For psyches, Gulf is Valdez on ‘fast forward’
CNN’s Jessica Ravitz reports that the damage to Gulf communities in the wake of the spill has played out like a faster version of the disintegration of Cordova, Alaska, in the wake of Exxon Valdez. Unfortunately, she writes, that doesn’t mean a quicker route to recovery. It just means a deeper dive into discombobulation and destruction. Ravitz profiles the local victims and those reaching out to help them. In the process, she paints a bleak long-term picture.
Concern about communities sends [environmental sociologist Steven] Picou on an 80-mile drive west to Bayou La Batre, a small fishing town on the opposite side of Mobile Bay. He’s traveling around the Gulf Coast to where people are hurting – to start conversations, impart what he’s learned and teach people how to listen to each other. It’s a response modeled after programs devised in Alaska.
“Unlike a natural disaster where you have a therapeutic community emerging to help you rebuild, we know that in Alaska a corrosive community emerged,” he says. “All of a sudden you have this incredible collapse of community capital.”
He describes how people may self-isolate to cope and how their distrust of others will grow and likely spread. Cynicism about BP, he says, will move on to the federal government, the Coast Guard, the Environmental Protection Agency, local governments, neighbors. Even family.
Ravitz looks at the strong sense of community now present in these places and whether the changes wrought by an influx of new people and money from BP will be permanent. She also reports that domestic violence shelters and hotlines are busier than ever as stress builds and and oil workers, who used to be away from home for weeks at a time, are now stuck on land.
For its part, BP has so far declined a request from Louisiana for $10 million for mental health aid for its residents. Catholic Charities is waiting to hear from BP about another grant that includes about $1.2 million for counseling. Peer-to-peer counseling programs, in which local residents are trained to reach out to other community members, have been launched. One mental health worker says people who were affected by Katrina have been “re-traumatized” by the oil spill.
CPI: Insurers prepare $20 mil lobbying effort
On the Center for Public Integrity’s PaperTrail blog, Peter Stone reports that five of biggest insurers in America are preparing to go to the mat for round two, this time with the intertwined goals of swinging midterm elections and influencing health reform implementation regulations.
According to Stone, Aetna, Humana, United HealthCare, WellPoint and (maybe) Cigna will pool something like $20 million. Look for the new lobbying organization, probably a 501(c) (4) nonprofit, in the next few months. Television ads and a variety of other campaigns will likely follow.
Reporter’s dumpster diving led to HIPAA deal
Filed under: Health journalism, Hot Health Headline
With a $1 million settlement, HHS and Rite Aid have closed the book on a HIPAA privacy case that began with a journalist’s investigative reporting in 2006. In a nut shell, Rite Aid employees across the country were tossing prescriptions and pill bottles out without taking measures to secure the sensitive information they held.
They were exposed by Bob Segall, Jim Hall and Bill Ditton of WTHR-Indianapolis. For the story, Segall eventually checked dumpsters in 12 cities nationwide and found unsecured information in all of them. Segall told the tale of how he broke the story, and how other reporters could do the same, in this article for AHCJ members.
For those unfamiliar with the case’s background, NPR’s April Fulton can get you up to speed. CVS settled with HHS last year, and NPR’s Fulton reports that Walgreens will be next.
Hearing on public access to research will be online
Filed under: Health data, Health journalism, Public records, Studies
Representatives of a number of medical- and publishing-related organizations will testify today at a hearing on “Public access to federally funded research” before the Information Policy, Census and National Archives Subcommittee of the U.S. House of Representatives’ Committee on Oversight and Government Reform.
You can catch the webcast of the hearing at 2 p.m. EDT. Update: It appears the hearing is not being webcast.
(Hat tip to the Electronic Frontier Foundation for the webcast link.)
Earlier
- Bill would require public access to research
- AHCJ: Proposal would be blow to public access
- Progress on open access issue not what it seems
HIPAA’s role in transplant story, correction
Filed under: Health journalism, Hospitals, Public records
The Village Voice says things are rather tense at the New York Post after it incorrectly reported on Monday that an alleged killer received a liver transplant at New York-Presbyterian Hospital. Frederik Joelving of Reuters Health reported on Tuesday that the hospital denied the transplant had taken place there.
