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If you want to know what it means for something to grow exponentially, consider the death toll of fentanyl. This powerful synthetic opioid seemingly came out of nowhere and is now killing tens of thousands of Americans each year. A new report from the Centers for Disease Control and Prevention details the meteoric rise of a drug that was first approved by the Food and Drug Administration back in 1968. It shows that fentanyl’s role as a driver of the opioid epidemic can be traced to late 2013. (Healy, 3/20)

The synthetic opioid fentanyl has been driving up the rate of fatal drug overdoses across racial and social lines in the United States, with the sharpest increase among African Americans, according to a new analysis by the Centers for Disease Control and Prevention. The death rate among African Americans from fentanyl-involved drug overdoses rose 141 percent each year, on average, from 2011 to 2016, the study showed, with a particularly dramatic spike starting in 2014. The death rate for Hispanics rose 118 percent in that period every year on average, and 61 percent for non-Hispanic whites. The CDC did not have reliable data on Asian Americans and Native Americans. (Achenbach, 3/21)

Increased trafficking of the drug and increased use are both fueling the spike in fentanyl deaths. For drug dealers, fentanyl is easier to produce than some other opioids. Unlike the poppies needed for heroin, which can be spoiled by weather or a bad harvest, fentanyl's ingredients are easily supplied; it's a synthetic combination of chemicals, often produced in China and packaged in Mexico, according to the U.S. Drug Enforcement Administration. And because fentanyl can be 50 times more powerful than heroin, smaller amounts translate to bigger profits. (Bebinger, 3/21)

Medicines proven to treat opioid addiction remain vastly underused in the U.S., the nation's top medical advisers said Wednesday. Only a fraction of the estimated 2 million people addicted to opioids are getting the medications, according to a report by the National Academies of Sciences, Engineering and Medicine. The influential group, which advises the federal government, called for increased prescribing of the drugs and other changes to reduce barriers to their use. (3/20)

As the opioid crisis dawned in the U.S., continuing educational material that doctors are required to review may have contributed to the burgeoning problem, according to a newly published study. How so? The study compared a continuing medical education module, or course, that was funded by a drug maker that sold a fentanyl lollipop and lozenge with practice guidelines issued by a medical society. The scope of the two publications was not completely identical, but both focused on the use of opioids in treating non-cancer pain. And the study found the industry-funded course contained a “subtle bias.” (Silverman, 3/20)

Democratic presidential candidate Kirsten Gillibrand says she's "open to improving" a Senate bill that would limit opioid prescriptions for acute pain. The senator from New York was addressing criticism she received last week when she tweeted that she and Republican Sen. Cory Gardner of Colorado had introduced the bill "because no one needs a month's supply for a wisdom tooth extraction." (3/20)

One of the most popular and effective treatments used to fight the U.S. opioid epidemic is about to get much cheaper. Based in Hyderabad, a rambling boomtown in south India, Dr. Reddy’s Laboratories Ltd. is a major supplier of generic drugs used by Americans for everything from infections to cardiovascular ailments. After a two-year legal battle, the company has won the right to sell a cheaper version of Suboxone Film, the best-selling opioid addiction drug in the U.S. too. (Altstedter, 3/20)

So, as the UAW negotiates wages, health care, job security and other traditional issues this summer with Detroit automakers, it also has identified combating opioids as a key priority in the upcoming collective bargaining talks this year. Manufacturing employees are exposed to injury from standing for long periods of time, repetitive motion and heavy lifting, and they seek treatment, which in the past two decades has increasingly come in the form of prescription painkillers containing codeine, oxycodone (such as OxyContin) or hydrocodone (such as Vicodin). Those pills can quickly result in addiction, in time leading some people to seek cheaper, more accessible heroin. (Howard, 3/21)

The former Army soldier was slumped in the back seat of a sheriff’s department squad car when Shannon Teague and Tyrone “T-bone” Anderson arrived on the scene. A couple of hours earlier, high on meth, he’d been yelling “you will die” from the front porch of a transition house for homeless veterans. Teague made the introductions. Neither she nor Anderson wore a uniform, except for the patch on their jackets and the ID tags clipped to their shirts. “I’m a social worker, and this is my partner, T-bone,” she told the man. “We are from the VA. You’re not in trouble.” (Kuznia, 3/20)

