Health & Veritas

Harlan reports on three negative—but striking—trials presented at the American Heart Association’s annual meeting; Howie reflects on the victories for health in Tuesday’s election. And they’re joined by Dr. Marcella Nunez-Smith, a Yale internist and nationally known expert on healthcare equity, to discuss her service in the Biden administration and the need for a broad approach to tackling racism in healthcare and systemic inequities in health. Links: “Another Fibrate Fails to Show Cardiovascular Benefit” “DCP: HCTZ vs. Chlorthalidone in Improving CV Outcomes in Elderly Veterans With HTN” “TRANSFORM-HF: Loop Diuretics Show No Difference in Mortality and Hospitalizations for Heart Failure” “Nunez-Smith to lead Biden health equity task force”  Pozen-Commonwealth Fund Fellowship in Health Equity Leadership at Yale University “Voters will have a say on abortion in 5 states with high-stakes ballot measures” “South Dakota votes to expand Medicaid” Employer-Reported Workplace Injuries and Illnesses—2021 Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan describes a revealing new study on the long-term impacts of COVID; Howie reflects on the escalating costs of health insurance. And they are joined by Dr. Lisa Leffert, Yale’s chief of anesthesiology, to discuss her unusual career path, disparities in maternal mortality, and her approach to tackling the gender pay gap in the field. Links: “Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank” Health & Veritas: Saving Mothers’ Lives (Ep. 7) Lisa Leffert: “The ‘Unexplained’ Portion of the Gender Pay Gap in Anesthesiology” KFF: 2022 Employer Health Benefits Survey Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by physician, sociologist, and thinker Nicholas Christakis to talk about how humans have evolved to form powerful connections. Howie provides updates on concussions among high school athletes and the use of Ivermectin for COVID, and Harlan remembers Dr. Barry Zaret, an important figure in cardiology at Yale and beyond. Links:  In Memoriam: Barry L. Zaret, MD Yale News: “Blueprint: The Evolutionary Origins of a Good Society” Steven Pinker: “The Better Angels of our Nature” “The Moral Life of Babies” Nicholas Christakis: “The Spread of Obesity in a Large Social Network over 32 Years” Nicholas Christakis: “Algorithms for seeding social networks can enhance the adoption of a public health intervention in urban India”  “Concussions are a bigger problem for kids’ football than the NFL”  “Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19”  ”These Doctors Admit They Don’t Want Patients With Disabilities” Learn more about the MBA for Executives program at Yale SOM Email Howie and Harlan comments or questions.

Harlan reports on a new study testing the effectiveness of the OCD drug fluvoxamine in treating COVID; Howie reflects on the potential of continuous glucose monitoring for people with diabetes. And they’re joined by Dr. Utibe Essien of the University of Pittsburgh to discuss the barriers preventing people of color from getting innovative new treatments and medications.  Links: “Fluvoxamine for Outpatient Treatment of COVID-19: A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial” Utibe Essien: “Association of Neighborhood Disadvantage and Anticoagulation for Patients with Atrial Fibrillation in the Veterans Health Administration: the REACH-AF Study” “Prevalence and Correlates of Patient Rationing of Insulin in the United States: A National Survey”  Harlan Krumholz: “Life Expectancy after Myocardial Infarction by Hospital Performance”  “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites”  Antiracism in Medicine podcast   “Intermittently Scanned Continuous Glucose Monitoring for Type 1 Diabetes” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan check in on new research and health issues in the news, including studies on colonoscopies and the timing of hypertension medication, the state of the monkey pox and polio outbreaks, and the wave of legislation restricting treatment of trans youth. Links: “Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death”  “Monkeypox Cases Are Declining in New York City and Globally”  “WHO declares monkeypox a global health emergency as infections soar”  “Evening dosing of blood pressure medication not better than morning dosing”  “Arkansas cannot enforce ban on gender-affirming care for trans kids, court rules”  “Watch Jon Stewart Calmly Excoriate the Arkansas Attorney General on Anti-Trans Legislation”  “Yale’s Emily Wang and two alumni win MacArthur ‘genius’ awards” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan look at the plunging