Viewpoints: Exploring The Links Between Health And Housing; U.S. Has A Chronic Pain Mismanagement Crisis

JAMA: Investing In Housing For Health Improves Both Mission And Margin
During the last 20 years, low-income families have had their incomes plateau or decline as their housing costs soared. Public aid has not been expanded to meet the growing need: only 1 in 4 households that qualify for housing assistance receives it. As a result, today most renting households below the federal poverty line spend more than half of their income on housing costs, and 1 in 4 spends more than 70% of its income on rent and utility costs alone. Rent-burdened families not only have less money to spend on wellness and health care but also regularly face eviction and homelessness, which further threaten their health. According to recent estimates, 2.8 million renting households are at risk of eviction and more than 500 000 people are homeless on any single night. (Megan Sandel, and Matthew Desmond, 10j/31)

JAMA: Homelessness—Challenges And Progress
Homelessness is not a new phenomenon in the United States, but its visibility has increased, and the composition of the homeless population has changed. Formerly the province primarily of single men, the homeless population today increasingly includes women, children, and families. The exact number of homeless persons has always been difficult to estimate because of differences in who is defined as homeless (eg, living on street [unsheltered] only or persons also living in an unstable housing arrangement), differences in time course (eg, on a given night or within the last year), and the fact that some homeless persons hide from view. Nevertheless, the best estimates are that on a given night in 2016, approximately 550 000 individuals were homeless, of whom 32% were unsheltered and 35% involved families with children.1 Los Angeles had the highest number of homeless persons (32 803) of any US city, 82% of whom were unsheltered. (Mitchell H. Katz, 10/31)

Stat: An Integrative Approach To Chronic Pain Can Help Solve The Opioid Crisis
That’s what worries me about the president’s approach to the opioid crisis. It isn’t focused on curing addiction or adequately treating the pain that fuels it. We’re just making it harder for people to get drugs — which adds to the burden of human suffering and desperation — and calling it a solution. (Wayne Jonas, 10/31)

WBUR: I've Been Treating Opioid Addiction For A Decade. This Is What We Need To Do
President Donald Trump declared the opioid epidemic a public health emergency last week, a move that waives some federal regulations and eases state access to federal funds. ...The declaration is long overdue, but the limited funding is worrisome, as is the tone than evokes antiquated and failed measures: expecting a drug-free America, dubbing drug use a moral failing, and reverting to the turf of the marijuana battle. (Bachaar Arnaout, 11/1)

The New York Times: Glasses Are Cool. Why Aren’t Hearing Aids?
If I do my job right, this column might actually change your life. More important, it might change the lives of the people you love. But first, I need to talk about Elton John’s glasses. It was my first concert. Philadelphia Spectrum, 1972. Elton opened up with “Tiny Dancer” on solo piano. Later, during “I Think I’m Going to Kill Myself,” a character named Legs Larry Smith came out and tap danced. (Jennifer Finney Boylan, 10/31)

JAMA: The Iatrogenic Potential Of The Physician’s Words
Some of the information that physicians convey to their patients can inadvertently amplify patients’ symptoms and become a source of heightened somatic distress, an effect that must be understood by physicians to ensure optimal management of patient care. This effect illustrates the iatrogenic potential of information, as opposed to the iatrogenic potential of drugs and procedures. (Arthur J. Barsky,10/31)

Stat: Don't Want 'Heroic Measures' In End-Of-Life Care? Have The Conversation
Doctors often don’t adequately convey these grim outcomes; many patients remain falsely optimistic, tending to overestimate their chances of surviving a cardiac arrest. And few people understand what the resuscitation process truly entails, and how these efforts often lead to a painful, undignified death. Recent research also shows that patients and caregivers tend not to be on the same page when it comes to what level of disability or pain might be acceptable to a patient in the future, including after a code. There’s got to be a way to close these gaps. (Allison Bond, 10/31)

JAMA: Responsible Care In The Face Of Shifting Recommendations And Imperfect Diagnostics For Zika Virus
The US Centers for Disease Control and Prevention (CDC) recently released updated interim guidance for when pregnant women should receive serologic testing for the Zika virus. The circumstances within which these recommendations emerge are complex: the public concern about the Zika virus is declining, the severity of epidemics around the globe is abating, and as a critical consideration in the development of recommendations, the rate of false-positive Zika virus test results (and the consequential unnecessary anxiety) is high. (Ilona Telefus Goldfarb, Elana Jaffe, Anne Drapkin Lyerly, 10/31)

Los Angeles Times: How Legalized Pot Can Make Up For The Disastrous War On Drugs
When recreational cannabis becomes legal in California on Jan. 2, part of the focus — in Los Angeles, at any rate — will be on “social equity.” That’s the term for a set of guidelines meant to spread legalization’s wealth to neighborhoods that have gotten the worst of the drug wars. According to draft legislation currently moving through the City Council, for every general license approved for a pot shop, one license must also be approved for social equity reasons. (David L. Ulin, 11/1)