Stay ConnectedThe Dose is the Commonwealth Fund’s podcast that presents fresh ideas, new perspectives, and compelling conversations about where health care is headed. Join host Joel Bervell this season for conversations with leading and emerging experts in health care and health policy.
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Yes, the planet is getting hotter, tropical storms are becoming ever more fierce, and the Arctic is melting — but what’s that got to do with health care? This week on The Dose podcast, host Joel Bervell explores the intersection of climate change and public health with Admiral Rachel L. Levine, M.D., the U.S. Assistant Secretary for Health. Levine, who oversees the federal Office of Climate Change and Health Equity, talks about how weather-related events are already having a serious impact on our fragile health system supply chain, even though those effects can go unnoticed by the broader public. In communities repeatedly ravaged by storms or heat waves, a lack of blood donations is leading to delays in surgeries and treatment for diseases like sickle cell. In rural Alaska, where the melting permafrost is wreaking havoc on wildlife populations, native tribal communities are forced to rely on shipments of food items that are typically high in sugar and salt — a diet contributing to rising rates of hypertension, diabetes, and heart disease.
“Climate change is the most significant threat to human health in the 21st century, and climate change is having those serious impacts on health right now,” says Levine.
As climate change intensifies and New Yorkers face record-breaking heat, the city is taking new measures to protect residents’ health. Landlords will soon have to provide air conditioning to tenants, school bus fleets are going electric, and efforts are underway to make housing more affordable.
Cameron Clarke of WE ACT for Environmental Justice is on the front lines of the push to build a healthier New York City. One recent initiative focused on developing an asthma policy agenda.
“We wanted to talk about housing, transportation, education, and the actual landscape of the built environment and craft a policy agenda that connects all of these different things to environmental justice — all through the lens of asthma,” Clarke explains.
On this episode of The Dose podcast, recorded during Climate Week NYC in September, host Joel Bervell talks to Clarke about advancing health and environmental justice in New York and providing people with the tools they need to navigate a complex health system.
Evidence of a mental health crisis is everywhere — from the recent surgeon general advisory about social media’s effects on our youth to the pandemic’s documented impact on medical professionals. To whom does a college student turn for help so far from home? And who cares for the mental health of those caring for us?
Enter Dr. Jessi Gold, a psychiatrist and the University of Tennessee’s first chief wellness officer, who aims to change the way student mental health is addressed on campus. She favors an open, flexible approach to helping students find the kind of help that’s right for them. Off campus, Dr. Gold has been conducting research into the overlooked mental health needs of our medical professionals.
On this episode of The Dose podcast, host Joel Bervell talks with Dr. Gold about the systemic changes needed to support mental wellness across our college campuses and the entire ecosystem of medical professionals.
Moving the needle on health care access and health disparities is no easy task. Inequities for people of color are embedded in the U.S. health system, shaping their health care journeys and often leading to outcomes worse than those experienced by white Americans.
That’s where Dr. Chris Pernell, director of NAACP’s Center for Health Equity, comes in. “Sometimes you got to make those systems bend, and other times you got to disrupt those systems, innovate and invent, and create and design.”
In this episode of The Dose podcast, host Joel Bervell talks to Dr. Pernell about her work on health equity, the systems that need to be disrupted, and the innovations needed to build a more inclusive health system.
In this special two-part edition of The Dose, we’re bringing listeners along to an exhilarating gathering of health care’s most innovative thinkers and changemakers — Aspen Ideas: Health. In part 2, host Joel Bervell talks to two people who are reshaping how we think about community health: Mary Oxendine, a Lumbee and Tuscarora woman and the former North Carolina Food Security Coordinator at Durham County; and Shameca Brown, a mental health provider and advocate for Black and brown people in Tulsa, Oklahoma, and former member of the Mental Health Association of Oklahoma’s board of directors.
In this special, two-part edition of The Dose, we’re bringing listeners along to an exhilarating gathering of health care’s most innovative thinkers and changemakers—Aspen Ideas: Health. In part 1, host Joel Bervell speaks with two people dedicated to supporting communities that have been excluded from our health care system: Lola Adedokun, executive director of the Aspen Global Innovative Group at the Aspen Institute and leader of the Healthy Communities Fellowship; and Elizabeth Lutz, executive director of The Health Collaborative in San Antonio, Texas.
This month, a 12-year-old boy in Washington, D.C., became the first person in the world to undergo a grueling gene therapy treatment that could cure his sickle cell disease. It is a game-changer for a disease whose history has been plagued by the racism baked into our health care system.
On The Dose podcast, host Joel Bervell sits down with Dr. Cece Calhoun, a leading adolescent sickle cell specialist from Yale University. The two dive into what it means to be a young Black person in America with the disease; why it took nearly 100 years for us to get to this point; and how health inequities continue to pose life-and-death challenges for sickle cell patients.
In Dr. Joseph Betancourt’s vision for the future of U.S. health care, “any patient who goes to any health care system around the country should get the highest quality of care, no matter who they are or where they’re from.” As the Commonwealth Fund’s new president, he’s tackling some of the biggest challenges facing the U.S. health system while trying to ensure equity is embedded in health care policy, coverage, technology, and practice.
Join Joel Bervell, host of The Dose podcast, for a wide-ranging conversation with Betancourt about AI and health care, America’s primary care crisis, and what the corporatization of health care means for doctors and patients.
As a physician, researcher, and educator, Dr. Cheryl R. Clark wants her students to understand what vision, love, and equity can bring to health care if we prioritize them — and why she believes doing so is critical to advancing health equity.
In the latest episode of The Dose podcast, host Joel Bervell talks with Clark about how she brings health equity to life, taking medical residents to Mississippi to break bread with the Civil Rights leaders who founded community health centers. They also discuss her work at the forefront of emancipatory research to connect the dots between academics, clinicians, and communities’ lived experiences.
In medical school, students learning about illness, pathology, and disease are trained almost exclusively on images of white patients. Even materials on illnesses that predominantly affect Black people, like sickle cell disease, and textbooks used in medical schools in countries where most people are Black, are filled with illustrations of white bodies and white skin. This leaves doctors underprepared to care for Black patients.
For Nigerian medical student and illustrator Chidiebere Ibe, accurate representation is a starting point for health care equity. Ibe has founded Illustrate Change, the world's largest open-source digital library of medical illustrations featuring people of color.
In the newest episode of The Dose podcast, host Joel Bervell talks to Ibe about his efforts to make inclusive imagery widely accessible — a critical step toward building health systems that can provide Black patients with the care they deserve. This is the third episode in a new series of conversations with leaders at the forefront of health equity.
Montgomery, Alabama’s capital, is known as the birthplace of gynecology. It’s a brutal history, as the field’s “founding father,” J. Marion Sims, advanced his work through the experimentation on enslaved women and babies. Artist and health care activist Michelle Browder has forced a reckoning with this legacy with one clear goal — we need to talk about the mothers.
On the newest episode of The Dose podcast, host Joel Bervell talks to Browder about her efforts to honor Sims’s victims — the names of only three of whom we know today: Anarcha, Betsey, and Lucy. They also discuss Browder’s work to channel the painful legacy of the past into a healthier future for Black women and their babies, as she prepares to open a midwifery clinic and birthing center as well as a national education center for medical students.
This year in the United States, an estimated 2 million people will receive a new cancer diagnosis, and a growing proportion will be younger adults and people of color. Many of these cases could be prevented — nearly 60 percent of colorectal cancers, for example, could be avoided with early detection.
Physician and UCLA researcher Dr. Folasade May is trying to understand why cancer screening rates are lagging, and what we can do to get people these potentially lifesaving tests.
