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California’s next governor Gavin Newsom is an avowed single-payer supporter in the country’s most populous state. But how much of his stand is principle and how much is policy is not totally clear. And no matter how he handles it, he'll inevitably anger part of his base. That, in a nutshell, is a preview of the Democrats' health policy dilemma heading into the 2020 election cycle. Single payer, or “Medicare for All,” has become a litmus test for the growing number of Democrats who are contemplating challenging President Donald Trump. (Colliver, 11/15)

Progressive Democrats are pushing for a vote on a controversial health-care bill after the party takes control of the House early next year. But the left’s push for “Medicare for all” legislation would likely divide Democrats and pose a headache for House Minority Leader Nancy Pelosi (D-Calif.), who is poised to become Speaker in the next Congress.  (Sullivan, 11/15)

Promoting a government-run health care system like "Medicare-for-all" was a popular campaign rallying cry for many Democrats, but one liberal senior House member acknowledged Wednesday that a quick vote on such a solution is unlikely. House Energy and Commerce member Jan Schakowsky, D-Ill., during a CQ Roll Call event, signaled that expanding coverage and reducing costs for consumers was an important priority but that Democrats are far from coalescing behind a plan to overhaul the system. (Raman, 11/14)

The Food and Drug Administration on Thursday launched a multipronged attack on the rising underage use of tobacco products, imposing sales restrictions on flavored e-cigarettes and announcing plans to ban menthol cigarettes and flavored cigars. The FDA says it will limit sales of many flavored e-cigarettes to bricks-and-mortar outlets that have either age-restricted entry or areas inside stores that are not accessible to people under 18. The agency also will require stepped-up age verification for online sales. (McGinley and Bernstein, 11/15)

The proposed menthol ban would be the most aggressive action the F.D.A. has taken against the tobacco industry in nearly a decade, and it was notable given the Trump administration’s business-friendly approach to regulatory issues. But the proposal is likely to face a protracted legal battle, so it could be years in the making. The effort to cut off access to flavored e-cigarettes stopped short of a ban that the F.D.A. had threatened in recent months as it sought to persuade e-cigarette makers like Juul Labs to drop marketing strategies that might appeal to minors. The agency said it would allow stores to continue selling such flavored products, but only from closed off-areas that would be inaccessible to teenagers. (Kaplan and Hoffman, 11/15)

In a statement, FDA Commissioner Scott Gottlieb says the moves are aimed at fighting smoking among young people. Flavored e-cigarettes, menthol-flavored tobacco cigarettes and flavored cigars are all popular among teenagers. "Today, I'm pursuing actions aimed at addressing the disturbing trend of youth nicotine use and continuing to advance the historic declines we've achieved in recent years in the rates of combustible cigarette use among kids," Gottlieb says. (Stein, 11/15)

The FDA concluded in 2013 that menthols are harder to quit and likely pose a greater health risk than regular cigarettes. But it wasn’t until last year that the agency signaled it was considering a ban on menthol and other flavored tobacco products. (Maloney and McGinty, 11/15)

Battery-powered e-cigarettes are more popular among teens than regular smokes and are considered safer. But many versions contain potentially addictive nicotine, and health officials believe they set kids who try them on a path toward regular cigarettes. Gottlieb called for additional steps to prevent the marketing of e-cigarettes directly to kids and online sales to minors. He also proposed beefing up measures to ensure that convenience stores and some other retailers do not sell e-cigarettes in kid-friendly flavors such as cherry and vanilla. They could still be sold in vape shops or other businesses that do not admit minors. (Stobbe, 11/15)

Youth use of e-cigarettes soared between 2017 and 2018, thanks largely to the popularity of the Juul and similar thumb-drive shaped vaporizers, according to a federal survey released Thursday. The number of U.S. high-school students who used e-cigarettes rose 78% between the spring of 2017 and the spring of 2018 to 3.05 million, according to data from the National Youth Tobacco Survey. That is 20.8%, or one out of every five high-school students. (McKay, 11/15)

He was supposed to inhale on something that looked like a flash drive and threw off just a wisp of a cloud? What was the point? A skeptical Matt Murphy saw his first Juul at a high school party in the summer of 2016, in a suburban basement crowded with kids shouting over hip-hop and swigging from Poland Spring water bottles filled with bottom-shelf vodka, followed by Diet Coke chasers. (Hoffman, 11/16)