Virginia’s U.S. senators, Tim Kaine and Mark Warner, are seeking to improve veterans’ access to mental health care. The two Democrats introduced the legislation in Congress on Monday along with Sens. Jon Tester, D-Mont., and Jerry Moran, R-Kan., in an effort to bolster the Department of Veterans Affairs’ mental health workforce; increase rural access to care; and expand access to alternative options such as animal therapy, outdoor sports and yoga. (Friedenberger, 3/19)

Health and Human Services (HHS) Secretary Alex Azar and departing Food and Drug Administration (FDA) Commissioner Scott Gottlieb penned an op-ed in The Washington Post on Wednesday warning of a regulatory crackdown on the e-cigarette industry if teen use doesn't decline. Gottlieb, who announced his resignation as FDA chief earlier this month, had repeatedly raised concerns about teenage use of e-cigarettes, with the FDA threatening to yank the products off the market earlier this year unless youth smoking rates drop in the coming months. (Axelrod, 3/20)

Scott Gottlieb was nominated to run the FDA in March 2017. Two years — and nearly 500 press announcements — later, the productive and high-profile commissioner is preparing to step down in early April 2019. Gottlieb joined POLITICO's Dan Diamond to discuss why he's leaving FDA, his regulatory and communications strategy, his work on medical device safety, digital health, opioid abuse, the Trump administration's approach to science and the choice of Ned Sharpless as acting FDA commissioner, what Gottlieb would've pursued if he had more time at FDA and if he'll ever return to government. (3/20)

The Food and Drug Administration’s top compounding staffer, Julie Dohm, is leaving the agency effective March 29. Since 2016, Dohm has steered the FDA through the contentious implementation of the compounding law passed by Congress in the wake of a 2012 meningitis outbreak that killed 64. During Dohm’s tenure, FDA released nearly two dozen far-reaching policies, conducted more than 400 inspections of compounders, and took a number of compounding pharmacies to court for alleged violations of the law. (Florko, 3/20)

The Trump administration and coal industry allies are insisting that a federal black lung trust fund will continue to pay benefits to sick miners despite a drastic cut in funding. But the expected shortfalls will be covered by taxpayers instead of coal companies, adding more debt to the already struggling fund. And at least one Republican congressman from the coalfields has added his voice to the chorus of miners and advocates worried that the fund's promise to sick workers and their families ultimately might not be kept. (3/20)

Unsafe drinking water, not climate change, is the world's most immediate public health issue, Environmental Protection Agency administrator Andrew Wheeler contended Wednesday. Environmental groups responded by saying the Trump administration was neglecting — or worsening — both health threats. Wheeler made his case for a shift in public focus in a CBS News interview that aired Wednesday, and in a speech later in the day in Washington on global water issues. (3/20)

The U.S. Army has put a price tag on releasing the results of water tests for a dangerous contaminant at military installations: nearly $300,000. In a March 12 letter, the Army told the Environmental Working Group, an advocacy group, that the military would charge the group $290,400 to provide records of water tests at 154 installations for a family of compounds known as PFAS, which federal authorities say appear linked to certain cancers and other health and developmental problems. (3/20)

It’s still not known which combination of factors — something in a person’s genes, environmental exposure to toxins and perhaps other things like previous military service or being an athlete — determine whether a person will develop ALS, [Dr. Stephen] Goutman said. But in studying blood samples of patients with ALS for a decade, he, Feldman and researchers at the University of Michigan’s School of Public Health discovered that exposure to now-banned organochloride pesticides like DDT and manufacturing chemicals like PCBs (polychlorinated biphenyl) do play a role not only in the development of ALS, but also in how quickly the disease takes its deadly course. (Shamus, 3/20)

Gov. Ralph Northam on Wednesday signed into law legislation to require the excavation of the state’s legacy coal ash now stored in Dominion Energy ponds across the state. The governor’s signature marks the end of a yearslong legislative fight over how to close the ash ponds; the legislation is the most significant piece of environmental legislation to move through the General Assembly this year. (Leonor, 3/20)

