Category Archives: Substance use

Aug 29 2013

Human Capital News Roundup: Depression and poverty, substance use among SNAP recipients, accountable care organizations, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

The U.S. News & World Report Economic Intelligence blog cites a study co-authored by RWJF Scholars in Health Policy Research alumna M. Marit Rehavi, PhD, that finds mothers who are physicians are 9 percent less likely to have unscheduled C-sections than their non-physician counterparts. The researchers used this and other data to examine the interaction between patient information and financial incentives for physicians, as C-sections are typically more profitable than traditional deliveries.

A low-cost, home-based program called “Beat the Blues” lowers depressive symptoms among older African Americans who are having trouble paying for basic needs, according to a study co-authored by RWJF Nurse Faculty Scholar Sarah Szanton, PhD, CRNP. Szanton’s findings coupled with those in another study that showed meaningful reductions in depressive symptoms from the program “suggest that depression can be 'decoupled’ from financial strain," reports.

Harold Pollack, PhD, MPP, co-authored a post for the Washington Post Wonk blog about research he led that finds adults whose households receive support from the Supplemental Nutrition Assistance Program (SNAP) are only slightly more likely than non-recipients to display substance use disorders. “Proposals to drug-test SNAP recipients don’t address the genuine challenges posed by drug and alcohol misuse in American society,” he writes. “Instead, poor families who seek a little help with the food money are being used as stage extras in a different, nasty ideological fight.” Pollack is an alumnus of the Scholars in Health Policy Research program and recipient of an RWJF Investigator Award in Health Policy Research.

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Aug 23 2013

Alcohol and Life Expectancy: Unraveling the Mystery of Why Nondrinkers Have Higher Risk of Premature Death

Patrick M. Krueger, PhD, is an alumnus of the Robert Wood Johnson Foundation Health & Society Scholars program. He is an assistant professor at the University of Colorado-Denver in the departments of sociology and health and behavioral sciences, and research faculty at the University of Colorado-Boulder Population Program. He recently co-authored a study, published in Population Research and Policy Review, that examines the characteristics and mortality risks of nondrinker subgroups to explain why people who do not drink alcohol are at greater risk for death than light to moderate drinkers.


Prior research has documented that both heavy drinkers and nondrinkers have higher risks of premature death than their peers who drink in moderation. Heavy drinkers have elevated rates of death from accidents, suicides, homicides, liver disease, and some cancers. But the reason for the elevated rates of death among nondrinkers is less well understood. Some researchers* have advocated for national guidelines that discourage nondrinking and encourage moderate alcohol consumption. But physicians are reticent to suggest that their nondrinking patients drink more, because alcohol is a nonessential part of a person’s diet, is disallowed by many religions, and can have adverse consequences for health if consumed to excess.

I have worked with collaborators at the University of Colorado to understand the factors that explain the elevated risk of premature death among nondrinkers relative to their peers who drink in moderation. In particular, we use the stated reasons that people report for nondrinking to better understand why they have higher rates of premature death than their peers who drink in moderation.

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Jul 25 2013

Human Capital News Roundup: Mortality rates for non-drinkers, screening newborns for rare diseases, air conditioners’ impact on climate, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Previous research has shown that non-drinkers have a slightly higher mortality risk than light drinkers, and a study co-authored by RWJF Health & Society Scholars alumnus Patrick Krueger, PhD, is the first to examine the characteristics and mortality risks of non-drinker subgroups to explain the phenomenon. The study confirms that some, but not all, subgroups of non-drinkers have a higher mortality rate than light drinkers, and uncovers some of the reasons. Among the outlets to report on the findings: Health Canal, the Aspen Business Journal, Science Daily and the Denver Journal.

The research of Health & Society Scholars alumnus Andrew Papachristos, PhD, is informing a new technique used by the Austin Police District in Chicago to quell gang violence, the Chicago Tribune reports. Papachristos found that much of the violence on the West Side of Chicago involves a relatively small number of victims and offenders. The Austin District has put those people on a “heat list” and will begin visiting them individually to issue warnings to stop the violence.

States that have expanded family planning services under Medicaid have seen an increase in women receiving potentially life-saving Pap tests and breast exams, according to a study led by Health & Society Scholar Laura Wherry, PhD. Health Canal and Medical XPress are among the outlets to report on the findings.