Try as she might, Brittany Kligman couldn’t free herself of a pack-a-day cigarette habit, eight years in duration. And she ached to. She was mortified the time that a taxi driver sniffed as she entered his cab and remarked, “You’re a smoker, huh?” (And she had just showered!) She was getting more sinus infections. Because her chest felt uncomfortably tight when she exercised, she stopped high intensity interval training. Then SoulCycle classes. Finally, she quit working out. (Hoffman, 11/16)

The announcement kicks off what is likely to be a protracted period of policy making and legal wrangling. The agency’s tobacco staff must draw up the new regulations, which will be eventually subject to public comment and could face court challenges from the industry. (Edney, 11/15)

As the Food and Drug Administration captured national headlines Thursday announcing plans to reduce underage tobacco product use, health advocates in Fremont hosted a meeting on the issue, and called on local leaders to take further steps to protect youth from nicotine addiction. About 50 people showed up Thursday evening to hear about the results of a recent study examining the offerings and pricing of tobacco products at retailers in Fremont. (Geha, 11/16)

There are two ways e-cigarettes can affect your health — one is directly, from the product itself, and the other is from Gottlieb’s primary concern: Kids who vape are more likely to become addicted to nicotine and to try regular cigarettes. After all, he pointed out, 90 percent of adults who smoke started before age 18. The key to reducing deaths and debilitating illness from smoking is to prevent kids from starting. (McClurg, 11/15)

The term “electronic cigarette” refers to a battery-powered device that heats a tank or cartridge of liquid usually containing nicotine, flavorings and other chemicals, but not the cancer-causing tar found in tobacco cigarettes. Users inhale and exhale the vapor. The devices come in numerous shapes, including ones that look like pens, flash drives and hookahs. Many consumers are confused about the health implications of e-cigarettes. This is a primer about what research so far shows about these devices. (Hoffman, 11/15)

Fewer Americans lack health insurance. In the first six months of 2018, 28.5 million Americans were uninsured -- 20.1 million fewer than 2010, the year the Affordable Care Act was signed into law by then-President Barack Obama, according to data from the federal Centers for Disease Control and Prevention. Among U.S. adults aged 18–64, about seven in 10 were covered by private health insurance plans in the first six months of 2018. Of this total, four percent or just under eight million people were covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges. (Tanzi, 11/15)

House Democrats began this week to discuss the outlines of a bill to protect pre-existing conditions, hoping to set up a vote early next year when they officially control the House floor. Rep. Richard E. Neal, D-Mass., the top Democrat on the Ways and Means Committee, said he was in a meeting Thursday morning to discuss what a measure would include. Rep. Bill Pascrell Jr., another member of the panel, said he also discussed the topic with Neal during a Wednesday night dinner. (McIntire, 11/15)

Amid a numbing succession of mass shootings, gun control groups outspent the National Rifle Association in the midterm election cycle, federal filings and additional reporting indicate, upending the usual order in the partisan battle over gun use. Two groups that are focused on gun control, Giffords and Everytown for Gun Safety, spent at least $37 million at the state and federal level in the midterms, compared with at least $20 million by the N.R.A. (Hakim and Shorey, 11/16)

For months, members of the panel investigating Florida’s high school massacre have called the sheriff’s deputy assigned to guard the campus “a coward” for hiding and not rushing inside in an attempt to stop the shooter. Given an opportunity to confront his critics Thursday, now-retired Broward Sheriff’s Deputy Scot Peterson sent his attorney instead before the Marjory Stoneman Douglas High School Public Safety Commission. (Spencer and Fischer, 11/16)

The Virginia House of Delegates has a blueprint for how it hopes to improve school safety during the upcoming General Assembly session. A special committee appointed by Speaker Kirk Cox, R-Colonial Heights, after February’s deadly school shooting in Florida agreed to a set of 24 recommendations Wednesday that it will take up in January when the full legislature convenes. ... Included in the group’s recommendations was an endorsement of increasing funding for more school resource officers, more time spent by counselors with students, and creating a mental health and suicide prevention tip line, among others. (Mattingly, 11/14)

After the recent mass shooting in Thousand Oaks, Calif., in which 11 people were killed at a country music bar, President Donald Trump struck a familiar refrain: “It’s a mental health problem,” he said of the gunman, Ian David Long. “He was a very sick puppy.” Similarly, after a school shooting in Parkland, Fla., that killed 17 students and staff members in February, Trump tweeted that there were “so many signs that the shooter was mentally disturbed.” (Waters, 11/16)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Doctors, Guns And Lame Ducks