When it comes to using them safely, 56 county agricultural officers are local communities final line of defense. But a new report produced at UCLA suggests that a lack of guidance for county agricultural offices in considering alternatives or cumulative impacts for toxic exposures, may be putting people at risk. (Peterson, 3/20)

America’s largest employer is having a hard time filling jobs. The skills gap in the health care sector, now the largest U.S. industry, is greater than the gap in the overall economy, according to a report published Wednesday by Indeed economists Martha Gimbel and Tara Sinclair. The economists studied job postings and resumes on Indeed, an employment-related search engine, between January 2014 and December 2018 and found a mismatch between employers who were looking to hire and the skills offered in candidate resumes. This suggests healthcare faces a greater hiring challenge than other sectors. (Hagan, 3/20)

Maurice Wysocki, an information technology worker, was looking to branch out on his own as a contractor last year, allowing him a more flexible schedule and sharply reduced hours some months of the year. But then the Poughquag, New York, resident hopped on the federal health care exchange to see how much he would have to pay for insurance for himself, and his wife and two children. “It was a huge amount,” Wysocki, 49, says, roughly 10 times his current costs as an employee of a financial services company. “I chickened out.” (Davidson, 3/18)

Investor-owned hospital chain HCA was hit with a whistleblower lawsuit accusing it of cheating the federal government out of millions of dollars through inflated or fraudulent billing through its rehabilitation hospitals. In a False Claims Act complaint unsealed Tuesday, a former HCA occupational therapist alleged the health system submitted false claims from its rehabilitation network across 18 states to secure higher reimbursement rates from the Inpatient Rehabilitation Facility Prospective Payment System than it could obtain from the Inpatient Prospective Payment System. (Kacik, 3/20)

Bausch Health Cos Inc. got a new bull and reawakened a bear within 14 hours, underscoring yet again how the company acts like a lightning rod on Wall Street. Analysts at SunTrust started coverage of the drugmaker with a buy rating Tuesday afternoon, telling investors that “management is doing the right things to strengthen the business” despite a heavy debt load. The next morning, Bank of America Merrill Lynch analyst Jason Gerberry re-started the bank’s coverage with a sell-equivalent rating, citing “fundamental challenges” in the next leg of the company’s recovery. (Lipschultz, 3/20)

Kaiser Health News: Health Plans For State Employees Use Medicare’s Hammer On Hospital Bills

States. They’re just as perplexed as the rest of us over the ever-rising cost of health care premiums. Now some states are moving to control costs of state employee health plans. And it’s triggering alarm from the hospital industry. The strategy: Use Medicare reimbursement rates to recalibrate how they pay hospitals.  If the gamble pays off, more private-sector employers could start doing the same thing. “Government workers will get it first, then everyone else will see the savings and demand it,” said Glenn Melnick, a hospital finance expert and professor at the University of Southern California. “This is the camel’s nose. It will just grow and grow.” (Appleby, 3/21)

When hospitals and doctors cheat to line their pockets, health care costs shoot up for everyone who has insurance, federal prosecutors say. In many cases, taxpayers are left to foot the bill. A case in point: an employee had back surgery at Forest Park Medical Center and a two-day stay to recover, and already the hospital bill was up to $400,000, the witness told jurors. (Krause, 3/20)

The hot-button proposals involve nudging Connecticut’s minimum wage to $15 an hour, up from $10.10, over the course of several years, and imposing a 0.5 percent payroll tax to fund a pool of money for paid leave. Corporate officials have denounced the measures as unfriendly to businesses, particularly small companies that could struggle with workers’ absences and additional costs. (Carlesso and Pazniokas, 3/20)

Amid a renewed national conversation about childhood vaccinations, Gov. Matt Bevin of Kentucky said this week that he and his wife made sure all nine of their children got chickenpox. “Every single one of my kids had the chickenpox,” Mr. Bevin said in an interview on Tuesday with a radio station in Bowling Green, Ky. “They got the chickenpox on purpose because we found a neighbor that had it and I went and made sure every one of my kids was exposed to it, and they got it. They had it as children. They were miserable for a few days, and they all turned out fine.” (Bosman, 3/21)

