A blog covering the health/care ecosystem and people.

I’ve returned to the U.S. for a couple of months, having lived in and worked from Brussels, Belgium, since October 2021 (save for about ten days in March 2022). Work and life slow down in Europe in July and August, giving us the opportunity to return to our U.S. home base, reunite with friends and family, and re-join life and living this side of the Atlantic. The timing of my return to the U.S. coincides with a retail health hurricane of big announcements shaking up the health/care ecosystem. Among these events are Amazon’s plan to acquire One Medical, Apple’s publication of

People whose sense of well-being shifted positively in the past two years are finding greater personal purpose and financial health, we see in Sharecare’s Community Well-Being Index – 2021 State Rankings Report.                   Sharecare has been annually tracking well-being across the 50 U.S. states since 2008. When the study launched, Well-Being Index evaluated five domains: physical, social, community, purpose, and financial. In 2020, Sharecare began a collaboration with the Boston University School of Public Health to expand the Index, including drivers of health such as, Healthcare access (like physician supply per 1,000

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

As more than 1 in 3 U.S. workers were unemployed during the pandemic and another 38% had reductions in hours and pay, Americans’ personal forecasts and expectations for retirement have been disrupted and dislocated.                 In its look at The Road Ahead: Addressing Pandemic-Related Setbacks and Strengthening the U.S. Retirement System from the Tramsamerica Center for Retirement Studies (TCRS), we learn about the changing views of U.S. workers on their future work, income, savings, dreams and fears. Since 1988, TCRS has assessed workers’ perspectives on their futures, this year segmented the 10,003 adults

The best U.S. states to live in for health and health care are Hawaii, Massachusetts, Connecticut, Washington, Vermont, Rhode Island, and Maryland…             Those are the top health system rankings in the new 2022 Scorecard on State Health System Performance annual report from the Commonwealth Fund. If you live in Mississippi, Oklahoma, West Virginia, Texas, Missouri, Alabama, Georgia, or Arkansas, your health care and outcomes are less likely to be top-notch, the Fund’s research concluded.                 The Commonwealth Fund has conducted this study since 2006, assessing a range

Doctors heads and hearts are jammed with concerns beyond curing patients’ medical conditions: U.S. physicians are worried about big social issues, according to a Medscape survey report, Physicians’ Views on Today’s Divisive Social Issues 2022.               Topping physicians’ list of their top-five most important social issues, far above all others ranked healthcare access. Underneath that top-line statistic, it’s important to note that: 52% of doctors are “very concerned” about healthcare access, 28% are “concerned,” and 13% are “somewhat concerned.” Medscape underscores that in 2020, 31 million U.S. residents had no health insurance coverage, and

For millions of older people in America, health and well-being got worse in the wake of the COVID-19 pandemic. Physical, mental and behavioral health took hits, depending on one’s living situation, social determinants of health risks, and even health plan, I write in the Medecision Liberate Health blog.                     In this essay on health disparities and equity for older adults, I weave together new data from, The United Health Foundation’s study on seniors’ health status in America’s Health Rankings for 2022 RAND and CMS research into seniors health disparities among Medicare Advantage

Year 3 into the COVID-19 pandemic, health citizens are dealing with coronavirus variants in convergence with other challenges in daily life: price inflation, civil and social stress, anxiety and depression, global security concerns, and the safety of their families. Add on top of these significant stressors the need to deal with medical bills, which is another source of stress for millions of patients in America. I appreciated the opportunity to share my perspectives on “The Patient As the Payer: How the Pandemic, Inflation, and Anxiety are Reshaping Consumers” in a webinar hosted by CarePayment on 25 May 2022. In this

With peoples’ anxiety about COVID-19 at its lowest point since 2020, folks are most anxious in spring 2022 about current global events and the safety of their families, based on the latest Healthy Minds study from the American Psychiatric Association (APA).           Morning Consult conducted the poll for the APA in March and April 2022 among 2,210 U.S. adults. The survey covered peoples’ perspectives on mental health care, anxiety, COVID-19, children’s mental health, and the workplace. The results were published May 22, 2022. The key findings of the study were that, 3 in 4 people are

