A blog covering the health/care ecosystem and people.

Today as we appreciate the legacy of Martin Luther King, Jr., I post a photo of him in my hometown of Detroit in 1963, giving a preliminary version of the “I Have a Dream” speech he would deliver two months later in Washington, DC. Wisdom from the speech: “But now more than ever before, America is forced to grapple with this problem, for the shape of the world today does not afford us the luxury of an anemic democracy. The price that this nation must pay for the continued oppression and exploitation of the Negro or any other minority group is

Today is Day 1 of two Media Days at #CES2020 in Las Vegas, kicking off this manic week of the Consumer Electronics Show at the Mandalay Bay convention center. For several years, I’ve convened with journalists and industry analysts from around the world for these two days before the “official” opening of CES to hear the latest news from some of the largest tech-focused companies on Earth. Announcements come from across industry sector — from automotive and transportation, telecoms, consumer goods, entertainment, social media, travel, and retail…with platform technologies playing a role including but not limited to AI, AR/VR/XR (the

As Boomers age, they’re adopting mobile and smart technology platforms that enable people to communicate with loved ones, manage retirement investment portfolios, ask Alexa to play Frank Sinatra’s greatest hits, and manage prescription refills from the local grocery store pharmacy. Last week, the Giant Eagle grocery chain was the first pharmacy retailer to offer a new medication management skill via Alexa. That program has the potential to change our Medicare members manage meds at home to ensure better adherence, supporting better health outcomes and personal feelings of efficacy and control. [As an aside, consumers really value pharmacies embedded in grocery

Two separate and new OECD reports, updating health and the global economic outlook, raise two issues that are inter-related: that gains in longevity are stalling, with chronic illnesses and mental ill health affecting more people; and, as wealth grows more concentrated among the wealthy, the economic outlook around most of the world is also slowing. First, we’ll mine the Health at a Glance 2019 annual report covering data on population health, health system performance, and medical spending across OECD countries. The first chart arrays the x-y data points of life expectancy versus health spending for each of the OECD countries

“What’s the evidence on the role of the arts in improving health and well-being?” asks a report from the World Health Organization‘s Europe region team (WHO-Europe). There’s a lot of proof supporting arts-as-medicine, WHO details in this paper, which synthesizes research published in over 3,000 studies. The first chart illustrates the logic model that bridges arts to health in three segments: “Components” of arts programs, including but not limited to cognitive stimulation (e.g., learning a new arts skill such as painting, drawing or journaling), social interaction (e.g., participating in theatre), physical activity (e.g., dance), and evocation of emotion (e.g., listening

It was the best of times, It was the worst of times, It was the age of wisdom, it was the age of foolishness, It was the epoch of belief, it was the epoch of incredulity, … starts Dickens’ Tale of Two Cities.  That’s what came to my mind when reading the latest global health report from the OECD, Health at a Glance 2019, which compares the United States to other nations’ health care outcomes, risk factors, access metrics, and spending. Some trends are consistent across the wealthiest countries of the world, many sobering, such as: Life expectancy rates fell in 19 of the

Rising health care costs continue to concern most Americans, with one in two people believing they’re one sickness away from getting into financial trouble, according to the 2019 Survey of America’s Patients conducted for The Physicians Foundation. In addition to paying for “my” medical bills, most people in the U.S. also say that income inequality and inadequate social services significantly contribute to high medical spending for every health citizen in the nation. The Physicians Foundation conducts this study into Americans’ views on the U.S. health care system every other year. This year’s poll was conducted in September 2019 and included input

The market for caregiving is growing and the business community has, finally, begun to pay attention. The Washington Post referred to this market as a “gold rush” to design smart shoes, custom razors and technology for the “over-65 crowd.” Caregiving in the U.S., the seminal report from AARP, estimated that 43,5 million adults in the U.S. had provided unpaid care to an adult or child in the past year, about one in five people being caregivers. Over half of caregivers are women, and are about 49 years of age on average. Caregivers spent over 24 hours a week providing care go

