Research Roundup: Smoking In Adolescents; Salt Intake And Heart Failure; And Medicaid
Each week, KHN compiles a selection of recently released health policy studies and briefs.
A Tool To Identify Adolescents At Risk Of Cigarette Smoking Initiation
Cigarette smoking typically begins during adolescence, and the younger the age of initiation, the greater the risk of daily smoking, heavy cigarette consumption, nicotine dependence (ND), and difficulty quitting. The prevalence of “tried smoking” has declined markedly in North American youth (from 20% of US middle school students in 20136 to 7% in 20167 and from 45% of sixth- through ninth-grade Canadian students in 1994 to 8% in 2014–2015). However, 25% to 30% of never-smokers lack firm commitment to never smoke and are classified as “susceptible to smoking.” These individuals represent a key target group for prevention because the transition from never to ever smoking can lead to rapidly increasing cigarette use. (Sylvestre et al, 11/1)
JAMA Internal Medicine:
Reduced Salt Intake For Heart Failure: A Systematic Review
Recent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to reduce dietary salt intake, although the benefits are uncertain. (Mahtani et al, 11/5)
The Henry J. Kaiser Family Foundation:
What Does The Outcome Of The Midterm Elections Mean For Medicaid Expansion?
While not typically an election issue, Medicaid — particularly the Medicaid expansion created under the Affordable Care Act (ACA) — was an important issue in the 2018 midterm elections in a number of campaigns throughout the country. Following the election, 37 states including the District of Columbia have adopted the ACA’s Medicaid expansion. States may implement the expansion at any time, and while they can no longer receive 100% federal financing for three years, they remain eligible for enhanced federal financing of 93% in 2019 and 90% in 2020 and beyond. Many studies on the effects of the ACA Medicaid expansion point to positive effects on coverage, access to care, service utilization, and state budgets and economies. This fact sheet highlights key states in which the results of the 2018 midterm elections have implications for Medicaid expansion adoption or implementation. States examined include those that had Medicaid expansion ballot initiatives and states in which governor races have potential implications for Medicaid expansion. In states that had governor races with implications for Medicaid expansion, changes in the composition of state legislatures are also important as governors in most states will need to work with their legislatures in order to adopt the expansion. (11/7)
New Evidence Shows The Safety Net Reduces Americans’ Material Hardship By 48 Percent
The American economy has seen strong growth and low unemployment, but many families continue to struggle. A recent Urban Institute study (based on data from the Well-Being and Basic Needs Survey) found that 4 in 10 nonelderly Americans had trouble playing for housing, food, utilities, or health care in 2017. Our study released today found that the social safety net is one tool to help Americans cope with these challenges. (McKernan and Ratcliffe, 11/5)
Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?
[W]e compared nursing homes’ performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors. Although Nursing Home Compare captures some aspects of patient safety, we found the relationship to be weak and somewhat inconsistent, leaving consumers who care about patient safety with little guidance. We recommend that Nursing Home Compare be refined to provide a clearer picture of patient safety and quality of life, allowing consumers to weight these domains according to their preferences and priorities. (Brauner et al., 11/05)