Connect with us

Health

Postpartum mental health visits 30% higher during COVID-19 pandemic

Published

on

Mental health surveys of young mothers during the COVID-19 pandemic were 30% higher than before the pandemic, especially in the first 3 months after giving birth, a new study in the CMAJ (Canadian Medical Association Journal) found. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210151

“In March 2020, increased attendance rates began, although the state of emergency was only declared in the middle of the month, which suggests that the distress caused by the pandemic very quickly led to an increased need for care,” writes Dr. Simone Vigod, Chief Psychiatrist, Senior Scientist and Interim Vice President of Academics at Women’s College Hospital (WCH) and Senior Adjunct Scientist at ICES in Toronto, Ontario, with co-authors.

Postpartum mental illness affects up to 1 in 5 mothers and, if chronic, can have long-term effects on children and families.

The researchers examined the visits of 137,609 people to Ontario during the postpartum period (from date of birth to 365 days after) from March to November 2020 and collected data on age, number of children, neighborhood income based on zip codes, ethnic neighborhood diversity, and area of ​​residence based on the 34 provincial public health facilities. They also divided the province into northern and southern public health units.

During the study period, visits to general practitioners and psychiatrists were more frequent than before the pandemic, especially to parents with anxiety, depression, and alcohol and substance use disorders. People living in public health facilities in the north saw a relatively small increase after July 2020, possibly due to fewer COVID-19 restrictions in these areas recently.

Care during the pandemic period differed from the time before: 84.8% of postpartum psychiatric visits were carried out virtually in April 2020, compared with only 3.1% of visits during the prepandemic period.

The authors suggest that increased use of virtual care may have removed barriers to postpartum psychological care, such as: For example, the need to travel, find childcare for older children, or manage irregular schedules so that more people can receive care.

Patients in the neighborhoods with the lowest incomes had the smallest increase in mental health visits compared to people in other neighborhoods, which the authors were surprised to find.

“This is a cause for concern about the potential for unmet need as low-income patients may face greater barriers to accessing health care, including difficulty in affording the technology or finding private space for virtual appointments (e.g. crowded homes) or fewer opportunities to attend “live” appointments because of employment in front-line jobs, “the authors write.

They recommend targeted approaches to mental health support.

“Health systems should proactively focus on patients in high-risk groups, monitor waiting lists for care, and explore creative solutions to expand system capacity, with particular attention to postpartum patients who may face care obstacles,” they advise.

###

“Postpartum Mental Illnesses During the COVID-19 Pandemic: A Population-Based Repeated Cross-Sectional Study” will be released on June 7, 2021.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of press releases sent to EurekAlert! by contributing institutions or for the use of information via the EurekAlert system.

Health

As COVID-19 comes under control, it could become just another common illness, health officials say

Published

on

The future of COVID-19 could look very similar to seasonal flu or other common illnesses like measles or pneumonia, the British Columbia Provincial Assistant Health Officer says.

Dr. Reka Gustafson said it was hard to speculate on the longevity of COVID-19, but public health officials are preparing to switch to more typical communicable disease management based on the characteristics and behavior of the coronavirus that causes the disease , based.

“We would certainly not be surprised if this virus develops into one of the coronaviruses circulating in the population. That would be our best choice at the moment, ”she said in an interview.

BC entered the second phase of its reopening plan on Tuesday after surpassing target rates for first-dose vaccinations amid a sharp decline in new cases. Further restrictions are due to be lifted on July 1, and the fourth and final stage of the reopening plan is due to take effect on September 7, if this path continues.

For the public, life should revert to pre-pandemic interaction norms in September if all goes as planned, Gustafson said, adding that she thought the plan was “very cautious and sensible”.

Behind the scenes, public health officials expect a shift away from emergency pandemic management towards communicable disease control, she said.

But even if a more routine strategy replaces the all-hands-on-deck approach, Gustafson said it will include many of the same tools: testing, monitoring, case and contact management, and vaccination strategies.

“These are actually things that go on behind the scenes with a number of communicable diseases in the population,” she said.

