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Good morning! It’s 11/11. Make a wish at 11:11 PM!
But actually: what can Trump & RFK Jr. realistically do?
After years of being sidelined by a Democratic majority, Republicans and President-elect Donald Trump have a long list of changes they want to make to public health authorities. My colleagues have assessed how much change will be possible on some of the party’s key priorities. Here’s a sneak peek:
- About vaccines: Robert F. Kennedy Jr. and others in Trump’s inner circle have long publicly questioned vaccines. But what could the government actually do? Agencies could be used to delay approvals, and spots on advisory committees could be filled with fellow skeptics. The simplest thing a Trump-empowered RFK Jr. could do is continue to sow unfounded doubt about the safety and efficacy of vaccines, STAT reporters write.
- About health and science agencies: If Republicans take control of both the House of Representatives and the Senate, it will open up avenues for reforms they implemented earlier this year, such as restructuring the NIH, cutting CDC funds and eliminating “duplicative” programs.
- On pandemic preparedness: Trump has promised to disband the White House Office of Pandemic Preparedness and Response, but that would require Congress to take action. Still, there are informal ways to undermine the office, such as returning officials on loan from other departments to their regular positions.
Read more about what’s possible in pharmaceutical drug advertising, fluoride, reproductive care and addiction.
Two new studies into reproductive care
JAMA Network Open published two studies on reproductive care that caught my attention on Friday. Here’s an overview:
- Pregnant women and women in the first year after pregnancy are more likely to be killed when state laws prohibit divorces from being finalized during pregnancy, according to a study study of the CDC’s National Violent Death Reporting System from 2018 to 2021. (Three states – TX, MO, and AR – currently have these divorce systems laws.) That increase in deaths was statistically significant for intimate partner homicides.
- An estimated 42% of people who seek abortions have incurred “catastrophic health expenses” as a result, according to a study. study of 675 patients from before Roe v. Wade was overturned. “Catastrophic” here means that the expenditure interfered with a person’s ability to meet basic needs. When people had to leave the state to get an abortion, 65% were dogged by these high costs – a challenge that is especially relevant as more states pass abortion bans.
LA hospital tests AI to translate discharge notes into Spanish
When a patient is ready to leave the hospital, discharge notes are the important instructions they take home about how to care for themselves and when to contact a doctor. These are published in English; at most hospitals it can take hours or even days to translate these notes. Now, Children’s Hospital Los Angeles is beginning to pilot a program that uses generative AI to translate for Spanish-speaking patients in seconds.
The hospital’s language and culture services team, which had long had concerns about the performance of machine translations, tested the Spanish translations on anonymized discharge notes. “I’ve seen horrific translations before,” said Troy McGuire, CHLA’s Chief Health Information Officer. “I think this is really the first time I recognize the quality of a machine translation tool.
Read more in STAT’s exclusive story from Katie Palmer.
Sickle cell disease, loss, and survival in America
Tammy Clemons was back in the hospital, a place where she had already spent too much of her life. This time, when a nurse asked her what level her pain was, Clemons said eight — as if her insides no longer wanted to be a part of her and were trying to get out.
The pain had started while she was at work, in the beauty salon. A customer had asked for some extensions, but when Clemons raised the gripper, a sharp feeling in her stomach made her gasp. She had been living with sickle cell disease for decades at that point, and the pain it caused her was just one of life’s heartbreaks. She would never be able to have children thanks to a tubal ligation she had as a teenager on the advice of a doctor. But there was also the death of her brother, her grandmother.
Read more about Clemons and her experience with sickle cell disease in part 5 of Eric Boodman’s Coercive Care series. And if you haven’t read the first four parts yet, please do so. Eric writes vividly about how doctors force sickle cell patients into unwanted sterilizations and reports on new data showing how common sterilizations are among these patients; about how patients, if they do become pregnant, can be pushed towards or against abortion; and about the federal rule’s failure to protect patients.
911 operators could eliminate CPR discrepancies between bystanders
Bad news: When a woman’s heart suddenly stops beating, she is less likely to be resuscitated by a bystander than a man. Good news: The difference is eliminated when a 911 operator walks a caller through the steps.
This is evident from new research presented today at the The American Heart Association CPR Science Symposium. Researchers from Duke University School of Medicine analyzed nearly 2,400 emergency cardiac arrest calls in North Carolina. CPR was administered in approximately half of all calls. When it did, 911 operators assisted 81% of the time.
Last research has shown that the fear of being seen as someone who is being touched inappropriately and the concern about harming someone who is weak contribute to the hesitation to resuscitate women. But when bystanders are accompanied by 911 operators, both men and women are much more likely to be resuscitated. The study authors hope their findings provide insight into improving the low percentage of people who survive cardiac arrest when it occurs outside a hospital, according to a news release.
Even more puzzling differences in heart health
STAT’s Liz Cooney highlights four new articles that reiterate how people in different socio-economic groups have different health outcomes.
Here’s what researchers found: Cardiac care before delivery helped white, but not black, mothers with preeclampsia. Black veterans were less likely to be prescribed weight loss medications than white veterans. Social needs prevent patients with heart failure from receiving the benefits of “quadruple therapy,” that is, all four forms of guideline-directed medical therapy. And cardiology fellows have mixed reviews of their programs’ DEI efforts.
Read more from Liz about those studies, which will also be presented at AHA scientific sessions later this week.
What we read
- Study maps how religious nonprofit groups set up facilities near abortion clinics NBC News
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Doctors Providing Trans Healthcare Are Preparing for the Trump Era, STAT
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For older, unmarried couples, responsibilities for care can be unclear. New York Times
- Twelve states pledged to open the books on their opioid settlement funds. We checked them, KFF Health News
- RFK Jr. is busy crowdsourcing large quantities of Trump health administration nominees, STAT