Election Day was Nov. 6, but results remain undetermined in some races at the state and federal levels. Nonetheless, it is already clear that the election could have major implications for health policy in 2019. The current Congress is back in Washington for a lame-duck session, and while the budget for the Department of Health and Human Services is set for the fiscal year that began Oct. 1, other health bills, including ones addressing AIDS and bioterrorism, are on the to-do list. (11/15)

Smoke masks. Eye drops. No outdoor exercise. This is how Californians are trying to cope with wildfires choking the state, but experts say an increase in serious health problems may be almost inevitable for vulnerable residents as the disasters become more commonplace. Research suggests children, the elderly and those with existing health problems are most at risk. (Tanner, 11/15)

The number of people unaccounted for soared to 631 — up from 130 on Wednesday evening — after authorities combed through additional 911 calls and other reports generated at the peak of the chaotic evacuation. Honea said that number may include some people who are counted twice or others who may not know they were reported missing. (Tchekmedyian, Santa Cruz and Panzar, 11/15)

When the Camp Fire first tore through Butte County, John Pohmajevich stayed put in the small town of Magalia — a place he’s called home for several years now. He knew if he left, there would be no telling when he would be able to return. On Thursday, the San Mateo native surveyed the devastating damage the fire’s left in its wake and recalled the last time he saw something like this: the Loma Prieta earthquake that shook the Bay Area in 1989. (Salonga, 11/15)

Nearly two dozen people who evacuated to escape the devastating Camp Fire in Northern California have been sickened by a contagious virus that has spread through an emergency shelter, officials say. Lisa Almaguer, a spokeswoman for the Butte County Public Health Department, said Thursday in a statement that 21 people being housed at the Chico Neighborhood Church Shelter have tested positive for norovirus, an extremely contagious virus known to spread easily, causing vomiting and diarrhea. (Bever, 11/15)

Twenty-one people staying at Neighborhood Church in Chico; 31 at Oroville Church of the Nazarene; 9 at Butte County Fairgrounds, and one at East Avenue Church in Chico had symptoms Thursday, according to a Butte County Public Health Department news release. About 179 people are staying at Neighborhood Church; 352 are at Oroville Church; 142 are at Butte County Fairgrounds in Gridley, and 200 are at East Avenue Church in Chico, the release said. At Nazarene Church, some people are staying inside and some are staying in their cars on the church property, said Lisa Almaguer, health department spokeswoman. (Clift, 11/15)

Don Hardin burrowed between blankets in his SUV, and switched on the heater whenever the shivers returned. Even during the day Thursday, the 81-year-old Camp fire evacuee, who has arthritis, struggled to stay warm. When temperatures dropped near freezing Wednesday night, Hardin popped a sleeping pill. (Santa Cruz, La Ganga and Gerber, 11/15)

Wendy Bailey, a widow and retired stay-at-home mother, hunched over a charred bathtub, surrounded by ash, looking for any trace of human remains. It was her second day searching for victims of the ferocious wildfire that destroyed this city of about 26,000 residents last week, an effort that authorities say has become the largest search operation in California history. (Craig, 11/15)

Fire stations are ending free distribution of N95 respirator masks in the Sacramento region at the direction of the county, though smoke from the Camp Fire continues to create unhealthy air conditions. The city of Sacramento released a statement Thursday afternoon saying the mask program is “nearing its conclusion” because the city has been unable to obtain additional masks from the California Office of Emergency Services or California Department of Public Health. While a news release by Cal OES on Sunday promoted the use of N95 masks to help “breathe easy” in light of wildfire smoke blanketing Northern California, Sacramento County this week published multiple warnings discouraging the use and distribution of such masks. (McGough, 11/15)

The administration is working on a plan to shift millions more veterans to private doctors and is aiming to unveil the proposal during Trump’s State of Union address in January, according to four people briefed on the proposal. The people spoke on the condition of anonymity because they weren’t authorized to disclose information about the administration’s plans. The cost of expanding private care is hard to predict, but VA officials have told Congress and veterans groups that it will range from $13.9 billion to $32.1 billion over five years, the four people said. Since the administration opposes lifting overall government spending, Democrats say the increased cost of private care will come at the expense of the VA’s own health system. Some lawmakers said the administration’s plan defies the purpose of the law they passed. (Arnsdorf, 11/15)