A couple retiring in 2022 should budget $315,000 to cover their health care costs in retirement, based on the 21st annual Retiree Health Care Cost Estimate from Fidelity Investments. For context, note that the median sales price of a home in the U.S. in April 2022 was $391,200.             It’s important to understand what the $315,000 for “health care costs” in retirement does not cover, explained in Fidelity’s footnoted methodology: the assumption is that the hypothetical opposite-sex couple is enrolled in Original Medicare (not Medicare Advantage), and the cost estimate does not include other health-related expenses

Delivering health care during the heights of the COVID-19 pandemic proved to both patients and their clinicians that virtual care was not only a viable channel for care, but very often a preferable “place” to collaborate for treatment. Even before the coronavirus pandemic emerged in early 2020, telehealth and the hospital-to-home movement were beginning to become part of a portfolio of delivery modes across the continuum of care. Deloitte spells out the current and future prospects for the Hospital in the future “without” walls in a new report that spells out driving forces, future scenarios, and impacts on a business long

“Telehealth certainly appears to be here to stay,” the AARP forecasts in An Updated Look at Telehealth Use Among U.S. Adults 50-Plus from AARP.                         Two years after the emergence of the COVID-19 pandemic, one-half of U.S. adults over 50 said they or someone in their family had used telehealth. In early 2022, over half of those over 50 (the AARP core membership base) told the Association they would likely use telehealth in the future. This future expectation varies by race, the implications of which I discuss below in

The coronavirus pandemic has re-shaped consumers across many life- and work-flows. When it comes to peoples’ relationship to consumer packaged goods (CPG), the public health crisis has indeed impacted consumers’ purchasing behaviors and definition of “value,” based on IRI’s latest analysis of CPG shifts in 2022 and 2023.           IRI has been tracking COVID-19’s impact on CPG and retail since the emergence of the coronavirus. In this Health Populi post, I’ll discuss the research group’s assessment of CPG shifts of consumer packaged goods through my lens on health/care, everywhere — especially, in this case, the home.

As health care industry stakeholders and policymakers have begun to recognize and address the underlying drivers of peoples’ health, there’s another acronym that is taking hold in health care beyond SDoH: that is ESG, standing for Environment Social, and Governance pillars of responsibility and activity.               To mark this Earth Day 2022, I’ve written a brief primer on ESG for the health care community published today in the Medecision Liberate Health blog. Here in Health Populi, I’ll give you a few highlights with graphics you won’t see in that essay to illustrate some key

“Until now, focus on….the social determinants of health has been for government and civil society. The private sector has not been involved in the discussion or, worse, has been seen as part of the problem. It is time this changed,” asserts the report, The Business of Health Equity: The Marmot Review for Industry, sponsored by Legal & General in collaboration with University College London (UCL) Institute of Health Equity, led by Sir Michael Marmot.               Sir Michael has been researching and writing about social determinants of health and health equity for decades, culminating publications

Inflation and rising prices are the biggest problem facing America, most people told the Kaiser Family Foundation March 2022 Health Tracking Poll. Underpinning that household budget concern are gas and health care costs. Overall, 55% of people in the U.S. pointed to inflation as the top challenge the nation faces (ranging from 46% of Democrats to 70% of Republicans). Second most challenging problem facing the U.S. was Russia’s invasion into Ukraine, noted by 18% of people — from 14% of Republicans up to 23% of Democrats. The COVID-19 pandemic has fallen far down Americans’ concerns list tied third place with

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

The COVID-19 pandemic revealed long-systemic health disparities in the U.S. and in other parts of the world. Income inequality, sickly environments in homes and communities (think unclean air and water), lack of public transportation and nutritious food deserts combine to limit peoples’ health and well-being., Beyond the traditional social determinants of health, such as these, we’ve called out another health risk that became crucial for life in the coronavirus pandemic era: digital connectivity, Indeed, WiFi and broadband represent the newest social determinant of health to add to a growing list of risk factors that challenge health citizens’ health. Kudos to

There’s more evidence that doctors and patients, both, want to use telehealth after the COVID-19 pandemic fades. Doximity’s second report on telemedicine explores both physicians’ and patients’ views on virtual care, finding most doctors and health consumers on the same page of virtual care adoption. For the physicians’ profile, Doximity examined 180,000 doctors’ who billed Medicare for telemedicine claims between January 2020 and June 2021. Telemedicine use did not vary much across physician age groups. Doctors in specialties that manage chronic illnesses were more likely to use telehealth: endocrinology (think: diabetes), gastroenterology, rheumatology, urology, nephrology, cardiology, ENT, neurology, allergy, and