Cover of Monday's New York Post.
That was followed by a correction in the Post on Wednesday morning. The original story is no longer available on the Post’s site but is available through Google’s cache.
According to the Village Voice, which quotes unnamed sources in the Post newsroom, “Rupert Murdoch was so enthralled with the story when it ran, that he called Post editor-in-chief Col Allan to personally congratulate him on it.” It also says the tip for the story came from Allan.
Because of the Post’s story, the hospital eventually had to deny that Johnny Concepcion, accused of killing his wife, received a transplant there after eating rat poison in a suicide attempt. Hospital comments on whether a patient has been treated are fairly unusual as hospitals try not to run afoul of the privacy rules outlines in the Health Insurance Portability and Accountability Act.
In fact, the Post’s correction says the hospital declined to comment before it published the original story, citing HIPAA, but that “Curiously, the hospital now sees itself free to publicly discuss Concepcion’s case.”
Speaking of HIPAA, The Reporters Committee for Freedom of the Press recently released “FERPA, HIPAA & DPPA: How federal privacy laws affect newsgathering,” a guide to federal privacy protection laws.
The section on HIPAA explains the history of the privacy rules, the Standards for Privacy of Individually Identifiable Health Information, and discusses how it has been misunderstood and misused to keep information from reporters. AHCJ President Charles Ornstein, a senior reporter at ProPublica, is quoted extensively and offers examples of its misapplication. The piece also outlines what the law does allow.
FDA site tracks post-approval drug dangers
Thanks to new requirements, the FDA is now publishing updates on its safety evaluations of drugs that are already on the market. The evaluations get posted after the drug has been on the market for 18 months, or after 10,000 people have used it. It only includes drugs approved since Sept. 27, 2007.
The site also includes a full list of those drugs flagged by the FDA for various reasons, including ongoing safety alerts. Simply click on any drug in the list to find out what problems were identified and what action has been taken.
(Hat tip to The Plain Dealer’s Diane Suchetka)
Frugal Minnesota splurges on lower backs
Filed under: Health data, Health journalism, Health policy, Hospitals, Hot Health Headline, Public health, Studies, Tools
For physicians and patients, treating lower back pain is an exercise in restraint and patience. According to federal guidelines, such pain usually resolves itself within six weeks with minimum intervention, so it’s often a matter of resisting the temptation to order a $500 MRI within that time window. And in Minnesota, a state known for its health-care-related moderation, that temptation seems to be too much.
As the Christopher Snowbeck of the St. Paul Pioneer Press reports, Minnesota doctors are worse than the national average when it comes to giving lower back pain patients MRIs without exploring cheaper alternatives. And in the land of Lake Wobegon, being below average is a big deal. The conclusions come from Hospital Compare’s newly released 2008 outcomes data. To learn more about this data, check out AHCJ’s recent conference call on the subject.
For some help reading between the lines of Snowbeck’s story (and the Hospital Compare data), see Gary Schwizter’s recent blog post on the subject; he doesn’t mince words.
The story includes other excuses from local providers along the lines of “the data are outdated…we’ve changed…we’re better now…that can’t be right…it’s not us!” When have you ever seen a story on health care data that didn’t have these predictable reactions? It reminds me of The Tobacco Institute continually rejecting any new finding that showed new harms from smoking. When you don’t like the data, damn the data. For most of the history of medicine we had no outcomes data to show patterns of practice or what happens to people over time. Now that we’re starting to collect some such data, vested interests find that information is a menacing thing.
For more about treatment of back pain, particularly how much money is spent on it, see the just-released “Back Problems: Use and Expenditures for the U.S. Adult Population, 2007” (PDF) from the Agency for Healthcare Research and Quality.
Stadium concessions rack up health violations
ESPN’s Paula Lavigne examined 2009 health department inspections from the 107 stadiums that host MLB, NBA, NHL and NFL games in the United States and Canada. The resulting report may keep you from indulging in your favorite ballpark food.
At 30 of the venues (28 percent), more than half of the concession stands or restaurants had been cited for at least one “critical” or “major” health violation. Such violations pose a risk for foodborne illnesses that can make someone sick, or, in extreme cases, become fatal.
