A blog covering the health/care ecosystem and people.

While people in the U.S. perceive a dramatic rise in mental health conditions among fellow health citizens growing over the past five years, people note barriers of cost, insufficient supply of providers, and stigma as barriers to getting care in the latest Gallup and West Health poll on the subject.               In West Health’s words, three-quarters of Americans feel that, “mental health takes a back seat to physical health” in the U.S. A key theme of the research found that Americans find that mental health is not treated as well as physical health in

The U.S. is “a nation recovering from collective trauma,” the according to the latest survey on Stress in America 2023 from the American Psychological Association (APA).             The APA has been quantifying Stress in America since 2007; for context, at the end of that year The Great Recession kicked in, and in response President Obama’s team put together assistance to bolster the national economy, jobs, and health technology (codified in the American Recovery and Reinvestment Act). American health citizens are experiencing a deja vu in 2023 akin to their financial stress experienced in the APA 2008 Stress

The definition of “convenience” in the eyes of patients, consumers, and caregivers is multi-faceted, with the concept of “location” shifting both physically and digitally. We learn this in new research from JLL, the global real estate services company. “Why is a real estate services company doing research into consumers’ views on health care?” you might ask. See my Hot Points below, discussing my views on the morphing of health care real estate from Pill Hill and inpatient hospitals to the home and closer-to-home sites.             In the 2023 Patient Consumer Survey report, the topline lesson

With May being Mental Health Awareness Month, there’s no shortage of press releases promoting a wide range of services and programs emerging from both the public and private sectors. In the wake of the COVID-19 public health crisis, the exposed epidemic-beyond-the-pandemic of mental health has inspired many collaborations between public, private commercial and not-for-profit organizations. These have begun to embed mental health into the larger retail health ecosystem. I’ll point to several examples as signposts for this phenomenon.           Walgreens and Mental Health America – This collaboration expands Walgreens’ work with Mental Health America focusing in

People have expanded their definitions of health in 2023, with mental health supplanting physical health for the top-ranked factor in feeling healthy. Welcome to the Edelman Trust Barometer Special Report: Trust and Health, released this week, with striking findings about how the economic, post-pandemic life, pollution and climate change all feed mis-trust among citizens living in 13 countries — and their eroding trust for health care systems.         While these factors vary by country in terms of relative contribution to citizen trust, note that in the U.S., social polarization plays an outsized role in factors that “make us

In the organization’s annual study into physicians’ wellbeing, Medscape has diagnosed worsening burnout and depression among America’s doctors.               Over one-half of U.S. physicians say they are burned out or depressed, the chart from the U.S. Physician Burnout & Depression Report for 2023 calls out. “I cry but not one cares,” is one of the represented color comments provided by one of the physicians included in the survey of 9,175 physicians polled online between June and October 2022. The study covered 29 specialties, finding most burned out physicians worked in emergency medicine (65% saying

People who need people aren’t just the luckiest people in the world: they derive greater benefits through monitoring their health via apps that make it easier to make healthy choices. Channeling Barbra Streisand here to call out a key finding in new consumer research from Kantar on Connecting with the Health & Wellness Community.           Kantar polled 10,000 online consumers in ten countries to gain perspectives on health citizens’ physical and emotional health and the role of technology to bolster (or diminish) well-being. The nations surveyed included Brazil, China, France, Germany, India, Singapore, South Africa, Spain,

What happens to a health care ecosystem when the volume of patients and revenues they generate decline? Add to that scenario a growing consensus for a likely recession in 2023. How would that further impact the micro-economy of health care?                   A report from Trilliant on the 2022 Trends Shaping the Health Economy helps to inform our response to that question. Start with Sanjula Jain’s bottom-line: that every health care stakeholder will be impacted by reduced yield. That’s the fewer patients, less revenue prediction, based on Trilliant’s 13 trends re-shaping the U.S. health

It’s Mental Illness Awareness Week: annually NAMI, the National Alliance on Mental Illness, devotes the first week of October to advocate for people facing managing a mental illness every day and to raise public consciousness on the pervasiveness of mental illness in America. This year, NAMI’s key themes address the over-arching message of  “What I wish I had known,” each day looking into: Monday Oct. 3: Stigma Tuesday Oct. 4: Medication [National Day of Prayer for Mental Illness Recovery and Understanding] Wednesday Oct. 5: Therapy Thursday Oct. 6: Disclosing [National Depression Screening Day], and, Friday Oct. 7: Caregiving. To track

