A blog covering the health/care ecosystem and people.

As the nation battles an obesity epidemic that adds $$ costs to U.S. national health spending, there are many opportunities to address this impactful social determinant of health to reduce health spending per person and to drive public and individual health. In this post, I examine a few very current events in the food-as-medicine marketspace. Big Food as an industry gets a bad rap, as Big Tobacco and Big Oil have had. In the case of Big Food, the public health critique points to processed foods, those of high sugar content (especially when cleverly marketed to children), and sustainability. But

In the US, when it comes to life and death, it’s good to live in Hawaii, Utah, Minnesota, North Dakota, and Iowa — the top five states with the greatest life expectancy and healthy life expectancy at birth in 2016. For health and longevity, sorry to see the lowest five ranked states are Washington DC which ranks last, along with Mississippi, Louisiana, South Carolina, and Alabama. This sober geography-is-health-destiny update was published this week in JAMA, The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. The first chart illustrates states down the left

We are only just past the dawn of the second machine age, where digitization is enabling artificial intelligence. “Our new tools are destroying both trust and truth, creating a hunger for community and authenticity. We crave actual physical connection to neighbours, colleagues, and fellow townspeople, even if digitally facilitated.”  Anne-Marie Slaughter wrote this in a column I read this morning in the Financial Times titled, “Our struggle with technology to protect trust and truth.” Trust and truth underpin health engagement, we learned in the first Edelman Health Engagement Barometer launched ten years ago. Those were the early days of the formation

It’s February 1st, which marks the first of 28 days of American Heart  Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America. It’s the leading cause of death for both men and women in the U.S. Knowing your blood pressure is an important step for managing the risks of heart disease. That hasn’t yet been available to those of us who quantify our steps, weight, sleep, food intake, and other health metrics. In 2017, Hugh Langley

Connecting Life’s Dots, the organization Living in Digital Times partners with CES to deliver conference content during the show. At CES 2018, LIDT is connecting a lot of dots to help make health streamline into daily living. Robin Raskin, founder, kicked off LIDT’s press conference setting the context for how technology is changing lifestyles. Her Holy Grail is to help make tech fun for everybody, inclusive for everybody, and loved by everybody, she enthused. LIDT has been a presence at CES for many years, conceiving the contest the Last Gadget Standing, hosting  tech-fashion shows with robots, and supporting a young innovators

The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal is valued at $69 billion. I wrote about this inflection point for U.S. healthcare four weeks ago here in Health Populi. CVS is both the biggest pharmacy and pharmacy benefit manager in the U.S., as the first chart shows. In my previous post, I talked about the value of vertical integration bringing together the building blocks of retail pharmacy and pharmacist care, retail clinics, the PBM (Caremark), along with Aetna’s health plan member base and business. As Amazon and other

Old-age inequality among current retirees in the U.S. is already greater than in ever OECD country except Chile and Mexico, revealed in Preventing Ageing Unequally from the OECD. Key findings from the report are that: Inequalities in education, health, employment and income start building up from early ages At all ages, people in bad health work less and earn less. Over a career, bad health reduces lifetime earnings of low-educated men by 33%, while the loss is only 17% for highly-educated men Gender inequality in old age, however, is likely to remain substantial: annual pension payments to the over-65s today are

Obesity, conflict, and mental illness contribute most to the ill health and mortality of the world’s population – especially in the U.S., according to the annual Global Burden of Disease study published this month in The Lancet and funded by The Bill & Melinda Gates Foundation. There’s good news and bad news in this research: on the upside, people are living longer. On the downside, there’s a lot of morbidity – that is, sub-optimal health – in those years. The study examines both YLLs (years of life lost) and YLDs (years lived with disability). “Death is a powerful motivator, both

The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs. Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; Medicare accounted for 27% of retail prescriptions. “But if affordability, accessibility, quality, innovation, responsiveness and choices are among the standards that will be applied to any future changes, pharmacy has strong legs to stand on,” Steve Anderson, president and CEO of the National Association of Chain Drug Stores, said in the PoweRx Top 50

