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After weeks of uncertainty atop the Department of Veterans Affairs, President Trump dismissed its secretary, David J. Shulkin, on Wednesday and announced he would replace him with the White House physician, Dr. Ronny L. Jackson, a rear admiral in the Navy. ... The announcement punctuated what has been a rapid fall from favor for Dr. Shulkin, a politically moderate former hospital executive who delivered Mr. Trump a string of bipartisan legislative victories at a time when he was struggling to find them. But in his final weeks, he struggled to fight off attempts by more conservative administration officials to have him removed and was dogged by an unflattering inspector general report on his overseas travel that undermined his relationship with the president. (Fandos and Haberman, 3/28)

His removal comes at a critical point in what lawmakers say are urgent changes to the VA Choice program—debate over which had highlighted political tensions between Shulkin, lawmakers and the White House—as well as in the midst of his hefty effort to modernize the VA's EHR system. (Luthi, 3/28)

When a Republican congressman was critically wounded in a shooting at a baseball game last summer, U.S. President Donald Trump dispatched his physician, an Iraq war veteran trained in emergency medicine, to the hospital to check on his condition. Later on that June day, Navy Rear Admiral Ronny Jackson accompanied the Trumps to meet with Representative Steve Scalise's family and medical team. Scalise survived and has returned to Congress. Now Trump is counting on Jackson to take charge at Veterans Affairs, a behemoth of a bureaucracy that has vexed a slew of decorated military officers and corporate managers. (Holland, 3/28)

Ronny Jackson passed his screen test with President Donald Trump before casting even began. Jackson, the president's personal physician and surprise choice to lead the massive Department of Veterans Affairs, stood before the White House press corps in January to announce the results of the president's first physical in a performance that showed he was quick-witted, hard to throw off-kilter and unfailingly complimentary of Trump. Marveling at the 71-year-old president's good health, Jackson opined, "It's just the way God made him." (Colvin, 3/29)

A biography released by the White House shows Jackson is credentialed and experienced in medicine but has no background in management. He nonetheless will be charged with delivering on one of Trump’s signature campaign promises: to fix the federal government’s second-largest bureaucracy. VA, which employs 360,000 people and has a $186 billion annual budget, serves a growing population of veterans in need and is suffering from a shortage of doctors, nurses and mental health experts. (Rein, Rucker, Wax-Thibodeaux and Dawsey, 3/28)

Top veterans groups praised Dr. Shulkin on Wednesday, while some expressed concerns about his replacement. “We’re really surprised at this nominee,” said Joe Chenelly, national executive director of Amvets, a veterans advocacy group. “Looking at his background we don’t see anything that indicates he’s capable of running a $200 billion agency. The VA is a lot more than just a medical system.” (Ballahus and Kesling, 3/28)

Lawmakers on the Hill were full of praise for Shulkin and muted about Jackson, although many said they looked forward to meeting the president’s pick who has to be confirmed by the Senate. “Dr. Shulkin has made a tremendous impact toward improving the lives of veterans during his time at the U.S. Department of Veterans Affairs. He has been instrumental in all that we have accomplished in the last year,” said Sen Johnny Isakson (R-Ga.), the chairman of the Senate Committee on Veterans Affairs. (Kenen, 3/28)

Shulkin ran afoul of some conservatives for his go-slow approach to expanding government-paid private care for military veterans outside the VA system. Shifting more veterans to private care is a top priority for the influential network of conservative groups funded by Charles and David Koch. An effort to expand the existing Veterans Choice program, under which veterans can get government reimbursement for seeing a private doctor in certain circumstances, failed this month when Congress did not include it in the massive government spending bill that Trump signed into law.The Koch-backed Concerned Veterans of America has pushed for the legislation, but most other major veterans organizations opposed it. (Cloud, 3/28)

Robert Wilkie, currently the undersecretary of for Personnel and Readiness at the Defense Department, will serve as acting secretary for Veterans Affairs while Jackson awaits Senate confirmation, Trump said. (Shields, 3/28)

