April 11th, 2022
The Out-of-Pocket Health News Digest
Below you will find briefs about recent health policy news stories. Our hope is for students to have an information outlet at their fingertips to keep up-to-date with the most pressing news stories in health policy.
This compilation is produced by the HPSA Education Committee: Brynna Thigpen, Christopher Whitlock, Easheta Shah, Hannah Lane, Hassan Kourani, Jourdan Clements, and Lizzy Peppercorn
Teen Mental Health Crisis Emerging in Pandemic Aftermath
by Christopher Whitlock
The Centers for Disease Control and Prevention (CDC) published results from its most recent Adolescent Behaviors and Experiences Survey (ABES) with new data that reveal the significant toll the COVID-19 pandemic took on U.S. high school students. The biennial survey was administered during the first full year of pandemic-era schooling in early 2021 and asked questions on topics including teens’ mental health, substance use, and experiences with violence, abuse, and racism.

The data show an alarming prevalence of mental health issues among U.S. high school students and highlight worsening disparities among already marginalized populations. According to the survey, nearly half of students felt “persistently sad or hopeless,” and 1 in 5 students reported they have contemplated suicide. CDC deputy director Debra Houry referred to the results as “a cry for help,” and believes traumatic stressors from the pandemic may continue to negatively impact students’ mental health down the road. The pandemic also contributed to other social stressors, with nearly 30% of students reporting that at least one parent or other adult at home recently lost their job.

LGBTQ youth are also facing unique challenges that have been exacerbated by the pandemic. ABES results show they continue to experience disproportionately worse mental health and increased suicide-related behaviors compared to their peers. While over half of all students reported emotional abuse at home, 20% of LGBTQ students experienced physical abuse at home compared to just 10% of heterosexual students.

Meanwhile, the survey results also highlight racism as a public health issue. More than 1 in every 3 U.S. high school students experienced mistreatment due to their race or ethnicity, and these students were more likely to feel disconnected at school and report poorer mental health.

Despite these alarming trends, the data also suggest multiple potential solutions. Feeling connected to people at school was identified as a major protective factor among students surveyed with the best mental health, though its strength is diminished when these students also experience racism. This underscores the importance of the school social environment on teens’ mental health. Schools play a critical role in addressing this looming mental health crisis, and additional efforts should be designed to address the unique needs of particularly vulnerable populations such as LGBTQ youth and those experiencing racial discrimination.
Health Risks of the Will Smith Chris Rock Incident
by Lizzy Peppercorn
“Love will make you do crazy things,” were the words Will Smith used to explain his actions after slapping Chris Rock at the Oscars. Jada Smith, the target of Chris Rock’s joke, suffers from alopecia, an auto-immune disorder that often causes hair loss as a side effect. After Will was allowed to return to his seat and then accept the award for best actor, he justified his slap in the name of love and protecting his family. 

Since then, people have had a hard time figuring out how they feel about the action and whether or not to condemn it. Some Black women have expressed that they appreciate the action as a protection of a Black woman’s dignity, while some may view the actions as chivalrous and brave with society’s expectations of masculinity. Everyone’s perception of the slap comes from their own histories and traumas. While it is important to understand other lenses on the action, it is extremely important that society does not allow love to be a justification for violence. 

Wong, a professor and chair of the counseling and education psychology department at Indiana University Bloomington explained that when a man embodies some unhealthy masculine behaviors, he sees an attack on a family member as an attack on himself and feels the need to preserve his honor publicly and socially. The rhetoric of acting out of love was triggering for many domestic abuse survivors. According to an International Journal of Environmental Research and Public Health study, some men and abusers justify their violence and aggression with “true love.”

There is a “macho mentality” in society that tells men it is okay to be violent. This mentality causes men to think that more observers would approve than they actually do. However, according to a 2020 study by Powell, the director of the Health Disparities Institute and associate professor of psychiatry at UConn health, most people do not believe it is okay for men to be aggressive. For there to be a cultural shift, violent actions must be condemned when they occur. 