Daniel Gorman knows what it’s like to return from war, and he wants to help fellow veterans come home, too: The former sailor turned New York National Guardsman is finishing a graduate degree in social work at Fordham University. But the Department of Veterans Affairs has thrown his fall semester into chaos by underpaying him without notice or explanation — making him one veteran among potentially tens of thousands on the GI Bill who have watched their bank accounts dwindle because of the agency’s ongoing technology failures. (Horton, 11/15)

Meditation worked as well as traditional therapy for military veterans with post-traumatic stress disorder in a small experiment sponsored by the Department of Defense. One method preferred by the Department of Veterans Affairs is exposure therapy, but it doesn't work for everyone and many can't handle what it requires: purposely recalling traumatic events and confronting emotions. (Johnson, 11/15)

U.S. Rep. Matt Gaetz and a Massachusetts Democrat on Wednesday introduced a package of legislation to change the Department of Veterans Affairs' medical marijuana practices in an attempt to make cannabis a more realistic treatment option for veterans. Gaetz, a Northwest Florida Republican, joined with U.S. Rep. Seth Moulton, D-Mass., to prepare three bills that seek to learn more about how veterans use cannabis, to prepare better medical-marijuana education for providers and to protect the benefits of veterans who use marijuana. (Young, 11/15)

Doctors, hospitals and medical labs used to be concerned about patients who didn’t have insurance not paying their bills. Now they’re scrambling to get paid by the ones who do have insurance. For more than a decade, insurers and employers have been shifting the cost of care onto their workers and customers, tamping down premiums by raising patients’ out-of-pocket costs. Last year, almost half of privately insured Americans under age 65 had annual deductibles ranging from $1,300 to as high as $6,550, government data show. (Dodge, 11/15)

The suicide rate among Americans of working age increased 34 percent from 2000 to 2016, according to a report released Thursday by the Centers for Disease Control and Prevention. “Increasing suicide rates in the U.S. are a concerning trend that represent a tragedy for families and communities and impact the American workforce,” said Dr. Debra Houry, director of the CDC National Center for Injury Prevention and Control.  (Hellmann, 11/15)

Men who work in construction and extraction had the highest rates of suicide in the United States, according to a report published Thursday by the US Centers for Disease Control and Prevention. For women, suicide rates were highest among those who work in arts, design, entertainment, sports and media. From 2000 to 2016, the suicide rate among the US working-age population -- people 16 to 64 -- increased 34%, the report says. (Thomas, 11/15)

New Zealand managed to quell an infectious child-killer with the help of a new type of vaccine. A decade later, scientists in the South Pacific nation found it may be critical combating an age-old, sexually transmitted infection that’s making a comeback: gonorrhea. That’s spurring optimism that the fast-spreading disease could be slowed using a vaccine already on the market to prevent its bacterial cousin -- a strain of the so-called meningococcal bacterium notorious for causing potentially deadly meningitis epidemics in college dorms, such as the recent ones on campuses in San Diego and Massachusetts. While gonorrhea isn’t life-threatening, it’s now on the verge of becoming unstoppable due to antibiotic resistance. (Paton, 11/15)

Nearly 19 million Americans take fish oil supplements and some 37 percent of us take vitamin D. Many may be motivated by research that has suggested these pills can protect heart health and prevent cancer. On Saturday, NPR published a story on long-awaited research on both supplements that called those claims into question. (Neighmond, 11/15)

The rate of sudden cardiac death in African-Americans is twice as high as in whites, and no one knows why. Sudden cardiac death is an unexpected fatality from cardiac causes that happens within an hour of the onset of symptoms, usually with no known cause. (Bakalar, 11/15)

A startup genetics company says it's now offering to sequence your entire genome at no cost to you. In fact, you would own the data and may even be able to make money off it. Nebula Genomics, created by the prominent Harvard geneticist George Church and his lab colleagues, seeks to upend the usual way genomic information is owned. (Harris, 11/15)

What Google has done with Internet searches and Facebook with sending birthday wishes, a Harvard professor is ready to do with genome sequencing: make it free. Nebula Genomics, devised by geneticist George Church to allow people to sell their DNA data for drug research and other uses, will provide complete DNA decoding at no charge for customers who answer a series of questions about their own health. The company begins offering its service Thursday and anyone is eligible to use it, Church said. (Lauerman, 11/15)

