Every year, Health Affairs publishes a retrospective look at national healthcare spending. In 2020, Anne Martin and colleagues from the CMS Office of the Actuary found that U.S. healthcare spending increased 4.6% to $3.8 trillion in 2019. 

The rate of health spending declined slightly from 2018, which noted a growth rate of 4.7%. Hospital care, physician and clinical services, and retail purchase of prescription drugs, which accounted for 61% of total national health spending, saw faster growth rates in spending in 2019.

These figures predate the coronavirus, which has led to major changes in healthcare delivery and spending. 

In this week’s episode of A Health Podyssey, Alan Weil invites Sherry Glied, dean of the Robert F. Wagner Graduate School of Public Service at New York University, to the program. They take a step back from the main findings from the paper and discuss the relationship between administrative costs and the high costs of healthcare prices. 

Listen to Sherry Glied share why she thinks value-based care won’t be transformational and how public health is a desirable field to choose a career in now.

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As we close the books on the year 2020, we turn the tables on Health Affairs Editor-in-Chief Alan Weil wherein the interviewer becomes the interviewee.

Alan shares a bit about his educational background, what it actually means to be the editor for the leading health policy journal, and how empirical research has changed since the COVID-19 pandemic.

Looking back at the year's event, he elaborates on his blog post from June explaining his skepticism that the healthcare system can actually address social determinants of health. Looking forward to 2021, he predicts that administrative moves may continue to dominate the health policy landscape as a result of the 2020 election.

Listen to Alan Weil talk about these topics and more on a special episode of A Health Podyssey.

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From severe weather such as the destructive wildfires in California to air pollution nationwide, there's a growing body of knowledge linking climate change to human health.

On this episode of A Health Podyssey, host Alan Weil interviews Dr. Kristie Ebi, a professor in the Department of Global Health at the University of Washington, to discuss this complex relationship.

Ebi served as the theme advisor for the December edition of Health Affairs, which is fully dedicated to exploring that link between climate and health. She published two papers in the issue. One notes that the people most harmed by climate change are those who have so far contributed the least to greenhouse gas emissions. The second connects how detection and attribution studies could quantify how climate change is affecting health.

They note that while emissions have fallen during the COVID-19 pandemic, it's not enough to make a long-term impact. With the healthcare industry responsible for about 4.5% of the worldwide greenhouse gas emissions, hospitals and health systems can take the moment to re-evaluate their relationship to climate change.

Listen to hear why Dr. Ebi believes individuals shouldn't feel hopeless in the face of climate change.

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Does America have a healthy relationship with food?

In addition to the direct health effects of diet, food production and distribution affects environmental factors, which then trickles down to our health statuses. For example, an estimated one quarter of global greenhouse gas emissions relate to food production.

In a new paper published in the climate-centric December edition of Health Affairs, Mary Kathryn Poole, a PhD student in population health sciences at the Harvard T.H. Chan School of Public Health, and colleagues explored the relationship between The National School Lunch Program, one of the largest federal food programs, and its impacts on the environment.

In this week’s episode of A Health Podyssey, Alan Weil interviews Mary Kathryn Poole to discuss her paper, the EAT-Lancet Commission’s reference diet, strategies to reduce red meat consumption, and how they relate to planetary health diets.

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How are Indigenous communities responding to climate change?

It’s an important but often under-looked question. As a new paper published in the climate-centric December edition of Health Affairs posits, Indigenous communities are uniquely vulnerable as climate-related events can impact their day-to-day lives, self-determination, and physical and emotional health.

In 2016, the Pala Band of Mission Indians tribe, who are located in southern California, conducted a vulnerability assessment regarding the effects of climate change. High temperatures, wildfires, storm flooding and drought were all identified as major concerns.

And yet, the assessment revealed few participants were aware of many of the potential health consequences at the individual and community levels as a result of these threats.

Indigenous communities have a history of adapting to their environment but some impacts from climate change for these communities are unexpected.