School was about to start. Doctors at a Pennsylvania pediatric practice wanted to remind parents to get their children vaccinated against human papillomavirus, or HPV, which can cause a variety of cancers. The doctors produced a 90-second video and posted it to the practice’s Facebook page. The video sparked positive feedback initially and resulted in more parents scheduling appointments for their children and adolescents to get the recommended vaccine. But three weeks later, anti-vaccine activists began inundating the Facebook page of Kids Plus Pediatrics, a Pittsburgh doctors group, with hostile messages. (Sun, 3/21)

New Zealand will ban military-style semiautomatics and assault rifles, Prime Minister Jacinda Ardern announced Thursday, six days after attacks on two mosques in Christchurch that left 50 people dead. "On 15 March, our history changed forever. Now, our laws will too," Ardern said. "We are announcing action today on behalf of all New Zealanders to strengthen our gun laws and make our country a safer place." (Fifield, 3/20)

The quick action was a stark contrast to the slow pace of making gun legislation in the United States. Firearms are part of the culture in both countries. New Zealand has 4.7 million people and 1.5 million guns, and the U.S. has 328 million people and between 265 million and 393 million guns. But when it comes to gun laws, there are some big differences. Most importantly, New Zealand’s constitution does not guarantee the right to own a gun. And though the gun lobby is influential in both countries, it is stronger in the U.S. “There is a lot of energy in the days after a mass shooting in America, but it tends to wane pretty quickly,” said John Donohue, a law professor at Stanford University who teaches on gun policy. (Kaleem, 3/21)

Adolescents and young adults being treated for attention-deficit hyperactivity disorder may be at a higher risk of having a psychotic event if they are provided amphetamine medicines, such as Adderall and Vyvanse, instead of medications based on the compound methylphenidate, such as Ritalin or Concerta, according to a study published Wednesday. The risk of psychosis was generally low, occurring in one in 660 patients, according to the study, which was published in the New England Journal of Medicine. (Herper, 3/20)

A new study on the effects of medication prescribed to those with attention deficit hyperactivity disorder suggests that teens and young people could face an increased risk of psychosis with certain drugs. The study, conducted by researchers at McLean Hospital and Harvard Medical School, looked at teens and young people who had recently begun taking two classes of drugs – amphetamines (marketed as Adderall and Vyvanse) and methylphenidates (marketed as Ritalin or Concerta) – used to treat ADHD. (Lord, 3/20)

U.S. and international health officials are easing warnings against travel to regions with Zika virus because the threat has diminished markedly since the virus began to sweep across the globe four years ago. The World Health Organization designated Zika a global health emergency in 2016, and the Centers for Disease Control and Prevention told women who were pregnant or might become pregnant to stay away from nearly 100 countries or regions. The mosquito-borne virus can cause severe birth defects. (Sun, 3/20)

Drinking sugary beverages is associated with a slightly increased risk for early death, a new study has found. Researchers used data from two large continuing health studies begun in the 1980s that include more than 118,000 men and women. Among many other health, behavioral and diet characteristics, the researchers collected data about their consumption of sugar-sweetened beverages, including noncarbonated fruit punches, lemonades and other sugary fruit drinks. (Bakalar, 3/21)

The number of children and young adults visiting the emergency department for psychiatric concerns rose 28 percent over a four-year period, and visits having to do with suicide more than doubled, according to a study published this week in the journal Pediatrics. The findings amplify concerns that the mental-health care system is failing to meet the country’s needs, forcing people to rely on emergency rooms ill-equipped to deal with psychiatric concerns. (Pattani, 3/20)

Postpartum depression is a common complication after birth, affecting hundreds of thousands of American women every year. A new treatment could offer much-needed help to some new mothers with this disorder, but questions remain about how affordable or accessible it will be. (Santhanam, 3/20)

CBD has landed at CVS. CVS Health Corp. this week will begin selling products infused with the trendy, non-intoxicating hemp component at more than 800 of its stores as part of a partnership with marijuana company Curaleaf Holdings Inc., Curaleaf said Wednesday. Curaleaf announced the agreement during an earnings conference call on Wednesday. The company’s CBD products will be available in about 800 stores to start, Curaleaf said on the call, and hopes to expand to more. (Giammona, 3/20)