“Constipation is hard. Talking about it is even harder,” reads a card I received from the senior director of marketing at Synergy Pharmaceuticals. Emojis-meet-direct-to-consumer pharmaceutical promotion in a new campaign from the drug company, which is embarking on a disease education campaign to bring greater awareness to the condition of chronic idiopathic constipation (CIC). This condition impacts 14% of the global population. The messengers for this effort are a cast of emojis who populate a continuum from constipation-to-diarrhea and every poop step in-between. Meet The Poop Troop: Stressed-Out Stooly Clogged Chris Left-Out Lumpy Plugged-Up Paulie Miss La Poop Mr. Smooth Sausage Sally

Health care costs will trend upward by 6.5% in 2018 according to the forecast, Medical Cost Trends: Behind the Numbers 2018, from PwC’s Health Research Institute. The expected increase of 6.5% is a half-percentage point up from the 2017 rate of 6.0%, which is 8% higher than last year’s rate matching that of 2014. PwC’s Health Research Institute has tracked medical cost trends since 2007, as the line chart illustrates, when trend was nearly double at nearly 12%. The research consider medical prices, health care services and goods utilization, and a PwC employer benefit cost index for the U.S. The key

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

The economics of kidney disease in America is a hefty burden: about 26 million people in the U.S. have some aspect of chronic kidney disease and are at-risk of kidney failure. The number of people diagnosed with kidney disease doubled during each of the last two decades, according to the American Society of Nephrology. The annual cost of treating end-stage renal disease (ESRD) is over $32 billion, consuming 28% of Medicare expenditures…and increasing. Now consider the personal costs of dialysis in America: about $500 for a single hemodialysis treatment in a center, roughly $72,000 a year for one patient. There

Former Surgeon General Dr. Regina Benjamin was the first person who quoted to me, “Health isn’t in the doctor’s office. It’s where people live, work, play and pray,” imparting that transformational mantra to me in her 2011 interview with the Los Angeles Times. I wrote about that lightbulb moment here in Health Populi. Dr. Benjamin was the 18th Surgeon General, appointed by President Obama in 2009. As “America’s Doctor,” she served a four-year term, her mission focused on health disparities, prevention, rual health, and children’s health. Today, Dr. Benjamin wears many hats: she’s the Times Picayune/NOLA.com professor of medicine at

The American Psychological Association reports that Americans are experiencing greater levels of stress in 2017 for the first time since initiating the Stress in America Survey ten years ago in 2007. This is a statistically significant finding, APA calculated. The member psychologists of the American Psychological Association (APA) began to report that patients were coming to appointments increasingly anxious about the 2016 Presidential election. So the APA polled U.S. adults on politics for the first time in ten years of conducting the Stress in America survey. Two-thirds of Americans are stressed and/or anxious about the future of the nation, and

Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost. It’s very clear that more consumers tend to avoid filling and taking prescription drugs, due to cost barriers, when faced with higher direct charges for medicines. This evidence is presented in the research article, Cost-related non-adherence to prescribed

60% of Americans are currently trying to lose weight. So it shouldn’t be a surprise that when asked, “what’s the most serious health problem in the United States?” Americans say it’s obesity, tied with cancer, and ahead of heart disease and diabetes. Overweight and obesity are top-of-mind for most Americans, according to research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. This research has created two reports which can be accessed at the link. The survey, conducted among 1,509 consumers in August and September 2016, found that Americans’ understanding of

If you’re retiring in 2016, you’ll need $260,000 to cover your health care costs during your retirement years. In 2015, that number was $245,000, so retiree health care costs increased 6% in one year according to Fidelity’s Retirement Health Care Cost Estimator. The 6% annual cost increase is exactly what the National Business Group on Health found in their recently published 2017 Health Plan Design Survey polling large employers covering health care, discussed here in Health Populi. The 6% health care cost increases are driven primary by people using more health services and the higher costs for many medicines — specifically, specialty