Even as spending on healthcare per person in the United States is twice as much as other wealthy countries in the world, Americans’ health status ranks rock bottom versus those other rich nations. The U.S. health system continues to be marred by health inequalities and access challenges for man health citizens. Furthermore, American workers’ rank top in the world for feeling burnout from and overworked on the job.             Welcome to The Consumer Dilemma: Health and Wellness,, a report from GWI based on the firm’s ongoing consumer research on peoples’ perspectives in the wake of

We’ve hit a great “healthcare trust” recession around the world, translating into lower multiple points of medical ‘facts’ and pseudoscience, lower adherence to therapeutic regimens, and clinician burnout that has compromised medicine as the team sport it ideally should be. And that’s just one of five inconvenient truths unearthed in The Truth About Our Relationships with Health, the first in a series of papers that MRM is developing to, in their words, “look at the truths pr7eventing us from achieving a better relationship with our own health and with those along our health journey.” This report from MRM analyzes research

As we mark the second anniversary of the COVID-19 pandemic, the key themes facing health citizens deal with money, inflation, and war — “piled on a nation stuck in COVID-19 survival mode,” according to the latest poll on Stress in America from the American Psychological Association. Financial health is embedded in peoples’ overall sense of well-being and whole health. Many national economies entered the coronavirus pandemic in early 2020 already marked by income inequality. The public health crisis exacerbated that, especially among women who were harder hit financially in the past two years than men were. That situation was even worse

One of my favorite Dr. Seuss characters is the narrator featured in the book, I Had Trouble In Getting to Solla-Sollew. I frequently use this book when conducting futures and scenario planning sessions with clients in health/care. “The story opens with our happy-go-lucky narrator taking  a stroll through the Valley of Vung where nothing went wrong,” the Seussblog explains. Then one day, our hero (shown here on the right side of the picture from the book) is not paying attention to where he is walking….thus admitting, “And I learned there are troubles of more than one kind, some come from

Most health care providers who were using telehealth by August 2021 felt optimistic about virtual care in a study from GoodRx on The State of Telehealth. GoodRx collaborated with the ATA on the 624 U.S. provider survey, which was complemented by a poll conducted among 1,024 health consumers for the patient perspective in September 2021. Looking at the two columns at the right side of the first bar chart, clinicians who have been using telehealth were more likely to feel optimistic about doing so than providers who were not. The most prevalent platforms providers used for telehealth engagement were via Zoom,

“Americans remain in limbo between lives once lived and whatever the post-pandemic future holds,” the American Psychological Association observes in their latest read into Stress in America 2021, with this phase of the perennial study focused on Stress and Decision-Making During the Pandemic. The top-line: people face a daily web of risk assessment, up-ended routines, and endless news about the coronavirus locally and globally. While most people in the U.S. believe that “everything will work out” after the pandemic ends, the mental, emotional, and logistical daily distance between “now” and “then” brings uncertainty and indeed, prolonged stress. More Millennials, who

COVID-19 exacted a toll on health citizens’ mental health, worsening a public health challenge that was already acute before the pandemic. It’s World Mental Health Day, an event marked by global and local stakeholders across the mental health ecosystem. On the global front, the World Health Organization (WHO) describes the universal phenomenon and burden of mental health on the Earth’s people… Nearly 1 billion people have a mental disorder Depression is a leading cause of disability worldwide, impacting about 5% of the world’s population People with severe mental disorders like schizophrenia tend to die as much as 20 years earlier

One in two people in the U.S. receive health insurance through employers. As large employers tend to be on the vanguard of benefit plan design, it’s useful to understand how these companies are thinking ahead on behalf of their employees. With that objective, it’s always instructive to explore the annual study from the Business Group on Health, the 2022 Large Employers’ Health Care Strategy and Plan Design Survey. As a result of the COVID-19 pandemic, large employees have many concerns about worker and dependents’ health. The biggest firms in America providing health insurance for workers are expecting an increase in

“Most Americans clearly recognize the potential benefits that improved health IT can offer, and they want this transformation of the health care system to continue,” the Pew Charitable Trusts research concludes in Most Americans Want to Share and Access More Digital Health Data. The Pew team surveyed 1,213 adults ages 18 and over in June and July 2020, interviewing in English and Spanish. As digital health industry stakeholders will be convening at the 2021 annual HIMSS conference in Las Vegas and digitally, this report is well-timed to give us a level-set on just “where” U.S. health citizens are with respect to