It felt super appropriate that I met up with Abner Mason, Founder of SameSky Health, on Valentine’s Day 2022. While we conversed via Zoom, Abner’s positive energy vibrated over the 5,600 miles between him in LA County and me in Brussels, Belgium – nine hours apart, but in the proverbial same room in the conversation. My initial ask of Abner was to discuss the re-branding of ConsejoSano to SameSky Health, but I first wanted to hear the man’s origin story. And that, you will learn, has everything to do with loving parents, the power of education from a young age,

The Future of Wellness in 2022 is, “shifting from a ‘feel-good’ luxury to survivalism as people seek resilience,” based on the Global Wellness Institute’s forecast on this year’s look into self-care and consumer’s spending on health beyond medical care — looking beyond COVID-19. GWI published two research papers this week on The Future of Wellness and The Global Wellness Economy‘s country rankings as of February 2021. I welcomed the opportunity to spend time for a deep dive into the trends and findings with the GWI community yesterday exploring all of the data, listening through my health economics-consumer-technology lens. First, consider

One of the best parts of watching the biggest U.S. football game of the year are the ads which can provide great entertainment in-between touchdowns, time-outs, and referees’ video replays. This year, Ad Age provides us with an early inventory of some of the high-expectation commercials, including the usual suspects like Budweiser, Google, TurboTax, and Avocados from Mexico. For the first time, cryptocurrency brands will advertise on the  Super Bowl, too. But I’m most looking forward to seeing the 30-second spot from Hologic, the medical technology company. AdWeek wrote, quoting a Hologic press release, “As a leader in women’s health,

People around the world have made health a “proactive priority,” most important to live a longer, healthier life, to avoid preventable diseases, to protect against disease, and to look and feel healthier, according to NielsenIQ’s latest health and wellness report. As the triangle here illustrates, NielsenIQ has turned Maslow’s Hierarchy of Needs upside down, shifting protective and physical needs to the top rung and altruistic — the “me-to-we” ethos — at the base. Note the translations of these needs, on the ride, into the “care” flows — moving from urgent care down to self-care, preventive care, innovative care, and selfless

Members of his congregation kept going to the hospital with diet-related issues, Reverend Dr. Heber Brown, III, realized. “I got tired of praying and hoping they made it and walked out,” Reverend Brown realized. And then… “God gave us an idea and vision to be proactive on the issue of health in our congregation,” Rev. Brown explained to us yesterday on Day 2 of Real Chemistry’s Health Equity Summit. This was the seed for the Black Church Food Security Network, planting a pragmatic vision for health and well-being weaving together local food, civic empowerment, economic development, and faith. “We had

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

Compared with the rest of the developed world, people living in the U.S. may be concerned about income inequality, but their demand for income redistribution is the lowest among peer citizens living in 31 other OECD countries. In their  latest report, Does Inequality Matter? the OECD examines how people perceive economic disparities and social mobility across the OECD 32 (the world’s developed countries from “A” Australia to “U,” the United Kingdom). Overall the OECD 32 average fraction of people who believe it is the government’s responsibility to reduce income differences among those who think disparities are too large is 80%

“The pandemic has shown that effective health spending is an investment, not a cost to be contained: stronger, more resilient health systems protect both populations and economies,” the OECD states in the first paragraph of the organization’s perennially-updated report, Health at a Glance 2021. This version of the global report incorporates public health data from the “OECD35,” 35 nations from “A” to “U” (Australia to United States) quantifying excess deaths experienced during the COVID-19 pandemic, the obesity epidemic, mental and behavioral health burdens, and health care spending, among many other metrics. The first chart illustrates that calculation of excess deaths,

“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

Before the coronavirus emerged, the top causes of death in developed countries were heart disease, cancers, diabetes, and accidents. Then COVID-19 joined the top-10 list of killers in the U.S. and the issue of pandemic preparedness for the next “Disease X” became part of global public health planning. But the biggest health threat to human life is climate change, according to a new report from the World Health Organization titled The Health Argument for Climate Action. It’s WHO’s special report on climate change and health, dedicated to the memory of Ella Kissi-Debrah — a child who died succumbing to impacts