In 1999, a trio of economists emerged from a conference at the University of California, Los Angeles, squinting without sunglasses in the unfamiliar sun, and began a slow walk through the hills overlooking the city. The three of them — a Harvard economist-in-training, Daniel Benjamin, and the Harvard economists Edward Glaeser and David Laibson — were reeling. They had just learned about a new field, neuroeconomics, which applies economic analysis to brain science in an effort to understand human choices. Now they were strolling through the taxonomy of midday joggers and dog-walkers in Los Angeles, talking all the while about how people become what they are. Benjamin recalls feeling very out of place. “Everyone was so beautiful,” he says. (Ward, 11/16)

Move over Bifidobacterium and Lactobacillus. There’s a new health-promoting gut bacterium in town, and it’s called Akkermansia muciniphila. You will not find its benefits at the bottom of a yogurt cup. But a new study has identified more than one way to nurture its growth in the gut, and offered evidence that it may maintain — and even restore — health as we age. Published this week in the journal Science Translational Medicine, the new research found that in mice and monkeys whose metabolisms had grown cranky with age, taking steps to boost A. muciniphila in the gut reduced the animals’ insulin resistance. (Healy, 11/15)

The HIV epidemic remains centered in the South, health officials say. And the region must overcome several factors before this disease burden will ease, they add. More than half of the new HIV diagnoses in 2016 – about 20,000 — were in the South, a CDC official told an Atlanta conference last week. (Miller, 11/15)

When it comes to America's escalating epidemic of psychological disorders, odds are you either know someone or you are someone. One in five adults have a mental health condition — which can range from post-traumatic stress to chronic anxiety to bipolar disorder — equivalent to more than 46 million Americans — spanning all ethnicities, geographies and economic classes. (Schmid, 11/15)

Kaiser Health News: Women Applaud Michelle Obama’s Decision To Share Her Trauma Of Miscarriage

Miscarriage is “lonely, painful, and demoralizing,” Michelle Obama writes in her new memoirs. Yet, by some estimates, it ends as many as 1 in 5 pregnancies before the 20-week mark. The former first lady’s disclosure that she and former President Barack Obama suffered from fertility issues, including losing a pregnancy, has sparked conversations about miscarriage, a common but also commonly misunderstood loss. (Huetteman, 11/16)

For the second time in as many years, the Ohio House on Thursday passed a “heartbeat bill” that would create some of the strictest anti-abortion rules in the country. House Bill 258, which passed the Republican-dominated House by a mostly party-line vote of 58-35, seeks to make Ohio the fourth state to ban abortions when a fetal heartbeat can be detected, except to prevent the mother from dying or being seriously impaired. That can be as early as six weeks into a pregnancy – in some cases, before a woman even realizes she is pregnant. (Pelzer, 11/15)

Abortion should not be singled out or stigmatized because it is part of standard medical care, the new leader of Planned Parenthood said. "Abortion is a safe, legal medical procedure that one in four women in America will have in the course of their lifetime," said Dr. Leana Wen, the first physician to lead the Planned Parenthood Federation of America in nearly 50 years. ... Wen spent her third day on the job visiting Phoenix, meeting with Planned Parenthood Arizona and members of the public-health community. She told The Arizona Republic in an interview that that there is a "real probability" that the U.S. Supreme Court decision Roe v. Wade could be overturned or further eroded. (Innes, 11/15)

A major hospital system based in North Carolina agreed to settle a closely watched Justice Department lawsuit, promising to change practices that antitrust enforcers alleged thwarted competition. The antitrust suit against Atrium Health focused on language in its agreements with health insurers that had restricted the insurers from creating plans that steered patients to competitors offering lower prices, according to the Justice Department. Under the settlement, Atrium said it would stop enforcing such clauses and not seek them in future contracts in the Charlotte area, where it has a large market share. (Wilde Mathews, 11/15)

"With healthcare costs rising, vigilant antitrust enforcement is an essential tool for protecting consumers," Assistant Attorney General Makan Delrahim said in a news release announcing the settlement. "By eliminating restrictions that curb comparison shopping and interfere with competition among healthcare providers, today's resolution of our antitrust action allows consumers in the Charlotte area to benefit from competition when making critically important healthcare choices." (Livingston, 11/15)