One in 2 hospitals currently use three or more connected health technologies, according to the 2016 HIMSS Connected Health Survey released today at the annual HIMSS conference. The most commonly used connected health applications cited were: Patient portals, among 58% of providers Apps for patient education and engagement 48% Remote health monitoring, 37% Telehealth via fee-for-service, 34% SMS texting, 33% Patient-generated data, 32% Telehealth via concierge, 26%. 47% of health care providers plan to expand use of connected health technologies, especially for telehealth via concierge, patient-generated data, and SMS texting. HIMSS worked with the Personal Connected Health Alliance (PCHA) to

The Old School retail clinic is going beyond checking your child’s ear infection and sore throat, giving immunizations and filling out back-to-school forms just-in-time over LaborDay  weekend. The new-new retail clinic is supporting patients’ chronic disease management, partnering with academic medical centers, and bolstering medication management. Accenture’s bullish forecast is titled “US Retail Health Clinics Expected to Surge by 2017,” making the case that these brick-and-mortar providers are shifting from a relatively limited retail scope to a broader and deeper clinical focus. The so-called surge in the number of retail clinics is projected to be nearly 50% growth between 2014 and 2017,

Noncommunicable diseases (NCDs) are the #1 cause of death in the world. NCDs are the yin to the yang of infectious diseases. Mortality from infectious disease has fallen as national economies have developed, while NCDs such as heart disease, respiratory disease, cancer, diabetes, and other NCDs are a growing burden. Health Affairs devotes its September 2015 issue to The Growing Burden of Noncommunicable Diseases, featuring research focusing both on global trends and U.S.-specific challenges. In their look into the relationships between NCDs, unhealthy lifestyles and country wealth, Thomas Bollyky et. al. note that NCDs aren’t only the “diseases of affluence,”

May 31st is World No Tobacco Day, heralded by the World Health Organization, and celebrated by the advocacy group Action on Smoking and Health (with the very appropriate acronym ASH). Smoking is one of the most addictive (anti-)health behaviors around, so persuading people to quit the habit continues to challenge public health advocates. Enter ASH’s engaging campaign called “The Wrinkler,” with the introductory question, “Ever notice how some people who are 25 look 45?” The video continues to explain how we can “expedite the aging process….Ladies, wish you were half your age? Don’t wait for him to look younger; make yourself

“Live long and prosper,” Mr. Spock repeated, like a mantra, throughout his life. We say goodbye, on this dimension anyway, to Leonard Nimoy, who passed away today at the age of 83. Star Trek is a staple entertainment — perhaps even a relaxation therapy — in my home. So Mr. Nimoy’s departure from the Planet is indeed a sad event here. In thinking about Spock’s mantra about living well, I am reminded of an interchange between him and Captain Kirk in the Star Trek movie, The Wrath of Khan. In that film, Spock is severely irradiated while saving the ship, and

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

Mobile and digital technologies will bend the health care cost curve, drive individual and population health, and solve the nagging challenge of health disparities. Mobile and digital technologies will increase costs to health providers, disrupt work flows and lower clinicians’ productivity, and hit a market bubble. Depending on your lens into mHealth, and what product categories and user segments you’re looking at, all of the above can be true. The plenary session of the 2014 mHeath Summit kicked off with Dr. Harry Leider, Chief Medical Information Officer of Walgreens, who spoke of the pharmacy’s evolving role across the entire continuum of care,

I lost my dear friend Tony M. in 1987 in the first generation of deaths from the scourge of AIDS. Remembering Tony, here he is helping me get dressed on my wedding day, along with my BFF Susan. When Tony was diagnosed within months of this photo being taken, he was with full-blown AIDS. At that time, Tony had no access to the portfolio of drug therapies available to an HIV+ patient today. Those were the days of denial, experimentation, toxicity, and really, really tough side effects. We remember Tony and all our loved ones everyday and especially today, on

With the goal of driving a digital health platform for well-informed, effective self-care, the nation’s largest retail pharmacy chain and prominent consumer-facing health information portal are allying to move from serving up pills and information to health “care.” Walgreens and WebMD launched their joint effort on 2nd October 2014, a few weeks after CVS/pharmacy re-branded as CVS Health. Welcome to the reinvention of the retail pharmacy. I spoke for a few minutes with David Schlanger, CEO, WebMD, and Alex Gourlay, President, Customer Experience and Daily Living, Walgreens, the day of the launch, to get early insights into the vision for