SelfCare is health/care, particularly as patients, everyday people, take on greater responsibility for clinical decisions and paying for medical services. We’re convening today through Sunday in Indianapolis with GMDC, the Global Market Development Center and Retail Tomorrow to brainstorm the current and future prospects for SelfCare, health and wellness in the hands, hearts, and homes of consumers. To bolster the message and engage with industry stakeholders, GMDC collaborated with the Hamacher Resource Group to develop a SelfCare Roadmap, an interactive tool that provides insights into twelve conditions where consumers typically looking to DIY their health using over-the-counter medicines, supplies and

Based on the influx of research studies and position papers on social determinants of health flowing into my email box and Google Alerts, I can say we’re past the inflection point where SDoH is embraced by hospitals, professional societies, health plans and even a couple of pioneering pharma companies. PwC published a well-researched global-reaching report this week appropriately titled, Action required: The urgency of addressing social determinants of health. The “wheel of determinants” illustrates potential partners for collaborating in communities to address SDoH factors. The collaborators include governments, health care providers, payors, life science and pharma, tech and telecomms, policy

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

“Every company is a tech company,” Christopher Mimms asserted in the Wall Street Journal in December 2018. Connectivity, artificial intelligence, and automation are now competencies every company must master, Mimms explains. This ethos underpins Humana’s decision to join CTA, the Consumer Technology Association which hosts CES every January in Las Vegas. If you read this blog, you know one of the fastest-growing “aisles” at the annual conference is digital health. Humana joined up with CTA’s Health and Fitness Technology Division this month. Last year, Humana hired Heather Cox in the new post of Chief Digital Health and Analytics Officer, reporting directly

Over the past couple of weeks, Walmart is demonstrating its growing commitment to and leadership in healthcare and public health. The company’s announcement this week of pulling products that can be used in military-style weapons from its Outdoor Sports/Shooting department is a major move for public health that is something of a watershed that will impact well beyond the company’s inventory and stock price. This announcement will continue a trend among some thoughtful business leaders, like CEO Edward Stack of Dick’s Sporting Goods, banning gun sales from the retailer’s 125 stores in March 2019, who have begun to listen to

In 2020, large employers will be “doubling down” efforts to control health care costs. Key strategies will include deploying more telehealth and virtual health care services, Centers of Excellence for high-cost conditions, and getting more personal in communicating and engaging through platforms. This is the annual forecast for 2020 brought to us by the National Business Group of Health (NBGH), the Large Employers’ Health Care Strategy and Plan Design Survey. The 42-page report is packed with strategic and tactical data looking at the 2020 tea leaves for large employers, representing over 15 million covered lives. Nearly 150 companies were surveyed

Two in three Americans believe their trust in each other has been shrinking. And most people connect the dots between that low level of trust and America’s ability to solve problems. It’s been well-documented that Americans’ trust in institutions, and especially government and media, has eroded over the past decade. I’ve tracked that social trend here in Health Populi each year since covering the Edelman Trust Barometer, which has traced the downward sloping curve on trust globally and certainly in the U.S. The precipitous decline in trust in America among fellow Americans is described in Pew Research Gr0up’s report, Trust

There are about 55 million patient records held by the United Kingdom’s National Health Service (NHS). Their monetary value to private sector companies would be £5 billion and nearly that much in patient benefits. Add in value for patient outcomes, and the total approaches £10 billion. In today’s UK:US currency exchange rate, 10 billion British pound sterling is worth roughly $12 billion. Realising the Value of Healthcare Data from EY explores how patient data can, in the words of the report, “unlock significant operational savings, enhanced patient outcomes, and wider economic benefits” for the NHS and patients through using artificial

There’s been a “clear lack of progress on health equity during the past 25 years in the United States,” asserts a data-rich analysis of trends conducted by two professors/researchers from UCLA’s School of Public Health. The study was published this week in JAMA Network Open. The research mashed up several measures of health equity covering the 25 years from 1993 through 2017. The data came out of the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System looking at trends by race/ethnicity, sex and income across three categories for U.S. adults between 18 and 64 years of age.