A new watchdog report reveals that the Department of Veterans Affairs (VA) employed thousands of workers at medical facilities without properly performing background checks. The inspector general (IG) report released Monday faults the VA for employing an estimated 6,200 workers over five years through 2016 who did not undergo background checks within the mandated first 14 days of their employment. (Bowden, 3/28)

The Trump administration’s latest effort at banning transgender individuals from serving in the military amounts to what legal experts said is essentially a reprise of an all-too-familiar directive at the Pentagon: the 1994 “don’t ask, don’t tell” policy. A slew of medical and legal professionals have already lined up against the newest White House order, issued late Friday night, which experts said may survive only if it is backed by the Supreme Court. (Cooper, 3/28)

In health care, breakthrough cures are no longer just hidden in the innumerable mysteries of biology and chemistry. Increasingly, they are locked away in a place even harder to access: electronic patient records. These files could help establish which patients, with which backgrounds and disease characteristics, respond best to certain therapies — secrets that are often carefully guarded in service of patient privacy, and private profit. (Ross, 3/29)

HHS has delayed posting comments on rules aimed at protecting individual providers who refuse care based on religious beliefs. Legal experts and industry stakeholders say that places a veil over what's supposed to be a transparent process and could put the agency in a legal bind. ...On Tuesday, comments were due on the proposed rule. HHS received 72,000 comments. In the past, HHS has posted comments as they come in. (Dickson, 3/28)

Iowa’s governor is poised to sign legislation that would allow insurers to sell cheaper plans that don’t comply with certain ObamaCare consumer protection regulations. According to the Des Moines Register, the state Senate approved the bill Tuesday, and Gov. Kim Reynolds (R) is expected to sign it. (Weixel, 3/28)

States are on their own to stabilize their individual insurance markets ahead of the 2019 coverage year, after a major bipartisan health care deal in Congress fell apart last week. But the path forward won’t be easy with ongoing market uncertainty under the Trump administration and insurers preparing to file 2019 premium requests this spring, experts say. Some states are exploring setting up reinsurance programs to help insurers cover the sickest, most expensive Americans, as they look to rein in premiums for plans sold on the individual marketplace next year. But the process is lengthy, costly and politically challenging. (McIntire, 3/28)

A new report finds that health insurance premiums available on the state's MNsure exchange in 2018 are lower than last year due in large part to a Minnesota state government program. Researchers from the Urban Institute said the average premium across the country for a 40-year-old nonsmoker moved the other way — growing this year by nearly one-third, according to a study released this month. (Snowbeck, 3/28)

A key House committee will hold the last of three major hearings to address the opioid crisis on April 11, and hopes to bring a legislative package to the floor before the House breaks for Memorial Day on May 24, according to GOP aides on Capitol Hill. The third hearing of the House Energy & Commerce health subcommittee will focus on insurance coverage, payment issues, and prescription regulations for Medicaid beneficiaries. An initial session focused on enforcement issues and a second discussed public health, treatment, and prevention strategies. (Facher, 3/29)

A pipe was the only sign of drug use found near Chris Bennett's body in November. But it looked like the 32-year-old Taunton, Mass. native had stopped breathing and died of an opioid overdose. Bennett's mother Liisa couldn't understand what happened. Then she saw the toxicology report. "I'm convinced he was smoking cocaine that was laced," she says. "That's what he had in his system, [it] was cocaine and fentanyl." (Bebinger, 3/29)

Velva Poole has spent about 20 years as a social worker, mostly in Louisville, Ky. She's seen people ravaged by methamphetamines and cocaine; now it's mostly opioids. Most of her clients are parents who have lost custody of their children because of drug use. Poole remembers one mom in particular. "She had her kids removed the first time for cocaine. And then she had actually gotten them back," she says. But three months later, the mother relapsed and overdosed on heroin. (Gillespie, 3/28)

Kaiser Health News: Omissions On Death Certificates Lead To Undercounting Of Opioid Overdoses