Photo by Katie Spence via Flickr
An interactive map lets you see the venues based on the number of violations there; rolling your mouse over the location tells you the percentage of vendors found in violation and gives some information about the kinds of violations that were found.
The same information, compiled by Lavigne and Producer Lindsay Rovegno, is also available in a text format broken down by state.
Many of the excerpts cite instances in which food was not being kept at appropriate temperatures and a few are related to pests, but there are a few more unusual examples:
- At the Jobing.com Arena, where the Phoenix Coyotes play, “inspectors spotted an employee scooping ice with his bare hands instead of using scoops.”
- At Dodger Stadium, there was mold growing inside an ice machine.
- At Invesco Field at Mile High Stadium and at the Pepsi Center in Denver, inspectors found flies in bottles of liquor.
- At Ford Field, home of the Detroit Lions, inspectors found an employee’s half-eaten hamburger in a warming unit.
Another interesting note: Food inspectors aren’t always visiting unannounced nor are they always visiting when concessions are open. In Chicago, inspections are done when the stadiums are empty and no workers are preparing or serving food. At Cincinnati’s Paul Brown Stadium, inspectors must “submit a list of employees’ names and make an appointment a few days in advance.”
Reporters who have a major sports venue in their community might want to see how it stacks up against others, what kinds of violations have been found and do some further reporting.
Resources for covering food safety
Tip Sheets
- Lifting the shroud: Using multiple-cause-of-death data
- FDA Reform: The Time Has Come (Nancy Donley presentation)
- Why Is It So Difficult to Prevent Foodborne Illnesses? (Michael Doyle presentation)
- Reporting on the intersection of health and the environment
- Fatal Food: A study of illness outbreaks
Websites
- Center for Infectious Disease Research & Policy
- Outbreak Alert! Database
- Center for Food Safety and Security Systems
- FoodRisk.org
Related
- Recent stories and studies on foodborne illnesses
- Video study finds risky food-safety behavior more common than thought
- Airlines delay testing of onboard water
- A selection of stories about a 2008 salmonella outbreak
- Private companies, not the FDA, increasingly perform food safety inspections
How reform will affect America, group by group
Filed under: Health care reform, Health policy, Hot Health Headline, Studies
In Health Affairs (AHCJ members get free access), economist Joseph Newhouse considers how health care reform will affect four major groups. They’re summarized below.
- Uninsured or on Medicaid or CHIP (30 percent)
- Insured individually or through a small business (10 percent)
- Insured through a mid-size or large business (45 percent)
- Recipient of Medicare (15 percent)
Medicaid expansion and broader subsidies are “major gains.”
This group will undergo the most change, with the individual mandate expanding their ranks to as much as 50 million people (16 percent of Americans). Health reform should “repair” this now-broken sector of the market.
A wash, as an insurance tax is balanced out by a reduced need to cover uncompensated care for the uninsured.
Complicated. The doughnut hole will close, but future financing sources are murky. Newhouse goes pretty deep into just how murky.
His conclusion is relatively upbeat. Newhouse writes that while reform “addressed many issues in health care financing, it left many others unresolved.” The system will need to be revised and updated throughout the foreseeable future, Newhouse writes, and effective implementation will “require persistence for many years to come.”
Journalist recounts the pressure of GSK clinical trial
Filed under: Health journalism, Hot Health Headline
In the wake of questions about GlaxoSmithKline’s Avandia clinic trials, the Austin American-Statesman’s Ana Cantú talks about her own experience in a different GSK clinical trial five years ago. Her column isn’t long, but she manages to capture the pharmaceutical giant’s desperation and the pressure put on participants. It helps that Cantú was, in some ways, a fulcrum for the study’s success.
I don’t want to spoil the story, but it all revolves around the requirement that seven of the 20 participants complete the study to garner sufficient data for submission to the FDA. After 13 participants dropped by the wayside, a sick and unhappy Cantú found herself on the bubble. She needed a medical authorization to drop out and still receive the $4,800 she was due for her participation, but the physicians in charge of the study were under immense pressure to keep her around and maintain that all-important quorum.
In the end, there’s a reason she refers to it as the “most miserable month of my life,” but at the time Cantú had only scratched the surface of the significance of her participation. Now, her reflections are revealing.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