In 2020, Genentech launched its first study into health inequities. The company spelled out their rationale to undertake this research very clearly: “Through our work pursuing groundbreaking science and developing medicines for people with life-threatening diseases, we consistently witness an underrepresentation of non-white patients in clinical research. We have understood inequities and disproportionate enrollment in clinical trials existed, but nowhere could we find if patients of color had been directly asked: ‘why?’ So, we undertook a landmark study to elevate the perspectives of these medically disenfranchised individuals and reveal how this long-standing inequity impacts their relationships with the healthcare system

When Dignity Health, the Catholic health care system, launched the “Hello humankindness” PR campaign in June 2013, well, they had me at “Hello.” When the project went live, Dignity Health’s President/CEO Lloyd Dean provided the rationale for the program, saying: “What’s missing in the public discourse about health care is the fact that while medicine has the power to cure, it’s humanity that holds the power to heal.” Dean pointed to two drivers shaping U.S. culture and the nation’s health care industry: The institutionalization of health care, and, The decline of civility in society. That was 2013. #HelloHumankindness sought to

The COVID-19 pandemic exacerbated food insecurity in the U.S., a situation that was already challenging for millions of American families before the public health crisis emerged. While several Congressional and administrative actions were implemented in 2020 and the first half of 2021, the issue of food insecurity — defined as being unable to acquire enough food due to insufficient money or resources — remains a tragic aspect of daily living for many Americans — and especially for children who live in households where jobs have been lost and incomes reduced. Nutrition security has also been a health risk where people

“Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care,” begins the editorial introducing an entire issue of JAMA dedicated to racial and ethnic disparities and inequities in medicine and health care, published August 17, 2021. This is not your typical edition of the Journal of the American Medical Association. The coronavirus pandemic has changed so many aspects of American health care for so many people, including doctors. Since the second quarter of 2020,

“We don’t un-learn,” Dr. Amy Abernethy asserted as she shared her pandemic perspectives on a panel with 2 other former U.S. health policy and regulatory leaders. The three spoke about navigating compliance (think: regulations and reimbursement) in an uncertain world. An uncertain world is our workplace in the health/care ecosystem, globally, in this moment. So to give us some comfort in our collective foxhole, my last post for this week of immersion in #HIMSS21 is based on the keynote speech of Michael Dowling, CEO of Northwell Health. Dowling keynoted on the theme of “Leading for the Future,” sharing his lessons

The COVID-19 pandemic digitally transformed most people living in the U.S., re-shaping consumers to work from home when possible, go to school there, and buy all manners of goods and services via ecommerce. In March 2021, Zoom conducted research into the question, “how virtual do we want our future to be?” posing that to thousands of citizens living in 10 countries including the U.S. As the first chart from the study illustrates, most people in America expect hybrid lifestyles, from fitness and retail to entertainment and education. And 7 in 10 U.S. health citizens want their health care to be

Simply put, is the equation, “Spend more, get less” a sustainable business model? Of course not. But that’s the simple math on U.S. health care spending and what comes from it, according to Mirror, Mirror 2021: Reflecting Poorly, a perennial report from The Commonwealth Fund that compares health system performance across eleven developed countries. The first table details the metrics that the Fund compares across the eleven peer nations, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The metrics compared were access to care, care process, administrative efficiency, equity,

While women continue to outlive men in the U.S. in terms of life expectancy, the COVID-19 pandemic revealed continued healthcare access, physical and mental health disparities, and economic inequities for women in America. I addressed the changing state of post-pandemic women’s health in my latest contribution to the Medecision Liberation blog. This first graphic illustrates how women interacted with the U.S. health system during the pandemic in 2020. These data come from Kaiser Family Foundation’s women’s health survey conducted from the beginning of the pandemic starting March 1, 2020, and discovered that women in poorer or fair more likely went

As the COVID-19 pandemic shifts to a more endemic phase — becoming part of peoples’ everyday life for months to come — impacts on peoples’ mental health will persist, according to new research from CVS Health in the company’s annual Health Care Insights Study. CVS conducted the annual Health Care Insights Study among 1,000 U.S. adults in March 2021. To complement the consumer study, an additional survey was undertaken among 400 health care providers including primary care physicians and specialists, nurse practitioners, physician assistants, RNs and pharmacists. CVS has been tracking the growing trend of health care consumerism in the

