CDC: America’s teens in distress

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Apr 28, 2023 View in browser   By Daniel Payne and Krista Mahr Presented by With help from Robert King and Carmen Paun Driving the day The CDC’s 2021 Youth Risk Behavior Survey offers a troubling window into high school students’ physical, emotional and mental health. | Marta Lavandier/AP Photo KIDS IN CRISIS — The results of the CDC’s 2021 national Youth Risk Behavior Survey and dozens of local surveys, released Thursday, create a stark picture of a fast-changing teenage population that is struggling with mental health, widespread community, physical and sexual violence, and substance use, Krista reports. They also offer the largest window to date into how the upheaval and stress of the Covid-19 pandemic impacted teenagers’ emotional, physical and mental health. Shifting demographics: Just over 49 percent of respondents identified as being part of a racial or ethnic minority group, compared to 48.9 percent in 2019. About 25 percent of students identified as LGBQ+, compared to just over 11 percent of students who identified as lesbian, gay or bisexual in 2019. Worsening mental health: While the number of male students who said they had considered, planned or attempted suicide was stable between 2019 and 2021, female students reported a sharp increase in all three, with 30 percent having seriously considered suicide in the last year, 24 percent having made a suicide plan, and 13.3 percent having attempted suicide. Widespread personal and community violence: Students reported higher rates of sexual violence and higher rates of having been forced into sex at some point in their life, with female students experiencing overall higher rates of interpersonal violence than their male counterparts. Researchers found that 1 in 5 students said they witnessed community violence, and 3.5 percent said they carried a gun. A few bright spots: More than 86 percent of students said their parents or other adults in their family “know where they are going or with whom they will be all or most of the time,” and 62 percent of kids said they felt “connected” to others at school. Both factors had positive impacts on teenagers’ health. WELCOME TO FRIDAY PULSE. Social distancing isn’t just for humans — it can be for dogs, too. In Minnesota, owners are urged to steer clear of dog parks amid a canine flu outbreak. What other outbreaks — or tips — do we need to know about? Drop us a line at dpayne@politico.com and kmahr@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Carmen Paun talks with Krista Mahr about stark results from the CDC’s 2021 Youth Risk Behavior survey, which offers a troubling window into high school students’ physical, emotional and mental health. Listen to today’s Pulse Check podcast   A message from PhRMA: The 340B program was designed to support true safety-net providers and help their patients afford medicines. But many hospitals have co-opted the program turning it into one that boosts their bottom lines at the expense of patients. In fact, an analysis found 340B hospitals charge uninsured patients nearly 4X what they pay to acquire cancer medicines through 340B. The 340B program should help patients afford their medicines, not make hospitals a profit.     A message from PhRMA:   At the Agencies MEDICAID MANAGED CARE UNDER THE MICROSCOPE — CMS issued two proposed regulations aimed at ramping up scrutiny of Medicaid managed care plans, including a requirement for plans to follow mandatory appointment wait times, Robert reports. The proposed rules come amid concerns from industry groups around a lack of transparency in managed care, which are private plans that oversee state Medicaid programs. Recent data shows more than two-thirds of Medicaid beneficiaries are in a managed care plan. CMS proposed the establishment of a maximum time before an appointment for a range of services from primary to mental health care. The requirement applies to both managed care and traditional fee-for-service Medicaid programs. CMS officials told reporters Thursday the appointment wait times are only a floor that states can go beyond. States also have to conduct “secret shopper” surveys to ensure plans are complying. One other proposal focuses on shining a light on the rates managed care plans pay providers. If finalized, a state must publish and update traditional and managed care rates online. The proposed rules also seek to boost quality for home health workers, a key requirement in a recent executive order from President Joe Biden. It would require 80 percent of Medicaid payments towards any home health service to go to the worker as opposed to overhead or profits. Providers Rep. James Clyburn (D-S.C.) was among the lawmakers calling for more diversity in the health workforce. | AP Photo/Matt Rourke OTHER WORKFORCE WOES — Amid the debates about how to boost the number of health workers, some lawmakers are also asking about how to increase the diversity of that workforce. Reps. James Clyburn (D-S.C.), Frederica Wilson (D-Fla.) and Lucy McBath (D-Ga.) are pushing for lawmakers to find ways to get more Black men to become physicians, they said at an event Thursday hosted by the Caucus on the Commission on the Social Status of Black Men and Boys. Just under 6 percent of doctors are Black, according to data from the Association of American Medical Colleges — which was also part of the event. The Senate has also considered the issue, with the