Why gun violence research has been shut down for 20 years – The Washington Post

Lamenting the absence of studies has been a part of our post-massacre what-can-be-done for a number of years and a larger number of mass shootings. But what could research do to get us out of these dire straits?

Scientists, lab coat-ed spreadsheet fillers, create the data that uncovers the truth. I’m not sure if you’ve heard yet but truth is a powerful thing. Evidence is the pointy triangle on which change is leveraged.

Traffic deaths, often sited by gun lobby as even with gun deaths, get a healthy amount of study. The Federal Transit Administration gave out 7 million in grants to advance transportation safety.  Research is done, evidence is collected, and regulations (seat belts, which I find sexy) are put into place. The auto industry isn’t going to make those crumple zones, laminate that glass, put in that little switch that turns your passenger airbag on and off so a tiny seat occupant is not killed by its deployment, out of the goodness of its heart.

To make industry safer, we need regulations. To make regulations, we need evidence. To make evidence, we need research.

The gun industry has put an impressive chill on learning anything about the safety of firearms. The 1996 Dickey Amendment, legislating that no research may advocate gun control, has been reauthorized every year by Congress. Data quoted in the aftermath of mass shootings is culled from CDC databases that collect cause of death information. CDC numbers tell us that guns are killing people in epic numbers. But epidemiological data alone does not a policy make.

Source: Why gun violence research has been shut down for 20 years – The Washington Post

No more free birth control, says President

That’s right. I was pretty stoked about the Affordable Care Act requirement that birth control to be 100% covered by all insurance plans. What a great thing! To not have to pay more for health care simply because you have a uterus! To make accessible the means of controlling when you will have children, thereby increasing your chances of advancing your education and career, making you, a uterus-haver, more able to pursue the dream of being an independent and self-sufficient citizen-contributor.

Allegedly the pres. wants to put a stop to abortions. Presumably the fewer abortions the better?  Since free birth control provided by the ACA became available the number of abortions per capital dropped to its lowest level since data collection began at Roe v. Wade.

MAKE UP YOUR MIND.

This is abysmal health policy. Terrible public policy. Bad economic policy. And its perfectly in tune with the administration’s regard for women. NONE.

Global public health development goals: Paul Farmer on who lives and who dies.

Global public health development goals: Paul Farmer on who lives and who dies..

Economics should never have sought to divorce itself from the other social sciences and can advance only in conjunction with them. -Thomas Picketty

A day late for World Health Day. I hope my prof won’t mind if I share an article from this week’s readings. It’s going to be a task to disentangle the social injustice from the ethics of access from the rageifying post-colonialist cut-and-run, then weave in a thread of third world problems here in the US, but hey I’ll do my best to analyze coherently.

I can’t tell if the article is unwieldy or if it’s just my feelings on the subject. Either way a worthwhile read.

Why Health Care Tech Is Still So Bad – NYTimes.com

I interviewed Boeing’s top cockpit designers, who wouldn’t dream of green-lighting a new plane until they had spent thousands of hours watching pilots in simulators and on test flights.

via Why Health Care Tech Is Still So Bad – NYTimes.com.

Let me tell you about my favorite provider. She faces me, each of us at right angles to each other at her computer desk, and writes everything down on a yellow legal pad. She goes system by system, like a quality shift hand-off report. We use the computer to review labs. She never prints out “educational information.” I get handwritten notes and web addresses as needed. She talks and writes fast, with military precision (active Air Force) and maintains eye contact. She pauses and sits back in her chair to look at me when she senses I’m holding back or is working to figure out a complex set of problems.

Her pad is on the table between us, and I can see everything she is writing. I sometimes correct or edit it. It is never longer than a page.

Duplication of work you say! Well, with Alice there is no time lost, no errors made by the anguish of garbage in garbage out. We draft it together. Then it goes in the permanent record.

The big hurdle, the big secret… she works at NIH. Where time and dollars aren’t the exact same thing.

Just a thought. PSST she is also a nurse by training <3.

Universal health care through the lens of national history, identity.

The Lancet-The Trap of History

Every country has its own story, its own fears and dark shadows. One of the biggest unacknowledged challenges facing global health is adapting evidence to these national stories, resolving a persistent and troubling discrepancy between knowledge, history, and identity.

A MUST READ. Also though not directly related, an argument for liberal arts education as a grounding force in our science-and-tech obsessed world.

Short but oh-so relevant as we in the US scratch heads and gnash teeth and poor poor policy makers can’t seem to get a handle on HOW DO WE MAKE THESE PEOPLE HAPPY! My dream team that will save US health care: The Social Anthropologist, The Historian, The Sociologist, The Behavioral Economist, The Nurse!, and we’ll have a doc too if Atul Gawande has the time. He we be called The Atul Gawande.

Health policy incontrovertible truths

Sorry y’all for all the personal posts of late. I’ve had some trouble crossing the Lethe that runs between the hospital and my house (rt. 29). Forgive me, that’s the last time “death” becomes a tag in three consecutive posts.

From my policy textbook this AM, I thought I’d share:

The evidence that insurance and the access to care it facilitates improves health, particularly for vulnerable populations (due to age or chronic illness, or both) is as close to an incontrovertible truth as one can find in social science.” -Austin Frakt

The Story of Medicare-Video from the Kaiser Family Foundation

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I booed, I cheered, I said OH SNAP when the senior protesters lost it on Reagan for passing a bill on the backs of the elderly.

Thanks to Dr. Rick Mayes for making this part of our coursework.

Health Policy Quiz

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So I’m working up the guts to post a statement of benefits that will help show the calculus that goes into medical billing. As I’m finding the courage, take these two super-fun health policy quizzes! It’s like Jeopardy but the only category is health policy! IS THIS HEAVEN?!

International health policy quiz

Medicaid quiz

Final Jeopardy: The Medicare program was signed into law by this president. (Hint: to answer this question you must know the difference between Medicare and Medicaid, study up!).

You are so welcome.

<3

FDA Proposes Easing Lifetime Ban On Blood Donations By Gay Men | Kaiser Health News

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FDA Proposes Easing Lifetime Ban On Blood Donations By Gay Men | Kaiser Health News.

Let’s look at some facts and data, shall we? Then I’ve got questions.

Statement from the FDA.
From Red Cross:

redcross blood safety

redcross blood safety 2

What it means: Blood is tested for antibodies to HIV 1&2 as part of the battery of tests performed to ensure donated blood is safe for use. However it may take several weeks to months after infection for HIV antibodies to present in the serum (if you contracted it last night, it may not be apparent until 3 months from now).

From CDC:
cdc hiv transmission rts

What it means: The population of concern are people who have been exposed to HIV but have not yet developed screen-able antibodies–new infections. So we look at the most recent transmission data from the CDC and note that men having sex with men are 2.5 times as likely to have a new infection as the second largest category, heterosexual contact.

My questions: How is the one year waiting period scientifically justified? One year would allow time for antibodies to appear, of course. But there is risk of undetectable infection in blood of people engaging in heterosexual contact, too. Even it it’s 2.5 times less than MSM is that risk not deserving of the one year abstinence period? And then where would be be in terms of blood supply? What is the risk benefit analysis here? I don’t yet get how this is a decision based in evidence on the part of the FDA. To me, it’s a little don’t-ask-don’t-tell-y. And by that I mean homophobic and embarrassing.

Also, I would like to know that data on the risk of transmission of HIV and the Heps when anitgen/antibody complexes are undetectable in the serum. And the number of people per year who contract HIV or Hep B or C from blood transfusions. Add that lit search to the pile.