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2 posts from January 2021


Dr. Steven Woolf Discusses How (Un)Healthy Are Americans (January 31st)

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(As noted below on the podcast website this discussion is the first of eight interviews concerning federal healthcare policy reform.  This discussion with Dr. Woolf was conducted in early November.  As you will hear this podcast, and all seven others, are introduced by ProMedica's CEO, Randy Oostra.  This series was produced in an effort to interest or persuade federal healthcare officials to pursue substantive health care policy reform.)   

Devoted listeners of the podcast will recall I interviewed Dr. Woolf in early 2013, or soon after the Institute of Medicine published,  "US Health in International Perspective, Shorter Lives, Poorer Health," a report in which Dr. Woolf served as the lead author.  As the 2013 report demonstrated, Americans are, compared to our peers in comparative countries, more disease burdened throughout our lifespan leading to earlier mortality.   This is true even for Americans whom are white, educated and insured.  Since the IOM report was published, US population health has not improved.  It has worsened.  Added to continuing epidemics in opioid overdoses and suicides, a long list of disease conditions, or over 30, have contributed to Americans experiencing shorter lifespans.   The greatest decline has been in midlife or among young and middle-aged adults, or from age 25 to 65.   US life expectancy stopped increasing in 2010 and have been decreasing since 2014.  Needless to say the effects of the ongoing COVID-19 pandemic is exacerbating this problem.   Systematic causes for our country's comparative health disadvantage include, beyond deficiencies in medical care, the prevalence of risky behaviors, socioeconomic inequalities, unhealthy environmental conditions and detrimental public policies.    

During this interview Dr. Woolf begins by discussing the effects the COVID-19 pandemic is having on US population health.  He goes on to discuss what explains our shorter life expectancy or our comparative health disadvantage, where geographically we see the greatest declines in life expectancy, he explains that even rich Americans are dying comparatively earlier, explains five systemic problems or factors that determine our health status, and notes the economic implications or poorer population health.      

Steven H. Woolf, MD, MPH, is the C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health WoolfphotoMay2019-358x537 Equity Director Emeritus and Senior Advisor at VCU's Center on Society and Health in the Department of Family Medicine & Population Health, at Virginia Commonwealth University.  Among other credentials, Dr. Woolf has served as scientific adviser and member of the U.S. Preventive Services Task Force, has consulted in Europe as a visiting scholar, is a past North American editor of the British Medical Journal and was elected to the Institute of Medicine, National Academy of Sciences in 2001.  Dr. Woolf has published more than 170 articles in a career that has focused on evidence-based medicine and the development of evidence-based clinical practice guidelines, with a special emphasis on preventive medicine, cancer screening, quality improvement, and social justice.  Dr. Woolf, a clinical epidemiologist, he received in BA at the University of Missouri, his MD degree from Emory University and his MPH from Johns Hopkins.  in 1987. He is board certified in family medicine and in preventive medicine and public health.

For a transcript of this interview or to post a comment or question, please go to: https://commissiononhealthcare.org/

Concerning Dr. Woolf's more recent, related publications, see, for example, these 2018 BMJ and 2019 JAMA articles: https://www.bmj.com/content/362/bmj.k3096 and https://pubmed.ncbi.nlm.nih.gov/31769830/


221st Podcast: NRDC's Dr. Vijay Limaye Discusses Measuring the Health-Related Costs of the Climate Crisis (January 14, 2021)

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2020 was yet another record setting temperature year tying 2016 as the warmest on record.  2020 was strikingly warmer than 2019, by about .75 degrees Fahrenheit, and some parts of Arctic were warmer by more than 10 degrees Fahrenheit.   2020 also set a US record for $1 billion climate disasters numbering 22 and totaling $95 billion damages (the previous records were 16 in 2017 and more than double the 41-year average of $45 billion).  Seven of the 22 events were hurricanes or tropical storms several others were wildfires that, for example, burned over 10 million acres in CA or double the previous record of 4.1 million acres in 2018.  Despite increasingly extreme climate-crisis events and the mounting health harms caused, including vector-borne diseases (think: COVID-19), federal policy makers remain non-responsive including, for example, MedPAC (Medicare Payment Advisory Commission) and MACPAC (Medicaid And CHIP Payment Advisory Commission).  These two independent Congressional commissions, given broad authority to address issues affecting Medicare and Medicaid beneficiaries or our most vulnerable citizens: children; pregnant women; and, the elderly, have never discussed, much less mentioned the climate crisis despite the fact these programs bear the lion share of climate crisis-related health care costs.     

During this approximately 30 minute conversation Dr. Lamaye briefly describes the NRDC's Science Center's work.  He moreover explains the current knowledge gap between climate crisis-related health effects and recognizing or accounting for these effects, it, he describes or unpacks work published in 2019 in GeoHealth in which he and his colleagues calculated the costs of ten 2012 climate crisis events including Hurricane Sandy, i.e., moreover how costs were calculated, what costs were incurred and the limitations of this research, and makes recommendations for how research to measure climate crisis-related health impacts can be, or need be, improved.    

Dr. Vijay Limaye is a Climate and Health Scientist at the National Research Defense Council's (NRDC's) Science Center.  His work largely concerns quantifying, Limaye_colorcommunicating and reducing risks associated with the climate crisis with a particular emphasis on the public health burdens of air pollution and extreme heat.  He leads the Science Center's economic valuation work that demonstrates the significant health costs of the climate crisis and works to defend the science that underpins the Clear Air Act.   Prior to NRCD, Dr. Limaye worked at the US Environmental Protection Agency (EPA) where he focused on Clear Air regulatory implementation, air quality, quality monitoring policy, risk communication and citizen science.  Dr. Limaye speaks Spanish and Hindi, has published several research studies on the health impacts of the climate crisis in the US and in India.  He received his undergrad degree from the University of California, Berkeley and his Ph.D. in environmental epidemiology from the University of Wisconsin, Madison.

Dr. Limaye's Health Affairs article discuss during the interview is again titled, "Estimating the Costs of Inaction and the Economic Benefits of Addressing the Health Harms of Climate Change,"  (Subscription required.) 

His 2019 GeoHealth article, freely available, discussed during this interview is again titled, "Estimating the Health-Related Costs of 10 Climate Sensitive Events During 2012," is at: https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2019GH000202.

Re: NOAA's $1 billion 2020 climate disasters, see their 15-page January 8, 2021 memo at: https://www.noaa.gov/stories/record-number-of-billion-dollar-disasters-struck-us-in-2020