In this week’s episode of A Health Podyssey, Alan Weil interviews Shasta Gaughen, director of the Pala Environmental Department for the Pala Band of Mission Indians, to discuss her recent paper and these unintended consequences of climate change as it relates to physical, mental, and cultural health for Indigenous communities.

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Brooke Cunningham is a general internist, sociologist, and assistant professor in the Department of Family Medicine and Community Health at the University of Minnesota.

After George Floyd's killing, she wrote and published a Narrative Matters essay in Health Affairs on how the health effects of racism become embodied for her and other Black Americans.

On this episode of A Health Podyssey, Health Affairs Editor-in-Chief Alan Weil interviews Brooke Cunningham about the essay and what she hopes listeners and readers take from her writing. After the interview, Brooke reads her essay in full.

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In November, the pharma companies Pfizer and Moderna both announced substantial progress on a potential COVID-19 vaccine. While both vaccines showed promising results during clinical trials, questions remain for what's next and how to distribute a vaccine once it's available for public use.

One major question mark concerns logistics. For example, the Pfizer vaccine needs to be kept at extremely cold temperatures while traveling through the supply chain — though that doesn't seem to be the case for Moderna's vaccine.

Another worry is ensuring equitable access to an effective vaccine. Dr. Angela Shen, visiting scientist at the Children's Hospital of Philadelphia and vaccine policy expert, recently published a paper on the topic in a special cluster on COVID-19 vaccines in Health Affairs. She joins A Health Podyssey to discuss her paper, as well as the challenges and opportunities the US will face to secure equitable access to a COVID-19 vaccine.

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New York City was an initial focal point for COVID-19 outbreaks in the U.S. with the virus then quickly spreading across the country. With time, data, and analysis, researchers are learning more about how the novel coronavirus is affecting different swaths of the U.S. population.

Leonard Egede, division chief of the Division of General Internal Medicine in the Department of Medicine and director of the Center for Advancing Population Science at the Medical College of Wisconsin, and colleagues recently published a paper in Health Affairs which aimed to understand the racial and ethnic differences in COVID-19 screening, hospitalization, and mortality rates in Milwaukee and Southeast Wisconsin.

Using data from more than 31,500 adults, Egede and his colleagues found that blacks and Hispanics were both more than three times more likely to test positive for COVID-19 than non-Hispanic whites. In addition, both blacks and Hispanics were two times more likely to be hospitalized relative to whites.

What do these findings mean for national hospitals, communities, and policymakers? 

Health Affairs Editor-in-Chief Alan Weil interviews Leonard Egede to discuss his paper and what the findings tell us about the challenges that lie ahead as the COVID-19 pandemic continues.

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No matter which side of the aisle you sit, the 2020 U.S. presidential election has been as memorable as it's been remarkable. 

On November 4th — less than 24 hours after the final polls closed — Health Affairs' Alan Weil sat down with Kimberly Leonard, Senior Healthcare Reporter at Business Insider, and Shannon Muchmore, Editor at Healthcare Dive, to share his perspective on what the future of health policy may look like when the election is finally in the rearview mirror. 

The group touches on the fate of the Affordable Care Act, what's on deck for future coronavirus relief packages, and how the next administration may continue federal policies on pricing transparency. We also hear how Alan, Kimberly, and Shannon maintain bipartisanship in their publications in the face of increasing polarization.

Listen to hear what Alan, Kimberly, and Shannon are hearing across Washington, D.C. and how it could influence future health policies.

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We’ve long known that community resources — good schools, walkability, food security, etc. — affect opportunities for children’s health and behaviors to develop. But how do we measure these characteristics and use our knowledge to create better policy? 

In this episode of A Health Podyssey, Health Affairs Editor-in-Chief Alan Weil interviews Brandeis University’s Dr. Dolores Acevedo-Garcia to discuss her research on racial and ethnic inequities in children’s neighborhoods.

The results are stunning as they are surprising. While differences across the country were expected and noted, more than 90% of the variation in neighborhood opportunity occurs in metro areas.

What are the implications at the policy level for these results? Alan Weil and Dr. Acevedo-Garcia discuss.

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