In the newest episode of The Dose podcast, host Joel Bervell talks to Dr. May about what might be behind the rise in colorectal cancer among younger people, the barriers to widespread cancer screening — especially for underserved communities — and her work empowering people to save their lives. This episode kicks off a new series of conversations with leaders at the forefront of health equity.
Overtreatment is a big problem in American health care. The proliferation of unnecessary medical tests and procedures not only harms patients but costs the United States billions of dollars every year. Between 2019 and 2021, Medicare spent as much as $2.4 billion on unnecessary coronary stents alone. At some hospitals, it’s estimated that more than half of all stents are unwarranted.
For this week’s episode of The Dose podcast — the latest in our series on the affordability of health care — host Joel Bervell talks to Vikas Saini, M.D., a cardiologist and the executive director of the Lown Institute, a think tank that examines overspending and overtreatment in the health care system. Dr. Saini unpacks how health care practices are misaligned with patient needs and discusses strategies for “rightsizing” U.S. health care.
Health care is a $4.3 trillion business in the United States, accounting for 18 percent of the nation’s economy. It should come as no surprise then that the industry has become attractive to private investors, who promise cost savings, expanded use of technology, and streamlined operations.
But according to Yale University’s Howard Forman, M.D., “most private equity money does seem to be making matters worse rather than better.” One issue is that investors chase the healthiest and most profitable patients, undermining another kind of equity — health equity — in an already deeply unequal health care system.
In the latest episode of The Dose podcast, host Joel Bervell charts a wide-ranging discussion with Dr. Forman, a professor of radiology and biomedical imaging, public health, management, and economics, about private equity’s growing role in American health care. This is the second episode of our new series of conversations about health care affordability.
Nearly one in five Americans has medical debt. Black households are disproportionately affected, carrying higher amounts of debt at higher rates.
Berneta Haynes, senior attorney with the National Consumer Law Center, describes Black Americans’ medical debt burden as a continual cycle fed by higher rates of chronic illness and lower rates of wealth. As a result, many are left without savings or family resources to tap into when faced with an unexpected medical bill.
Join host Joel Bervell on the newest episode of The Dose podcast, where he talks to Haynes about the history of medical debt and efforts to ease pressure on the families and communities hit hardest, including the Consumer Financial Protection Bureau’s initiative to change what kinds of medical debt can show up on a person’s credit report.
This episode kicks off a new series of conversations about affordability, including everything from the role of private equity in health care to why Americans pay more for care than any other high-income country.
Forty-four percent of U.S. women now live with some form of heart disease, a number that’s been climbing steadily over the past decade. And although it’s the leading cause of death among women, just 14 percent of cardiologists are women.
This week on The Dose podcast, host Joel Bervell interviews cardiologist Martha Gulati, M.D., associate director of the Barbra Streisand Women’s Heart Center at Cedars-Sinai Heart Institute in Los Angeles and president of the American Society for Preventive Cardiology. She talks about women’s historical exclusion from clinical trials for heart disease, why sex and gender matter in the search for better treatments, and the persistent gaps in women’s cardiology care and research — especially related to women of color.
“In cardiology, we are still thinking about men more than we are about women,” Dr. Gulati says.
Even though the U.S. has the highest maternal mortality rate of any developed country, federal programs that have been proven to improve maternal health outcomes are often the target of budget cuts.
This week on The Dose podcast, guest host Rachel Bervell speaks with Dr. Jamila Taylor, president and CEO of the National WIC Association, the nonprofit voice of the federal program that provides nutritious foods to more than 6.3 million women, infants, and children. They discuss the potential policy and funding solutions that can advance health for women, especially women of color.
Their conversation ranges from the debt ceiling legislation’s impact on WIC to the pending “Momnibus” package of measures for improving health equity and quality of care for Black mothers.
“Those essential programs are always the first to be on the chopping block,” Taylor says. “That's something that we really need to change in our approach to funding.”
Research shows that Black women and other women of color experience the worst health outcomes of any group in the United States — regardless of income level. On The Dose podcast this week, host Joel Bervell talks to public health innovator Ashlee Wisdom, founder of a digital platform that connects women of color to culturally competent health care providers.
Black people make up 13 percent of the U.S. population but less than 6 percent of physicians, making it difficult for Black patients to connect with Black doctors. As Wisdom, founder of Health in Her HUE, explains, technology can be a tool for bridging that access gap until the physician workforce becomes more diverse. A new focus, she says, is fibroids, an oft-misdiagnosed condition in Black women that can lead to referrals for invasive interventions like hysterectomies.
The health care system, Wisdom says, is starting to put things in place. “We’re seeing people shift away from the status quo and think about ways that they can learn how to provide culturally competent care.”
This week on The Dose podcast, host Joel Bervell talks to Michelle Morse, New York City’s first-ever chief medical officer. Starting in her role at the height of the COVID pandemic, Dr. Morse quickly understood the importance of establishing strong connections between the health department and the city’s health care providers to help close gaps in equity, choose where to focus resources, and coordinate testing and vaccination efforts.
In a wide-ranging conversation, Dr. Morse talks about Black New Yorkers’ disproportionately high rates of premature death, having racism declared a public health crisis in New York City, using community health workers to reach people where they live, and tracking the connection between wealth gaps and health outcomes. She also discusses the use of race in clinical algorithms that have “solidified racial inequities instead of trying to fix them and end them.”
Listen, and subscribe wherever you get your podcasts.
On this week’s episode of The Dose, host Joel Bervell talks withDr. Fatima Cody Stanford about obesity: its history, including the racist origins of the body mass index (BMI), as well as the flawed science, misperceptions, and stigma that people with obesity encounter.
Stanford, who’s based at Massachusetts General Hospital, calls obesity “a really complex, multifactorial, relapsing, remitting chronic disease.” She discusses genetic differences that account for the prevalence of obesity in racial and ethnic minority communities, the financial profitability of the weight loss and pharmaceutical industries, and the biases and dangerous risks of misdiagnosis that patients with obesity face every day at doctors’ offices.
On this week’s episode of The Dose, host Joel Bervell speaks with Dr. Ziad Obermeyer, from the University of California Berkeley’s School of Public Health, about the potential of AI in informing health outcomes — for better and for worse.
Obermeyer is the author of groundbreaking research on algorithms, which are used on a massive scale in health care systems — for instance, to predict who is likely to get sick and then direct resources to those populations. But they can also entrench racism and inequality into the system.
“We've accumulated so much data in our electronic medical records, in our insurance claims, in lots of other parts of society, and that’s really powerful,” Obermeyer says. “But if we aren’t super careful in what lessons we learn from that history, we’re going to teach algorithms bad lessons, too.”
Citations
Dissecting racial bias in an algorithm used to manage the health of populations
On this special season of The Dose, guest host Joel Bervell is hosting a series of conversations with experts and leaders in health equity. In examining how we can uproot racism in our healthcare system, we are starting at the beginning of many healthcare careers: medical school.
Naomi Nkinsi was one of the few Black students in her cohort at University of Washington School of Medicine. She noticed that the images in her lectures depicted Black patients living in impoverished and hygienic conditions, while pictures of white patients showed polished school photos. Nkinsi recognized that the disparity in images reinforced harmful biases for her classmates, and she began to advocate for a change.
Through a back-and-forth with her university’s administration, Nkinsi continued to advocate against racism. She eventually sparked a conversation that led to the reversal of the race-based component of the eGFR equation in many settings, thus removing a barrier to proper kidney treatment for thousands of Black patients.
On the latest episode of The Dose, Nnkinsi joins Joel Bervell to discuss why and how she continues to challenge racism, despite institutional pushback, and shares what medical schools can learn from their students.