In a refrigerator in the coroner’s office in Marion County, Ind., rows of vials await testing. They contain blood, urine and vitreous, the fluid collected from inside a human eye.In overdose cases, the fluids may contain clues for investigators. “We send that off to a toxicology lab to be tested for what we call drugs of abuse,” said Alfie Ballew, chief deputy coroner. The results often include drugs such as cocaine, heroin, fentanyl or prescription pharmaceuticals. (Harper, 3/29)

A California lawmaker is seeking to rein in addiction treatment centers and dialysis providers accused of profiteering off vulnerable patients by collecting millions of dollars in inflated medical claims. Supporters of the proposed legislation, scheduled for a key Senate hearing next month, say some providers, industry middlemen and charities with ties to providers are signing up patients for health insurance and paying the premiums only to line their own pockets. They say these arrangements drive up insurance costs industrywide. (Terhune, 3/28)

Word of a frightening spike in overdose deaths began circulating in the addiction-treatment community several days ago, and Franklin County Coroner Anahi M. Ortiz on Wednesday publicly revealed the toll: Eighteen people lost in just seven days. ...Initial toxicology screenings indicate that the majority of the deaths are related to fentanyl, an increasingly prevalent and powerful synthetic opioid that’s often added to other drugs. (Renault and Price, 3/28)

After years of skirmishes, the most comprehensive statewide drug take-back program in the nation became law late last week in Washington, potentially creating a new template for states to press the pharmaceutical industry to underwrite these efforts. The Washington law requires drug makers to fully finance and operate the program, which is designed to lower the threat of drug abuse stemming from medicines that linger in households and also reduce contamination in drinking water. (Silverman, 3/28)

Two major hospital systems have halted talks about a possible merger, shelving for now the prospect of a combination that would have created the nation’s largest owner of hospitals, according to people familiar with the discussions. Ascension, the largest U.S. nonprofit hospital system, and Providence St. Joseph Health, also a major nonprofit hospital owner, put talks on hold to restructure as more medical care moves outside of hospitals, putting pressure on their core operations, according to the people. A big, complex merger would split attention between restructuring and combining the two giants, the people said. (Evans, 2/28)

A Delaware court ruled in Kindred Healthcare's favor, rejecting shareholders' request to block the home healthcare provider's proposed sale to Humana and two private equity firms. The Court of Chancery of the State of Delaware on Tuesday denied shareholder Brigade Capital Management's request for a preliminary injunction against the $4.1 billion deal announced in December, according to Kindred. (Livingston, 3/28)

Sally Clark lost both her infant sons shortly after their births. In 1996, 11-week-old Christopher fell unconscious after being put to bed and never woke up. Two years later, 8-week-old Harry was found dead slumped forward in his bouncy chair. Doctors initially concluded the first boy had died of sudden infant death syndrome (SIDS) — in which a seemingly healthy baby dies without warning and without an obvious cause. But after Clark's second child died, prosecutors in the United Kingdom charged her with murder and put her on trial. According to scholars analyzing the widely publicized case, Clark was wrongly convicted based on a statistic. An expert witness for the prosecution claimed the chance of two cases of SIDS, in an affluent family like hers, was astronomically high — 1 in 73 million. (Cha, 3/28)

Embedded in a lung cancer tumor, scientists have found a gastrointestinal tract in miniature. Duke University researchers have observed rudimentary, but functional, stomachs, small intestines, and duodenums growing inside cancerous lungs — illustrating how varied and plastic these metastatic cells can be. (Keshavan, 3/29)

While the season was mainly dominated by the H3N2 virus, an influenza A strain that is more severe and less receptive to vaccines than other types of the flu, influenza B has now overtaken influenza A. And that, says the CDC, could be setting the stage for a second wave of misery. (May, 3/28)

