Research Roundup: Fetal Alcohol Syndrome; Rural Health Care; Medicare Plans; And More

American Academy Of Pediatrics: Early-Life Predictors Of Fetal Alcohol Spectrum Disorders
Fetal alcohol spectrum disorders (FASD) comprise the continuum of disabilities associated with prenatal alcohol exposure. Although infancy remains the most effective time for initiation of intervention services, current diagnostic schemes demonstrate the greatest confidence, accuracy, and reliability in school-aged children. Our aims for the current study were to identify growth, dysmorphology, and neurodevelopmental features in infants that were most predictive of FASD at age 5, thereby improving the timeliness of diagnoses. (Kalberg et al, 12/1)

Health Affairs: Rural Counties With Majority Black Or Indigenous Populations Suffer The Highest Rates Of Premature Death In The US 
Despite well-documented health disparities by rurality and race/ethnicity, research investigating racial/ethnic health differences among US rural residents is limited. We used county-level data to measure and compare premature death rates in rural counties by each county’s majority racial/ethnic group. Premature death rates were significantly higher in rural counties with a majority of non-Hispanic black or American Indian/Alaska Native (AI/AN) residents than in rural counties with a majority of non-Hispanic white residents. (Henning-Smith et al, 12/1)

Health Affairs: The Decline In Rural Medical Students: A Growing Gap In Geographic Diversity Threatens The Rural Physician Workforce
Growing up in a rural setting is a strong predictor of future rural practice for physicians. This study reports on the fifteen-year decline in the number of rural medical students, culminating in rural students’ representing less than 5 percent of all incoming medical students in 2017. Furthermore, students from underrepresented racial/ethnic minority groups in medicine (URM) with rural backgrounds made up less than 0.5 percent of new medical students in 2017. Both URM and non-URM students with rural backgrounds are substantially and increasingly underrepresented in medical school. (Shipman, 12/1)

The Henry J. Kaiser Family Foundation: No Itch To Switch: Few Medicare Beneficiaries Switch Plans During The Open Enrollment Period
ach year, Medicare beneficiaries in private Medicare Advantage plans and Part D stand-alone prescription drug plans (PDPs) have the opportunity to change plans during the annual open enrollment period (October 15 to December 7). Medicare’s private plans vary significantly from each other and can change from one year to the next, which can have a significant impact on enrollees’ coverage and costs. The Centers for Medicaid & Medicare Services (CMS) encourages beneficiaries to shop for Medicare Advantage and prescription drug plans to potentially save money on prescriptions or get new benefits. (Koma et al, 12/2)

JAMA Internal Medicine: Potential Medicare Savings On Inhaler Prescriptions Through The Use Of Negotiated Prices And A Defined Formulary
Medicare is prohibited by US law from directly negotiating drug prices with manufacturers. The Department of Veterans Affairs (VA) Health System, in contrast, relies on direct negotiation and closed formularies to reduce costs. A 2018 US congressional report found that Medicare would have saved $2.8 billion in 2015 if it had paid VA-negotiated prices for the 20 most commonly prescribed drugs to beneficiaries of Medicare Part D. A 2019 study estimated that, for the 50 costliest oral drugs, Medicare Part D would have saved $14.4 billion in 2016 with VA-negotiated prices. However, neither study assessed the influence of formularies in conjunction with price negotiations, and the 2019 study excluded products with nonoral routes of administration. (Feldman et al, 12/2)

The New York Times: Diabetes In Mothers Raises Heart Risks In Children
The children of mothers with diabetes may be at increased risk for early heart disease. Researchers used Danish national health registries that included 2.4 million children who were born without heart disease. During 40 years of follow-up, 1,153 of the children whose mothers had diabetes — either Type 1 or Type 2 disease, or diabetes of pregnancy (gestational diabetes) — were given diagnoses of cardiovascular disease. Cardiovascular disease developed in 91,311 children whose mothers who did not have diabetes. (Bakalar, 12/4)

JAMA Internal Medicine: Public Awareness For A Sexual Assault Hotline Following A Grey’s Anatomy Episode
Results from the National Intimate Partner and Sexual Violence Survey indicate that 18.3% of US women and 1.4% of men have experienced rape. Trauma from sexual assault can lead to severe, long-standing negative sequelae, particularly when left untreated. Further complicating matters, only 23% of sexual assault crimes are reported to the police, in part because of a lack of awareness of how to obtain help. (Torgerson et al, 12/2)