“The days I didn't say anything, I felt worse than when I did,” Nkinsi says. “I had already been outspoken, I already had the reputation of the angry Black student. Other classmates already viewed me as unprofessional… So if I already have that reputation, then I should just keep speaking out because it's not going to get worse.”
Citations
Health inequities and the inappropriate use of race in nephrology
Joel Bervell joins The Dose to host a special season examining equity in health care.
Joel has garnered hundreds of thousands of followers on TikTok and Instagram debunking medical myths and dissecting racism in health care. This season, he'll host a series of compelling conversations with emerging and established leaders working to transform the health care system's approach to equity.
The first episode releases on April 7th.
The maternal mortality rate in the United States is more than double that of our peers – and it’s especially high among Black birthing people. Why? The Commonwealth Fund collaborated with Lemonada Media to create Uncared For, a six-part podcast series, hosted by award-winning journalist SuChin Pak (Add to Cart, MTV News) to take a personal and wide-ranging look at maternal health care around the globe to find the answer.
On today’s episode of The Dose, we’re sharing the first episode of Uncared For. SuChin Pak talks to Brandi Jordan, a doula who was an essential support for Pak’s own childbirth. Even though Jordan has decades of childbirth experience, when it came time for her own pregnancies, she was repeatedly ignored and neglected by her doctors. Unfortunately, Jordan is not alone in experiencing a system that disproportionately fails Black birthing people.
The first episode of Uncared For examines some of the factors that contribute to the systemic racism that Black birthing people face in the United States and unpacks the historical roots of these inequities. Over the course of the series, the show explores health care systems in Germany, the Netherlands, and Costa Rica to find solutions for a health care system that’s safer for all birthing people.
All six episodes of Uncared For are now available wherever you get your podcasts.
What people eat, where they live, and how much they earn can impact their overall health more than the medical care they receive — sometimes much more. Now, for the first time, federal policymakers are trying to measure and screen for what are known as the drivers of health.
On this week’s episode of The Dose, Shanoor Seervai talks with Alice Chen, M.D., chief medical officer at Covered California, the state’s health insurance marketplace, about gathering momentum in the health sector to acknowledge and address nonmedical risk factors for health.
Chen, a physician with years of experience caring for underserved patients (as well as a former Commonwealth Fund Harvard Fellow in Minority Health Policy), explains how food insecurity, housing instability, and transportation issues, among others, are all inextricably linked to people’s health.
“As people started thinking about how you actually improve health and not just provide transactional health care services, you start to widen your lens and realize, oh, there are all these other factors that are actually driving population health,” she says.
For the next few months, The Dose will be going on hiatus. We’ll be back in touch in the new year with more conversations about how to make health care better for all Americans.
In post-Roe America, many women seeking abortions are treading on landmines, particularly in states where access is banned or severely restricted.
On the latest episode of The Dose, host Shanoor Seervai talks to Raegan McDonald-Mosley, M.D., about a tool that makes it easier for people to determine what the laws are in their state and where they can get care.
Mosley, the CEO of Power to Decide, talks about the huge risks for women – particularly low-income women of color – who can’t get the reproductive health services they need.
“Instead of… investing in maternal health services on the ground in communities that need it, [some states are] literally doing the opposite to make it harder for people to connect to care and services,” she says.
The midterm elections are around the corner, and health care is likely to be a major factor in how Americans vote. Abortion and reproductive health access will motivate many people, as will inflation (which impacts the cost of care).
On the latest episode of The Dose, host Shanoor Seervai talks about the most pressing health care battles to watch with Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University Law Center’s O’Neil Institute.
Keith talks about how access to abortion may play out at the federal and state level, legal challenges to the Affordable Care Act’s guarantee of free preventive care, and the impact of the impending end of the public health emergency.
Bills targeting the rights of LGBTQ+ people are under consideration in state legislatures across the country. Many aim to make it more difficult for transgender people to get health care — something that’s already a challenge for many, particularly trans youth.
On the latest episode of The Dose, host Shanoor Seervai interviews Austin Johnson, an assistant professor of sociology at Kenyon College and the research and policy director for the Campaign for Southern Equality, an advocacy and direct services organization.
One way to expand access to care for transgender youth, Johnson says, is to “make sure you center trans experience, center trans people's understandings of their health care, education, and family life, and rely on … scholarship that is led by trans people.”
Earlier this week, President Biden declared the pandemic over. This tracks with public opinion: most Americans have long abandoned their masks, and federal funds may soon dry up for testing, treatment, and even vaccines.
Of course, this doesn’t mean the virus has disappeared. In fact, hundreds of Americans are still dying each day from COVID-19, and thousands more are suffering from long COVID, a host of protracted symptoms that could lead to severe health complications down the line.
On the latest episode of The Dose, host Shanoor Seervai talks to Dr. Bob Wachter about what it's like to live with COVID in 2022. Dr. Wachter, professor and chair of the Department of Medicine at the University of California, San Francisco, is one of the nation’s foremost experts on the pandemic.
Among other things, the Inflation Reduction Act is being hailed as a potential breakthrough in making health care more affordable. But what does this landmark legislation, enacted last month, really mean for Americans – now and in the future?
To open the new season of The Dose, host Shanoor Seervai interviews Stacie Dusetzina, an associate professor in health policy and cancer research at Vanderbilt University. Dusetzina breaks down the key health provisions of the new law, from drug price negotiation in Medicare to the redesign of Part D coverage.
We’ve “repeatedly been burned by the health care system… [so] we're all suspicious when something sounds really too good to be true,” she says. “The changes here for people who have very expensive drugs are almost too good to be true.”
Social programs like Medicaid are supposed to help people, but often they reproduce racial inequities — and sometimes actually create them. That’s because even well-intentioned policymakers can’t always see the disproportionate impact their decisions have on people of color.
But what if there were a tool to help legislators and government officials identify when and how they should be thinking about racism? Well, Jamila Michener has developed one. And on this encore episode of The Dose podcast, she explains how it can be applied to Medicaid’s transportation benefit specifically and to health policy more broadly.
Michener, an associate professor in Cornell University’s Department of Government, speaks about how her research on, and personal experiences with, Medicaid has highlighted the importance of hearing from people impacted by policy choices.
“You can't really address the ways that racism manifests… unless you have people who experience it directly at the table, not only having voice, but also having some power,” she says.
This encore episode was originally released on 2/11/2022.
Climate change can have a devastating impact on our health. When people are injured or exposed to disease related to floods or fires, it’s up to health systems to pick up the pieces.
But health care itself is one of the world’s most carbon-intensive industries, responsible for 4.5 percent of all greenhouse gas emissions. What can health systems do to address climate change?
In the United Kingdom, the National Health Service (NHS) has set some ambitious goals to reduce its carbon footprint.
On this encore episode of The Dose, Nick Watts, the NHS’s chief sustainability officer, talks about how the health service is meeting these goals, and whether its efforts could be replicated in countries like the United States. A low-carbon health care system, he says, is actually just a good health care system.
This encore episode was originally released on 1/28/2022.
The Dose will be taking a short summer break while our team works on brand-new episodes for the next season. Listen to our season finale, in which we highlight some of the accomplishments of our guests. Join us in the fall, for new conversations with health policy experts as they share ideas about how the U.S. can improve health care for everyone.
Episodes Mentioned:
A well-functioning public health system is vital to keeping individuals, and the population at large, safe and healthy. Except that success is often invisible when it comes to public health—we don’t notice it until the system breaks down.
The U.S. public health system has taken a drubbing from COVID-19. But the pandemic has also driven home just how critical it is to invest in this key component of national infrastructure.
On the latest episode of The Dose, Dr. Dave Chokshi, who led New York's pandemic response as the city's health commissioner, talks about how we can apply the lessons of the past two years in rebuilding the U.S. public health system.