A Colombian woman has given birth to a baby whose abdomen contained the tiny, half-formed — but still growing — body of her own twin sister. This type of birth, an example of “fetus-in-fetu,” is very rare but not unprecedented. The condition was described in a British medical journal in 1808 and is thought to occur in about one in every 500,000 births. In recent years, similar births have occurred in India, in Indonesia and in Singapore. (McNeil, 3/20)

Gov. Brian Kemp has thrown his support behind major reforms of the state health care regulatory system, acting as legislation on the contentious issue was revived in a Senate committee Wednesday. A House bill to make sweeping changes to the certificate-of-need (CON) system recently failed to pass the House on Crossover Day. That normally means a piece of legislation is dead for the year. (Miller, 3/20)

The Washington-backed drive to roll back hospital certificate-of-need laws lurched forward in Florida this week, as the state's two legislative bodies deliberated over two very different approaches. On Monday, a key state Senate panel had to table its limited overhaul of the state's so-called CON laws due to lack of support. But the state's House of Representatives voted to move forward its proposal for full repeal—a key priority for GOP Speaker of the House Jose Oliva. Florida is one of 35 states with a certificate-of-need law. (Luthi, 3/20)

Elizabeth Brandt lives modestly on the income she receives from Social Security, drives a 16-year-old car and has to tap savings for unexpected costs, such as the hearing aids she needs to fully participate in conversations. But Gov. Ned Lamont says people like Brandt have saved too much money to benefit from a health program for low-income seniors. He proposes to implement an asset test for the Medicare Savings program, a joint federal-state program that helps Brandt and about 180,000 other older, low-income seniors in Connecticut pay for services Medicare doesn’t. (Radelat, 3/21)

The California Legislature has revived an insurer-backed bill to cap dialysis pay at Medicare rates if industry-backed third parties have helped a patient pay for the insurance to fund treatment and don't give certain disclosures. The new momentum has picked up less than a year after then-Gov. Jerry Brown vetoed a similar measure amid intense opposition from the dialysis industry. (Luthi, 3/20)

House Speaker Michael Busch said Wednesday that he will introduce sweeping legislation to reform the University of Maryland Medical System’s board of directors as accusations of “self-dealing” have rocked the hospital network. Busch’s legislation — which will act as a companion bill with Sen. Jill P. Carter’s legislation in the state Senate — came as top officials from the medical system met with Gov. Larry Hogan and Senate President Thomas V. Mike Miller for an hour in the State House. (Broadwater, 3/20)

Average hourly pay for the workers who provide home and personal care to Ohioans with developmental disabilities would increase by 11 percent over the next two years — to $12.38 an hour — under a state-budget proposal that seeks to address the worsening labor shortage. If approved, the plan would mark the state’s biggest effort yet to boost wages in an industry desperate to recruit and retain front-line employees. (Price, 3/20)

Gov. Ralph Northam on Wednesday signed legislation that will lower the sales tax on feminine hygiene products such as tampons and sanitary napkins. The “Dignity Act,” introduced by Sen. Jennifer Boysko, D-Fairfax, originally sought to nix the sales tax for these products altogether. Boysko’s bill was changed to match that of Del. Kathy Byron, R-Bedford, which passed as it was introduced. The final legislation lowers the sales tax on the products to 2.5 percent. (Leonor, 3/20)

Barbara’s son had just gotten out of the shower and gone back downstairs to where his 6-month-old son was napping when she heard a scream. Then came the pounding of feet on the stairs of their home in Warwick, Rhode Island. Conner handed her Alijah, who was limp. Barbara tried to stay calm as she carried her grandson into the living room. She’d watched medical shows on TV where they did CPR on babies. (Arditi, 3/20)

A Tennessee woman says Vanderbilt University Medical Center operated on the wrong kidney during her surgery in what federal officials call a "never event." The Tennessean reports Carla Miller says the error damaged her urinary system and she now needs dialysis for life. She's seeking more than $25 million in damages in a lawsuit filed Tuesday. Vanderbilt officials declined comment to the newspaper. (3/20)

State and local health authorities and University of Kentucky health experts were in Northern Kentucky on Wednesday to announce the program that will start in Northern Kentucky. It will provide public health specialists and technology to fight HIV and other blood-borne diseases that are plaguing the region. (DeMio, 3/20)