Surgical reduction of the stomach may do more than change signals of hunger and appetite, improve metabolic function and induce substantial weight loss. New research suggests it may change some hearts as well. A large Swedish study has found that obese people who had a spouse or live-in partner and then underwent weight loss surgery were 28% more likely to become separated or divorced compared with those in a comparison group who didn't have surgery. (Healy, 3/28)

Surgeon General Jerome Adams on Wednesday said that his wife, Lacey, who was treated for melanoma years ago, had experienced a recurrence and was undergoing surgery for metastatic melanoma. He said he was choosing to highlight their story as a way to raise awareness about the risk factors for the skin cancer. In a Facebook post, Adams outlined how exposure to ultraviolet rays from the sun or tanning beds can increase the likelihood of melanoma and described the warning signs. He said Lacey Adams used to tan frequently. (Joseph, 3/28)

People with poor hearing are at increased risk for accidents, a new study reports. Using a nationwide health survey conducted by the Centers for Disease Control and Prevention, researchers found that of 232.2 million adults, 15.7 percent reported hearing problems; 2.8 percent were injured in an accident within three months of the survey date.The study, in JAMA Otolaryngology — Head and Neck Surgery, tracked injuries related to driving, work, and leisure or sports. (Bakalar, 3/27)

The “catastrophic” failure of a storage tank this month at an Ohio fertility clinic caused the apparent loss of more than 4,000 frozen embryos and eggs, the clinic said this week. About 950 patients were affected by the failure, in which the tank’s temperature rose and an alarm did not go off, the University Hospitals Cleveland Medical Center, which oversees the clinic, said in a letter that was sent to patients on Monday and posted on its website. (Hauser, 3/28)

In a letter to affected patients on Tuesday, the University Hospitals health care system wrote: "[W]e have determined that the total number of affected eggs and embryos for these patients is more than 4,000, not the estimate of 2,000 previously used. We are heartbroken to tell you that it's unlikely any are viable." University Hospitals said its investigation into the incident on March 3 to 4 at its fertility clinic in suburban Cleveland suggested the problems might have been caused by human error, mechanical failure or both. (Wamsley, 3/28)

But on the weekend of March 3-4, the cryofreezer storing those embryos had a temperature fluctuation, rendering all 4,000 of the eggs and embryos in UH's care nonviable. UH, which offered few details in the first weeks following the incident, sent a letter to patients March 26 explaining in more depth what happened, citing a deactivated alarm and ongoing issues with its cryofreezers. (Christ, 3/29)

The Delaware House has unanimously approved a "red flag" bill requiring efforts to temporarily seize guns from people with mental health issues who make an "explicit or imminent threat" to kill or injure someone. House Bill 302 imposes a series of "duties to warn." (3/28)

A group of Northern Virginia lawmakers, frustrated over a failure to pass gun-safety measures in Richmond, is pushing the state’s two largest jurisdictions to use an existing law that allows local governments to bar people from driving with a loaded shotgun or rifle. Seeking to capi­tal­ize on momentum from last week’s March for Our Lives, 10 Democratic state legislators sent a letter to Prince William County’s Board of Supervisors on Wednesday that urged them to adopt an ordinance regulating the transport of loaded weapons. (Olivo, 3/28)

Kansas officials are moving to protect more than 800 vulnerable residents of 15 financially troubled nursing homes across the state. The Kansas Department for Aging and Disability Services is seeking court orders to put the facilities — currently owned by a New Jersey company — into receivership. (Mclean, 3/28)

Mission Health Care — which operates 14 nursing homes in Kansas, Tennessee, Georgia, Minnesota and Wisconsin — has agreed to oversee the operation of the Kansas facilities. ... Skyline Health Care acquired the Kansas facilities in 2016. Angela de Rocha, KDADS spokesperson, said that Skyline Health Care has been having trouble paying its vendors recently and owes about $500,000 in bed taxes to the state. (Ryan, 3/28)

"Our most pressing concern at this point is stability," KDADS Secretary Tim Keck said in a news release. "We want to ensure the residents of these facilities continue to receive the care they need, and to make sure the staff, which provides that care, continues to be paid." (3/28)