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

In reading the July/August issue of Eating Well magazine this week, I came across this ad which I scanned for you to see yourself: “We believe in food as medicine.” Signed, Kroger Health. Here’s the introductory text in the full-page ad: “As Kroger Health, our vision is to help people live healthier lives. And now, more than ever, through our experts, innovation, and technology, we’re uniquely positioned to bring that vision to life,” the copy read. “We know food,” the text continued, as part of The Kroger Co. which is the largest grocery chain in the U.S. celebrating 135 years

Food insecurity ranks high on Americans’ greatest social health risks. In local communities, grocery stores are playing key roles in bolstering neighborhood wellness. Publix and other food chains, collaborating with the Produce for Kids program, are walking the talk on nutrition for local health citizens. Produce for Kids is associated with Feeding America, which works with local food banks and non-profits to help channel healthy food to children and families. Feeding America is a national network of over 200 food banks fighting hunger in America, serving over 46 million people and 60,000 food pantries, and advocating for legislation that addresses

“How should we define ‘health?'” a 2011 BMJ article asked. The context for the question was that the 1948 World Health Organization definition of health — that health is, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”– was not so useful in the 21st century. The authors, a global, multidisciplinary team from Europe, Canada and the U.S., asserted that by 2011, human health was marked less by infectious disease and more by non-communicable conditions that could be highly influenced, reversed and prevented through self-care by the individual and public health policy

Enlightened health/care industry and public policy stakeholders have begun to embrace and address social determinants of health. These are the inputs that bolster health beyond health care services: they include economic stability like job security and income level (and equity), education, and access to healthy food, food security, safe neighborhoods, social support, clean environments (water and air), and in my own update on SDoH factors, access to broadband connectivity. As physician leaders in the AMA, technology advocates from AMIA, and numerous health plans focus efforts on strengthening social determinants, what do people – consumers, patients, caregivers — think about these

People who are in poor health or use more health care services are more likely to report multiple unmet social needs, such as food insecurity, unsafe neighborhoods, lack of good housing, social isolation, and poor transportation access, found through a survey conducted by McKinsey. The results are summarized in Addressing the Social Determinants of Health. The growing recognition of the influence of social determinants reached a tipping point last week with the news that Kaiser-Permanente would work with Unite US to scale services to people who need them. The mainstreaming of SDoH speaks to the awareness that health is made

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. As a response, the Chairman of the House Budget Committee in the U.S. Congress, Rep. John Yarmuth (D-Ky.), asked the Congressional Budget Office (CBO) to develop a report outlining definitions and concepts for a single-payer health care system in the U.S.         The result of this ask is the report, Key Design Components and Considerations for Establishing a Single-Payer Health Care System, published on 1st May by the CBO. The report provides

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

As patients now assume the role of health consumer, they rationally expect retail-level experiences with greater first-dollar payment for health insurance, health care services and medical products like prescription drugs. Consumers know what good retail looks and feels like, and are focusing that experiential lens on health care, Aflac found when their Workforces Survey polled Americans on their desirable health insurance shopping experience. One in two people said it should feel, “like Amazon,” and another 20% of folks said, “like retail.” Chapter 3 of HealthConsuming is titled, “How Amazon Has Primed Health Consumers,” and explains this re-shaping of patient expectations.

We are all Homo informaticus these days, multi-channel, multi-platform beings using digital platforms. “Computing is not about computers anymore. It is about living,” Nicholas Negroponte wrote in Being Digital. He said that in 1995. In that quarter-century since Negroponte made that prescient observation, we come to better understand that being a Digital Society has its upsides and downfalls, alike. We need a “new needs model” for the digital age, asserts a new report, Human Needs in a Digital World, the 2019 Digital Society Index report from the Dentsu Aegis network. Taking Maslow’s Hierarchy of Needs as a basic construct, the Index

As more mobile app users — consumers, patients, and caregivers — use these handy digital health tools, much of the data we share can be re-identified and monetized by third parties well beyond those we believe we’re sharing with. This compromised health data privacy scenario comes out of research published this month in the BMJ, Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis. The researchers, faculty from the University of Toronto (Canada) and the University of Sydney (Australia), come from nursing, pharmacy, and computer science expertise — a sound combination of disciplines

Medical costs in America are still the top contributor to personal bankruptcy in the U.S., a risk factor in two-thirds of bankruptcies filed between 2013 and 2016. That’s a sad fiscal fact, especially as more Americans gained access to health insurance under the Affordable Care Act, according to a study published this month in the American Journal of Public Health (AJPA). Between 2013 and 2016, about 530,000 bankruptcies were filed among U.S. families each year associated with medical reasons, illustrated in Table 1 from the study. The report, Medical Bankruptcy: Still Common Despite the Affordable Care Act, updates research from 2007 which

