Research Roundup: State Gun Laws; The ‘Public Charge’ Rule; And Medicare Advantage

Pediatrics: State Gun Laws And Pediatric Firearm-Related Mortality
Firearms are the second leading cause of pediatric death in the United States. There is significant variation in firearm legislation at the state level. Recently, 3 state laws were associated with a reduction in overall deaths from firearms: universal background checks for firearm purchases, universal background checks for ammunition purchases, and identification requirement for firearms. We sought to determine if stricter firearm legislation at the state level is associated with lower pediatric firearm-related mortality. (Goyal et al, 8/1)

Urban Institute: How Uncertainty Surrounding The “Public Charge” Rule Leads To Hardship For Immigrant Families
Recent Urban Institute survey data show that heightened immigration-related fears and concerns are shaping immigrant families’ daily lives. Many families are changing their daily routines and avoiding safety net programs. This “chilling effect” and fear is affecting families with a wide range of immigration and citizenship statuses, including green card holders and US citizens. To complement our national survey findings, we conducted follow-up interviews with 25 adults in immigrant families in March 2019. We spoke with interviewees across the US who had reported avoiding the Supplemental Nutrition Assistance Program (SNAP), Medicaid or the Children’s Health Insurance Program, and/or housing assistance in 2018 because of immigration concerns. (Bernstein, McTarnaghan and Gonzalez, 8/7)

The Henry J. Kaiser Family Foundation: Financial Performance Of Medicare Advantage, Individual, And Group Health Insurance Markets
Medicare-for-All proposals have sparked discussion about the role of private health insurance in the U.S. health care system. Some of the current Medicare-for-All proposals would essentially eliminate private insurance. Others would allow private insurers to administer benefits under the new public program, similar to the role of Medicare Advantage plans today, which serve as a private-plan alternative to traditional Medicare. Another set of proposals would create a new Medicare-like public plan option, but preserve a role for private health insurance, including employer-sponsored coverage and policies sold to individuals and families in the Affordable Care Act (ACA) Marketplaces. (Jacobson, Fehr, Cox and Neuman, 8/5)

JAMA Internal Medicine: Effect Of A Professional Coaching Intervention On The Well-Being And Distress Of Physicians: A Pilot Randomized Clinical Trial
Among the 88 physicians in the study (48 women and 40 men), after 6 months of professional coaching, emotional exhaustion decreased by a mean (SD) of 5.2 (8.7) points in the intervention group compared with an increase of 1.5 (7.7) points in the control group by the end of the study (P < .001). Absolute rates of high emotional exhaustion at 5 months decreased by 19.5% in the intervention group and increased by 9.8% in the control group (−29.3% [95% CI, −34.0% to −24.6%]) (P < .001). (Dyrbye et al, 8/5)

The New York Times: Arthritis Tied To Heart Disease. Pain Relievers May Be To Blame.
Osteoarthritis has been linked to an increased risk for cardiovascular disease, and a new study suggests that a large part of the risk comes from the use of nonsteroidal anti-inflammatory medicines, or NSAIDs. Such drugs include ibuprofen (Advil or Motrin) and naproxen (Aleve), as well as a variety of prescription NSAIDs. Researchers used Canadian health databases to match 7,743 osteoarthritis patients with 23,229 healthy controls who rarely or never used NSAIDs. The study is in Arthritis & Rheumatology. (Bakalar, 8/7)

The New York Times: Statins Provide Heart Benefits Past Age 75
Statins are proven effective in reducing the risk for cardiovascular disease, but some studies suggests that after age 75, the risks outweigh the benefits. Now new research has found that stopping the drugs may be a bad idea. The retrospective study, published in the European Heart Journal, included 120,173 people who turned 75 while taking statins. None had any heart problems. (Bakalar, 8/5)