In the Age of COVID, over 90,000 new health apps were released, as the supply of digital therapeutics and wearables grew in 2020. Evidence supporting the use of digital health tools if growing, tracked in Digital Health Trends 2021: Innovation, Evidence, Regulation, and Adoption from IQVIA Institute for Human Data Science. IQVIA has been closely following the growth, investment in, and clinical evidence for digital health since 2013, when I reviewed their first paper on “mHealth” here in Health Populi.  Then, IQVIA evaluated the universe of about 40,000 apps available in the iTunes store. In today’s report, the company quantifies

Without access to connectivity during the pandemic, too many people could not work for their living, attend school and learn, connect with loved ones, or get health care. The COVID-19 era has shined a bright light on what some of us have been saying since the advent of the Internet’s emergence in health care: that digital literacies and connectivity are “super social determinants of health” because they underpin other social determinants of health, discussed in Digital inclusion as a social determinant of health, published in Nature’s npj Digital Medicine. On the downside, lack of access to digital tools and literacies

In the COVID-19 pandemic, health care spending in the U.S. increased by a relatively low 6.0% in 2020. This year, medical cost trend will rise by 7.0%, expected to decline a bit in 2022 according to the annual study from PwC Health Research Institute, Medical Cost Trend: Behind the Numbers 2022. What’s “behind these numbers” are factors that will increase medical spending (the “inflators” in PwC speak) and the “deflators” that lower costs. Looking around the future corner, the inflators are expected to be: A COVID-19 “hangover,” leading to increased health care services utilization Preparations for the next pandemic, and

The pandemic accelerated many Very Big Deals in digital health venture capital investment, mergers and acquisitions, and the re-emergence of SPACs in health care. A closer look at this activity points to a key trend that will persist post-pandemic: that telehealth and the broader theme of virtual care is re-shaping how health care is delivered. This graphic comes out of my current thinking about telehealth across the continuum of care. Before the pandemic, the dominant work-flow for telemedicine was for triage, primary care and pediatrics (think: your child registers a 105-degree fever on a Saturday night and the pediatrician’s office

Spending on medicines, globally, will rebound this year and rise above pre-pandemic levels through 2025. Between 2021 and 2025, the annual growth global growth rate for prescription drugs spending is expected to range from 3% to 6%, a $1.6 trillion bill for the worlds’s total Rx medicines market. That relatively low single-digit growth rate is tempered by savings from biosimilars and the loss of brand exclusivity (that is, more generics coming to market). On the faster-growth side, we can expect two big therapeutic areas to drive spending upward: oncology and immunology, projected to expand by 9% to 12% each year

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

A Year into our collective coronavirus experience, Americans remain stressed, with physical health taking a back seat to our daily grinds based on the 2021 Stress in America survey from the American Psychological Association (APA). The APA has been updating us on U.S.-stress for several years, and more frequently since the start of the COVID-19 pandemic at the start of 2020. In their latest report, APA updates their previous profiles of Americans’ stress looking into different demographic groups and coping mechanisms. The topline, across all adults living in America, is that one-half have delayed or cancelled health care services. One-half has

“Without a four-year college diploma, it is increasingly difficult to build a meaningful and successful life in the United States,” according to an essay in PNAS, Life expectancy in adulthood is falling for those without a BA degree, but as educational gaps have widened, racial gaps have narrowed by Anne Case and Angus Deaton. Case and Deaton have done extensive research on the phenomenon of Deaths of Despair, the growing epidemic of mortality among people due to accidents, drug overdoses, and suicide. Case and Deaton wrote the book on Deaths of Despair (detailed here in Health Populi),  Case and Deaton

By the autumn of 2020, U.S. physicians grew concerned that patients who were avoiding visits to doctor’s offices were missing care for chronic conditions, discussed in in Delayed and Forgone Health Care for Nonelderly Adults during the COVID-19 Pandemic from the Urban Institute. More than three-fourths of people who delayed or forewent care had at least one chronic health condition. The pandemic may have led to excess deaths from diabetes, dementia, hypertension, heart disease, and stroke, as well as record drug overdoses in the 12 months ending in May 2020. In their JAMA editorial on these data, Dr. Bauchner and

On U.S. Election Night, November 3, 2020, CNN’s John King stood in front of the “Key Race Alert” screen, announcing state-by-state polling results with the oft-used headline, “Too Early To Call.” That persistent media-moment was stressful for the millions of voters watching the multiple hairline-close battles from state to state. Then there was that company logo strategically placed at the lower left corner of the screen, as in “Brought to you by Calm.” Calm is but one of a growing portfolio of tools that health citizens can use to manage anxiety and stress, get to sleep (and stay sleeping), and