“The Fourth Industrial Age,” Dr. Abraham Verghese writes, “has great potential to help, but also to harm, to exaggerate the profound gap that already exists between those who have much and those who have less each passing year.” Dr. Verghese asserts this in his forward to Deep Medicine, Dr. Eric Topol’s latest work which explores the promise of artificial intelligence (AI), Big Data, and robotics — three legs of the Fourth Industrial Age stool. [If you don’t know the work of Dr. Verghese, and since you’re reading the Health Populi blog, you must get to know Dr. V now. Your

In America, one in three people over 50 years of age feels a lack of companionship, and one-fourth feel isolated from other people, according to a new poll on loneliness and aging from the University of Michigan, sponsored by AARP. The University of Michigan National Poll on Healthy Aging surveyed some 2,000 U.S. adults age 50–80 in October 2018, assessing older peoples’ health, health behaviors, experiences and feelings related to companionship and social isolation. While three in four people have frequent social contact with family, friends and neighbors outside of their home, the remaining one in four have social contact once a

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

Consumers put food front-and-center when thinking about their health. Viewing food-as-medicine is going mainstream for health consumers, who look beyond the “medicine” in that phrase toward a broader concept of personal well-being. This is the theme of a new report from the FMI Foundation called The Power of Health and Well-Being in Food Retail. The report’s insights are based on surveys FMI has conducted over the past two years, as the Foundation has observed that consumers broadening their definition of health to include emotional health, energy levels, and sleep quality. The consumer-as-medical-bill-payor is now looking at foods with health benefits, first

To succeed in the business of health information technology (HIT), a company has to be very clear on the problems it’s trying to address. Now that EHRs are well-adopted in physicians’ practices and hospitals, patient data have gone digital, and can be aggregated and mined for better diagnosis, treatment, and intelligent decision making. There’s surely lots of data to mine. And there are also lots of opportunities to design tools that aren’t very useful for the core problems we need to solve, for the clinicians on the front-lines trying to solve them, and for the patients and people  whom we

Health begins at home. I found evidence for that, beyond my own N of 1 understanding, in a research article published in the UK in 2000 by Lyn Harrison and Frances Heywood. Lyn and Frances tested three assumptions that they believed linked housing and health: that housing contributes to health; that housing is not routinely included in health or social planning;’ and that the potential contribution of primary care is wasted. Their conclusion: that the housing-health link was not receiving the recognition that connection needs. Nearly two decades later, that housing-health link still isn’t universally embraced by health care stakeholders. But

As #CES2019 kicks off in Las Vegas with today’s first Media Day, the Consumer Technology Association presented its forecast on the 5 Technology Trends to Watch in 2019 — and they all play into health, wellness, and medical care. The five trends are: Artificial Intelligence on the Rise Envisioning the Smart Home of the Future Digital Health Tech Empowers Patients Esports and Sports Technology, and Smart Cities Promote Resilience. Here are how these five mega-trends can bolster our health and healthcare products and services over the next decade. AI is indeed on-the-rise in healthcare: as I have begun planning my agenda for

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

In the U.S., the highest levels of unemployment are in places that often have the lowest access to broadband connectivity. And, “without a proper broadband connection, these communities can’t start or run a modern business, access telemedicine, take an online class, digitally transform their farm, or research a school project online,” Microsoft President Brad Smith said yesterday as the company announced their continued commitment to expanding broadband in rural America. Microsoft is expanding a program the company launched last year to address the rural broadband gap in the U.S. The Airband Initiative is working from Northwest Georgia to South Africa to bolster

How long can people living in the U.S. expect to live? 78.6 years of age, if you were born in 2017. That’s a decline of 0.1 year from 2016. This decline especially impacted baby boys: their life expectancy fell to 76.1 years, while baby girls’ life expectancy stayed even at 81.1 years. That’s the latest data on Mortality in the United States, 2017, soberly brought to you by the Centers for Disease Control and Prevention, part of the U.S. Department of Health and Human Services. Underneath these stark numbers are the specific causes of death: in 2017, more Americans died