Dallas-based insurance company Blue Cross Blue Shield of Texas will pay $75,000 to settle a disability discrimination lawsuit after the company allegedly failed to accommodate a deaf job applicant, officials said. The U.S. Equal Employment Opportunity Commission announced Wednesday that Blue Cross would settle the lawsuit filed by the agency, which alleged that the company had violated the Americans with Disabilities Act. The lawsuit was filed after Blue Cross declined to settle out of court. Blue Cross could not immediately be reached for comment. (Sarder, 3/20)

Zoll Medical reported that the personal information of 277,319 patients was exposed during a recent server migration. The medical-device and software maker said in a release on Monday that a third-party service archives Zoll's e-mails. Some personal information was included in the e-mail communications the third-party provider stores. (King, 3/20)

On a sunny afternoon on the first day of spring, Deepa Goraya opened her laptop and sat at her dining-room table in the bright Washington condominium she has never seen. Goraya, 34, a disability rights lawyer who is blind, prepared to do a Google search with screen-reader software — a program that reads each word on a website at blistering speed in a robotlike monotone. While unintelligible to the uninitiated, the reader is a vast improvement over research methods available to Goraya years ago, which included finding her mom or someone else willing to read to her. (Moyer, 3/20)

Members of a union representing research and technical workers walked picket lines Wednesday at University of California campuses and hospitals in a one-day strike amid a lengthening stretch of unsuccessful contract negotiations. About 10,000 members of University Professional and Technical Employees-Communications Workers of America were expected to take part statewide, spokesman Dan Russell said. (3/20)

State officials are preparing to write new standards for health care and mental health services in local jails. The move arises from legislation sent to Gov. Ralph Northam this year during an increased focus on jails in Virginia following the 2015 death of Jamycheal Mitchell in the Hampton Roads Regional Jail. Mitchell, 24, had severe mental health problems and was not transferred from the jail to a state hospital as ordered by a judge. (Wilson, 3/20)

Sutter Health and Anthem Blue Cross have reached an agreement that will allow Blue Cross Medi-Cal, HMO and PPO users to continue receiving care via Sutter Health facilities and doctors, Sutter announced Wednesday. The agreement will remain in place through Dec. 31, 2022, Sutter said in a news release. (McGough, 3/20)

Marin has been rated the healthiest county in California by the Robert Wood Johnson Foundation for the ninth time in 10 years. The annual rankings compare California’s 58 counties on more than 30 factors that influence health including length of life, quality of life, health behaviors, access to health care, socioeconomic factors and physical environment. (Halstead, 3/20)

A private equity-backed medical group that’s been forging ties with hospital systems around the U.S. to better coordinate patient care and control costs has signed a new deal in one of the nation’s most crowded health-care markets. One Medical, which raised $350 million last year from investment giant Carlyle Group LP, is joining Mount Sinai’s network of independent physicians in New York. The deal will make it easier for patients to move among One Medical’s nine primary-care clinics and Mount Sinai’s specialists and hospitals, executives from both entities said. (Tozzi, 3/20)

The latest step in the renovation of the Family Birthing Center at Carroll Hospital is designed to benefit babies who require more complicated care after birth. Hospital staff hopes keeping them close to their families will improve the experience and even shorten the length of hospital stay for some babies. ...The hospital previously debuted the new entrance to the Birthplace, with improved security and a renovated waiting room. A triage center in the Birthplace is only for patients who are pregnant, allowing them to avoid the emergency room. (Catalina, 3/21)

The cost of taking a city ambulance to the hospital will go up nearly 70 percent under a measure approved by City Council Wednesday that fire department leaders hope will help Houston keep pace with rising costs. Additionally, council approved three new emergency services fees aimed in part at dissuading repeat callers from using ambulance service as a convenience. (Scherer, 3/20)

Los Angeles-based MedMen is suing the city over new restrictions on how close dispensaries can be to each other. The company says the restrictions violate a state law preventing local governments from limiting the number of medical marijuana dispensaries. (Gurney, 3/21)

In Sacramento, where the Jump bike and scooter company recently introduced 100 motor-assisted rental scooters, there have been early reports of some riders falling when traversing midtown railroad tracks, and one reported injury crash in the street two weeks ago near Memorial Auditorium. (Bizjak, 3/20)