cost of sequencing an individual genome, and the problem of concussions among athletes at all levels. And they’re joined by Dr. Ania Jastreboff, a Yale obesity specialist, to discuss the dramatic results from a new class of drugs that target the brain’s system for regulating body fat. Links: “llumina Unveils Revolutionary NovaSeq X Series to Rapidly Accelerate Genomic Discoveries and Improve Human Health” “The race to a $100 genome” (2013) Ania Jastreboff: “Tirzepatide Once Weekly for the Treatment of Obesity” “FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014” “NFL under fire over its concussion protocol following Tua Tagovailoa's back-to-back game hits” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan discusses the problem of “financial toxicity”—how medical bills can wreak havoc in vulnerable patients’ lives. Howie reflects on the protests in Iran and the precariousness of the freedoms we enjoy in the United States. And they are joined by Ingrid Nembhard of the University of Pennsylvania to discuss her work on the organizational factors that shape patient care. Links: Cancer.gov: Financial Toxicity “They Were Entitled to Free Care. Hospitals Hounded Them to Pay.” Harlan Krumholz: “Atherosclerotic Cardiovascular Disease, Cancer, and Financial Toxicity Among Adults in the United States” Harlan Krumholz: “Out-of-Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States” Ingrid Nembhard: “Responding to Covid-19: Lessons from Management Research” Ingrid Nembhard: “COVID-19 Inspired Creativity In Health Care: Lessons For Management And Policy” “Can the CDC Repair Its Reputation?” Ingrid Nembhard: “A systematic review of research on empathy in health care” Ingrid Nembhard: “Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams” Ingrid Nembhard: “Perceived Usefulness of Patient Narrative Feedback in Primary Care Settings” “Why Iranian women are burning their hijabs after the death of Mahsa Amini” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan react to President Joe Biden’s declaration that the pandemic is over. Then they’re joined by Jonathan Rothberg, a Yale-trained scientist who has created new methods for sequencing DNA and founded a series of successful biotech companies. Disclosure: Harlan Krumholz is a consultant to Tesseract, a portfolio company of 4 Catalyzer, which was founded by Jonathan Rothberg. Links: “Biden: ‘The pandemic is over’” Eric Topol: “To boost or not to boost” “An integrated semiconductor device enabling non-optical genome sequencing” ”Butterfly Network Distributes 500 Butterfly iQ+ Devices to Healthcare Workers in Kenya to Transform Maternal and Fetal Health” ”AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings” Butterfly Network Protein Evolution Hyperfine ”Uncovered Medical Bills after Sexual Assault” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss the confusion over COVID therapeutics, even among professionals. Then they're joined by Dr. Jeremy Faust, a researcher, emergency physician, and public voice on COVID and other issues—as well as an active choral conductor. They discuss his unusual path, the state of the pandemic, and the importance of understanding “excess mortality.” Links: “Coronavirus (COVID-19) Update: FDA Authorizes New Monoclonal Antibody for Treatment of COVID-19 that Retains Activity Against Omicron Variant” Overview of Bebtelovimab COVID-19 Therapeutics Locator Jeremy Faust: Inside Medicine Robert T. Sataloff: “The Human Voice” Jeremy Faust: “Excess Mortality in Massachusetts During the Delta and Omicron Waves of COVID-19: All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020 Longwood Symphony and World Doctors Orchestra at Symphony Hall “Out-of-pocket spending on insulin among people with private insurance” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan outlines his new study tracking excess mortality over the course of the pandemic in the highly vaccinated state of Massachusetts; Howie discusses how the Inflation Reduction Act will tackle drug prices. They're joined by Dr. Esther Choo to talk about life as a doctor on social media and the crisis facing emergency departments. Links: Esther Choo: “Covid-19 is pushing doctors to the brink. Medicine needs to recognize they’re human and need help.” “Uncoupling of all-cause excess mortality from COVID-19 cases in a highly vaccinated state” “New York Governor Lifts Mask Mandate for NYC Subways” White House Fact Sheet: The Inflation Reduction Act Supports Workers and Families Learn more about the MBA for Executives program at Yale SOM. Learn more about the MD-MBA program at Yale. Email Howie and Harlan comments or questions.