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Morning Rounds Shraddha Chakradhar

Hospitals sue Trump administration over proposed price disclosure rule

Major hospital groups are suing the Trump administration over a proposed rule it announced last month that would require hospitals to disclose the prices of health services they provide. If finalized, hospitals would have to report online what they charge for common inpatient and outpatient services such as X-rays starting Jan. 1, 2021, and noncompliance could lead to a fine of up to $300 a day. In the new lawsuit, seven groups, including the American Hospital Association, are arguing that the new rule is “unlawful, several times over,” and that in issuing it, CMS overextended its authority. The groups also say that the rule would not accurately reflect what a patient’s actual out-of-pocket costs would be, since hospitals work with insurance companies to negotiate prices. 

Lab Chat: How police killings of unarmed black Americans could harm black infants’ health

A new study finds police shootings of unarmed black Americans could also be harming the health of infants not directly involved in these incidents. Black mothers who were exposed to such events during pregnancy were more likely to give birth to infants who were born prematurely or with low birth weight. I spoke to Joscha Legewie, a sociologist at Harvard University and the author of the study, to learn more. 

What did you find? 
There’s a substantial effect of exposure to police killings during the first and second trimester on [low birth weight and gestational age]. This correlational link is very specific to police killings of unarmed black [people]. I did not find a similar pattern or similar effects on the gestational age and birth weight in infants of other races or ethnic groups, [or] on armed black Americans. 

What do you think might be the underlying reason for these findings?
This very race-specific pattern helps me to, at least partially, rule out possible explanations, namely that this is driven by crime. The fact that this effect is concentrated among police killings of unarmed black individuals tells me that the stress and the perception of injustice is the most plausible explanation of this.

Read the rest of our conversation here

U.S. making gains against smoking, but challenges remain for chronic disease

United Health Foundation’s latest report on health in the U.S. paints a complicated picture: There have been significant strides against smoking and infant mortality, but chronic conditions are still a growing problem. Here’s a snapshot of the findings: 

  • Successes: Nationally, smoking rates have dropped by 45% since the foundation’s first report in 1990. Infant mortality rates are at a 30-year low. 

  • Challenges: Rates of obesity among adults across the country have increased 166% in the past 30 years. Drug-induced deaths (both intentional and unintentional) increased 104% since 2007. 

  • State-level trends: Vermont earned the spot for the healthiest state, for low levels of health disparities and low rates of mental health problems. Mississippi dropped to the bottom spot, with a higher-than-average rate of infant mortality and high rates of obesity and cardiovascular deaths. 

Inside STAT: For early signs of dementia, check bank accounts, not biomarkers

Biomarker-based tests can offer telltale signs of disease, and researchers are trying to develop such evaluations for dementia that rely on protein biomarkers such as amyloid and tau. But there may be another, easier way to detect early dementia: financial insecurity. In a new First Opinion for STAT, the Knoebel Institute for Healthy Aging’s Dr. Eric Chess explains how impaired financial decision-making can appear decades before traditional signs of dementia such as memory loss. People with early stages of the disease are prone to making impulsive, irrational financial decisions that are a departure from the way they previously managed things, he writes. And that's why Chess and his colleagues at the Financial Security and Cognitive Health Initiative at the University of Denver are studying the relationship between money management and various forms of dementia. Read more here

New vaping-related lung injury resembles condition from exposure to hard metals


Patient's lung tissue under the microscope (left) and healthy lung tissue under the microscope (right) (Kirk Jones, UCSF)

In a case study, researchers report what may be the first instance of a vaping-associated lung injury resembling a condition found among those who work with hard metals. Known as hard metal pneumoconiosis, the condition usually arises after exposure to metals such as cobalt in jobs like tool sharpening. In the report, a 49-year-old woman in California had trouble breathing and reported using a marijuana vape pen for six months. A biopsy of her lung samples showed “giant” cells characteristic of the disease. An analysis of her vaping pen's liquid showed the presence of hard metals, including cobalt and nickel. Although the researchers couldn’t find cobalt in the patient’s lung tissue samples — and establish a direct link — they suggest better regulation of what goes into vaping devices to avoid the possibility of disease. 

New report examines barriers to paid family medical leave, especially for men

A new report from the think tank New America finds that nearly half of the parents surveyed took less than two days off work after the birth or adoption of a child. Here’s more: 

  • Differences: 48% of fathers have taken some amount of time off, versus 55% of mothers. Those numbers are lower among working parents — 28% of working fathers took leave compared to 31% of working moms. 

  • Paid leave: About two-thirds of the men who took time off reported receiving some pay, compared to 53% of women. Parents who earned $30,000 or less were about half as likely to get some paid leave as those who earned $100,000 or more. 

  • Barriers: A majority of people believe financial concerns are why men don’t take time off. About a third of those surveyed believe supportive managers help men take leave. 

What to read around the web today

  • Meet Junaid Nabi, STAT 2019 Wunderkind. STAT
  • Unpacking the black box in artificial intelligence for medicine. Undark
  • Nearly 700,000 SNAP recipients could lose benefits under new Trump rule. NPR
  • How Scientific American ended up at the center of a massive Twitter war. Slate
  • Problems with medicines may be vastly underreported to the FDA. STAT Plus
  • ‘He showed us life’: Japanese doctor who brought water to Afghans is killed, The New York Times

Thanks for reading! More tomorrow,

Shraddha

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Thursday, December 5, 2019

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