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

COVID-19 reshaped people around the world, one-half of whom are re-defining their personal purpose and life-goals. This sense of purpose extends to peoples’ willingness to buy or patronize companies who do not meet their needs for health, safety, sustainability and trust. For example, two in three of these people would switch travel brands if they felt health and safety weren’t up to par, discovered in Life Reimagined – Mapping the motivations that matter for today’s consumers, from Accenture’s Voices of Change series. In May 2021, Accenture polled over 25,000 consumers globally, in 22 countries, and found that one-half of people

In 2020 in the U.S., 380,000 people are expected to die due to COVID-19. These people lost due to the coronavirus would, collectively, have lived another 5.5 million life-years would they not have succumbed to the virus. COVID-19 has cut lives short relative to their life expectancy, calculated in an analysis by the Pew Research Center based on CDC data from 2019 and 2020, coupled with additional statistics on life expectancy by age and gender. The bottom-line from the Pew Research Center’s analysis, simply stated, is that, “The pandemic…has killed many Americans who otherwise might have expected to live for

Wherever you live in the world touched by the coronavirus pandemic, you felt (and were) stress-tested. Both you were, and your home was as well. In this year’s 2021 annual report by Deloitte into Connectivity & Mobile Trends, their report details How the pandemic has stress-tested the crowded digital home. This analysis was done, as it is every year, by the Deloitte Center for Technology, Media & Telecommunications. Deloitte’s Center commissioned an online survey among 2,009 U.S. consumers to gauge five generations of peoples’ perspectives on connected life in the context of COVID. The report covers the various life-flows of

When a new technology or product starts to get used in a market, it follows a diffusion curve whose slope depends on the pace of adoption in that market. For telehealth, that S-curve has had a very long and fairly flat front-end of the “S” followed by a hockey stick trajectory in March and April 2020 as the COVID-19 pandemic was an exogenous shock to in-person health care delivery. The first chart from the CDC illustrates that dramatic growth in the use of telehealth ratcheting up since the first case of COVID-19 was diagnosed in the U.S. Virtual care has

The hearts and minds of nurses are fertile and inspirational sources and engines for health care innovation. This past weekend, and for the second time, I had the privilege and opportunity to be a panelist for the perennial hackathon meet-up of Nurse Hack 4 Health, sponsored by Microsoft, Johnson & Johnson, Sonsiel, and DevUp. This round, the hackathon attracted hundreds of nurses from at least 20 countries and 30 U.S. states. Even a few students attended, a growing trend as academia recognizes the shortage of workers trained to solve thorny problems of the world. In health care, right here, right

While the “in-person” visit to a doctor or medical professional continues to rank first as consumers’ most-trusted information source, the virtual doc or clinician rose in trust during the COVID-19 pandemic, according to Euromonitor’s latest read on Consumer Health: Changes in Consumer Behaviour during COVID-19 . The first four most-trusted sources for health information in 2021 remained the same short-list from 2020: doctors in-person, pharmacists, nutritionists and dieticians, and government or NGOs. But fifth place slipped from family and friends to the pharma industry, and sixth in line went to virtual doctors or medical professionals rising from 9th place in

In April 2020, the U.S. Centers for Disease Control issued a report featuring evidence that in the month of March 2020, the coronavirus pandemic was not an equal-opportunity killer. Within just a couple of months of COVID-19 emerging in America, it became clear that health disparities were evident in outcomes due to complications from the coronavirus. An update from that early look at differences in COVID-19 diagnoses and mortality rates was published in Health Disparities by Race and Ethnicity During the COVID-19 Pandemic: Current Evidence and Policy Approaches, In this report, the Assistant Secretary for Planning and Evaluation, part of

As the COVID-19 expanded peoples’ consciousness about infectious disease and opportunities to keep a tricky virus at bay, consumers grew new muscles about public and individual wellness…now, “more invested in achieving it,” according to In Health We Trust, a survey report from Healthline Media. To gauge Americans changing perspectives on personal health, HealthLine conducted surveys among 1,533 U.S. consumers age 18 and over in February 2020 (just about the time the coronavirus pandemic was emerging in the U.S.) and 1,577 consumers in December 2020. One of the subtle shifts in health care consumerism concerns cost, which before the pandemic has

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

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