“If we take the opportunity to build [a] community-based public health infrastructure, to embrace a mission of health equity as fundamental to health, then that’s what will help to protect… our community as a whole,” he says.
Racial bias in medical care extends all the way to the prescription pad. Research shows that people of color are less likely to receive the most effective treatments for life-threatening conditions, including cancer and heart disease.
One way to address this is by aiming for “pharmacoequity” — where all patients, regardless of race, socioeconomic status, disability, or other characteristics, have access to the highest-quality evidence-based medical therapies that meet their health needs.
On the latest episode of The Dose, the man who coined this term, Utibe Essien, M.D., an assistant professor of medicine at the University of Pittsburgh, explains what it will take to achieve pharmacoequity.
“The data are not lying about how we're prescribing medications,” Essien says. To eliminate such biases, he believes we must be honest about the data and develop strategies to ensure greater equity.
Nurses in the United States are experiencing burnout at unprecedented rates. More than two years into the pandemic, they are still processing the trauma of what they witnessed in the early days. Staffing shortages, meanwhile, are creating unmanageable workloads.
On the latest episode of The Dose podcast, host Shanoor Seervai interviews Rebecca Love, a nurse and president of SONSIEL, the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders, a nonprofit dedicated to creating new opportunities for nurses in health care innovation.
Love talks about what it would take to fix the nursing crisis, from changes in nursing reimbursement to new ways of training and empowering nurses to provide the best possible patient care.
When a federal judge lifted the national mask mandate on airplanes, trains, and other public transportation, some Americans broke out the champagne. Others wrung their hands, dreading the removal of a relatively simple public health tool at a time when COVID-19 cases are rising across the U.S.
On the latest The Dose podcast, Celine Gounder, M.D., Senior Fellow and Editor-at-Large for Public Health at the Kaiser Family Foundation and Kaiser Health News, talks about why people without privilege — like those who are poor or uninsured and many people of color — will be hit the hardest if we rush to return to normal.
“Having safety nets becomes really important,” she says. Measures like improved indoor air quality, paid sick and family medical leave, and better access to health insurance would help control the health, social, and economic impacts of the pandemic.
Access to health care is a constitutional right for the 2 million Americans in our criminal justice system. For some of those incarcerated – overwhelmingly people with low income and people of color – the first time they receive care is behind bars.
But when individuals transition back into their communities, this care often vanishes.
On the latest episode of The Dose, Emily Wang, M.D., director of the SEICHE Center for Health and Justice at Yale University, explains why we need to ensure continuity of care for people cycling in and out of the criminal justice system.
The first few weeks after release are critical, she says. “You want people to return home to reintegrate… to reestablish a life, get a house, get a job, contribute meaningfully as a member of our community.”
In the face of overwhelming demand for behavioral health services, the unmet needs of one group stands out: Black and brown teenagers. One reason they’re not getting the care they need is the shortage of child and adolescent mental health providers in the U.S. — particularly providers of color. Making matters worse are the racial stereotypes that play out in how Black and brown teens are perceived by school officials, health care providers, and some others in their communities. On the latest episode of The Dose, Kevin Simon, M.D., a psychiatrist at Boston Children’s Hospital and Commonwealth Fund Fellow in Minority Health Policy at Harvard University, talks about how to address the problem. In the long term, we need to diversify the mental health provider workforce, he says. But for now, providers currently practicing can work with families, teachers, and others to strengthen the system. They can demonstrate cultural humility and express genuine curiosity in the lived experiences of Black and brown youth.
In the face of overwhelming demand for behavioral health services, the unmet needs of one group stands out: Black and brown teenagers. One reason they’re not getting the care they need is the shortage of child and adolescent mental health providers in the U.S. — particularly providers of color. Making matters worse are the racial stereotypes that play out in how Black and brown teens are perceived by school officials, health care providers, and some others in their communities. On the latest episode of The Dose, Kevin Simon, M.D., a psychiatrist at Boston Children’s Hospital and Commonwealth Fund Fellow in Minority Health Policy at Harvard University, talks about how to address the problem. In the long term, we need to diversify the mental health provider workforce, he says. But for now, providers currently practicing can work with families, teachers, and others to strengthen the system. They can demonstrate cultural humility and express genuine curiosity in the lived experiences of Black and brown youth.
Although primary care is the lifeline of a health care system, the United States spends less on it, and more on specialty care, than other high-income countries. This sends a message to our primary care workforce: we don’t value what you do. The result? Burnout, high turnover, physician shortages—all of which were dire crises before the pandemic but are even worse now.
On the latest episode of The Dose, host Shanoor Seervai asks Asaf Bitton, M.D., executive director of the health innovation center Ariadne Labs, what it will take to rebuild the nation’s broken primary care system.
“What we've learned over these last 15 or 20 years is that primary care is a team sport,” says Bitton. A modern practice cares for a well-defined population using “technology in a different way… to start building a much more integrated primary care of the future.”
Americans pay more for prescription drugs than people in other countries do. As medicines become increasingly unaffordable — particularly for people with low incomes — policymakers in both parties are feeling the urgency to address the problem. But what could they do?
On the latest episode of The Dose podcast, Robin Feldman, a professor at the UC Hastings College of Law and an expert on intellectual property and pharmaceutical law, offers some answers. She talks about the problems with our current patent system, and how it could be redesigned to allow for innovation and to protect consumers from going into debt to pay for their medications.
Social programs like Medicaid are supposed to help people, but often they reproduce racial inequities — and sometimes actually create them. That’s because even well-intentioned policymakers can’t always see the disproportionate impact their decisions have on people of color.
But what if there were a tool to help legislators and government officials identify when and how they should be thinking about racism? Well, Jamila Michener has developed one. And on the latest episode of The Dose podcast, she explains how it can be applied to Medicaid’s transportation benefit specifically and to health policy more broadly.
Michener, an associate professor in Cornell University’s Department of Government, speaks about how her research on, and personal experiences with, Medicaid has highlighted the importance of hearing from people impacted by policy choices.
“You can't really address the ways that racism manifests… unless you have people who experience it directly at the table, not only having voice, but also having some power,” she says.
Climate change can have a devastating impact on our health. When people are injured or exposed to disease related to floods or fires, it’s up to health systems to pick up the pieces.
But health care itself is one of the world’s most carbon-intensive industries, responsible for 4.5 percent of all greenhouse gas emissions. What can health systems do to address climate change?
In the United Kingdom, the National Health Service (NHS) has set some ambitious goals to reduce its carbon footprint. On the latest episode of The Dose, Nick Watts, the NHS’s chief sustainability officer, talks about how the health service is meeting these goals, and whether its efforts could be replicated in countries like the United States. A low-carbon health care system, he says, is actually just a good health care system.
The Omicron variant is sweeping across the United States and the rest of the world, breaking previous records of COVID-19 cases and hospitalizations. While it may cause milder illness, its transmissibility and ability to evade vaccines make this surge particularly challenging to navigate.
On the latest episode of The Dose podcast, host Shanoor Seervai asks Alison Galvani, founding director of the Yale Center for Infectious Disease Modeling and Analysis, to bring listeners up to speed on this phase of the pandemic. Galvani and her colleagues have found that increasing the number of boosters administered each day could save thousands of lives.
Vaccination is relatively inexpensive, particularly compared with the costs associated with hospitalizations and productivity losses, even from mild cases, she says.
A year after adults in the U.S. began getting vaccinated against COVID-19, children ages 5 and up are now eligible for the shot. So far, uptake has been slow – in part because of parents’ concerns over vaccine safety.
On the latest episode of The Dose, pediatrician and American Academy of Pediatrics board member Michelle Fiscus, M.D., and the Commonwealth Fund’s Rachel Nuzum shed light on challenges and opportunities in raising child vaccination rates.