Rather than becoming depressed or anxious, people who find out they have a gene that predisposes them to Alzheimer’s disease often take steps to reduce their risk, including exercise, healthier diets, and vitamins and medications, according to a study led by RWJF Investigator Award in Health Policy Research Jason Karlawish, MD. GenomeWeb reports on the findings.

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Jun 7 2013

Receipt of High Risk Medications Among Elderly Enrollees in Medicare Advantage Plans

Amal Trivedi, MD, MPH, is an alumnus of the Robert Wood Johnson Foundation/U.S. Department of Veterans Affairs Physician Faculty Scholars program. He is an assistant professor of health services, policy and practice at Brown University and a hospitalist at the Providence VA Medical Center. His co-author, Danya Qato, PharmD, MPH, is a pharmacist and doctoral candidate in health services research at Brown University. They recently published a study that finds older patients are routinely prescribed potentially harmful drugs, particularly in the South.

file Amal Trivedi

Human Capital Blog: Why did you decide to look at this particular topic? And why are some drugs considered high-risk for elderly patients?

Danya Qato and Amal Trivedi: Adverse drug events are an important public health problem. For the elderly, such events are often precipitated by use of potentially inappropriate or high-risk medications. Over the past several decades, clinicians and researchers have sought to identify medications that should be used with caution in the elderly. These high-risk medications should be avoided among people 65 years of age or older because the associated adverse effects outweigh potential benefits or because safer alternatives are available. Elderly patients are susceptible to these medications because they have more chronic illness, greater frailty, and an altered ability to metabolize drugs. The Centers for Medicare and Medicaid Services now require all Medicare Advantage plans to report on the use of high-risk medications among their enrollees.

file Danya Qato

We undertook this study because successful efforts to reduce high-risk medication use in the elderly require knowledge of how prescribing of these agents varies geographically and the factors that predict their use. Half of persons aged 65 and older use three or more prescription medications a day. Therefore, potentially inappropriate use of medications in the elderly has important implications for health care spending and quality.

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May 30 2013

Human Capital News Roundup: How family structures affect obesity, physical education in elementary schools, ‘study drugs,’ and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Smoking and not having a job are the two factors most strongly associated with higher death rates among the country’s least educated white women, according to a study led by RWJF Health & Society Scholar Jennifer Karas Montez, PhD, published today in The Journal of Health and Social Behavior. The study found that the odds of dying for the least educated women were 66 percent greater than for their more highly educated peers between 2002 and 2006, the New York Times reports. Read more about Montez’s research.

Many consumers significantly underestimate the calorie counts of fast food meals, according to a study led by Health & Society Scholars alumnus Jason Block, MD, MPH. One-fourth of study participants underestimated the calories in the meals they ordered by at least 500 calories, USA Today reports, with teens underestimating the most. Among other outlets to report on the findings: United Press International, CBS News, and MedPage Today. Read more about the study.

A survey from Yale and George Mason universities finds that 70 percent of American adults say global warming should be a priority for the nation’s leaders, the Los Angeles Times reports, and an even greater percentage say developing sources of clean energy should be a priority. The survey was co-authored by RWJF Investigator Awards in Health Policy Research recipient Edward W. Maibach, PhD, MPH, who directs the Center for Climate Change Communication at George Mason University.

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Dec 20 2012

Human Capital News Roundup: Promoting health professions, generic drug manufacturers, traumatic brain injuries, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

The Baltimore Times reports on the Tour for Diversity in Medicine, founded in part by RWJF Summer Medical and Dental Education Program (SMDEP) alumnus Alden Landry, MD, MPH. Several weeks each year, the Tour visits college campuses across the country to promote careers in the health professions to students from groups underrepresented in higher education. Read more about the Tour for Diversity here and here.

Jason Karlawish, MD, recipient of an RWJF Investigator Award in Health Policy Research, spoke to the Philadelphia Inquirer about tests for Alzheimer’s disease. Read posts Karlawish wrote for the RWJF Human Capital Blog about the disease and the challenges associated with early diagnosis.

Pharmacy Times reports on a perspective piece in the New England Journal of Medicine, co-authored by Investigator Award recipient Aaron Kesselheim, MD, JD, MPH. It addresses concerns about a proposal to increase liability for generic drug manufacturers for adverse reactions. Read a post Kesselheim wrote for the RWJF Human Capital Blog about pharmaceutical industry marketing to medical students.