A North Texas hospital company violated state mental-health codes when one of its facilities illegally held patients, authorities say. A Tarrant County grand jury indicted SAS Healthcare Inc., also known as Sundance Behavioral Healthcare System, on nine charges Wednesday. Between March 2017 and July 2018, Sundance Hospital in Arlington held patients involuntarily past the 48-hour maximum without mandatory court orders necessary to do so, the indictment says. One patient who was admitted for preliminary examination was held for a week in March 2017, it says. (Sarder, 11/15)

Licensed practical nurses at the University of Illinois Hospital and Clinics walked off the job Thursday, striking after nearly a year of unsuccessful contract negotiations. The 35 nurses say they’re fighting for job protections and fair wages, among other things. In all, the health system has more than 1,000 nurses, including registered nurses, who are not part of the group that is striking. (Schencker, 11/15)

Boston Children’s Hospital has won a $14.7 million grant from the National Football League to study how hits to the head affect neurological health over time — and to identify potential treatments for brain injuries. The money enables Children’s and four collaborating institutions to study thousands of former NFL players and to investigate ways of mitigating the damage from head impacts. The grant to Children’s is the largest of five awards totaling $35 million that the NFL announced Thursday, as part of its commitment to support medical research. The grants included $1.5 million for a project of Spaulding Rehabilitation Hospital and Harvard Medical School to study the short- and long-term effects of concussions on high school athletes. (Freyer, 11/15)

A nurse’s decision to donate a kidney to a patient triggered a series of events that led to three people getting new organs at two Kansas City-area hospitals. Christa Jordan, a nurse at Children’s Mercy Hospital in Kansas City, Missouri, wanted to donate to her friend and patient, Dayshanae Hosman, who has a genetic condition called Alagille syndrome and went on dialysis in April, the Kansas City Star reported. (11/15)

California regulators approved the $69 billion CVS-Aetna merger with conditions on Thursday, bringing the deal another step closer to the finish line. The state's Department of Managed Health Care said CVS and Aetna agreed to keep premium increases "to a minimum" after the merger, though the agency didn't define a threshold in its announcement. Like other commercial health insurers, Aetna will still be subject to rate reviews by the department. (Livingston, 11/15)

A law firm hired by Ohio State University to investigate a former team doctor accused of sexual misconduct against athletes and students hopes to wrap up its fact finding by the end of the year. The investigators told the university’s governing board Thursday about 150 former students have given firsthand accounts of alleged sexual misconduct by the now-deceased doctor. The law firm says the allegations against Richard Strauss cover a time from 1979 through 1997. (11/15)

Seven current and former students in Dartmouth's Psychological and Brain Sciences Department are suing the school over alleged mishandling of sexual assault and harassment reports, saying administrators ignored years of criminal behavior by tenured faculty members. A complaint filed in federal district court in New Hampshire Thursday describes a “21st Century Animal House,” where female students were harassed, assaulted and raped. The lawsuit seeks $70 million in damages. (Greene, 11/15)

A California judge on Thursday granted an expedited trial in the case of a California couple suffering from cancer who sued Bayer AG's Monsanto unit, alleging the company's glyphosate-containing weed killer Roundup caused their disease. The order by Superior Court Judge Ioana Petrou in Oakland, California, comes on the heels of a $289 million verdict in the first glyphosate trial in San Francisco, in which a jury found Monsanto liable for causing a school groundskeeper's cancer. (11/15)

California regulators recommended new restrictions Thursday on a widely used pesticide blamed for harming the brains of babies. The Department of Pesticide Regulation issued temporary guidelines for chlorpyrifos that include banning it from crop dusting, discontinuing its use on most crops and increasing perimeters around where it's applied. (Melley, 11/15)

More than 10 million Texans have consumed drinking water with some level of atrazine – a toxic herbicide – with 472 water utility systems statewide testing positive in at least one detection, according to a new report from an environmental group. Comparing the test results submitted by water utilities to state environmental regulators to those from U.S. Environmental Protection Agency, the Washington D.C.-based Environmental Working Group concluded that water utilities are testing for atrazine at times when farmers aren't using it — the growing season typically spans late spring and early summer — and also appear to be lowballing their numbers. The group is calling for updates to federal federal drinking water standards. (Anchondo, 11/15)

State officials say they are working to address the issues behind a recent lawsuit filed by the New Hampshire ACLU. The federal suit alleges that mental health patients in New Hampshire are routinely denied their constitutional rights by being detained in emergency rooms without a hearing, what is called ER boarding. (Moon, 11/15)