One downstream concern is a growing trend of resistance to other childhood vaccines. As Dr. Fiscus says, if “vaccine hesitancy continues to build with the routine childhood vaccines, I am very concerned about the types of outbreaks that we're going to be fighting over the next years.”
The U.S. maternal health crisis has been well documented. Black Americans are three times as likely as white Americans to die from pregnancy-related causes.
Why do these disparities persist? And what would it take to dismantle structural racism in reproductive health care?
On the latest episode of The Dose, Rachel Hardeman, tenured associate professor at the University of Minnesota School of Public Health, discusses her research exploring ways to center equity in reproductive health care.
She says it’s a huge priority “to make sure that birthing people, regardless of the setting they're birthing in, have access to culturally centered maternity care.”
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Vaccines have saved thousands of lives and are an incredible tool in the seemingly endless battle against the coronavirus. But even with COVID surging anew in Europe as winter approaches, the rate at which Americans are getting vaccinated has plateaued.
On the latest episode of The Dose, Alison Galvani, founding director of the Yale Center for Infectious Disease Modeling and Analysis, and Eric Schneider, M.D., senior vice president for policy and research at the Commonwealth Fund, bring listeners up to speed on the state of the pandemic.
Galvani and Schneider have been using data to show how effective the vaccines are at preventing deaths and hospitalizations — and how, in the absence of successful vaccination campaigns, we are still losing people to the virus. Increasing vaccine uptake through mandates and administering boosters will help curb this pandemic. But to stave off future threats, it’s vital that we also strengthen the public health system and make it easier for all Americans to access health care, they say.
The U.S. housing crisis and health care are inextricably linked. Compared to the general population, people experiencing homelessness have higher rates of illness and mortality. These struggles are even more acute for transgender people, who often face discrimination when they seek both housing and health care.
On the latest episode of The Dose, Pam Klein, Manager of Transgender Services at the Boston Health Care for the Homeless Program, talks about how to provide health care to transgender people who lack housing. As public acceptance of transgender people grows, and more and more people who openly identify as trans enter the field of health care, there is hope for the future, she says.
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When the pandemic hit last March, mental health care, which was typically delivered in face-to-face sessions, rapidly moved online.
At a time when the need for support was greater than ever, this was a welcome shift. But as we glance – with cautious optimism – toward a return to “normal,” will telehealth be the dominant mode of delivering mental health services?
On the latest episode, Latoya Thomas, senior director of policy and government affairs at Included Health, and Solome Tibebu, director of the Upswing Fund for Adolescent Mental Health, talk about the future of virtual mental health care, particularly for underserved groups.
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While rich countries are doling out booster shots of the COVID-19 vaccine, many poor countries have vaccinated less than five percent of their population. And, while many leaders agree that vaccinating the world is the only way out of the pandemic, vaccines are still not moving around the globe in a rapid and equitable manner.
This is because “we live in a hierarchy of health,” says Priti Krishtel, a health justice lawyer and cofounder of I-MAK, a nonprofit focused on building a more just and equitable medicines system.
On the latest episode of The Dose, Krishtel argues that unequal access to vaccines is rooted in a long-standing system of incentives that governs drug development and allocation. She says rethinking the drug patent regime and other incentives — and working together to ensure every country gets a fair allocation of vaccines — is the way to end this and future pandemics.
Even as the Delta variant rages through the U.S., many Americans have not received a COVID-19 vaccine. The reasons are complex, but for Black and Latinx communities, a long history of poor access to health care has been a tall barrier.
On the first episode of our brand-new season of The Dose podcast, host Shanoor Seervai talks to Rhea Boyd, M.D., a pediatrician and public health advocate, about what it takes to dismantle the historic racism that has long prevented people of color from getting the health care they need.
Black and Latinx health care professionals like Dr. Boyd are answering questions about the COVID-19 vaccine online and in person. If we make it a national priority, she says, we can ensure Black and Latinx people get credible information about the vaccines and easy access to them.
The Dose is the Commonwealth Fund’s podcast that asks, What can the U.S. do differently when it comes to health care? Join host Shanoor Seervai every other Friday for conversations with leading and emerging experts. This season we’re focusing on new ideas that could strengthen and improve health care for everyone.
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Music by Blue Dot Sessions.
Many Americans have started to behave as if the pandemic is over, but large numbers of people remain unvaccinated. At the same time, other parts of the world are experiencing their worst COVID-19 surges yet.
On the season finale of The Dose, Sandro Galea, physician, epidemiologist, and dean of the Boston University School of Public Health, talks about what it will take to vaccinate the entire world and how we can protect ourselves from future pandemics.
He explains that while vaccines may mitigate the crisis in the short run, they cannot be a substitute for long-term investments in the social services that keep people healthy.
Please take a minute to fill out our survey and tell us what you think about the podcast: https://www.surveymonkey.com/r/themicrodose.
When the pandemic hit last March, the U.S. was still facing another major public health crisis —the opioid epidemic. Between COVID-19 lockdowns and economic devastation, overdose deaths soared. Experts estimate that around 90,000 people died of a drug overdose in 2020. That’s the highest number of overdose deaths ever, and it represents the largest one-year increase.
On the latest episode of The Dose, we explore why drug deaths are rising and how policymakers can help fix the problem with guests Brendan Saloner, professor of health policy at the Johns Hopkins School of Public Health, and Jesse Baumgartner, a research associate at the Commonwealth Fund.
Many of us can recall a time we felt nervous about seeing a doctor. Maybe it was because we were wary about how much the visit would cost, or what a diagnosis would mean for our health. Now, imagine how much more stress you would feel if you had experienced trauma — from domestic violence or human trafficking, for example.
Trauma survivors are the people family medicine physician Anita Ravi, M.D., cares for. On the latest episode of The Dose, Ravi and Keisha Walcott, one of her former patients, talk about how to design health systems for women and girls who have experienced gender-based violence. Ravi and Walcott explain how health, poverty, and trauma are interlinked and why providers must address all three.
Migrants are crossing the southern border in record numbers this year, many of them unaccompanied children. What happens to them once they make it into the U.S., or if they've been here for a long time, when they need health care?
On the latest episode of The Dose podcast, Carrie Byington, executive vice president of University of California Health explains, drawing on her expertise as a pediatrician and infectious disease specialist, and personal experience treating immigrants and their families.
Byington, a member of the Commonwealth Fund’s Board of Directors, describes how the pandemic has illustrated the urgent public health need for immigrants to have health care, because “people may choose to forgo testing, or choose to postpone vaccination if they're afraid to sign up for a vaccine.”
The Biden-Harris administration has taken several measures in its first three months to strengthen the nation’s social safety net. Many of these policies will have an outsized impact on women — particularly women of color, who often struggle to access health care and now are bearing the brunt of the COVID-induced economic crisis.
From mandating paid sick leave and shoring up childcare to addressing the maternal health crisis, the new administration clearly recognizes the ways health and economic security are intertwined and how this impacts women.
On the latest episode of The Dose, Debra Ness, president of the National Partnership for Women and Families, makes the case that the pandemic has exposed inequities too difficult to ignore. And she believes women will emerge “smarter and stronger” from this crisis.
Hate crimes against Asians in the United States more than doubled from 2019 to 2020. Last month, in one of the most conspicuous acts of violence against Asians in recent history, six Asian American women were shot dead in Georgia.
Racism against people of Asian descent is not a new problem, but it has been exacerbated of late by politicians using racist rhetoric to describe the coronavirus. Asians in America are now facing a dual pandemic: a heightened fear of racist abuse, from verbal slurs to physical assault, on top of all the anxiety of living through COVID-19.
