card to show they qualify for the program. The agency would create the guidelines for who will be eligible for the program.

That latter provision gave pause to Rep. Dan Caulkins, R-Decatur, who questioned why lawmakers would not set the guidelines for the program, as well as how individuals will know if they are eligible.

Ladisch Douglass said she expects providers, insurers and Medicaid managed care organizations to inform individuals if they are eligible for the program.

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Maternal Opioid Use Disorder and the Risk of Postneonatal Infant Mortality

18 May 2023 12:04 PM | Deborah Hodges (Administrator)

Key Points

Question What is the risk of postneonatal infant mortality among infants with neonatal opioid withdrawal syndrome (NOWS) diagnosis or born to individuals with opioid use disorder (OUD)? [JAMA Peds]

Findings In this cohort study of 390 075 infants, after adjusting for maternal and infant characteristics, the risk of postneonatal infant mortality was significantly higher for those born to individuals with OUD or diagnosed with NOWS as compared with unexposed infants.

Meaning In this study, maternal OUD and NOWS diagnosis were associated with an increased risk of postneonatal infant mortality.

Download PDF of article here>

Read on-line article here>

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NIH-funded study highlights the financial toll of health disparities in the United States

17 May 2023 7:29 AM | Deborah Hodges (Administrator)

Ground-breaking study provides national and state-level estimates of the economic burden of health disparities by race and ethnicity and educational levels.

New research shows that the economic burden of health disparities in the United States remains unacceptably high. The study, funded by the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health, revealed that in 2018, racial and ethnic health disparities cost the U.S. economy $451 billion, a 41% increase from the previous estimate of $320 billion in 2014. The study also finds that the total burden of education-related health disparities for persons with less than a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018. [NIH

The findings from this study by researchers from NIMHD; Tulane University School of Public Health and Tropical Medicine, New Orleans; Johns Hopkins Bloomberg School of Public Health, Baltimore; Uniformed Services University, Bethesda, Maryland; TALV Corp, Owings Mills, Maryland; and the National Urban League were published in JAMA.

This study is the first to estimate the total economic burden of health disparities for five racial and ethnic minority groups nationally and for all 50 states and the District of Columbia using a health equity approach. The health equity approach set aspirational health goals that all populations can strive for derived from the Healthy People 2030 goals. It establishes a single standard that can be applied to the nation and each state, and for all racial, ethnic, and education groups. It is also the first study to estimate the economic burden of health disparities by educational levels as a marker of socioeconomic status.

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Johnson focuses on addressing mental health in inauguration speech

16 May 2023 9:13 AM | Deborah Hodges (Administrator)

Newly inaugurated Chicago Mayor Brandon Johnson said Monday that ensuring access to mental healthcare will be a key priority for his administration. [Health News Illinois]

“I want to make sure that no one ever has to suffer because they do not have access to mental health services,” Johnson said during his inauguration speech at the University of Illinois Chicago’s Credit Union 1 Arena. “And people have told us for too long, ‘It's a matter of life and death.’ So let's bring together the private sector, the public sector, the county, the state and the federal government to find the best solutions for delivering these services.”

As part of that push, Johnson reiterated a plan to reopen the city’s mental health clinics that were closed in 2012 by then-Mayor Rahm Emanuel.

That comes as Johnson plans to, at least initially, keep on the current city health leadership.

Public Health Commissioner Dr. Allison Arwady told WGN Radio last week that she and Johnson recently met and that she will be staying in her role for the foreseeable future.

“I’m excited to work with the new administration,” Arwady said. “Public health is our primary focus — it’s not the political piece. But, of course, it’s important we can work with whoever the political leaders are.”

Arwady, as well as Johnson's predecessor, Lori Lightfoot, have focused mental health efforts on supporting community mental health organizations working in the city's 77 neighborhoods.

Johnson also said Monday Chicago must address the rise in immigrants coming to the city and meet their health and social needs. He did not go into specifics, but said Chicago is a welcoming city.

“We don’t want the story to be told that we were unable to house the unhoused or provide safe harbor for those who are seeking refuge here, because there is enough room for everyone in the city of Chicago,” Johnson said.

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New Mexico Program to Reduce Maternity Care Deserts in Rural Areas Fights for Survival

15 May 2023 11:35 AM | Deborah Hodges (Administrator)

Thirteen weeks into her pregnancy, 29-year-old Cloie Davila was so “pukey” and nauseated that she began lovingly calling her baby “spicy.” [KFF Health News}

Davila was sick enough that staffers at the local hospital gave her 2 liters of IV fluids and prescribed a daily regimen of vitamins and medication. This will be Davila’s third child and she hopes the nausea means it’s another girl.

Davila had moved back to her hometown of Clayton, New Mexico, so her kids could grow up near family — her dad, aunts, uncles, and cousins all live in this remote community of about 2,800 people in the northeastern corner of the state. But Clayton’s hospital stopped delivering babies more than a decade ago.

Aside from being sick, Davila was worried about making the more than 3½-hour round trip to the closest labor and delivery doctors in the state.

“With gas and kids and just work — having to miss all the time,” Davila said. “It was going to be difficult financially, kind of.”

Then, Davila spotted a billboard advertising the use of telehealth at her local hospital.

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Racial, Ethnic Disparities Persist in OUD Treatment-Differences emerged despite similar numbers of healthcare visits

12 May 2023 1:39 AM | Deborah Hodges (Administrator)

Black and Hispanic patients with a disability had a tougher time getting medication to treat opioid use disorder (OUD) despite frequent contact with healthcare providers, Medicare claims data showed.

Within 180 days of an index OUD-related event, Black patients received a prescription for buprenorphine 12.7% of the time, Hispanic patients 18.7% of the time, and white patients 23.3% of the time, reported Michael L. Barnett, MD, of Harvard T. H. Chan School of Public Health in Boston, and colleagues.

Naloxone receipt followed a similar pattern, occurring after 14.4%, 20.7%, and 22.9% of index events, respectively, the authors reported in the New England Journal of Medicineopens in a new tab or window.

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Culturally Competent Care Is Key to Overcoming Health Inequities

11 May 2023 5:31 PM | Deborah Hodges (Administrator)

Considering the variability in how patients are treated in a hospital setting, we can all agree that their outcomes can be vastly different based on their ethnicity, resources, socioeconomic background, and beliefs. Two different people can come to the same hospital for the same procedure and have a completely different experience. [ MedPage Today]

A patient of mine named Mariela* was recently admitted to labor and delivery for the birth of her baby. She was a high-risk, Latina patient who spoke only Spanish. Luckily, I did not have to use an interpreter as I am certified to speak Spanish to patients.

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