Negative experiences with health care have caused some minority patients, particularly African American men, to distrust the medical system. Experts say these patients are less likely to visit the doctor or participate in screenings and medical research, which can negatively impact their health. (Colombini, 11/15)

The University of Houston will build its medical school on campus, regents decided Thursday, a location pivotal to the role it plans to serve in the Third Ward. The Board of Regents selected a 43-acre tract of undeveloped property just southeast of the campus proper over a building in the Texas Medical Center for the planned college, which would be the first new medical school in Houston in nearly half a century. (Ackerman, 11/15)

A New Jersey doctor who manages the pediatric emergency room where two severely ill boys from the Wanaque Center for Nursing and Rehabilitation were taken is claiming that the children were allegedly too sick to save when they arrived. They are among the 10 children who have died in an adenovirus outbreak at the facility that has also sickened more than 20 others. Dr. Frank Briglia told NJ.com that the boys were “both in irreversible shock upon arrival.” (Hein, 11/15)

The Institute of Medicine concluded in To Err Is Human in 1999 that transformation of nurse work environments was needed to reduce patient harm. We studied 535 hospitals in four large states at two points in time between 2005 and 2016 to determine the extent to which their work environments improved, and whether positive changes were associated with greater progress in patient safety. Survey data from thousands of nurses and patients showed that patient safety remains a serious concern. (Aiken et al, 11/5)

The number of people with opioid use disorder (OUD)—which is marked by a dependence on opioids, including prescription pain relievers and illicit drugs such as heroin—far exceeds the treatment capacity across the country. In 2017, more than 450,000 individuals with OUD were unable to access treatment. (Rising, Connolly and Duncan, 11/9)

Researchers found urban-area premiums were associated with lower marketplace premiums in both 2016 and 2017, for the second-least expensive silver plan, which covers at least 70 percent of health care costs. Although urban areas tend to have health care systems that are more expensive, they also have large populations that invite competition among plans and spread the financial risk associated with health care coverage among more people, thus lowering premium prices. Rural areas, in contrast, typically have a lower cost of living, but fewer people spread out over a greater area, which can discourage competition among health plans. (Wengle, Blumberg and Holahan, 11/15)

Functional decline is prevalent among acutely hospitalized older patients. Exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients. ... Functional decline is prevalent among acutely hospitalized older patients. Exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients. (Martinez-Velila, 11/12)

To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when determining nursing home financial eligibility, but gave states the option to apply the rules to home and community-based services (HCBS) waivers. (Musumeci and O'Mailey Watts, 11/14)

The Trump administration has focused on rolling back regulations, but its Food and Drug Administration took major steps Thursday aimed at curbing use of traditional and electronic cigarettes. Those steps, if enacted over industry opposition, will significantly improve public health. (11/15)

The Food and Drug Administration’s naive plan to ban menthol cigarettes will lead to countless unintended consequences, including increased youth smoking, especially in minority communities, where a ban would spark illegal markets reminiscent of the days of alcohol prohibition. Kids could easily buy loose cigarettes stored in sealed baggies with unwrapped menthol cough drops. The FDA has failed to enforce its own rules. Consider the agency’s inability to prevent youth use of e-cigarettes, despite an outright federal ban. (Jeff Stier, 11/15)

Twenty years ago this month, I joined 45 other state attorneys general to enter into the landmark settlement with the tobacco industry. Since then, the U.S. cigarette smoking rate fell from 24 percent of adults to 14 percent last year — the lowest ever. We have the opportunity to go much lower. But we’re also at risk of reversing these gains if we fail to give smokers safe alternatives to cigarettes. (Tom Miller, 11/15)

The use of any type of tobacco product by teens is unsafe because experts say the nicotine is both addictive and damaging to developing brains, said Tami Silverman, president and CEO of the Indiana Youth Institute. Overall, Indiana ranks 34th in the country in kids health, Silverman said.“We can, and must, do better,” she said. “We will not change these trends without investing in our kids and our communities.”Little is known about the possible long-term health effects of vaping. More research is needed before it can be determined e-cigarettes are much safer than traditional cigarettes. (11/14)

It is no secret that many cigarette smokers wish to quit, but haven’t been able to. This incredible challenge has always been personal for me because I myself am a former smoker who struggled to quit, having tried every cessation means available prior with minimal to no success. This was the case for many years, until I discovered vaping. (John Burns, 11/15)