In this episode, Vivian Shaw and Susanna Park of the AAPI COVID-19 project talk about the deep roots of anti-Asian bias, as well as their research into how the pandemic is affecting the lives of Asians in the U.S.
If you’re an optimist, then every piece of good news about vaccine approvals and shots in arms has put the end of the pandemic in sight. If you’re a pessimist, then all the new variants with names sounding like computer-generated passwords signal the apocalypse. Will hope win, or will dread?
On the latest episode of The Dose podcast, Eric Schneider, M.D., talks about the high-stakes race between the quick-spreading variants of COVID-19 and the effective vaccines that more Americans receive each day.
Schneider brings us up to speed on the state of the pandemic and the challenges ahead. Drawing on his expertise in public health, he explains how we can “break the back of the virus” and ultimately win the race.
Share your stories of pandemic optimism or pessimism—send an email to thedose@commonwealthfund.org.
Health care workers are among the heroes of the pandemic. One year in, many of us are experiencing stress, fatigue, and grief. But this can pale in comparison to the toll faced by those caring for the sick and dying on a daily basis. On this episode of The Dose, we listen to the stories of one group of frontline health workers: nurses. Often dealing with inadequate PPE and staff shortages, nurses are putting their own lives at risk — and many are experiencing burnout and exhaustion.
Our guest, Mary Wakefield, takes us on a journey from rural hospitals to clinics in underserved areas, all through the eyes of nurses. Mary, a nurse with a long career in health care and public service, says the pandemic has revealed that America’s public health infrastructure is “incredibly anemic.”
Violence kills thousands of Americans each year and sends many more to the hospital with life-threatening injuries. Even though many people recover physically, the issues that cause violence often go unchecked.
On today’s episode of The Dose, we talk about how interventions, both in hospitals and in communities, that can help break the cycle of violence that traumatizes people over time.
Our guest, Fatimah Loren Dreier, is the executive director of the Health Alliance for Violence Intervention, and a Pozen-Commonwealth Fund fellow in Health Equity Leadership. She talks about how trained violence interruption specialists can help people navigate conflict, and how the national protests around police violence towards Black Americans has created an opportunity for communities to rethink the role of the police.
Living with the COVID-19 pandemic for a year, it’s hard to process the numbers. What we know is that nearly 500,000 Americans have lost their lives, and that Black, Latino, and Indigenous people are worst impacted.
But behind the statistics are stories, and on the latest episode of The Dose, we listen to one of those stories. Our guest, Dr. Magdala Chery, is a primary care physician and Commonwealth Fund Fellow in Minority Health Policy.
Magdala is also a daughter, and she experienced firsthand the racial inequities of our health care system when she lost both her parents to COVID-19 last spring. Magdala speaks of her personal tragedy without rancor: she believes that sharing stories like hers will help us see the people of color affected by COVID-19 not as case numbers and fatalities, but as lives.
Almost a year into the COVID-19 pandemic, the U.S. faces another health crisis – one of loneliness. Between lockdowns, social distancing, and the fear that contact with others could make us sick, many people are living in isolation.
But there are ways to cope.
On this episode of The Dose podcast, Matthew Pantell and Laura Shields-Zeeman, researchers at the University of California, San Francisco, talk about how innovative programs from around the world could help mitigate the effects of isolation.
A year into the COVID-19 pandemic, the United States appears to have learned few lessons from its disastrous early response. Hasty lockdowns and bungled reopenings have now given way to a sluggish and uncoordinated vaccine rollout. This month, the daily death toll crossed 4,000, and hospitals in many parts of the country are overflowing with sick patients. How are we going to get out of this mess? On the latest episode of The Dose, Ashish Jha, M.D., dean of the Brown University School of Public Health, explains how vaccine distribution could be sped up and carried out in a manner that addresses racial and economic disparities. Jha believes that swift action from the incoming administration could help America emerge from the pandemic by mid- to late 2021.
COVID-19 brought the lives of college students to an abrupt standstill – being in a classroom, a dormitory, a dining hall table with friends became risky activities overnight.
How did universities navigate the impossible tradeoff between having students on campus with the risks of the coronavirus, and keeping students remote but putting their education in peril?
Find out on this episode of The Dose podcast with Dr. Michael Drake, President of the University of California. Drake, who is also a member of The Commonwealth Fund Board of Directors, explains the decisions he made to keep students safe – and learning – on and off campus.
Listen here, and then subscribe wherever you find your podcasts.
A new president doesn’t get four years to shape health care, he gets six months. And for President-elect Joe Biden, the most pressing health care issue is – no surprise here – COVID-19.
On this episode of The Dose, the Commonwealth Fund’s President David Blumenthal, M.D., talks about Biden’s opportunity to leave a lasting health-care legacy by bringing the pandemic under control.
History will judge Biden by how he rises to our new reality, says Blumenthal, in which one in every 1,300 Americans has died of COVID, millions have lost their jobs, and science has been undermined and ignored.
President-elect Joe Biden says he is committed to strengthening the Affordable Care Act so that all Americans can get the health care they need. He also wants to work with people of all political stripes: in his acceptance speech, he said it’s time “to listen to each other again.”
This week on The Dose podcast, we’re bringing back an earlier episode on the compromise required to bring about big political change — in this case, change in U.S. health care.
The Commonwealth Fund’s Elizabeth Fowler, a key architect of Obamacare, talks about the behind-the-scenes effort it took to get the landmark law passed.
People who are incarcerated have complex health needs, and to make matters more complicated, prisons and jails have seen some of the worst COVID-19 outbreaks in the U.S.
But what happens when they leave prison or jail and need to receive health care on the outside?
Many states that have expanded Medicaid are also trying to ensure that people leaving jail or prison are able to enroll in health coverage upon release.
On the latest episode of The Dose podcast, learn how these and other health care and criminal justice reform efforts work together from guests Vikki Wachino, who heads a nonprofit that connects jails with community health care providers, and Rebekah Gee, who oversaw Medicaid expansion as Secretary of the Louisiana Department of Health.
Masks. Lockdowns. Shuttered businesses. Hospitals strained beyond capacity.
Weary of the pandemic’s myriad disruptions to normal life, many Americans are pinning their hopes on a COVID-19 vaccine. But even if an effective one is developed, it won’t make the virus magically disappear.
On today’s episode of The Dose podcast, Dr. Margaret “Peggy” Hamburg, former commissioner of the U.S. Food and Drug Administration and a member of the Commonwealth Fund’s board, talks about the race to develop and deploy a vaccine.
“Even the world's most safe and effective vaccine won't make a difference if people don't trust it and won't take it,” she warns.
Americans are stressed about COVID-19 – both the disease and what it’s doing to the economy.
And while the virus has touched every corner of the globe, many high-income countries have been more successful than the U.S. at easing some of the pandemic’s pain.
This week on The Dose podcast, we talk about why Americans are experiencing the anxiety and sadness of the pandemic differently than people in other countries, and how this is tied to economic concerns like food, jobs, and housing.
Health care is always important for voters, but this year, it is at the top of everyone's mind.
The health needs and economic costs of COVID-19, and protections for people with pre-existing health conditions tie for first place in the Commonwealth Fund’s latest poll on which health care issue matters most to voters in the 2020 election.
Voters are also worried about health care costs, the safety of voting in person, and whether or not their vote would be counted if they vote by mail.
Then there’s the question of which candidate – Former Vice President Biden or President Trump – would address voters’ health care concerns. To learn what they said, and unpack some of the poll’s key findings, listen to the latest episode of The Dose with the Commonwealth Fund’s Sara Collins.
