As the opioid epidemic deepens, Yale researchers say starting treatment with medication is the most cost-effective way to treat patients in hospital emergency departments. People with opioid addiction often seek treatment in EDs for overdoses and other ailments. Those who receive buprenorphine, a medication that reduces drug cravings, in the ED incur lower health care costs over the following month than those who get a referral to treatment services or receive a brief intervention with a facilitated referral, according to a new analysis of a randomized clinical trial. The analysis, published today in the journal “Addiction,” compared the estimated health care costs for patients over the 30 days following their ED visit. Those costs included ED care, addiction treatment, inpatient and outpatient costs and medications.
Struggles with unemployment, food insecurity and unstable housing can take a serious toll on individuals’ health, and stronger social supports could play a key role in improving their well-being, according to an advocacy group. While national health reform and the Affordable Care Act have focused largely on improving access to and the quality of health care, socioeconomic factors – like housing, employment and food security – play a larger role in someone’s overall health than clinical factors, according to the Universal Health Care Foundation of Connecticut. “Health is affected by many other things, not just whether you have access to a doctor, access to health care,” said Jill Zorn, senior policy officer at the foundation. “If you’re really interested in improving health, it’s not just about clinical care.”
In fact, just 20 percent of a person’s health is attributed to clinical are, according to the U.S. Centers for Disease Control and Prevention. Another 10 percent is attributed to physical environment, 30 percent to health behaviors and 40 percent – the largest share – is tied to socioeconomic factors, according to the CDC.
Women between the ages of 30 and 55 tend to ignore early heart attack symptoms, which may be part of the reason more young women die from heart attacks than young men, according to new research by Yale School of Public Health. Many women delay seeking medical attention when they have a heart attack because they don’t realize they are having one at first, said Judith Lichtman, associate professor and chairwoman of Yale School of Public Health’s department of chronic epidemiology. Researchers conducted in-depth interviews with 30 women between the ages of 30 and 55 who had suffered heart attacks within the previous two weeks. The resulting research recently was published in the journal “Circulation: Cardiovascular Quality and Outcomes.”
The study focused on women who were younger than the typical demographic for heart attacks, which more often strike people in their 60s. “A lot of the women had chest pain and pressure, which is the hallmark symptom of a heart attack, but also described other symptoms,” Lichtman said, such as fatigue, muscle pain and indigestion.
What if an aspirin a day could keep cancer away? A growing body of scientific research suggests that aspirin can prevent some cancers of the digestive system, and maybe even breast and prostate, too. In the latest study, published today in the journal Cancer Epidemiology, Biomarkers & Prevention, Yale University researchers found that patients from 30 hospitals across the state were less likely to develop pancreatic cancer if they took a small, daily dose of aspirin. Researchers are stopping short of recommending aspirin as a broad cancer prevention tool, because of its possible side effects, including stomach pain and gastrointestinal bleeding. “Aspirin is not a risk-free substance,” said Dr. Harvey Risch, a professor of Epidemiology at the Yale School of Public Health, who led the research.
When it comes to vaccinating adolescent females against human papillomavirus (HPV), the most common sexually transmitted disease known to be the main cause of cervical cancer, Connecticut boasts a slightly higher participation rate than the national average. About 58 percent of females in the state received the initial HPV vaccine dose compared with roughly 54 percent nationally, according to the National Immunization Survey, based on data from 2012 for girls aged 13-17. HPV vaccine is given in three shots and Connecticut has a completion rate of 44 percent, better than the national average of 33 percent, according to the survey. The U.S. Centers for Disease Control and Prevention recently reported that the number of girls receiving the HPV vaccine nationally lags behind other vaccination rates and has “not moved forward.’’
The state’s rate is “probably due to a combination of factors,” said Linda Niccolai, an associate professor of epidemiology at the Yale School of Public Health and director of the HPV-Impact Project at the Yale Emerging Infections Program. “Health insurance coverage and rates are pretty good in Connecticut, but it’s also possible that providers in Connecticut are more proactive in making sure their patients are vaccinated and parents are more aware of the need for the vaccination.”
The national data show that Hispanic females have the highest participation rate at 63 percent, followed by whites at 51 percent, and blacks at 50 percent.
In Alexandria, Va., the rate of antidepressant use is the highest in the country, with a full 40 percent of residents receiving prescriptions. Cape Cod, Mass., tops the country in the use of stimulants, with 16 percent of the population filling at least one prescription, compared to a mean of 2.6 percent nationally. Gainsville, Fla., has the highest utilization rate of antipsychotics – 4.6 percent of residents, well above the national mean of .8 percent. Usage rates of the three classes of mental health medications vary widely across the U.S., with Connecticut in the middle, according to a new study by the Yale School of Management. The study found that much of the geographic variation could be explained by access to health care and pharmaceutical marketing efforts, rather than by the underlying prevalence rate of the psychiatric disorders.