What We’re Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
The articles that have recently caught my eye are highlighted below and include the White House’s effort to promote food as intervention, bright light therapy as a treatment for PPD, and how we must consider and support proliferation of birth centers in hospital maternity deserts. The last article points out the rise of Black infant death (and likely preterm birth) during the pandemic - a likely correlation between increased maternal distress.
HEALTH SYSTEM TRANSFORMATION
Dear Payers: Can You Help Us Address the Mental Health Crisis?
There are several ways doctors, payers, and purchasers can work together to take on the crisis.
We must integrate mental health services into primary care settings, as I have written about previously. However, my primary focus here is the critical role of payers, including health plans and self-funded employers and union trusts, to help primary care physicians meet the growing and diverse needs of their patients.
TREATMENTS
Has the Benzodiazepine Backlash Gone Too Far?
When benzodiazepines were first introduced, they were greeted with enthusiasm. Librium came first, in 1960, followed by Valium in 1962, and they were seen as an improvement over barbiturates for the treatment of anxiety, insomnia, and seizures. From 1968 to 1982, Valium (diazepam) was the No. 1–selling U.S. pharmaceutical: 2.3 billion tablets of Valium were sold in 1978 alone. Valium was even the subject of a 1966 Rolling Stones hit, "Mother's Little Helper."
Adjunctive Agents in Depressive Disorders: L-Methylfolate
This accredited, on-demand activity features a presentation that discusses the mechanism of action of L-methylfolate and its role as adjunctive therapy for the treatment of major depressive disorder in patients with a poor response to SSRIs.
MATERNAL MORTALITY AND SUICIDE
Homicides and Suicides Linked to Pregnancy Often Associated with Mental Health Conditions, Substance Use Disorders and Intimate Partner Violence, Study Suggests
Maternal mortality in the United States in on the rise. Scientists increasingly recognize that pregnancy-associated deaths – those due to conditions unrelated to the physiologic effects of pregnancy – are important and potentially preventable contributors to maternal mortality. Maternal deaths due to homicide and suicide are thought to represent a significant number of pregnancy-associated deaths, but have been under explored as an area of potential intervention.
‘Whose Life Do I Prioritize?’ a Choice No Parent Wants to Make
In some pregnancies, a mother must weigh her own risks and benefits with those of her unborn child. It's a terribly difficult choice.
How Changes In Length Of Day Change The Brain And Subsequent Behavior
Seasonal changes in light — longer days in summer, shorter in winter — have long been associated with human behaviors, affecting everything from sleep and eating patterns to brain and hormonal activity.
Bright light therapy has proven an effective remedy for treating SAD, plus maladies such as non-seasonal major depression, postpartum depression and bipolar disorder, but how seasonal changes in day length and light exposure affect and alter the brain at the cellular and circuit levels has kept scientists largely in the dark.
ACCESS
Maternity Care Deserts Grow Across the US as Obstetric Units Shut Down
In many parts of the country, there are fewer places to give birth. Obstetric units have closed in New Hampshire, New York, Delaware, Florida, Mississippi, Texas, Wyoming and other states — creating maternity care deserts for millions of Americans. Alecia McGregor of Harvard University and Aubre Tompkins, president of the American Association of Birth Centers, join Lisa Desjardins to discuss.
SUD
Rahul Gupta, First Physician to Serve as Drug Czar, Says Stigma Among Doctors Is Key Culprit in Addiction Crisis
Rahul Gupta is no stranger to the nationwide addiction crisis.
Drug use and overdose defined his tenure as the top health official in West Virginia, arguably the state hardest hit by the epidemic, and before that as the health officer in the state’s largest county.
But even Gupta, now the nation’s top drug policy official, admits that the current U.S. drug crisis is unlike anything he’s ever seen.
PREVENTION & INTERVENTION
ROSE Scale-Up Study Aims to Scale Prevention of PPD
The study, titled “The ROSE Scale-Up Study: Informing a decision about ROSE as universal postpartum depression prevention,” is funded by a $6.2 million National Institutes of Health mental health research grant.
‘Food Is Medicine’ Interventions Should Be the Main Course at White House Nutrition Conference
Much of the public’s perceptions around food as an intervention for health are dated. So are the U.S. government’s perceptions and its health care policies. Not by a matter of years, but by decades.
COVERAGE
The No Surprises Act: A Band-Aid Protecting Business as Usual
The No Surprises Act does nothing to address the endemic flaws in private insurance that give rise to surprise bills.
Postpartum Women Never Lost Medicaid Coverage During the Pandemic. But in Mississippi, the State Told Them They Did.
Thanks to misleading letters sent by the Mississippi Division of Medicaid in recent years, tens of thousands of new moms may have chosen to forgo health care after giving birth – even as the federal government was sending Mississippi extra money to help pay for their care during the pandemic.
Medicare’s Current Strategy For Health-Related Social Needs Is Necessary But Not Sufficient
Medicare policy developments that have created major new opportunities for plans and providers to integrate HRSN into beneficiary care, such as the emergence of accountable health communities and other Innovation Center models, and of Special Supplemental Benefits for the Chronically Ill (SSBCI).
Now, within the first half of 2022, a series of proposed rules and requests for information hint at regulators’ readiness to take their next steps regarding social risk factors, and the opportunities and challenges that await.
RESEARCH
‘Jumping Gene’ Found to Be Strongly Linked to Depression, Fear, and Anxiety
By combining molecular biology with neuroscience, researchers have found that a well-known gene works to withstand psychiatric stress.
"This research is about understanding stress-resilience," explained lead author, Dr. Mohieldin Youssef, former PhD student in OIST's Cell Signal Unit, which is led by Prof. Yamamoto. "The presence of the gene helps with stress-resilience and if it's removed,
RELATED
Black Babies in Kansas Are More Likely to Die Than White Babies, and the Pandemic Made Things Worse
2020 brought a sharp rise in the already-dire rate of Black infant mortality in Kansas. Black babies are now nearly three and a half times as likely to die in their first year of life as white babies.
WICHITA, Kansas — For years, Black babies in Kansas faced an outsized chance of dying before their first birthday. Then the COVID-19 pandemic hit, and things got even worse.
Now, a Black baby is nearly three and a half times as likely to die in the state as a white baby. While the nationwide rate of infant mortality dropped between 2019 and 2020, the rate in Kansas swelled about 19% — and for Black children, it surged nearly 58%.
How Can We Improve the Hospital Discharge Process?
Right now, it's pretty much a mess. Let's make it a system that really works for our patients.
Maternal Deprivation: The Effects of the Fundamental Absence of Love
According to the maternal deprivation hypothesis, infants regardless of whether they are puppies, monkeys or humans will not develop normally unless they receive the warm loving attention of a mother figure to whom they can become attached.