Smith being allowed to return to his seat and accept the award normalized the violence in a way that contributed to viewers’ confusion. Smith has been a very likable public figure who has gained respect for his memoir last year that detailed an abusive childhood. When people are more likable, society justifies their actions more than people that already have a tainted image. While it is acceptable to view the slap through an understanding and sympathetic lens, it is important for society to now allow love to ever be a proper justification for violence.

Sources: CNN, USAToday
How is the U.S. Handling COVID-19 These Days?
by Brynna Thigpen
Running for president during a pandemic and weathering one of the most unusual elections in the nation’s history, now-President Biden ran on a promise to get America’s coronavirus pandemic under control. That has proven to be a challenging promise to keep, with emerging variants of various transmissibility and virulence, and overseas immunity impacting domestic affairs. 

Now, over a year into Biden’s presidency, and two years into America’s experience of the pandemic, where does the U.S. stand in terms of COVID-19 response activities? 
Internationally
1.1 billion vaccine promise The United States pledged to donate at least 1.1 billion vaccines to other countries, primarily lower- and middle-income nations with lower access to safe and effective vaccines. As of this month, the United States has almost reached the halfway point, with 509 million doses delivered or shipped, and 591 million still promised. 
Private industry under pressure On the private side, investors and global health advocates are pushing vaccine manufacturers to increase accessibility to their vaccines. Results from shareholder meetings will be released in public in April; previous efforts have failed thus far.
Domestically
Federal funding lapsing In recent weeks, Congressional Democrats have been scrambling to put together a deal to continue funding the government. Under pressure from Republicans who prefer states find other ways to fund pandemic mitigation and preparedness activities, billions of dollars were stripped from the funding bill. This loss of funding means testing capacity will fall, uninsured Americans will lose access to free testing and treatment, and the stock of monoclonal antibodies will fall. 
More Vaccines? Vaccines, ever the contentious issue, have become more widespread, though still resisted by some. Even in the least vaccinated state in the U.S. - Alabama - the vaccination rate is above 50%. In the most vaccinated state - Rhode Island - almost 82% of the population is fully vaccinated. Asian Americans have emerged as the racial group far and away most likely to have received a first dose at 84%, with Black Americans trailing at 57%. 

FDA approval of a fourth shot (or second booster) is expected shortly for those 50 and up; however, the U.S. may not be fully prepared to vaccinate the population if that moves forward. 
Tentative Transition to the “New Normal” With case counts and daily vaccination rates at historically low levels, the federal response is transitioning to one of maintenance and mitigation, rather than prevention and control. The shift to a “new normal” brings with it changes in approach. In early March, Biden released the Administration’s new plan, with four goals: protecting against and treating COVID-19, gearing up for new variants, avoiding shutdowns, and fighting COVID abroad.
Additionally, as reported in the OOP before, the federal “continuous coverage” requirement for Medicaid and the Children’s Health Insurance Program (CHIP) will be dropping, meaning that the growth in insurance coverage that every state saw over the course of the pandemic since Biden took office will likely fall sharply. 
On the local level, jurisdictions are dropping or modifying testing and vaccination requirements - most recently and controversially, in New York City under Mayor Eric Adams, allowing athletes and performers to work unvaccinated.
As the pandemic continues to evolve and change, the U.S. will continue to change with it. 
Marijuana Decriminalization Bill Approved by House
by Christopher Whitlock
Last week, the U.S. House of Representatives passed the Marijuana Opportunity Reinvestment and Expungement Act by a vote of 220-204. The new bill, sponsored by Democratic Representative Jerry Nadler of New York, aims to decriminalize marijuana at the federal level while addressing the history of racial injustice perpetuated by previous marijuana laws. While the legislation garnered some bipartisan support in the House - three Republican Representatives supported the bill while two Democrats voted against it – the proposed law is unlikely to pass through the evenly divided Senate where it will require 60 votes to advance.