Expecting health care cost increases of 5% in 2015, employers in the U.S. will focus on several tactics to control costs: greater offerings of consumer-directed health plans, increasing employee cost-sharing, narrowing provider networks, and serving up wellness and disease management programs. The National Business Group on Health’s Large Employers’ 2015 Health Plan Design Survey finds employers committed to health engagement in 2015 as a key strategy for health benefits. More granularly, addressing weight management, smoking cessation, physical activity, and stress reduction, will be top priorities, shown in the first chart. An underpinning of engagement is health care consumerism — which

It’s Independence Day week in America, and our British friends at The Lancet, the UK’s grand peer reviewed medical journal, dedicate this week’s issue to the Health of Americans – exploring life, death (mortality), health costs, chronic disease, and the Pursuit of Healthiness. This project is a joint venture between The Lancet and the U.S. Centers for Disease Control (CDC) which took 18 months to foster, called The Health of Americans Series. Americans mostly die from chronic diseases, aka non-communicable diseases, which are largely amenable to lifestyle changes like eating right, quitting smoking, drinking alcohol in moderation, and moving around more. 1 in

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

Over half of people using health and fitness apps began using them over six months ago, and one-half of these people who have downloaded health and fitness apps use them daily according to survey research summarized in the report, Get Mobile, Get Healthy: The Appification of Health and Fitness from Mobiquity. The company contracted a survey conducted among 1,000 U.S. adults in March 2014 who use or plan to use mobile apps to track health and fitness. Thus the “N” in this study was a group of people already interested in self-tracking health and not representative of the broader U.S. consumer

Health data is everywhere, but not much useful to drink. Is #bigdata in health care at the top of the Hype Cycle? And how do we humanize it, make it relevant and useful for our everyday life? In other words, can this data help us hack our lives and health for the better? That question has been on my mind for the past couple of years since the convergence of big data and data analytics and health has emerged. Yesterday at the 2014 South-by-Southwest happening, I attended a panel discussion called Hacking Your Life For Better Health (#hacklife on Twitter).

3 in 4 people in America will buy health care at retail with a subsidy within just a few years, according to Mark Bertolini, CEO of Aetna. Bertolini was the first keynote speaker this week at the 2014 HIMSS conference convened in Orlando. Bertolini’s message was grounded in health economics 101 (about which frequent readers of Health Populi are accustomed to hearing). A healthy community drives a healthy local economy, and healthier people are more economically satisfied, Bertolini explained. The message: health care can move from being a cost driver to being an economic engine. But getting to a healthy

This post appeared in my Huffington Post column on January 16, 2013. In the afterglow of the 2014 Consumer Electronics Show (CES), away from the neon lights of Las Vegas, 4D curved TV screens, and uber-hip Google Glass wearers, a big question remains: Do we, the people, really want to tech our way to self-health? The number of digital health companies exhibiting at CES grew by 40 percent, exceeding 300 based on the count of the International Consumer Electronics Association, sponsor of the event. The hockey-stick growth of “wearable technology” seen at the 2014 Consumer Electronics Show begs the question: Are there

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

Patient and health engagement is the flavor du jour in health circles these days, from the corridors of hospitals to the caffeinated marketing meetings in Big Pharma’s east coast meet-ups. But there’s no standard agreement on what we mean by peoples’ health engagement, whether by patient or well consumer. In Market Insights: The Evolution of Consumer Engagement in Health Care, Porter Research endeavors to deepen our understanding of this important concept. In the introductory section of the paper, “Understanding Engagement,” Porter proffers that industry – providers, payers and employers – consider engagement as “changing consumer behavior through increased participation in consumers’ own health

Can we age more slowly? And if so, what impact would senescence — delaying aging — have on health care costs on the U.S. economy? In addition to reclaiming $7.1 trillion over 50 years, we’d add an additional 2.2 years to life expectancy (with good quality of life). This is the calculation derived in Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research, published in the October 2013 issue of Health Affairs. The chart graphs changes in Medicare and Medicaid spending in 3 scenarios modeled in the study: when aging is delayed, more people qualify