The goal initially is simply to give people of color a comfortable medical home with a doctor who understands their needs both because of her training and her personal background. Eventually, she’d like to expand the clinic to teach other dermatologists to work with people of color and conduct research to improve care. (Allday, 3/20)

Wilder Research counted 10,233 people, on a single day — Oct. 25 — who were in emergency shelters, domestic violence shelters, and transitional housing programs, as well as people camped outside or who sought services at hot-meal programs and other drop-in sites. That's a jump of nearly 1,000 people since the last study in 2015, and marks the highest count since the study began in 1991. (Kraker, 3/20)

A little more than two years ago, Bowles met with his doctor and was approved to use medical marijuana to alleviate his symptoms. He registered with the state and obtained a special card from the Georgia Department of Health. The problem is, there’s no way for him to legally acquire the medical marijuana in Georgia. It’s against the law to grow medical marijuana. You can’t legally buy it, sell it or bring the drug into Georgia from another state. (Oliviero, 3/20)

Of more than 2 million very low-income renter households in California, roughly two-thirds are severely cost burdened, meaning they spend more than half their income on rent, according to a report by the California Housing Partnership. That news comes two years after the Legislature passed a slate of bills to expedite construction and subsidize affordable housing. (Bollag, 3/21)

The results show that Medicaid work requirements could weaken hospitals’ financial positions in states that implement these requirements as a condition of coverage. However, the design of states’ Medicaid work requirement programs will play a key role in how many beneficiaries lose coverage and the resulting financial impact on hospitals. (Haught, Dobson and Luu, 3/14)

Sleep problems are more than twice as common in young children with ASD and DD w/ASD. Screening for sleep problems is important in young children to facilitate provision of appropriate interventions. (Reynolds et al, 3/1)

Antiviral therapy cannot erase hepatocellular carcinoma (HCC) risk in patients with chronic hepatitis B, and it is not indicated for most hepatitis B virus (HBV) carriers. Another effective way of reducing HCC risk needs to be developed. Aspirin may prevent cancer development, but clinical evidence in patients with HBV-related HCC remains limited. (Lee et al, 3/18)

New York City officials have shifted resources to focus on once underserved communities such as the Brownsville neighborhood, in Brooklyn. (Gale, 3/4)

Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage and many go without needed care, according to a new KFF brief on dental coverage and costs for Medicare beneficiaries. Rates are even higher among black and Hispanic beneficiaries, and those with low incomes. Medicare does not cover routine preventive dental care or more expensive dental services that are often needed by older adults. Lack of dental care can lead to delayed diagnosis of serious health conditions, preventable infections and complications, chronic pain, and costly emergency room visits. (3/13)

Lost in the anxiety this year over the fate of Roe v. Wade is the reality that state legislatures nationwide are already taking steps to effectively ban all abortions. Not even three months into 2019, lawmakers in a dozen states have proposed so-called heartbeat bills, which would outlaw abortion at around six weeks of pregnancy, when a fetal heartbeat can be detected, and thus make it all but impossible for nearly all women to get the procedure. Six of those bills have passed in at least one legislative chamber, and on Friday Gov. Matt Bevin of Kentucky signed one into law. Hours later, a federal judge temporarily blocked the Kentucky law, which was to have taken effect immediately. (3/20)

Proponents of House Bill 481 contend that life begins once an embryo’s heartbeat can be detected — at about six weeks, when it is about the size of one’s fingernail. And before most women even realize they’re pregnant. Except there is no embryo or fetus in the “heartbeat” bill. (Jim Galloway, 3/19)

The e-cigarette craze among teenagers has become an epidemic. We agree with those who believe that e-cigarettes may offer a lower-risk alternative for adult smokers who still want access to nicotine. But the continued availability of this opportunity to adults is being endangered by the e-cigarette industry’s slowness to address the dangers its products pose to teens. The 2018 National Youth Tobacco Survey showed a nearly 80 percent increase in current e-cigarette use (meaning in the previous 30 days) by high-school-age teens over the previous year. The survey also showed a nearly 50 percent increase for middle-school-age children over the same period. The combined total reflects a surge of 1.5 million young e-cigarette users, to 3.6 million. Perhaps most disturbing, the survey revealed an almost 40 percent increase in teens using e-cigarettes on 20 or more of the past 30 days. (HHS Secretary Alex Azar and FDA Commissioner Scott Gottlieb, 3/20)