In the 21st century, health care is to elderhood as education is to childhood. But we don’t see bond measures for the “construction, expansion, renovation, and equipping” of hospitals to optimize care of old people, an investment that would surely benefit Americans of all ages. People age 65 and older make up just 16 percent of the U.S. population but nearly 40 percent of hospitalized adults. In 2014, Americans over age 74 had the highest rate of hospital stays, followed by those in their late 60s and early 70s. (Louise Aronson, 11/16)

We hear again and again calls for reasonable gun policy reform and “mental illness” uttered in the same breath. This apparent advocacy for improving mental health care seems fair- even though it has been clearly demonstrated, in countries such as Australia and Japan, that creating sensible gun laws is the only proven way to eliminate mass shootings and decrease gun violence- why not also work to solve the mental health crisis at the same time? (Rebekah Diamond, 11/15)

In her new book, “Becoming,” Michelle Obama reveals that she miscarried her first pregnancy, and went on to conceive her two daughters by in vitro fertilization. In an interview with ABC’s Robin Roberts, the former first lady described feeling “lost and alone” and like a failure after she miscarried. She didn’t realize that early miscarriages are very common, ending about 20 percent of confirmed pregnancies. (Lara Freidenfelds, 11/16)

Michelle Obama’s revelation in her new memoir that she and Barack Obama conceived their daughters through in vitro fertilization has placed the increasingly common medical procedure into the national spotlight. Malia and Sasha, it turns out, are among the more than 1 million babies born in the United States through IVF. Yet a full 40 years after the first IVF baby was born, even as the procedure has become safe and remarkably effective, it remains financially out of reach for many U.S. couples struggling to become parents. (Daniel Hemel, 11/15)

Probably the most important message from the 2018 guidelines is that the greatest health benefits accrue by moving from no, to even small amounts of, physical activity, especially if that activity is of moderate (eg, brisk walking) or vigorous (eg, jogging and running) intensity. Multiple studies demonstrate that the steepest reduction in disease risk, such as for coronary heart disease, occurs at the lowest levels of physical activity. Patients need to understand that even small amounts of physical activity are beneficial and that reductions in the risk of disease and disability occur by simply getting moving. The evidence demonstrates that adults obtain the maximal benefits of physical activity by regularly performing 150 to 300 minutes per week of moderate-intensity or 75 to 150 minutes per week of vigorous-intensity activity or an equivalent combination of moderate- and vigorous-intensity aerobic activity. These levels of activity are possible for most healthy people. (Paul D. Thompson and Thijs M. H. Eijsvogels, 11/12)

The United States is clearly at a health care policy crossroads. One path, promoted by liberals, entails more federal government intrusion, which will eventually force all Americans into a one-size-fits-all government-run system. Another path, favored by conservatives, embraces federalism and freedom, which would allow individuals to choose the type of health insurance best suited to their unique needs. As pundits digest the midterm results and political ramifications, one must wonder: Which health care policy path is the nation more likely to take over the next two years? (Chris Talgo, 11/15)

Observational studies like the ones investigating the link between organic food and cancer have a fatal flaw, a concept called residual confounding. Consider a guy moving into a new apartment who notices his neighbors are members of the trendy new gym and are all really fit. He might conclude that simply changing his gym membership to the new gym is enough to get fit. Obviously, the real reasons are that the trendy gym members are eating right and exercising. The link between the gym membership and being fit is confounded by other factors, diet and exercise. (Suneel Kamath, 11/15)

Population-trend analysis by the University of Nebraska at Omaha points to one of Nebraska’s biggest challenges in coming years: making sure the state is prepared to meet the needs of the elderly.The number of Nebraskans ages 65 and older increased by 4.1 percent during the 1990s and by 6.2 percent in the first decade of this century.But the projected increase during the 2010s is dramatically higher: 31.6 percent. For the 2020s, this population group is projected to increase 28.9 percent. (11/16)

Richard lives in Louisville and has been diagnosed with leukemia. His treatment is extensive, with intense chemotherapy and a stem cell transplant. The cost of his trips to Lexington following the stem cell transplant are overwhelming, and he and his wife have little monthly income. They struggle to find the money for gas to make the much-needed appointments. As staggering as it sounds, thousands of your neighbors miss and delay cancer treatment every year because they cannot afford transportation to the doctor. In Kentucky, where we have the country’s highest overall death rate due to cancer, we simply can’t allow these kinds of barriers to keep anyone from getting the care they need. (Vicki Blevins-Booth and Jeff Reynolds, 11/15)