An unnamed Texas donor has promised $9 million to Planned Parenthood of Greater Texas to help construct two new health centers in West Texas within the next year, the nonprofit confirmed this week. The group has not said whether the new clinics would be abortion providers. Planned Parenthood has had no clinics to offer abortion or other services in the region since 2013, shortly after Texas passed a law placing tough restrictions on groups that perform abortions. The laws were eventually struck down by the U.S. Supreme Court. But advocates say the damage had already been done as many clinics did not reopen. (Rice, 3/28)

A measure to prohibit health professionals from practicing "gay conversion therapy" on minors cleared the Maryland Senate on Wednesday — the same day the governor of Washington signed a bill into law to ban the practice. The Maryland Senate voted 34-12 for the bill, which now goes to the House. The measure would classify the practice as unprofessional conduct and subject providers to discipline by the state licensing board. (3/28)

Nebraska inched closer Wednesday to passing a budget that could deny federal money to Planned Parenthood of the Heartland, at least temporarily, despite furious opposition from a handful of lawmakers. Lawmakers advanced a budget measure that would prevent health clinics from getting family-planning dollars if they perform, counsel in favor of or refer patients to abortion services. (Schulte, 3/28)

Days after Harvard researchers reported that the mumps vaccine appears to lose its power over time, the once-dreaded disease is making a comeback in the Philadelphia region. Public health officials in Chester County, Montgomery County, and the state of Delaware are reporting outbreaks of the highly contagious, viral illness. (Giordano, 3/28)

The uninsured rate for those under age 65 in Greater Cleveland has fallen to near 6.4 percent, well below 2010 levels, according to data for 2016 released Wednesday by the U.S. Census Bureau. Overall, Ohio's uninsured rate of 6.7 percent ranks 13th lowest in country, the new survey found. (Exner, 3/28)

The Texas Department of Family and Protective Services is on track this year to exceed 180,000 abandoned calls to the agency’s abuse hotline, the most in at least a decade. As of Tuesday, there had been 23 days this year in which a caller had been on hold for more than an hour; in the past, the agency has had one or two such days per year. (Chang, 3/28)

A Fall River woman hired to care for an elderly Mattapoisett couple violated their trust when she stole $27,100 from them over an extended period of time, prosecutors alleged Wednesday. Vanessa L. Finglas, 40, pleaded not guilty Wednesday during her arraignment in Brockton Superior Court on two counts each of larceny over $250 from a person over 60, forgery of a check, and uttering a false check, Plymouth District Attorney Timothy J. Cruz’s office said in a statement. (Andersen, 3/28)

Providence Health & Services and Swedish Health Services have agreed to pay $1.4 million to settle a complaint filed by the Washington Attorney General’s Office alleging the health-care providers used a laboratory that was out-of-network for many patients, resulting in unnecessary costs. A civil complaint filed in King County Superior Court alleged that the two affiliated health-care providers for more than a year referred pathology tests to the laboratory CellNetix without informing patients that the company was out-of-network. (Blethen, 3/28)

National Institutes of Health is awarding the Children’s Healthcare of Atlanta Neurosciences Program with a grant to study a potential breakthrough in the diagnosis of pediatric traumatic brain injuries, according to a press release. Neurosurgeon Dr. Andrew Reisner and neuropsychologist Laura Blackwell will receive $466,650 from NIH to study a potential blood biomarker which could detect pediatric traumatic brain injuries, such as a concussion and the severity. (Miller, 3/28)

Eight measles cases have now been identified in Johnson County, with another two in Linn and Miami counties, according to the Kansas Department of Health and Environment. Health departments in the three counties have pinpointed where and when the individuals were infected. Because people can acquire measles anywhere from a week to three weeks after exposure, KDHE said there are concerns that additional cases may be identified. The agency is urging people who are ill or exhibiting symptoms to remain at home unless they’re seeking medical care. (Margolies, 3/28)

