The Bottom Health Stories of 2013

Dec 27, 2013

Lots of news organizations, including this one, are ticking off the year's top 10 stories. I'd like to run through some of Rhode Island's bottom health stories, meaning the ones least likely to have appeared on radar screens - but which should have. And don't worry: there's some good news in here too!

In no particular order:

- Uptick in hepatitis C: This is the year the CDC started recommending that baby boomers get tested, and public health officials sounded the alarm that we're going to face a crisis when infected boomers begin realizing they're sick (when they find out their livers are diseased, for instance), since you can carry Hep C for a while and not know it. In Rhode Island, Hep C cases are now outpacing HIV cases. HIV prevention and treatment gets far more funding here than Hep C, but some researchers would like to see more resources come to Hep C. It's a devastating illness, and until recently the treatment has been long and painful. But new options came out this year, too, which means more people might be willing to find out their status and start treatment.

- More opioid overdose deaths: These have surpassed all other accidental causes of death in Rhode Island. Yep. That's right. Accidental drug overdoses kill more people than car accidents here every year. It's prescription painkillers, and, increasingly, heroin (which is essentially the same as prescription opioids but often cheaper). Nearly 200 people died from accidental overdoses this year. I'll be covering this more in the new year, including a drug that can reverse an overdose and attempts to make it more widely available.

- More Rhode Islanders covered: It seems every day there's another headline about the deadline for signing up for health insurance coverage in order to avoid a tax penalty next year slipping yet again. In Rhode Island, it's still December 31st and it's been that for a little while now. What we haven't heard a lot is that, even though the numbers are small, more Rhode Islanders will have health insurance next year. And lots of research has shown that having health insurance is strongly correlated with being healthier. That's not necessarily a foregone conclusion - just because you have insurance doesn't mean you're going to use it, or even that you're going to lead a healthier lifestyle. But several studies have shown that when people have access to preventive and primary care, like physicals, screenings, etc., they have better health "outcomes," as the public health policy wonks like to say. That's a good thing, right?

- More $ for health research: Millions of dollars flowed into Rhode Island this year, from the new neuroscience institute at the University of Rhode Island to the big NIH grants for stem cell-related research in Lifespan/ Brown's labs in the Jewelry district in Providence. New attention was focused in particular on understanding autism (a statewide coalition was formed and there are research efforts to register children with autism in the state so that they can be part of any studies or treatments offered here) and fighting Alzheimers (the statewide plan on dealing with the disease was released this year).

- More primary care: Thousands more Rhode Islanders became part of some kind of "medical home" this year, or at least have a doctor who's part of a new model of paying for and organizing health care that rewards coordinated, preventive care over individual fee-for-service episodes. It's part of an effort started by the state's former health insurance commissioner and supported by lots of top RI officials, including the head of our department of health. The idea is that if doctors are paid to keep you healthy, and if you have access to a team of health care professionals who are working to do that, you'll be healthier and all of it will cost less. That's in contrast to the current way of doing things in most parts, which is paying doctors a fee for each service and not paying for things like nurse case managers or care coordinators. The Affordable Care Act has made funding for these kinds of initiatives available, and more are likely coming to a doctor's office near you.

So, those are my "bottom" health stories for 2013. Did I miss something big that should have been big? Let me know!