Organizations that address consumers’ data privacy and access to healthcare create greater social brand equity, inspiring people to say nice things about the companies, recommend them as good employers, and be welcomed as businesses operating in peoples’ community. In The Societal ROI Index: A Measure for The Times We Find Ourselves In, Finn Partners and The Harris Poll measure U.S. companies’ reputations for social good, the project’s press release explains. “Our new data shows that the public has a definite opinion about what issues they feel companies should address and the social impact bar has been set high,” according to Amy Terpeluk,

Most patients wish their doctors would have a conversation with them about non-medical issues. The Doctor-Patient Conversation, a survey conducted for the Samueli Foundation by the Harris Poll, examined how patients feel about their health, healthcare, and relationships with physicians. The Samueli Institute, has several missions including integrative health with a focuses on evidence-based practices for healing, wellbeing and resilience. Patients are keen to learn about non-medication alternatives, like food-as-medicine, meditation, and acupuncture. But most doctors base their conversations with patients on purely medical options like lab test results and surgical procedures. The top issues doctors discuss with patients are

“Happiness is within, but not within you alone as it is among us. If we can create happiness in a community, then we will be able to attain happiness as individuals,” observed Saamdu Chetri speaking at the International Psychological Congress last week. Chetri is head of Bhutan’s Gross National Happiness Centre, which developed the Gross National Happiness Index. The phrase “Gross National Happiness” was first mentioned in 1972 by the 4th King of Bhutan, King Jigme Singye Wangchuck in an interview with the Financial Times. King Wangchuck said that, “Gross National Happiness is more important than Gross Domestic Product.” The GNH

Food deserts aren’t just a U.S. phenomenon. They’re found all around the world. This week as I explore social determinants of health and technology solutions in several parts of Europe, I’ve learned more about food access challenges in the UK. These are discussed in a report published this month by the Social Market Foundation asking, What are the barriers to eating healthily in the UK?  The research was supported by Kellogg’s, the food manufacturer. The first table comes from the report, and the topline shows that about 4 in 10 Britons shopped at a cheaper food store in response to high

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

Obesity, diabesity, food deserts and food swamps co-exist across America, factors that cost the U.S. economy over $327 billion a year just in the costs of diagnosed diabetes. In addition, America’s overweight and obesity epidemic results in lost worker productivity, mental health and sleep challenges, and lower quality of life for millions of Americans. Food — healthy, accessible, fairly-priced — is a key social determinant of individual health, wellness, and a public’s ability to pursue happiness. There’s a lot the U.S. can learn from the food culture, policy and economy of Italy when it comes to health. This week, I have the

The saving rate in the U.S. ranks among the lowest in the world, in a country that rates among the richest nations. So imagine how well Americans save for healthcare? “Consumers are not disciplined about saving in general,” with saving for healthcare lagging behind other types of savings, Alegeus observes in the 2018 Alegeus Consumer Health & Financial Fluency Report. Alegeus surveyed 1,400 U.S. healthcare consumers in September 2017 to gauge peoples’ views on healthcare finances, insurance, and levels of fluency. As patients continue to take on more financial responsibility for healthcare spending in the U.S., they are struggling with finances and

Patients are the new healthcare payors, and as such, taking on the role of health consumers. In fact, health and wellness consumers have existed since a person purchased the first toothpaste, aspirin, heating pad, and moisturizing cream at retail. Or consulted with their neighborhood herbalista, homeopathic practitioner, therapeutic masseuse, or skin aesthetician. Today, the health and wellness consumer can DIY all of these things at home through a huge array of products available in pharmacies, supermarkets, Big Box stores, cosmetic superstores, convenience and dollar stores, and other retail channels – increasingly, online (THINK, of course, of Amazon — more on

Pre-existing conditions impact Americans north, south, east and west, the Kaiser Family Foundation maps. But those maladies aren’t evenly distributed across the U.S.: the highest incidences of people with pre-existing conditions are generally dotted in the eastern half of the U.S., in diverse metropolitan areas. This study looks at non-elderly adults, people between 18 and 64 years of age. That is, working-age U.S. adults who would be prospects for private health insurance coverage, whether through employers or on the individual insurance market. A striking aspect of this map is that one metro that has a higher rate of people with