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I. INTRODUCTION II. HEALTH POLICY FAILURE III. CLIMATE CHANGE POLICY FAILURE IV. ENFORCEMENT V. CONCLUSION APPENDIX I. INTRODUCTION The right to live in a healthy environment is the right to [...]

The international demographic landscape is undergoing a significant transformation with the considerable increase in the aging population. The competencies needed to care for older adults in their preferred location as [...], An increase in demand for health care services for older adults is being negatively impacted by lack of a sufficient nursing workforce with competence in home- and community-based services (HCBS). The current article examines the unique challenges and opportunities in caring for older adults in HCBS settings, outlines the core competencies nurses must possess to provide this care, and proposes strategies to leverage legislative and regulatory initiatives to incorporate these competencies into nursing education and practice. Examining the American Association of Colleges of Nursing's Essentials Competencies through the HCBS lens, it is an ideal time to create a roadmap for nurses in practice, policy, and education to shape the health care workforce to meet the needs of a diverse and vulnerable population: older adults who depend on home- and community-based care for maintaining or improving their health outcomes and overall quality of life. [Journal of Gerontological Nursing, 49(12), 11–16.]

Deprescribing is a structured process by which an individual's medications are evaluated to determine candidate medications for withdrawal or reduction where risks may outweigh benefits in light of an individual's [...], Deprescribing is a common practice in the care of older adults, including those living in nursing homes (NHs). Deprescribing represents an individualized approach to optimizing medication use; it considers the risks, benefits, and goals of an individual, and can mitigate the effects of polypharmacy and potentially inappropriate medications. In NH settings, prescribing practices are shaped directly and indirectly by historical and contemporaneous policies at federal, state, and local levels, which have primarily targeted chemical restraints and unnecessary medications. Understanding these policies, their impact, and potentially unintended consequences is essential for gerontological nursing to transition toward individualized practices and approaches to deprescribing. [Journal of Gerontological Nursing, 49(9), 15–20.]

Many physicians consider pregnancy or become pregnant during their residency, fellowship training, and the early years of independent practice. However, childbearing surgeons report negative reactions from their colleagues and the [...]

The National Women's Health Network works with members of Congress to improve the health and well-being of women across the life continuum. This article provides the highlights of our women's [...]

During World War II, to promote cooperation and standardize production among wartime allies, the United States, Canada, and Great Britain formed the United Nations Standards Coordinating Committee (UNSCC). (1) When [...]

March 5, 2024 Proposed changes to a document that regulates midwifery practice in Aotearoa have caught the eye of some trans-exclusionary groups. A group of midwifery academics explains why the [...]

Cannabis is the most widely used drug worldwide, aside from alcohol and nicotine. The potency of cannabis products worldwide has steadily increased over the years, sparking concerns over potential new [...]

As of August 2023, 38 US states, 3 territories, and Washington, DC, have approved the use of medical marijuana, and 23 states plus Washington, DC, have approved recreational marijuana. (1) [...]

1 | INTRODUCTION The constitutionally mandated decennial census survey, which includes the annual American Community Survey (ACS), is the foremost source of demographic and statistical information about the United States' [...], Objective: To investigate how county and state-level estimates of Medicaid enrollment among the total, non-Hispanic White, non-Hispanic Black or African American, and Hispanic or Latino/a population are affected by Differential Privacy (DP), where statistical noise is added to the public decennial US census data to protect individual privacy. Data Sources: We obtained population counts from the final version of the US Census Bureau Differential Privacy Demonstration Products from 2010 and combined them with Medicaid enrollment data. Study Design: We compared 2010 county and state-level population counts released under the traditional disclosure avoidance techniques and the ones produced with the proposed DP procedures. Data Collection/Extraction Methods: Not applicable. Principal Findings: We find the DP method introduces errors up to 10% into counts and proportions of Medicaid participation rate accuracy at the county level, especially for small subpopulations and racial and ethnic minority groups. The effect of DP on Medicaid participation rate accuracy is only small and negligible at the state level. Conclusions: The implementation of DP in the 2020 census can affect the analyses of health disparities and health care access and use among different subpopulations in the United States. The planned implementation of DP in other census-related surveys such as the American Community Survey can misrepresent Medicaid participation rates for small racial and ethnic minority groups. This can affect Medicaid funding decisions. KEYWORDS census, confidentiality/privacy issues, Medicaid, racial and ethnic differences in health and health care What is known on this topic * The census is the primary source of statistical information about the US population, and the accuracy of its data is critical to health services research. * The Census Bureau will infuse additional noise into its 2020 census data products to protect individuals' privacy. * Such privacy measures are suspected to disproportionately affect underrepresented populations and ethnic and racial subgroups. What this study adds * Increased privacy measures in the census can affect Medicaid participation rate accuracy for the non-Hispanic Black or African American and Hispanic or Latino/a population at the county-level with lower population counts by introducing errors up to 10%. * State-level accuracy of Medicaid participation rates is rarely affected by DP. * The implementation of DP in census-related surveys can misrepresent Medicaid participation rates for small racial and ethnic minority groups and affect funding decisions.