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Nov 9 2012

Health Issues on Ballots Across the Country

Voters across the country were presented Tuesday with more than 170 ballot initiatives, many on health-related issues. Among them, according to the Initiative & Referendum Institute at the University of Southern California:

- Assisted Suicide: Voters in Massachusetts narrowly defeated a “Death with Dignity” bill.

- Health Exchanges: Missouri voters passed a measure that prohibits the state from establishing a health care exchange without legislative or voter approval.

- Home Health Care: Michigan voters struck down a proposal that would have required additional training for home health care workers and created a registry of those providers.

- Individual Mandate: Floridians defeated a measure to reject the health reform law’s requirement that individuals obtain health insurance. Voters in Alabama, Montana and Wyoming passed similar measures, which are symbolic because states cannot override federal law.

- Medical Marijuana: Measures to allow for medical use of marijuana were passed in Massachusetts and upheld in Montana, which will make them the 18th and 19th states to adopt such laws. A similar measure was rejected by voters in Arkansas.

- Medicaid Trust Fund: Voters in Louisiana approved an initiative that ensures the state Medicaid trust fund will not be used to make up for budget shortfalls.

- Reproductive Health: Florida voters defeated two ballot measures on abortion and contraceptive services: one that would have restricted the use of public funds for abortions; and one that could have been interpreted to deny women contraceptive care paid for or provided by religious individuals and organizations. Montanans approved an initiative that requires abortion providers to notify parents if a minor under age 16 seeks an abortion, with notification to take place 48 hours before the procedure.

- Tobacco: North Dakota voters approved a smoking ban in public and work places. Missouri voters rejected a tobacco tax increase that would have directed some of the revenue to health education.

May 3 2012

Human Capital News Roundup: Babies born experiencing drug withdrawal, medication-dosing errors, permanent patients, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) scholars, fellows and grantees. Some recent examples:

A study led by Robert Wood Johnson Foundation (RWJF) Clinical Scholar Stephen W. Patrick, MD, MPH, MS, has received coverage in a number of major media outlets. The first-of-its-kind study examined the increasing trend of drug withdrawal in newborns and its impact on the U.S. health care system. The number of babies born experiencing drug withdrawal increased nearly three-fold between 2000 and 2009, the study finds, and the number of pregnant women using opiate drugs at the time of delivery increased nearly five-fold. During the same period, the cost of health care for these babies nearly quadrupled. Among the outlets to cover the findings: The New York Times, Wall Street Journal, U.S. News & World Report, USA Today, NPR, CNN’s The Chart blog, and Fox News. Read more about the study.

The Post-Standard (Syracuse, N.Y.) featured the work of RWJF Executive Nurse Fellows alumna Luvenia Cowart, EdD, RN, one of nine 2012 Post-Standard Achievement Award winners, for her efforts to eliminate health disparities experienced by Syracuse’s African American community. “Since 1999 Cowart has been using black barbershops and churches as her classroom to educate people about prostate cancer, diabetes and other diseases, and the importance of exercise and healthy eating,” the newspaper reports. The winners will be honored at a luncheon May 9.

A study co-authored by RWJF Physician Faculty Scholar H. Shonna Yin, MD, MS, finds parents with poor math and reading skills are more likely than others to give their children incorrect doses of medicine, Health Day reports. The researchers found that parents with math skills at the third-grade level were nearly five times more likely to make a medication-dosing error than those with math skills at the sixth-grade level or higher. “Dosing liquid medications correctly can be especially confusing, as parents may need to understand numerical concepts such as how to convert between different units of measurement, like milliliters, teaspoons and tablespoons,” Yin said.

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Jan 4 2011

Should FDA Require Drug Manufacturers to Test Effects of New Drugs on Varying Populations?

RWJF Scholars in Health Policy Research National Program Director Alan B. Cohen, Sc.D., had a letter in the December 29, 2010 New York Times (Avastin: Judging the Risks vs. Benefits), noting that Food & Drug Administration (FDA) approval of new drugs “commonly opens the floodgates to widespread use, often by many patients for whom the benefits are questionable.” Cohen argues that the FDA and the manufacturers of new drugs “should be required to consider the varying effects of a new drug on different groups of people so that drug approval decisions can be targeted at those who will really benefit while preventing or minimizing adverse effects for those who won’t.”