Finance Subcommittee on Health Care hearing testimony from Cherae Farmer-Dixon, dean of Meharry Medical College’s School of Dentistry — a school that trains nearly a third of the country’s Black dentists. She made arguments similar to those the lawmakers did Thursday: that diversifying the pool of physicians could be a key to ending health disparities in the U.S. “It is well established that a person’s health care improves and their trust in the medical community grows when they are seen by a provider of their own race,” Farmer-Dixon said in her testimony. It’s an issue that’s been considered recently by the administration as well. Amid new pushes to grow the health care workforce to the right size, HRSA has also pushed for the consideration of diversity in its efforts. And Republicans have picked at the politics of the issue, chiding administration officials for considering anything other than merit when supporting workforce development — an argument long made in questions over affirmative action. Global Health PEPFAR POSTPONES UGANDA MEETING — John Nkengasong, the U.S. Global AIDS coordinator and special representative for global health diplomacy, postponed a crucial meeting planned for Friday in Uganda over anti-LGBTQ legislation being considered by the nation’s parliament, a State Department spokesperson told Carmen. The Anti-Homosexuality Act would impose the death penalty for same-sex relations involving a person with disabilities, for example, and 20-year jail sentences for promoting homosexuality. Ugandan President Yoweri Museveni, who reportedly backs the bill, sent it back to parliament for strengthening last week, Reuters reported. Secretary of State Antony Blinken warned in a tweet last month that the bill could reverse gains in the fight against HIV/AIDS, which the U.S. supports through its global AIDS-funding program PEPFAR. The postponement of the Friday meeting will give the program more time to assess the impact of the bill on its work in the country, the spokesperson said. But it does not freeze or cut essential services or support PEPFAR provides across Uganda.   HAPPENING NEXT WEEK! GO INSIDE THE 2023 MILKEN INSTITUTE GLOBAL CONFERENCE: POLITICO is proud to partner with the Milken Institute to produce a special edition "Global Insider" newsletter featuring exclusive coverage, insider nuggets and unparalleled insights from the 2023 Global Conference, which will convene leaders in health, finance, politics, philanthropy and entertainment from May 1-4. This year’s theme, Advancing a Thriving World, will challenge and inspire attendees to lean into building an optimistic coalition capable of tackling the issues and inequities we collectively face. Don’t miss a thing — subscribe today for a front row seat.     In Congress COMMUNITY PHARMACISTS COME TO TOWN — The National Community Pharmacists Association, an industry group for independent pharmacists, flew into Washington this week and continued its push to have lawmakers crack down on pharmacy benefit managers, which manage prescription drug benefits for plans. Independent pharmacists have successfully lobbied for action against PBMs on the state level — which they argue have used their market power to treat independent pharmacies unfairly — and the group is trying to capitalize on the PBM-centric momentum on Capitol Hill. The Washington confab included appearances from prominent PBM critics, including House Oversight and Accountability Chair James Comer (R-Ky.), who opened an investigation into the industry; and Federal Trade Commissioner Alvaro Bedoya. The FTC is doing its own study of PBMs and how they impact how much consumers pay for medicine. Names in the News Elizabeth Hale Simpson is now director at Sirona Strategies. She previously was health advocacy manager at Woodberry Associates. Michael D. Hogue has been named the permanent CEO of the American Pharmacists Association. He is currently dean of the Loma Linda University School of Pharmacy and will take on the new role this summer.   A message from PhRMA: About 80% of 340B sales are to hospitals, but these hospitals are not required to use 340B-generated profit to help patients afford their medicines. Most 340B hospitals don’t have policies to help low-income patients access medicines through their financial assistance policies, and such hospitals often spend less on charity care than non-340B hospitals. So, who is the 340B program helping?   What We're Reading CBS News reports that no new cases of mpox have been reported for the first time since the outbreak began. KFF Health News reports on the role of incarceration on falling life expectancy in the U.S. Mississippi Today reports on a hospital that cut care to trans kids — even before it was outlawed.   DON’T MISS THE POLITICO ENERGY SUMMIT: A new world energy order is emerging and America’s place in it is at a critical juncture. Join POLITICO on Thursday, May 18 for our first-ever energy summit to explore how the U.S. is positioning itself in a complicated energy future. We’ll explore progress on infrastructure and climate funding dedicated to building a renewable energy economy, Biden’s environmental justice proposals, and so much more. REGISTER HERE.       Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops Ben Leonard @_BenLeonard_ David Lim @davidalim Krista Mahr @kristamahr Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Megan R. Wilson @misswilson   Follow us

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