1 | INTRODUCTION Changes to the 'public charge' rule implemented in 2019 by the Trump administration expanded the criteria under which immigrants could be denied a visa or US permanent [...], Objective: To estimate the avoidance of Medicaid enrollment among Latino and Asian immigrants due to fears about immigration status. In 2019, changes to the "public charge" rule made it difficult for immigrants to receive a green card or permanent residence visa, particularly for those who used health and nutrition benefits. Despite the Biden administration's reversal of these changes, fear and misinformation persist among immigrants. Data Sources: Pooled data from the 2017 to 2020 California Health Interview Survey. Study Design: We used adjusted predicted probability models to estimate differences in access to and use of health care and health insurance coverage among Latino and Asian immigrant adults with and without green cards, using US citizens as the reference. We estimated the avoidance of Medicaid enrollment among immigrants without a green card, the immigrant population subject to the public charge rule. Data Collection/Extraction Methods: Population stratified by race/ethnicity and green card status. Principal Findings: Latino immigrants without a green card were -23.1% (CI: -27.8, -18.4) less likely to be insured, -9.2% (CI: -12.8, -5.5) less likely to have Medicaid coverage, -9.3% (CI: -14.5, -4.1) less likely to have a usual source of care, and -8.4% (CI: -13.2, -0.3) less likely to have a physician visit relative to citizens. Asian immigrants without a green card were -11.7% (CI: -19.7, -3.72) less likely to be insured, -8.8% (CI: -11.6, -6.1) less likely to have Medicaid coverage, -11.6% (CI: -19.3, -3.9) less likely to have a usual source of care, and -11.0% (CI: -19.2, -2.3) less likely to have a physician visit. Between 107,956 and 192,905 Latino immigrants and 1294 and 4702 Asian immigrants in California likely avoided Medicaid enrollment due to fears about their immigration status. Conclusion: While our estimates are lower than those of previous studies, our findings highlight barriers to health care for immigrants despite the reversal of the changes in the public charge rule. Since the public charge rule was not abolished, immigrants with low incomes might choose not to seek health care, despite recent efforts in California to expand Medicaid coverage to all eligible immigrants regardless of documentation statuses. KEYWORDS Asian Americans, disparities, health care access, health insurance, Hispanic or Latino, immigration policy, public charge What is known on this topic * Applications to Medicaid and other public programs declined among immigrants, even if eligible, due to the chilling effects caused by changes in the definition of a public charge. * Changes to the definition of a public charge by the Trump administration expanded the share of noncitizen immigrants who could be considered a public charge from 3% to 47%. * Twenty-five percent of noncitizen immigrants with a confidence interval of 15%-35%, avoided public benefit enrollment due to the changes in the definition of public charge. What this study adds * We estimated the avoidance of Medicaid enrollment due to potential fears of the public charge rule among Latino and Asian adult immigrants without green cards. * This is the first study to use a statewide, population-based representative survey to estimate the avoidance of Medicaid among immigrants due to the changes in the public charge rule. * Between 107,956 and 192,905 Latino immigrants and 1294 and 4702 Asian immigrants in California likely avoided Medicaid enrollment due to fears about their immigration status.

1 | INTRODUCTION The recession caused by the COVID-19 pandemic was one of the most severe disruptions to normal economic activity in recent United States (US) history. In February 2020, [...], Research Objective: To explore whether expanded Medicaid helps mitigate the relationship between unemployment due to COVID and being uninsured. Unanticipated unemployment spells are generally associated with disruptions in health insurance coverage, which could also be the case for job losses during the COVID-19 pandemic. Expanded access to Medicaid may insulate some households from long uninsurance gaps due to job loss. Data Source: Phase 1 of the Census Bureau&apos;s Experimental Household Pulse Survey covering April 23, 2020-July 21, 2020. Study Design: We compare differences in health insurance coverage source and status linked to recent lob losses attributable to the COVID-19 pandemic in states that expanded Medicaid against states that did not expand Medicaid. Data Collection/Extraction Methods: Our analytical dataset was limited to 733,181 non-elderly adults aged 20-64. Principal Findings: Twenty-six percent of our study sample experienced an income loss between March 13, 2020, and the time leading up to the survey-16% experienced job losses (e.g., layoff, furlough) due to the COVID-19 crisis, and 11% had other reasons they were not working. COVID-linked job losses were associated with a 20 (p < 0.01) percentage-point (PPT) lower likelihood of having employersponsored health insurance (ESI). Relative to persons in states that did not expand Medicaid, persons in Medicaid expansion states experiencing COVID-linked job losses were 9 PPT (p < 0.01) more likely to report having Medicaid and 7 PPT (p < 0.01) less likely to be uninsured. The largest increases in Medicaid enrollment were among people who, based on their 2019 incomes, would not have qualified for Medicaid previously. Conclusions: Our findings suggest that expanded Medicaid eligibility may allow households to stabilize health care needs and they should become detached from private health coverage due to job loss during the pandemic. Households negatively affected by the pandemic are using Medicaid to insure themselves against the potential health risks they would incur while being unemployed. KEYWORDS affordable care act, COVID-19, health reform, Medicaid, state health policy, unemployment What Is known on this topic * The COVID-19 crisis--the pandemic and the accompanying recession-was the first major macroeconomic test of the Affordable Care Act (ACA). * The COVID-19 crisis was linked to sharp increases in joblessness and separation from private health insurance coverage. * Few studies describe the linkage between job losses associated with the COVID-19 crisis and the extent that Medicaid could function as a viable substitute to offset the risks of uninsurance. What this study adds * Our findings highlight how the ACA&apos;s Medicaid expansions perform in a major economic downturn. * We found that for households affected by job losses due to the COVID-19 crisis, transitioning from private coverage to Medicaid as a safety net was made easier via the Medicaid expansion. * Our findings suggest that expanding access to Medicaid may facilitate stabilizing access to needed health care during bouts of economic instability.

The Biden administration announced a final rule meant to lower costs and expand access for care for mental health and substance use disorders. Most of the provisions in the rule [...]