It has been my greatest professional honor to serve our country’s more than 20 million veterans. Almost three years ago, I left my private sector job running hospitals and came to Washington to repay my gratitude to the men and women who put their lives on the line for our country. I believe strongly in the mission of the Department of Veterans Affairs, and nothing about my political experience in Washington could ever change that. I also believe that maintaining a strong V.A. is an essential piece of the puzzle that is the United States’ national security system: We can only expect our sons and daughters to risk their lives and fight for our freedom if we can keep our promise to care for them when they return home broken, injured or traumatized. (David J. Shulkin, 3/28)

In 2017, the Centers for Disease Control and Prevention (CDC) warned that life expectancy in the United States dropped for the second year in a row — and drug overdoses are the single biggest reason why. As states and communities on the front lines struggle to respond to the opioid crisis, Washington has only nibbled around the edges. Politicians and policymakers make vague promises, treating the crisis as if it is a novel, intractable problem. It is neither. America has addressed this kind of public health emergency before, and we call on Congress to do so now. (Elizabeth Warren and Elijah Cummings, 3/28)

How certain Sen. Susan Collins seemed that day back in December. How confident that her political leverage, deftly applied to her fellow Republicans’ teetering tax-reform bill, ultimately would save countless Americans from losing access to health care. Looking back, how colossally wrong she turned out to be. ...In short, with the issuance of new annual premiums looming in October, the ACA is about to go over a cliff. And as it goes, speaking of consequences, so will go millions of Americans whose health care hangs in the balance. (Bill Nemitz, 3/29)

President Trump announced a ban on transgender people in the military with a series of tweets last year that surprised many, including senior military leaders. There had been no study, no analysis, no consultation. That arbitrariness was one reason four federal judges have temporarily blocked the policy from going into effect. So when the latest iteration of the ban was rolled out last week, the White House made a point of stressing that it was accompanied by a 44-page Defense Department report and had the backing of Defense Secretary Jim Mattis. (3/28)

It often seems that there is no end to President Trump’s cruel determination to transform America into a country that divides and dehumanizes its people. After his denigration of Muslims, refugees and undocumented immigrants, the latest example of this disgraceful proclivity is a presidential policy banning most transgender people from serving in the military — the second attempt to do so in less than a year. It puts thousands of servicemen and servicewomen at risk of losing their careers and means countless others may never get a chance to put on the uniform. (3/28)

On Sunday, former Pennsylvania GOP Senator Rick Santorum suggested during CNN’s State of the Union that students protesting gun violence should not petition the government for change but should instead take CPR classes. ...Usually just ancillary to the discussion on gun violence, doctors, nurses, and emergency medical technicians this time took center stage in their condemnation of Santorum’s infuriating and misleading statement. They sparked a national conversation about the actual lifesaving measures for gunshot victims as well as their own personal experiences treating patients. (Eugene Gu, 3/28)

In the wake of the inspiring but incredibly upsetting #MeToo movement, I find myself concerned not only for the women who have already experienced sexual harassment, and certainly there are many, but also for those yet to come. Some will unfortunately experience the same pain, fear, humiliation, and stigma of sexual harassment as the stories being brought to light by the brave women who have been reporting their experiences today. In addition, I worry about the potential for gender-based neglect, an unintended backlash in response to this bright light. (Julie Story Byerley, 3/27)

SB 562 is little more than a campaign bumper sticker – unachievable, woefully deficient in policy and fiscally irresponsible. Achieving the laudable goal of universal access will take significant and long-term changes. (Theodore Mazer, 3/28)

Under House Bill 314 (HB 314), which passed the Senate for the second time on March 23 – an earlier version passed unanimously in February – insurance plans would be required to pay for these unexpected out-of-network care situations through direct and fair payments to doctors. This solution will put an end to surprise bills for patients for emergency care while also increasing transparency and establishing a dispute resolution process for other unexpected bills. (Brent Cannon and John Palmer, 3/28)

