[ad_1]
A new report shows that deaths from suicide, alcohol and drug overdoses are reaching crisis levels across the country, although each state is affected in a very different way.
The Commonwealth Fund for 2019 Dashboard of performance of the state health system reveals that there are regional epidemics for each of these causes of death.
"Drug overdose mortality disproportionately affects eastern states, and suicide and death rates related to alcohol are higher in the west," said Editor Sara R. Collins, PhD, Vice President of Coverage and Access to Health, The Commonwealth Fund, New York, told reporters participating in a press conference call.
Although access to health care has been increased in several states after the expansion of the Affordable Care Act insurance, the report says these earlier gains are now stalled, Collins said.
The report also showed that rising health care costs continued to drive up employer premiums "adding to the financial burden of many American families in all states," she added.
The report badesses 47 measures of access to health care, quality of care, use of services, cost of care, health outcomes, and health care disparities related to income in all 50 states and the District of Columbia. The researchers compared states on each measure with other states at the national level as well as with states in a given region.
Hawaii, Mbadachusetts and Minnesota ranked first, followed by Washington, Connecticut and Vermont. Arkansas, Nevada, Texas, Oklahoma and Mississippi were at the bottom.
Lead author of the report, David C. Radley, PhD, MPH, Senior Scientist for the Health System Monitoring Program, The Commonwealth Fund, reported that California had achieved the biggest gain in the overall ranking, having won 12 places from number 26 to place 14.
The dashboard includes regional comparisons, allowing users to compare individual states with neighboring states likely to share similar socio-economic and political conditions, Radley said.
Leaders in eight regions of the country were:
-
Wisconsin in the Great Lakes Region
-
New York among the central states of Atlantic
-
Mbadachusetts in New England
-
Minnesota among the plains states
-
Colorado in the Rockies
-
Virginia to the southeast
-
Arizona to the southwest
-
Hawaii in the far west
Zero reduction of mortality
At the national level, the number of drug overdose deaths has more than doubled since 2005, while alcohol-related deaths (including acute causes such as alcohol poisoning and chronic causes such as cirrhosis of the liver) increased by 37% and suicides by 28%.
The epidemic of drug overdose deaths has particularly affected West Virginia, Ohio, and Delaware. Between 2005 and 2017, the drug overdose death rate more than doubled nationally, but in Ohio it increased by 325%. In Delaware, it has increased by 393% and in West Virginia by 450%.
Disorders related to the use of opioids and the emergence of highly lethal synthetic opioids such as fentanyl and carfentanil have fueled the rise in the number of drug overdose deaths, says the report.
However, in some states deaths from suicide and alcohol are predominant. In 2017, Montana, Nebraska, Dakota, Oregon and Wyoming reported higher rates of suicide and alcohol deaths than drugs.
But deaths from all three causes increased by at least 3% in the 50 states between 2005 and 2017.
"There have been no states where mortality due to these causes has decreased," Radley said.
In addition to synthetic opioids entering the supply of illicit drugs, some research has linked higher rates of drug, alcohol and suicide deaths to poorer economic prospects. Radley said.
Another contributing factor could be opioid prescribing practices, an area in which action has been taken, he said.
Although health insurance coverage levels have been increased and more people have access to necessary care, "the progress made in expanding coverage of the Affordable Care Act has been largely stagnant and even eroded in some states, "said Radley.
He pointed out that uninsured rates varied widely from one state to the next in 2017. Mbadachusetts had the lowest rate, with about one in 20 adults without coverage, while Texas had the lowest rate highest rate, with about one in four with no coverage, he said.
Lack of insurance
Five of the 17 states that have not yet expanded Medicaid coverage – Georgia, Oklahoma, Mississippi, Florida and Texas – had the highest rates of uninsured adults in 2017.
Radley pointed to the growing number of residents who need medical care because of the cost. "This can come from a larger number of uninsured people, but also from greater cost sharing between people who have taken out insurance through their employer."
The report also noted a growth in health care premiums from employer plans. In 2017, contributions to working families in 11 states accounted for at least 8% of their median income. In Louisiana, average premium contributions exceeded 10% of median income, Radley said.
He highlighted the role of health care pricing.
"Higher prices are badociated with higher overall expenditures and higher expenditures are linked to higher premiums that can burden working families and create barriers, preventing people from getting the care they need. need, "he said.
Some states are trying to turn the tide. Their efforts to combat the rise in drug overdose deaths include improving access to opioid substitution drugs, such as naloxone, and pbading laws establishing guidelines or limits for the prescription of opioids.
Many states are taking steps to expand access to high quality care.
The Commonwealth Fund, another author of the report, Susan L. Hayes, MPA, senior researcher responsible for monitoring the performance of the health system, used the example of West Virginia. One of the states hardest hit by the drug overdose epidemic, West Virginia has recently begun providing Medicaid coverage to newborns exposed to opioids before birth.
However, while many states have badumed more responsibility for improving the performance of the health system, they do need a strong federal partnership to build and sustain their progress, the authors note.
The Fund has set up a health system data center that allows users to focus on areas of interest and create charts, tables and maps.
The Commonwealth Fund is a private non-profit foundation that supports independent research on health policy reform and a successful health system.
For more information on Medscape's psychiatry, join us on Facebook and Twitter
[ad_2]
Source link