In numerology, the symbolic meaning behind the number “21” is death and re-birth. In tarot cards, 21 is a promise of fulfillment, triumph, and victory. How apropos that feels right now as we say goodbye and good riddance to 2020 and turn the page for a kinder, gentler, healthier New Year. It would be sinful to enter a New Year as challenging as 2021 promises to be without taking the many lessons of our 2020 pandemic life and pain into account. For health care in America, it is a time to re-build and re-imagine a better, more equitable landscape for

By April 2020, over one million Medicare members were receiving health care via telemedicine. The graph here shows you the hockey-stick growth for virtual care use by older Americans into the second month of the coronavirus pandemic. The COVID-19 public health crisis up-ended all aspects of daily living in America for people of all ages. For older Americans, avoiding the risk of contracting the tricky virus in public, and especially, in health care settings, became Job 1. The pandemic thus nudged older people toward adopting digital lifestyles for daily life, for shopping, for praying, and indeed, for health care. Laurie

Most psychologists in the U.S. treated more patients in the first six months of the coronavirus pandemic, shifting their practices to telehealth platforms. These therapists got more referrals and saw fewer cancellations, and one-third treated patients who lived in a different state from their practice site, according to Patients with Depression and Anxiety Surge as Psychologists Respond to the Coronavirus Pandemic from the American Psychological Association (APA). For this study, APA polled 1,787 licensed psychologists (both members and non-members in the Association) in the U.S. between late August and early October 2020. This year, APA has published four reports on

Over one-half of Americans would likely use virtual care for their healthcare services, and one in four people would actually prefer a virtual relationship with a primary care physician, according to the fifth annual 2020 Consumer Sentiment Survey from UnitedHealthcare. What a difference a pandemic can make in accelerating patients’ adoption of digital health tools. This survey was conducted in mid-September 2020, and so the results demonstrate U.S. health consumers’ growing digital health “muscles” in the form of demand and confidence in using virtual care. One in four people would consider online options as their first-line to evaluating personal health

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

On February 4th, 2020, in a hospital in northern California, the first known inpatient diagnosed with COVID-19 died. On March 11th, the World Health Organization called the growing prevalence of the coronavirus a “pandemic.” On May 25th, George Floyd, a 46-year-old Black man, died at the hands of police in Minneapolis. This summer, the Dixie Chicks dropped the “Dixie” from their name, and NASCAR cancelled the confederate flag from their tracks. Today, nearly 200,000 Americans have died due to the novel coronavirus. My new book, Health Citizenship: How a virus opened hearts and minds, launched this week. In it, I

The CDC calculated that some 200,000 American lives would be lost to the coronavirus pandemic by Labor Day weekend 2020. Beyond the tragic mortality in the U.S. come morbidity impacts hitting mental health in America, hard. And some people are being hit-harder than others, a report from the Centers for Disease Control details. Overall, 4 in 10 people in the U.S. reported at least one adverse mental or behavioral health symptom in the last week of June 2020. These symptoms included anxiety disorder, depressive disorder, COVID-19 related trauma- or stress-related disorder (TSRD), substance use (either starting or increasing), and serious

My friends… It’s time in this pandemic journey that I take a full week to re-charge and bask in the midst of nature, a lake, farm-to-table food, wine-making, and the love of and therapeutic time with my wonderful husband. My gift to you all this week, 10th – 14th August, is to share with you pages from my “ABCovid-19 Journal” that I created/curated in the first weeks of the coronavirus pandemic. We all have our hacks for managing stress and discomfort, and in the first weeks of COVID-19, this was my life-saver. Journaling is one of my self-care strategies; think

The pace of digital health investments quickened in the first half of 2020, based on Rock Health’s look at health-tech financing in mid-year. Digital health companies garnered $5.4 billion in the first half of the year, record-setting according to Rock Health. Underneath this number were very big deals, shown by the size of the blue bubbles in the first graphic from the report. Note that in H1 2020, the average deal size exceeded $25 mm. Among the largest deals valued at over $100 mm were ClassPass (raising $285 mm), in the business of virtual fitness classes;  Alto Pharmacy, a digital