Hospitals in the U.S. started preparing for COVID-19 as early as January, but it wasn’t until Italian doctors started tweeting in March that they had to decide which patients would get ventilators that Michael Apkon realized the severity of the crisis.
On the latest episode of The Dose, Apkon, President and CEO of Tufts Medical Center in Boston, takes listeners on one hospital’s journey through the harrowing past six months of dealing with the pandemic.
Apkon recounts conversations with former colleagues from his time running a hospital in Canada, and reflects on how the fundamental differences between the U.S. and Canada’s approach to health care contributed to two very different responses to COVID-19.
Over the next few weeks, The Dose will be covering how the pandemic and other health care issues are playing out in the 2020 Presidential election. Listen to today’s show, and then subscribe wherever you find your podcasts.
***Originally Aired Nov 2019*** Bias in medicine – based on race and sex – is a well-documented problem. It’s a problem because the health care system has historically marginalized the medical concerns of people of color and women, which has led to worse health outcomes.
On this episode of The Dose, host Shanoor Seervai discusses ways to tackle bias in health care with Ann-Gel Palermo, who works on diversity and inclusion at New York’s Icahn School of Medicine at Mount Sinai, and Joia Crear-Perry, who founded the National Birth Equity Birth Collaborative to address racial disparities in health care.
They explain that bias is not just a concern at the individual provider level; it’s actually baked into the system, starting in medical school. While fundamental change will be an uphill battle, they say, the fight is critical to ensuring that all patients are treated fairly when they seek care.
***Originally Aired Feb 2020***
More than 800 women across the globe die each day from complications related to pregnancy. Some of them bleed to death. Some of them develop infections or severe life-long medical conditions because they are delivering their babies in unsafe environments.
Many of these deaths could be prevented if more young people had access to birth control and other reproductive health care. Pathfinder International is a nonprofit working with communities in 20 countries to make this a reality.
On this episode of The Dose, Pathfinder CEO Lois Quam, a member of the Commonwealth Fund’s board, recounts some of the stories she’s heard from young people around the world. Quam tells host Shanoor Seervai about the challenges they face in deciding whether and when to have children — and how their lives change when they are able to make this choice.
***Originally Aired Oct 2019***
African American women die of pregnancy-related causes at three times the rate for white women, even after accounting for income, education, and access to other resources.
What is it about being born black in America that leads to such outcomes?
To answer this question, Shanoor Seervai interviews Kennetha Gaines, clinical nurse manager for UCSF Health in San Francisco, for the latest episode of The Dose podcast. Gaines, a Pozen Commonwealth Fund Fellow in Minority Health at Yale University, speaks candidly about her personal experiences and her work to transform the way health care providers treat black women.
Does the health care system treat people differently based on race? Tell us what you think – send an email to thedose@commonwealthfund.org.
When the pandemic hit, millions of Americans found themselves in a tight spot – practice social distancing to avoid COVID-19, but what if you have a health condition that requires seeing a doctor?
Technology could transform the way people access health care, and the U.S. has made huge investments in this over the past decade.
But, as health technology expert Aneesh Chopra explains on the latest episode of The Dose, we still haven’t realized the full potential of digitization when it comes to delivering health care.
On June 12, the Trump administration eliminated federal protections against discrimination in health care for transgender people. This means that transgender Americans can be denied access to health coverage and care – simply because they are trans.
With the U.S. still grappling with COVID-19, the decision could make it more difficult for trans people to seek testing or treatment for the disease. And it deepens the health risks for a population already facing barriers to care.
The Commonwealth Fund’s Corinne Lewis, Yaphet Getachew, and Mekdes Tsega talk about the implications of the new rule, particularly for trans people of color, on this episode of The Dose podcast.
COVID-19 cases in the U.S. are climbing again, and data show that Black and Latinx Americans are contracting and dying of COVID-19 at higher rates than white Americans.
The reasons for are complex, including: people of color are more likely to be poor, work in industries that expose them to the virus, live in crowded spaces, and have chronic health conditions.
Then there’s race -- the discrimination and violence that people of color experience on a daily basis puts their health at risk, further exposing them to the coronavirus.
Against the backdrop of a nationwide reckoning over police brutality against people of color, Dora Hughes, a professor of health policy at George Washington University, talks about the disproportionate impact of the pandemic on Black and Latinx people, and what policymakers could do to address these racial inequities.
Every day, primary care providers are on the front lines of the COVID-19 pandemic, treating sick patients even as they worry about bringing the virus home to their families. Many still lack adequate protective gear, and many worry about the financial stability of their practices.
With the U.S. starting to reopen, we need our primary care practices to keep their lights on — not only to test and treat people with mild symptoms but also to address health concerns that people have neglected while staying home.
On this episode of The Dose podcast, health policy expert Farzad Mostashari, M.D., who advises and supports hundreds of primary care practices across the country, explains what it will take to ensure doctors can continue caring for Americans throughout the pandemic.
Health care is about so much more than medical tests or treatments. But, too often, health care providers forget to ask patients what they think would make them feel better.
Community health workers can help people take charge of their own health. Often living in the same communities and coming from similar backgrounds, they are able to share life experience with their clients and engender trust.
On this episode of The Dose, we talk about one community health worker program, IMPaCT, that is helping some of the poorest and sickest Americans meet their health and social needs.
As the COVID-19 pandemic upends all our lives, this idea of putting patients in charge — rather than telling them what to do — has particular resonance. Listen to our conversation with guest Shreya Kangovi, a primary care doctor and professor at the University of Pennsylvania, and then subscribe wherever you find your podcasts.
Getting and staying healthy depends on more than just medical care. In some instances, a patient also needs legal services. What if doctors could “refer” their patients to lawyers for help in dealing with a housing dispute, immigration status, or any number of legal issues?
On this episode of The Dose, we hear from Norma Tinubu and Emily Foote about how attorneys from the New York Legal Assistance Group work with health care providers at NYC Health + Hospitals, the largest public health care system in the U.S.
Through this medical-legal partnership, some of the city’s poorest patients can get the support they need to resolve legal problems that, if ignored, could take a toll on their health.
Earlier this week, Germany became one of the first countries to start easing COVID-19 restrictions. That’s because its initial response to the pandemic helped keep the death rate low. Germany:
As the pressure mounts to reopen economies across the globe, other countries may have something to learn. On this episode of The Dose, Michael Laxy, a health economics researcher at the Helmholtz Center in Munich, talks about the German approach.
The coronavirus pandemic is impacting everyone, but the older you are, the more severe the health consequences. The recommendation is stay home, away from other people.
What does that mean for an older person managing a chronic health condition (like diabetes) and needs to fill an insulin prescription?
What about someone who may be used to seeing their grandchildren every weekend, and is not able to because they could be risking their health?
On this episode of The Dose, the Commonwealth Fund’s Gretchen Jacobson, vice president of the Medicare program, lays out just how tough COVID-19 has made life for older Americans.
The coronavirus pandemic is wreaking unprecedented havoc around the globe. So many of us are searching for information to keep ourselves and our loved ones safe – but how do we know whom to trust?
On this episode of The Dose, the Commonwealth Fund’s Eric Schneider, M.D., helps us make sense of what we know about COVID-19 so far:
Ten years ago, it took a monumental effort to pass the ACA, or Obamacare. As a result, today, no American is denied health insurance because of a pre-existing medical condition, and 20 million people who previously lacked coverage now have it.
On this episode of The Dose, The Commonwealth Fund’s Liz Fowler, who was one of the key architects of Obamacare, talks about the behind-the-scenes effort it took to get the law passed.
Fear of a coronavirus epidemic is rippling through the country faster than the disease is spreading – and the U.S. health care system may be unprepared to deal with the crisis.