Reka Gustafson, Assistant BC Provincial Health Officer, in Vancouver on February 19. “We can definitely see when … if you respond, we’ll change the vaccine as needed,” she said of COVID-19. (Ben Nelms / CBC)

Future outbreaks possible but manageable

As part of communicable disease control, local officials monitor reportable diseases for trends and respond to typically isolated outbreaks.

An example from Gustafson’s experience is a major pneumonia outbreak in Vancouver’s Downtown Eastside in 2006. Public health teams have brought the infections under control with detailed epidemiological studies and vaccination clinics, she said.

The difference between this outbreak and the pandemic was the vulnerability of the entire population to COVID-19 before vaccines were available and how little was known about the behavior of the new coronavirus early on, meaning that “the size of the outbreak had the potential to be huge of course, ” she said.

A medical lab technician tests COVID-19 samples in the BC Center for Disease Control laboratory in Vancouver in May. (Ben Nelms / CBC)

With the majority of Canadians expected to have received two doses of the vaccine by the end of the summer, scientists have a base to monitor changes in the virus over the next season, Gustafson said.

“We can definitely see the time when we are not treating COVID-19 as a global emergency because everyone is vulnerable, but like with other communicable diseases, we will monitor it, we will protect ourselves from local resurgence. we will respond to that and change the vaccine as needed. ”

The need for boosters could evolve with the virus

Health officials are also ready to adjust their response as they learn more about the virus’s behavior and levels of immunity in the population over time, she said. This happened with the measles, where second doses of vaccine were only introduced after they were identified as necessary for long-term protection, Gustafson said.

Depending on how COVID-19 plays out, that could mean vaccines reformulated every year like the seasonal flu shot, or refreshments required every five or ten years, she said.

There may also be a possible resurgence, but they shouldn’t be comparable to last year’s outbreaks, she said.

“It’s a very, very different context. It’s not the same as the pandemic because the pandemic requires everyone to be vulnerable at the same time, and we don’t expect this to be a state to return to. “

Of course, another pandemic is always possible as virologists monitor for new viruses. But the proven effectiveness of vaccines against COVID-19 is a “very powerful tool,” said Gustafson.

She said she couldn’t predict when the move to communicable disease control would come.

Last week, the Yukon Chief Medical Health Officer also said it was difficult to predict the end of the pandemic, but he doesn’t think the disease will go away on its own.

“We are definitely well positioned for future openings and the ability to live our lives close to normal, but COVID will definitely become a part of our lives,” said Dr. Brendan Hanley.

Hanley said he anticipated booster vaccinations similar to the flu vaccine, but added that it was too early to be sure as it will take time to determine how long the current vaccines will stay effective, how new variants will react, and which ones new vaccines are developed.

“[There’s] a lot to know and learn, especially as new variants come onto the market and also new vaccines and new studies. ”

Continue Reading

Health

Prescriptions alone cost us $5,000 a month: How the health care system fails working Americans

Published

on

In 2018, my 49-year-old husband, Mike, was diagnosed with ankylosing spondylitis: a degenerative, progressive, and incurable disease. Over the course of three years, he had over 50 doctor’s appointments and two hospital stays; he also had to give up his 30-year career in the hotel industry.

I have spent my career researching and writing books on topics that affect workers’ economic security, researching everything from discrimination to inequalities in retirement.

But until my husband’s medical problems, I was unprepared for the systemic dysfunctions and injustices of the American healthcare system.

This journey – both as a patient’s wife and as a sociologist – opened my eyes to the fact that all too often our health insurance system abandons those who work but are sick.


In my view, these days when you have serious medical bills you have three options: work sick to get your health insurance, go broke, or hope for a viral social media campaign.

Overstrained by the health system

Mike and I are one of the “lucky” group of Generation X members with a chronic illness. We have relatively good health insurance through my university. We have access to top doctors and medical facilities in New York City. As a university professor, I have some flexibility to help us with the many doctor’s appointments and care. And we’ve had some savings to cushion the huge expense that runs into the thousands.

