Morning Rounds: Americans’ health is trending downward, poll finds

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Good morning. What do the numbers say? That’s a question Olivia Goldhill tackled to estimate how many Texans may be struggling to get an abortion for serious medical reasons.

Kate Cox is one of hundreds in Texas denied abortions despite health risks, data show

The Texas woman who recently lost her legal fight for an abortion on medical emergency grounds was likely not alone in her plight. Kate Cox may be one of hundreds, if not thousands, of Texans facing a similar battle this year to obtain an abortion for medical reasons, according to a STAT review of studies and abortion data from other states. “We can logically assume there are hundreds, if not thousands, of cases … in a state like Texas every year,” said Gretchen Ely, of the University of Tennessee.

There were 34 legal abortions recorded in Texas in the first six months of 2023, all performed as medical emergencies, which is the only exception allowed under its abortion ban. That’s far below the expected number, so the pregnancies likely continued or the patients traveled out of state for access to  abortion. Right next door in Oklahoma, for example, 324 abortions were performed because the physical health of the mother was at risk — 59 to avert death  — in 2021, the year before Oklahoma banned abortion. Applying that rate to Texas, the population of which is more than seven times larger, the number of women at risk of death who needed abortions would exceed 400 a year. STAT’s Olivia Goldhill has more.

North Carolina sues HCA for lapses at Mission Health

Two weeks ago we told you about Tara Bannow’s sweeping report of problems at Mission Health’s six western North Carolina hospitals after HCA Healthcare took over and began cutting costs. In a complaint filed yesterday, attorney general Josh Stein accuses the country’s largest hospital chain of failing to provide the emergency and cancer care it had promised to keep intact. Its nearly 60 pages describe a catastrophic state of dysfunction at Mission’s flagship Asheville hospital.

The allegations describe patients being treated in waiting areas within full view of other patients, nurses emptying trash bins and delivering food, and patients found dead in emergency room beds hours after they died, Tara reports. In an emailed comment, Mission spokesperson Nancy Lindell emphasized the fact that Stein is currently running for governor: “We are aware of the announcement Gubernatorial Candidate Stein made in Asheville today.” Read more.

FDA product recalls are way up. Why?

Product recalls by the FDA and the Consumer Product Safety Commission more than doubled between 2018 and 2022, a new report notes. Whether something has changed about the products or their surveillance is hard to pin down, but the report suggests more frequent misuse or mislabeling of allergens may be at play.

Food and beverages made up 64% of those recalls and drugs accounted for 22%. Allergens were the most common reason (34%),  foodborne illnesses (25%) came next, followed by contamination or inadequate manufacturing processes (21%). Politics might be a factor. “Regulations are only as good as the degree to which you enforce them,” safety label and litigation warning expert Gerald Goldhaber told STAT’s Annalisa Merelli. “Under the Trump administration, their philosophy was that any regulation was a bad regulation.” Read more.

Electrical stimulation may help amputees with balance and phantom pain, early study suggests

Like other people after amputation, Lauren Gavron needed oxycodone to dull the pain from her missing lower left leg. But the drug fogged her thinking, keeping her from driving. Then she became one of three participants in a proof-of-concept study, now described in Nature Biomedical Engineering, in which electric jolts to her spine not only made her pain vanish but also helped her walk and keep her balance.

“You really wouldn’t believe it,” Gavron, 67, said. “As soon as the pain would start, it just all went away.” That feeling was temporary and came with the risk of infection, a chance she wasn’t willing to take longer-term because she had lost her leg to a sepsis infection. And while stimulating spinal nerves to generate sensation in a missing limb isn’t a new idea, the researchers wanted to test whether that could also reduce pain. STAT’s Lizzy Lawrence explains.

In new medical schools, diversity language did not match diverse student populations

Medical schools that include language about diversity in their mission statements do not have significantly more diverse student populations, according to an analysis of 60 medical schools that opened since 2000. The newer medical schools also contain student populations with similar or even less diversity than older schools, with the analysis showing newer schools had a Black population of 5% compared to 8% in medical schools as a whole.

Of the 60 new allopathic and osteopathic medical schools, 45% referred to diverse patient populations in their mission statements and 23% referred to a diverse student population, found the study, published yesterday in JAMA Network Open.

“These results suggest that substantial reform is needed in the recruitment and admissions process so that mission statements are not just hollow words,” the authors wrote, noting that numerous studies show a diverse health care workforce improves care but that diversity will also be more difficult to achieve following the recent Supreme Court ban on the use of affirmative action in school admissions.

The study found there was not a single Native American or Alaska Native medical student in any of the newer schools, whether they included a diversity statement or not, STAT’s Usha Lee McFarling tells us. (Because of data limitations from more recent years, the analysis excluded schools opened after 2020, and therefore did not include the Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, which opened in 2021 and has more than 100 Native American students.)

Americans’ health is trending downward, poll finds

The Gallup National Health and Well-Being Index entered some negative territory this year compared to the pre-Covid era. The percentage of U.S. adults classified as obese (38.4%) and who have diabetes (13.6%) have both gone up, while healthy eating has gone down since 2019. The brightest spot in the report was exercise. It didn’t go up, but it didn’t go down either, with half of respondents saying they got 30 or more minutes at least three days per week.

The survey relied on more than 5,000 respondents to report their habits, their height and weight, and if they’d been diagnosed with diabetes (type 1 or type 2). Asked if they had eaten healthy food the day before, fewer than half said yes. More people in 2023 said they were being treated for high blood pressure or high cholesterol. “Much of the recent increase in obesity may be associated with modified health behaviors resulting from the pandemic,” the report concludes.

What we’re reading

• 230,000 more RSV shots on the way after pressure from Biden officials, Politico
• Smithsonian took brains from children, fetuses and the disabled, Washington Post
• Sanders blames food companies for diabetes epidemic, STAT
• 1,374 days: My life with long Covid, New York Times
• RNA biologist loses disability case against Howard Hughes Medical Institute, Nature
• In response to criticism, FDA publishes new database of wayward clinical trial sponsors, STAT