Big Pharma has had many grand successes—from correcting erectile dysfunction to masking bald spots on the president’s head. But its TV commercials are starting to make me sick. Across the dial, but especially on cable news, it’s hard to avoid drug ads in which the dominant theme seems to be a risk of sudden death. Worse, if the prescription doesn’t kill you, there’s a chance you’ll simply kill yourself. (Peter Funt, 3/28)

On January 12, 2017, the Centers for Medicare & Medicaid Services (CMS) and the Commonwealth of Pennsylvania announced the launch of the Pennsylvania Rural Health Model. The program provides rural hospitals an opportunity to transition from a fee-for-service reimbursement system based on volume to a multipayer global budget payment method that is intended to improve population health outcomes and quality of care while lowering costs. While rural hospitals provide essential health care services for 57 million people across the country, the ability to achieve financial stability is difficult for some hospitals. ...Over the past 7 years, 83 of 2244 rural hospitals in the United States have closed. One analysis suggests that without intervention, an estimated 673 rural hospitals in the United States may also close over the next 5 years. (Karen M. Murphy, Lauren S. Hughes and Patrick Conway, 3/27)

Although it is difficult to imagine a health care service that is more valuable to society than childbirth, US hospitals often lose money when they provide local childbirth services for healthy mothers. This discrepancy is a major flaw in the design of the maternal health system that may be the basis for lagging birth outcomes in the United States compared with other high-income nations. (Neel T. Shah, 3/27)

Zika remains a health threat in the United States, and public health systems are essential to monitoring the full effect of congenital Zika virus infection on infants and children. Because some healthy infants born following pregnancies complicated by Zika may have developmental problems that become evident later, developmental milestones should be closely monitored throughout the child’s first years of life. (Brenda Fitzgerald, Coleen Boyle and Margaret A. Honein, 3/27)

It’s possible that Bill Harris could have saved Tom Petty’s life, and Prince’s too. But they didn’t ask him. Wait a minute. . . . What does a retired Harvard Medical School professor have to do with the titans of rock and roll? Let me explain. Tom Petty died of an accidental drug overdose last year. An autopsy found three kinds of fentanyl and oxycodone in his system, all of them powerful and addictive painkillers. His wife and daughter revealed that Petty had been performing tour dates — 53 of them — with a fractured hip. “Despite this painful injury he insisted on keeping his commitment to his fans and, as he did, it worsened to a more serious injury,” Dana Petty and Adria Petty said in a statement. “On the day he died he was informed his hip had graduated to a full-on break, and it is our feeling that the pain was simply unbearable and was the cause for his over use of medication.” (Alex Beam, 3/28)

Sugar hasn’t just played its part in Britain’s reputation for tea, cakes and bad teeth; it’s also a major contributor to the country’s obesity and diabetes crisis. ...It’s an issue you might think would weigh on the mind of Prime Minister Theresa May, herself a diabetic, though not a known sugar addict. In fact, May has been, at best, a part-time flagbearer for sugar intake reduction, having scrapped such a tax as one of her first moves in 2016, a cave-in to heavy industry pressure. That will hopefully change this April, when a tax on sugary products — announced last year by Chancellor Philip Hammond as the Soft Drinks Industry Levy — comes into effect.( Richard Martyn-Hemphil, 3/29)

Infectious disease is distinguished from most other fields of medicine by constant and rapid change. As microorganisms emerge, new treatment and prevention strategies also evolve. Although much progress has been made, infections remain a major and often preventable cause of death worldwide. In this issue of JAMA, el Bcheraoui and colleagues report mortality trends for major infectious diseases in the United States, both nationally and at the county level, using data from the National Center for Health Statistics. In one of the first studies of its kind, the authors used deidentified death records to examine mortality trends for the most common causes of infectious diseases mortality, including lower respiratory infection, diarrheal disease, HIV/AIDS, hepatitis (excluding chronic hepatitis B and C), meningitis, and tuberculosis. (Emily K. Shuman and Preeti N. Malani, 3/27)