Despite these privileges, the past few years have been overwhelming for us.

Mike’s illness made it impossible for him to continue working. We had to learn to navigate the complex social security disability system to apply for disability insurance and Medicare, a process that has taken us years.

See: Get ready – you need $ 300,000 to pay for retirement health care

During that time, without access to my health insurance, he would have had to either get health insurance on the market (something that can use up your savings quickly) or forego it. With over $ 5,000 a month in prescriptions, insurance is a must.

Many of us with private insurance are grateful for our insurance – as long as we have it. However, there is always a concern that we might lose it. Businesses are shrinking, spouses subject to compulsory insurance may die, and workers are getting sick.

This connection between work and health insurance may seem natural at this point, but it is a direct result of decades of federal policy.

Why health insurance and jobs are related

The growth in employer-funded health insurance can be traced directly back to World War II, when the Stabilization Act of 1942 was passed. It froze federal workers’ wages to address inflation concerns and in response employers used health insurance as a recruiting tool to address labor shortages.

Today health costs have risen faster than wages, making it difficult for employers and workers to maintain the current system.

The reality is that our employment and health systems are inadequate for workers who are stricken with illness in their prime at work.

Even those with health insurance find that the insurance cover is insufficient in the event of a serious illness and the expenses can be exorbitant. Deductibles, co-payments, and prescriptions can run into the tens of thousands.

See: Food or medication? The dangerous decision many seniors have to make

And navigating the health insurance itself is a challenge. After a syncope (faint or faint), Mike was taken to a hospital where the doctors do not work with our health insurance. We then received surprisingly high medical bills from several providers who treated him.

For over a year we had non-stop correspondence with our insurance and medical billing companies to clear these bills, but they continued to arrive in our mailbox (although New Jersey, where we live, has a law prohibiting them).

Medical bills can lead to economic ruin

Many middle-aged Americans are only an illness or accident away from economic ruin.

Generation X members, between 40 and 50, are generally more financially insecure than boomers at this stage in life. A 2020 study by University College London found that while Generation X will live longer than their boomer counterparts, they face more years of illness, with chronic illness starting earlier in life.

It is therefore not surprising that 1 in 3 crowdfunding campaigns by GoFundMe is supposed to pay for the medical costs of the uninsured and underinsured. There are over 250,000 such medical campaigns annually, grossing $ 650 million.

In my view, these days when you have serious medical bills you have three options: work sick to get your health insurance, go broke, or hope for a viral social media campaign.

The biggest threat to your health is losing your health insurance, and the pandemic has only added to that uncertainty. A report from the Urban Institute estimates that 10 million Americans lost their health insurance as a result of the COVID-19 pandemic.

How to fix the current system

I think the time has come to decouple access to health care from employment. That way, anyone could get the care they need, regardless of employment, marriage, a pandemic, or other factors.

How? The US could provide universal and expanded Medicare for All.

There are many models around the world that demonstrate the effectiveness of this type of health insurance – from countries with single payer health insurance such as Canada and France to other countries with a mix of public and private insurance.

The results are clear: Compared to our international comparison countries, our health insurance system is consistently more expensive and has poorer health outcomes for the individual.

Meanwhile, Americans face the highest medical debt and bankruptcies compared to citizens of any other country because of healthcare costs. We are third in the world for medical bankruptcies, only behind China and India.

And the progressive Economic Policy Institute determined that Medicare for All would have a positive impact on our labor market that would benefit workers and employers.

A little step forward from Washington, DC

On the positive side, there has been some progress in health at the national level.

The American bailout plan, enacted by President Joe Biden, lowers health care costs by expanding the subsidies and tax credits of the Affordable Care Act.

And Senate Democrats recently tabled a bill to reduce the age for Medicare eligibility from 65 to 50 – signaling the importance of expanded access to health care. Bringing the Medicare age down is certainly a step in the right direction, but if my experience has taught me anything, it is that we have to completely separate healthcare from work and only one Medicare For All plan will to reach.

connected: How to Pay for Healthcare Expenses in Retirement

Mike’s diagnosis made me realize that a system based on work-subsidized health insurance is pretty shaky. Until we have real Medicare-for-all, it is conceivable that the dreaded diagnosis that may come your way is not that you are short of living, but that you are too sick to work and not to die sick enough.