Regardless, supporters of the bill believe it is an important step in modernizing the federal government’s marijuana policy to match the legalization movement sweeping through many states. Although marijuana is federally classified as a Schedule I substance under the Controlled Substances Act, 37 states currently permit medicinal marijuana use while 18 states now allow recreational use for adults over the age of 21.
The proposed bill contains several measures to update federal marijuana policy including:
  • Removal of marijuana from the federal Controlled Substances list.
  • Establishing an 8% sales tax on retail cannabis products.
  • Clearing criminal records of some non-violent marijuana offenses and reducing current marijuana-related sentences.
  • Allowing cannabis businesses to receive loans from the Small Business Administration.
  • Creating an Opportunity Trust Fund to ameliorate losses of those harmed by previous marijuana prohibition policies.

Detractors cite the proposed legislation as short-sighted, putting children at greater risk for marijuana exposure and ignoring the known adverse effects of long-term marijuana use in adults. They also mention concerns regarding the increasing potency of current marijuana strains compared to those in the past.
While it remains unlikely that the bill will pass through the Senate, there are multiple other versions of federal marijuana decriminalization laws currently in the works. Democratic lawmakers remain committed to the goal of modernizing federal drug policy, but it appears they will need significant bipartisan support to enact lasting change.
Ann Arbor Moving Toward Unarmed Crisis Response
by Easheta Shah
On April 5, 2021 the Ann Arbor City Council passed Resolution 21-0612 directing the City Administrator to Develop an Unarmed Public Safety Response Program by December 2021. The resolution stipulates the need for non-police response to various situations and the intention from The City of Ann Arbor for these situations to be addressed in a safer and more effective way. Many states across the country have implemented these kinds of programs, including Eugene, OR; Denver, CO; Olympia, WA; San Francisco, CA; Austin, TX, which may serve as models for the city of Ann Arbor. 

The Washtenaw County based Coalition for Re-envisioning Our Safety, or CROS, came together in response to the Resolution with the intent of collaborating with the City of Ann Arbor through the development and implementation of this program. Their advocacy work aided in the recently approved allocation of funds through the American Rescue Plan Act. 

Once the Resolution had passed in 2021, money was needed to fund Ann Arbor’s unarmed response program. Resolution 21-396, passed October 2021, required direct public engagement and a final recommendation for use of Federal ARP funds by March 2022. ARPA allocated $350 billion for state and local governments and $24.1 million for Ann Arbor. Thus, the city instituted a robust campaign through virtual town halls and an online survey to develop a final recommendation for Council’s approval, incorporating CROS advocates as well. On April 4, 2022, Council approved a $3.5 million allocation of ARPA funds to go to an unarmed response among other allocations. 

One-Liners
  • Disparities in Diagnosis: Women and people of color are more likely to have their symptoms dismissed by medical professionals than white men, an experience known as “medical gaslighting.” (New York Times)
  • Potential Public Health Crisis in Ukraine: Decades of progress in containing and managing communicable and often deadly diseases like HIV and hepatitis in Ukraine are under threat as the war waged by Russia has disrupted transportation and normal operations. (New York Times)
  • Uninsured Losing Access to Free COVID Tests and Treatment: As federal funding for the COVID-19 pandemic dwindles, those without health insurance are now unable to obtain free COVID-19 tests and treatment. The Provider Relief Fund, which reimburses hospitals and clinics for treating uninsured patients with COVID, has recently stopped accepting reimbursement claims due to insufficient funds. (NPR)
  • Exercise Perks: Longer Life and Disease Prevention: According to a new study published in the British Journal of Sports Medicine, strengthening exercises could help prevent disease and increase life expectancy. Those who did 30 to 60 minutes of resistance, strength, or weight training weekly had at least a 10% lower risk of early death from all causes. (CNN)
  • Still Not Budging: Vaccine advocates had hoped that full FDA approval of the Pfizer vaccine would convince some hesitant Americans who were uncomfortable with only having the Emergency Use Authorization (EUA), but that bump in vaccinations has not materialized. (USA Today)
  • EPA to Ban Asbestos Use: The EPA proposed a rule this week to ban the use of asbestos, a known carcinogen linked to lung cancer and mesothelioma. Asbestos is no longer found in most consumer products, but it is currently used in production of car brakes, gaskets, and as a disinfectant in water treatment. Previous attempts to ban the substance have been unsuccessful. (Kaiser Health News)