Axios Vitals: Maternal mortality worries

Plus, Pfizer's COVID gains | Tuesday, July 05, 2022

Open in app View in browser   Presented By PhRMA   Axios Vitals By Tina Reed · Jul 05, 2022 Welcome back to a short week, Vitals readers! Today's newsletter is 969 words or a 3.5-minute read. 🫀 An alarming stat: Fewer than 7% of Americans have "optimal cardiometabolic health," according to a study published in the Journal of the American College of Cardiology today. Time to get back on track with our wellness goals, folks.     1 big thing: Abortion-ban states also have highest maternal mortality Note: Select mortality data unavailable due to reliability and confidentiality restrictions. Data: CDC; Map: Jacque Schrag/Axios The six states with the highest maternal mortality rates in the nation each quickly banned abortion following the decision to overturn Roe v. Wade, Axios' Oriana Gonzalez writes. Why it matters: U.S. women already are likelier to die during or after pregnancy than anywhere else in the developed world. But public health experts predict things will get worse in the post-Roe landscape as health providers weigh legal exposure against clinical decisions. Zoom in: Arkansas, Kentucky, Alabama, Tennessee, Louisiana and Mississippi top the CDC's list of states with the highest maternal mortality, each with more than 30 deaths per 100,000 live births. Each had "trigger" laws, or abortion bans that took effect in the immediate aftermath of the Supreme Court eliminating a federal right to the procedure. By the numbers: Maternal death rates in states with "trigger" laws are about two times higher than in those states with laws protecting abortion access. Most of those states are identified as having "maternity care deserts" that lack hospitals offering obstetric care, birth centers and no obstetric providers. The maternal death rate in the U.S. could jump 24% if a nationwide abortion ban was enacted, a University of Colorado study says. Between the lines: States with restrictive laws instead of outright bans — such as Ohio, which outlaws the procedure after six weeks into a pregnancy — could also see an increase in maternal deaths, said Katie McHugh, an OB-GYN and abortion provider in Indiana. "When people decide to end their pregnancies for a medical reason, that is almost always discovered later," she said. The other side: It's "dishonest and scientifically inaccurate" to claim that there is a connection between abortion bans and maternal mortality because the CDC's data is "incomplete," said Tara Sander Lee, senior fellow and director of life sciences at Charlotte Lozier Institute, an anti-abortion research organization. Go deeper.     2. Pfizer's COVID gains Photo illustration: Jakub Porzycki/NurPhoto via Getty Images   Pfizer has experienced outsized benefits from the pandemic, not only reaping huge profits from its successful COVID medicines, but also gaining massive influence in U.S. health policy, Kaiser Health News reports. Why it matters: At times, the company's executives have gotten ahead of top U.S. officials, at times leaving the public "unsure whom to trust." By the numbers: Pfizer registered $36.8 billion of sales in 2021 from the COVID-19 vaccine it makes with BioNTech, making it the top-selling pharmaceutical product ever in a single year, by a huge margin. Most recently, the Biden administration dipped into its dwindling reserves for COVID-19 countermeasure, directing $3.2 billion to Pfizer-BioNTech for 105 million doses of vaccine that could be ready if the virus surges this fall. Between the lines: That came after Pfizer publicly announced trial results of its two Omicron-modified COVID-19 vaccine candidates in the days before a key FDA advisory committee grappled with how COVID shots should be updated in the fall. The FDA ultimately issued a recommendation for updated boosters. What they're saying: "We're being pushed along … The pharmaceutical companies are acting like public health agencies," Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia said earlier in the campaign to start boosters, per KHN. In a statement, Pfizer spokesperson Sharon Castillo told KHN: "Since Day 1 of this pandemic, we have been laser-focused on working collaboratively with all relevant stakeholders to bring to the world two medical breakthroughs. In doing so, we have moved at the speed of science, complied with the strict regulatory processes, and relied on our scientists' expertise and manufacturing prowess."     3. Mixed success with social inventions Illustration: Lazaro Gamio/Axios   Addressing social needs like housing, food security and transportation could reduce hospital inpatient admission rates by 11% and emergency department visits by 4%, according to a study published in the Annals of Internal Medicine. But, but, but: The cost of those interventions may be greater than the savings derived, the researchers found. Why it matters: Addressing so-called social determinants of health is nothing new but has gained currency within federal programs and major health systems for its potential to help drive health costs down for some people. But it's still unclear what the true impact is. Zoom in: The researchers from Contra Costa Health Services and the University of California, Berkeley School of Public Health studied an adult Medicaid population where patients were randomly assigned to 12 months of social needs case management or the control group. The intervention programs saved $3.4 million, or 17% of yearly program expenses, in hospitalization costs. The effort also helped build trust with the health system and resolve basic social needs, they said.     A message from PhRMA Out-of-pocket costs create significant barriers to care     New data show that 35% of insured Americans spent more on out-of-pocket costs than they could afford in the past month. The story: Many patients are experiencing an insurance system that isn't working for those who need care. Learn how insurance is leaving patients exposed to deepening inequities.     4. Quote du jour Photo: Lisa Lake/Getty Images for Geisinger Health System   "Part of my approach to it is to break it down and try to identify where your single most important simple leverage point is. That is making sure there are health workers who are salaried, they're paid on time, they're supported with training … and they're plugged into clinics that can support [them]." — Atul Gawande, head of the U.S. Agency for International Development's global health office, told Politico. Gawande, a famed surgeon and writer best known for examining and explaining the systems behind our health outcomes, took the role at USAID to turn that lens on global health earlier this year. Gawande was describing his approach to addressing protracted global health concerns which have only worsened with the COVID-19 pandemic — and are already losing support for funding support in Washington and abroad.     5. While you were weekending Illustration: Aïda Amer/Axios   👎 HHS Secretary Xavier Becerra told NBC's "Meet the Press" Sunday that Democrats criticizing the Biden administration's strategy to ensure abortion rights ought to "give us some good ideas." (Axios) 🩺 Arizona prisoners and advocates are calling for an overhaul after a federal judge ruled the health care system behind bars is unconstitutional. (Arizona Republic) 👀 With the latest disappointments in drug research for Alzheimer's disease, experts are pushing for a stronger focus on the value of modifying risk through behaviors. The latest target: healthy vision. (New York Times)     A message from PhRMA Voters want Congress to address health insurance     According to a new poll, 71% of Americans would like to see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductibles and copays. The reason: Many believe current health insurance coverage options are confusing and unaffordable.   Are you a fan of this email format? It's called Smart Brevity®. Over 300 orgs use it — in a tool called Axios HQ — to drive productivity with clearer workplace communications.   Axios thanks our partners for supporting our newsletters. 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