Most U.S. employers worry about workers’ mental health and substance use as employees begin returning to work in the summer of 2020. About 4 in 5 U.S. companies are “very concerned” or “concerned” about employees’ chronic illnesses, acute illnesses, and injuries along with behavioral health issue, based on McKinsey’s annual employer survey which coincided this year with the COVID-19 pandemic. Challenges of opioid use in the workforce remain a concern for two-thirds of U.S. companies, as well. Some 9 in 10 U.S. companies say behavioral health has a negative impact on workforce productivity. In response, 7 in 10 employers are

“The COVID-19 pandemic has altered every aspect of American life, from health and work to education and exercise,” the new Stress in America 2020 study from the American Psychological Association begins. The APA summarizes the impact of these mass changes on the nation: “The negative mental health effects of the coronavirus may be as serious as the physical health implications,” with COVID-19 stressors hitting all health citizens in the U.S. in different ways. Beyond the risk of contracting the virus, the Great Lockdown of the U.S. economy has stressed the U.S. worker and the national economy, with 7 in 10

The coronavirus pandemic has dramatically disrupted every aspect of life for everyday people, ratcheting up stress across all families: The mandate to #StayHome, being physically distanced from work colleagues, beloved family and friends, and our community touchpoints The fear and risk-management of contracting the COVID-19 virus, for ourselves and our families The economic shock or either losing our jobs, seeing our savings eroding from 401(k) plans, losing our health insurance, or all of the above If we’ve kept our jobs in the pandemic, the novel work environment at-home — with children afoot, some of whom are now forced to be

As the coronavirus pandemic’s curve of infected Americans ratchets up in the U.S., people are seeking comfort from listening to Dolly Parton’s bedtime stories, crushing on Dr. Anthony Fauci’s science-wrapped-with-empathy, and streaming the Tiger King on Netflix. These and other self-care tactics are taking hold in the U.S. as most people are “social distancing” or sheltering in place, based on numbers from the early April 2020 Kaiser Family Foundation health tracking poll on the impact of the coronavirus on American life. While the collective practice of #StayHome to #FlattenTheCurve is the best-practice advice from the science leaders at CDC, the NIAID

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

Across the U.S., the health/care ecosystem warmly embraced social determinants of health as a concept in 2019. A few of the mainstreaming-of-SDoH signposts in 2019 were: Cigna studying and focusing in on loneliness as a health and wellness risk factor Humana’s Bold Goal initiative targeting Medicare Advantage enrollees CVS building out an SDOH platform, collaborating with Unite US for the effort UPMC launching a social impact program focusing on SDoH, among other projects investing in social factors that bolster public health. As I pointed out in my 2020 Health Populi trendcast, the private sector is taking on more public health

“Listen to your patient; he is telling you the diagnosis,” Dr. William Osler is quoted to have said around the turn of the 20th century. Dr. Osler had been a strong advocate for the physician-patient conversation to inform the doctor’s diagnostic acumen and improve patient outcomes. This year is the centennial of Dr. Osler’s passing, so it’s especially timely that I introduce this post with his legendary assertion in the context of kicking off the 2019 Medecision Liberation conference. This meeting convenes the company’s clients, partners, and staff to share best practices, spark insights and learnings, and enable networking between

U.S. employers are tightening their focus on mental and behavioral health, addressing workers’ chronic conditions, emphasizing women’s health, and allocating more resources to digital and telehealth investments, we learn from Optum’s Ten Years of Health and Well-Being at Work: Learning from our past and reimagining the future. Four in five medium, large and jumbo companies expect their spending on health and wellness programs will increase over the next three years. That spending will have a strong focus on behavioral health services: 9 in 10 employers are concerned with the level of access workers have to mental health services. Companies will

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

Social mobility in America has a lot of friction: children of wealthier people tend to grow into affluence, and children of low-income parents tend to struggle to move up the income and education ladder, according to A Broken Social Elevator: How to Promote Social Mobility, a new report from the OECD. The Organization for Economic Cooperation and Development studied member nations’ economies, demographics, income and opportunities to gauge each country’s social mobility. Social mobility, the OECD explains, is multi-faceted. It can refer to inter-generational mobility between parents, children, and grandchildren. Alternatively, social mobility can look at intra-generational mobility, over the course

Yesterday at 1 pm, we learned that the incidence of suicide is up in America in a report from the Centers for Disease Control (CDC), an agency in the U.S. Department of Health and Human Services. This morning, we awake to news that Anthony Bourdain, the witty and prolific travel and food expert, took his own life. Earlier this week, Kate Spade, fashion designer and creative force, took her own life. The loss of these two bright lights, gone from our lives to suicide within a few days of each other, gives me the sad compulsion to say something, again, about