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

1 in two people who are insured and have a regular doctor are interested in trying out an electronic medical record. But they need a doctor or nurse to suggest this, and they need it to be easy to use. The EMR Impact survey was conducted by Aeffect and 88 Brand Partners to assess 1,000 U.S. online consumers’ views on electronic medical records (EMRs): specifically, how do insured American adults (age 25 to 55 who have seen their regular physician in the past 3 years) view accessing their personal health information via EMRs? Among this population segment, 1 in 4 people (24%)

Most older Americans 60 years of age and up (57%) say the last year of their lives has been “normal” – a large increase from the 42% who said life was normal in 2012. And nearly 9 in 10 older Americans are confident in their ability to maintain a high quality of life in their senior years. The good news is that seniors are maintaining a positive outlook on aging and their future. The downside: older people aren’t doing much to invest in their future health for the long run. They’re also worried about the financial impact of living longer.

People who live in U.S. cities with low levels of well-being have twice the rate of heart attacks as people who live in healthier America. That’s 5.5% of the population in sicker America versus 2.8% of the population living in healthy America. The first chart illustrates this disparity, taken from the Gallup-Healthways index that examined 190 metropolitan areas in 2012. Based on this study, it’s good to live in parts of Utah, Nebraska and Colorado, but not so healthy to be a resident in West Virginia, Alabama, and parts of Kentucky and Ohio. Heart disease and diabetes are killing a plurality

Consumers in America are spending more, and especially at the grocery store. Most people say they want to eat healthy — but, although they’re spending more at the food store, one-half of supermarket shoppers say cost is the main obstacle for healthy eating. 2 in 3 U.S. grocery shoppers define health and wellness as being physically fit and active, and over half believe that feeling good about yourself is another facet of health. Not being overweight equals health for about one-half of U.S. shoppers. The Why? Behind the Buy, from Acosta Sales & Marketing, explores buying patterns among U.S. consumers

The American health infrastructure is not First World or First Rate, based on the outcomes. This, despite spending more on health care per-person than any country on the planet. Two seminal reports are out this week reminding Americans that our return-on-investment in health spending is poor. The first research comes from JAMA titled  The State of US Health, 1990-2010:  Burden of Diseases, Injuries, and Risk Factors. There is some good news in this report at the top line: that life expectancy for Americans increased in the two decades from 75.2 years to 78.2 years. But this positive quantitative outcome comes with

Employers who provide health insurance are getting much more aggressive in 2013 and beyond in terms of increasing employees’ responsibilities for staying well and taking our meds, shopping for services based on cost and value, and paying doctors based on their success with patients’ health outcomes and quality of care. Furthermore, nearly one-half expect that technologies like telemedicine, mobile health apps, and health kiosks in the back of grocery stores and pharmacies are expected to change the way people regularly receive health care. What’s behind this? Increasing health care costs, to be sure, explains the 18th annual survey from the National

It’s called “primary” care for a reason: it’s first and foremost important in the health care services a person can use. In its report, Primary care: our first line of defense, The Commonwealth Fund explains why primary care is crucial to one’s individual health, and how primary care is morphing into medical teams and patient-centered medical homes. And that’s a good thing for you and me, the Fund says. That’s because people in the U.S. who have a primary care doctor have 33% lower health costs and 19% lower risk of dying than people who see only a specialist (Source:

The notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures. Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer

Only 1 in 5 Americans got the minimum recommended amount of physical activity in 2011, based on guidelines offered by the U.S. Centers for Disease Control. More men than women met the standard: 23.4% of men versus 17.9% of women. There are wide variations across the 50 states, as the map shows, with the healthiest folks exercise-wise living in the west, Alaska, upper midwest, and New England. The range runs from a 12.7% low in West Virginia and Tennessee to 27.3 at the high end in Colorado. That bar is set at 150 minutes a week (that’s 2.5 hours) of