President Trump’s proposal to cut $1.4 trillion from Medicaid over 10 years not only is unethical in its heartless attack on the nation’s poorest and most vulnerable — it’s also bad policy that will cost taxpayers far more than it saves in the long run. The proposal, unveiled in Trump’s 2020 budget, was a shocker that nonetheless surprised no one. As Rep. Anna Eshoo (D-Calif.) put it during a congressional hearing on March 12, this administration “has taken a hatchet to every part of our health care system.” (Jacob Reider, 3/20)

After a gunman carried out a horrifying attack on two mosques in Christchurch, New Zealand, that killed 50 people, Prime Minister Jacinda Ardern announced that she had ordered an inquiry to determine whether government agencies could have prevented the tragedy. “The purpose of this inquiry,” she said, “is to look at what all relevant agencies knew — or could or should have known — about the individual and his activities, including his access to weapons.” How did this happen? What could have been done differently? The questions are simple and obvious. They are nonetheless still striking for the contrast they show between how New Zealand and the United States respond to mass shootings. (3/20)

America’s opioid crisis is a terrible tragedy in itself. Increasingly, though, the evidence suggests that it’s behind another malaise: the growing ranks of prime-aged males dropping out of the labor force. The epidemic of opioid and opiate drug abuse contrasts sharply with a broader improvement in Americans’ health. Violent crime, domestic violence and teen pregnancy are all way down. Cancer survival rates are up, and HIV is on the way out. Air and water pollution have decreased. (Noah Smith, 3/19)

Imagine a scenario in which a 57-year-old man with an individual health-insurance policy is diagnosed with cancer. As soon as the diagnosis is made, the incentives of the man and those of his health insurer diverge. He wants the best treatment immediately, while the insurer seeks to meet its obligations in the most financially prudent way possible. That could mean paying for less-expensive treatments first before gradually moving up a ladder of remedies if they fail. If the patient switches to a different insurance plan after being cured, his first insurer will have in effect subsidized a competitor. Moreover, the insurer’s obligations end with his death. (Dana P. Goldman and Darius Lakdawalla, 3/20)

In 2015, more than 3.6 million cataract procedures were performed in the United States. For many Americans — including me — the procedure is covered by insurance. That’s a lot, but the American Academy of Ophthalmology estimates that more than 24.4 million Americans have cataracts, including half of all those over 70 years old. Surely such surgery should not be limited to people of privilege. I’ll leave it to someone to the right of me to explain why the ability to see should not be the right of every citizen. (Jennifer Finney Boylan, 3/20)

Childbirth and infectious diseases were once the leading causes of death among women around the globe. That’s changed over the last three decades. Today, noncommunicable diseases (NCDs), once considered diseases of affluence, are, along with injuries, the leading causes of death and disability among women in developing and developed countries alike. Noncommunicable diseases affect women and children across the life-course: They are a critical issue for child and adolescent health, a threat to maternal and reproductive health, and a major driver of ill health for older women. (Robyn Norton and Katie Dain, 3/21)

The same economic challenges that affect Trenton’s fiscal health impact the physical health of its residents. Low income often goes hand in hand with food insecurity and reliance on less healthful foods. When unemployment is high, so are rates of stress and accompanying poorer mental and physical health outcomes. Poverty often leaves families unable to afford safe housing, resulting in health-degrading exposures to lead and mold. (David Eichenthal and Marc Gourevitch, 3/20)

Should it be a privilege for menstruating women to have access to tampons and pads? According to the Maine’s Republican state representative, Richard Pickett of Dixfield, incarcerated women should not have comprehensive access to menstrual hygiene products for free. Dixfield recently voted against a bill allowing state jails and prisons to provide free, unrestricted comprehensive access of tampons, pads and menstrual cups to incarcerated women because, according to a reporter who tweeted his response, “Quite frankly, and I don't mean this in any disrespect, the jail system and the correctional system was never meant to be a country club.” (Sameena Rahman, 3/20)