On this episode of The Dose, The Commonwealth Fund’s David Blumenthal, M.D., and Sara Collins, break down how gaps in our health system are placing the entire population at risk in the current outbreak.
People who worry they are sick with the COVID-19 virus need to seek immediate medical care. But in the U.S., 30 million people don’t have health insurance. Another 44 million have such bare-bones coverage that they are always worried about the costs of getting care.
While Medicaid has come to the rescue in past catastrophes like 9/11 and Hurricane Katrina, recent changes to the program mean that millions of Americans living in poverty may not be able to access needed care.
Nearly 700,000 Americans have died of AIDS since the beginning of the epidemic in the 1980s, and more than 1.1 million are living with HIV today.
Advances in medical science have provided people with access to highly effective treatments for HIV. But is it possible to eliminate the disease altogether?
Some cities are trying. On this episode of The Dose, Grant Colfax and Susan Buchbinder of San Francisco's public health department talk about how the city is trying to eliminate HIV.
Through a range of projects, from increasing the uptake of preventive medicine to running mobile clinics to serve hard-to-reach patients, the city is making progress toward its goal of getting to zero HIV infections, deaths, and stigma.
More than 800 women die each day from complications related to pregnancy across the globe. Some of them bleed to death. Some of them develop infections or severe life-long medical conditions because they are delivering their babies in unsafe environments.
Many of these deaths could be prevented if more young people had access to birth control and other reproductive health care. Pathfinder International is a non-profit working with communities in 20 countries to make this a reality.
On this episode of The Dose, Pathfinder’s CEO, Lois Quam, recounts some of the stories she has heard, firsthand, from young people around the world. Lois tells host Shanoor Seervai about the challenges people face when they are unable to decide whether and when to have children – and how their lives change if they are able to make this choice.
Prescription medicines have become so expensive in the United States that we've reached a point where four in five Americans think drug prices are unreasonable. While political leaders have certainly taken notice, what are they doing to solve the problem?
On the latest episode of The Dose, host Shanoor Seervai sits down with the Commonwealth Fund’s Lovisa Gustafsson to talk about how drugs could be made more affordable for those who bear the brunt of high prices – ordinary Americans.
Gustafsson believes some important issues are missing from the drug pricing debate, including a broken patent system, high launch prices, and the lack of cheaper medical treatments.
Primary care is the bedrock of a health care system that works. For most people, seeing a doctor regularly can help prevent small medical concerns from turning into full-blown emergencies.
On this episode of The Dose podcast, we hear from Los Angeles Times reporter Noam Levey, who recently wrote about the differences between the primary care systems in the United States and the Netherlands through the eyes of two doctors, one working in each country.
A cesarean section can be a life-saving procedure for a woman with a complicated pregnancy – but in some countries, too many women deliver by c-section, even when it isn’t necessary. In other countries, women can’t get a c-section when they need it.
Why does this huge difference persist?
On this episode of The Dose, Pierre Barker, who heads global partnerships at the Institute for Healthcare Improvement, explains why some countries have a much higher c-section rate than others. Pierre and his colleagues use a method called quality improvement to change the approach taken by health care systems around the world when it comes to c-sections.
Health care was front and center for the American public in 2019 – and with good reason. It’s one of the top issues voters are worried about going into the 2020 election.
On this episode of The Dose, David Blumenthal, M.D. and Shanoor Seervai review some of the big health care developments of the year, including the Democratic presidential candidates’ health reform plans, legislative activity around drug costs and surprise bills, and Silicon Valley’s growing interest in care delivery.
The number of women who die in the U.S. because of complications related to pregnancy is shockingly high – nearly 30 deaths for every 100,000 births each year. But some women die at higher rates than others: the maternal mortality rate for black women is three to four times higher than it is for white women.
On this episode of The Dose, the Commonwealth Fund’s Laurie Zephyrin, M.D., and Akeiisa Coleman talk about one way to address this crisis: Medicaid, which pays for nearly half the 4 million births in the U.S. each year. States have a real opportunity, they say, to take innovative steps to improve the care pregnant women and new mothers receive through their Medicaid programs.
Bias in medicine –based on race and sex – is a well-documented problem. It’s a problem because the health care system has historically marginalized the medical concerns of people of color and women, which has led to worse health outcomes.
On the latest episode of The Dose, host Shanoor Seervai discusses ways to tackle bias in health care with Ann-Gel Palermo, who works on diversity and inclusion at New York’s Icahn School of Medicine at Mount Sinai, and Joia Crear-Perry, who founded the National Birth Equity Birth Collaborative to address racial disparities in health care.
They explain that bias is not just a concern at the individual provider level; it’s actually baked into the system, starting in medical school. While fundamental change will be an uphill battle, they say, the fight is critical to ensuring that all patients are treated fairly when they seek care.
Many Americans are worried about how they will afford care if they get really sick, and policymakers are responding to this concern with a whole range of complicated policies. Are you confused about what these policies mean for you, your family, and the health system in general?
You’re not alone, so on this episode of The Dose, host Shanoor Seervai sits down with the Commonwealth Fund’s Sara Collins to break down what she learned in her latest survey on American’s views about health care.
They discuss how Medicare for All, and other Democratic proposals, would change the health system; they also talk about open enrollment, an ongoing court case on the future of the Affordable Care Act, and much more.
What do you think is the best way to fix our health care system? Send us an email on thedose@commonwealthfund.org.
African American women die of pregnancy-related causes at three times the rate for white women, even after accounting for income, education, and access to other resources.
What is it about being born black in America that leads to such outcomes?
To answer this question, Shanoor Seervai interviews Kennetha Gaines, clinical nurse manager for UCSF Health in San Francisco, for the latest episode of The Dose podcast. Gaines, a Pozen Commonwealth Fund Fellow in Minority Health at Yale University, speaks candidly about her personal experiences and her work to transform the way health care providers treat black women.
Does the health care system treat people differently based on race? Tell us what you think – send an email to thedose@commonwealthfund.org.
Each day, Philadelphia’s fire department responds to nearly a thousand emergencies, whether it’s saving someone from opioid overdose or helping a person having trouble getting out of bed.
What would it be like to spend a day in the life of the person who runs emergency medical services for a big city? Listen to the latest episode of The Dose podcast to find out how Philadelphia EMS deputy commissioner Crystal Yates deals with crises on a daily basis.
Yates, one of the first recipients of the Pozen-Commonwealth Fund Fellowship at Yale University, has made it her mission to find innovative ways to come to the rescue of people with no other resources to turn to.
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Sickle cell disease is a life-threatening blood disorder that affects around 100,000 Americans, mostly African Americans. In addition to coping with the disease itself, many face a host of other challenges, like getting to the hospital for treatment, paying bills, and figuring out where their next meal will come from.
On the latest episode of The Dose, Dr. Cecelia Calhoun talks about her work helping children and young adults with sickle cell cope with these issues day to day. Calhoun is one of the first experts to receive the Pozen-Commonwealth Fund Fellowship at Yale University to advance her work on health disparities.
Many poor Americans get health coverage through Medicaid. Last year, with encouragement from the Trump administration, some states decided to try and change their Medicaid programs. For people to be eligible for health coverage, they needed to show that they were working, or met some other requirement.
On this episode of The Dose, Ben Sommers, a professor of health policy, and economics at the Harvard School of Public Health, talks to host Shanoor Seervai about what happened in Arkansas the first state to implement a “work requirements” program.
The program was intended to promote better health and employment – instead, it led to more than 17,000 people losing health coverage in just three months, and no significant increase in the number of people with jobs.
Listen to learn more, and then subscribe to The Dose wherever you get your podcasts.
Should having a job be a requirement to get health coverage through Medicaid? Tell us what you think – send an email to thedose@commonwealthfund.org.
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