Mary Gatta is Associate Professor of Sociology at the City University of New York and a member of the Scholars Strategy Network.

This article reprinted with permission from NextAvenue.org, © 2021 Twin Cities Public Television, Inc. All rights reserved.

More from Next Avenue:

Continue Reading

Health

Permitless carry and mental health in Texas – State of Reform

Published

on

Texas died recently invoice Permit the unlicensed carrying of firearms national headlines when it passed its second chamber last month, causing an outcry from people who were concerned about endanger the public. Public safety aside, some opponents of the bill say the soon-to-be legalized “constitutional transfer” initiative could already make the situation of many Texans worse deteriorating mental health.

Get the latest country-specific health policy information in your inbox.

Have public polls shown that a majority of Texans are against allowing unlicensed transportation in the state, but their state officials still pursued the initiative. After passing through both chambers last month, the law is awaiting final approval from Governor Greg Abbott – the announced in April he wants to sign the law.

A 2020 study by Stanford Medicine showed that possession of handguns significantly increased the likelihood of suicide. As COVID-19 further exacerbates mental health issues – and potential suicidality – Texans with mental illness will have easier access to firearms with HB 1927.

According to Greg Hansch, executive director of the National Alliance for Mental Illness (NAMI) Texas, suicide rates in Texas have increased 36% since 2000.

“NAMI Texas is primarily concerned about access to lethal resources and the associated increase in suicide rates for those experiencing mental health problems. … Every two hours someone dies by suicide. Suicide is the second leading cause of death for people between the ages of 15 and 34. “

Hansch believes the no-permit law will only exacerbate the pandemic-induced mental health problems Texans face.

“When there are fewer restrictions on gun ownership, people may be more inclined to buy a gun. More guns in more hands can mean people with mental health problems have more access. It is also possible that people who buy guns due to the easing of restrictions do not practice safe storage, which in turn makes them easier to access. “

The National Rifle Association (NRA) – a strong supporter of the law – expressed its support last month in a statement from Jason Ouimet, president of the NRA Institute for Legislative Action:

“A right that requires you to pay a tax or obtain a government permit is not a right at all, so the NRA prides itself on having worked closely with leaders and lawmakers to bring about the most significant pro-second change in to say goodbye to the history of Texas. Our members have worked tirelessly to provide vital grassroots support to bring constitutional implications to life and restore the rights of law-abiding Texans. “

Larry James, CEO emeritus of CitySquare, an organization committed to reducing poverty, says this improved access to weapons will do further harm to impoverished Texans struggling with mental health.

“All of the bad things that and could happen with guns are just magnified by this ridiculous legislation. And that in turn will … exacerbate the social, psychological and behavioral health effects of the proliferation of firearms. “

He condemned the legislature’s refusal to increase funding for mental health initiatives in the state.

“We have a mass shooting here in this country every day. And so absolutely it will have an effect. And the same people who [agree with] That doesn’t give you a hearing to talk about the increase in Medicaid dollars for mental health services. “

Along with a possible increase in suicides, the new law came into being at a time of unprecedented mass shootings. The US saw over 200 mass shootings alone in 2021. According to Statista, Texas has the third highest number of mass shootings in the country since 1982.

Texas has fully reopened stores and facilities 3 March. About a third The state is fully vaccinated, which means more people are likely to be willing to go public in the summer. The convergence of increasingly crowded public spaces and a new law allowing easy access to firearms – both of which are occurring as mass shootings increase – raises fears of increased gun violence, says James.

A 2019 survey by the American Psychological Association on the Link between Stress and Mass Shootings showed that 79% of US adults experience stress due to the possibility of a mass shooting. A third of respondents said fear of mass shootings prevented them from visiting certain places. 62% of parents said they lived in fear that their children would be the victims of a mass shooting.

Continue Reading
Advertisement

Trending