The Dose

Americans are stressed about COVID-19 – both the disease and what it's doing to the economy. And while the virus has touched every corner of the globe, many high-income countries have been more successful than the U.S. at easing some of the pandemic's pain. This week on The Dose podcast, we talk about why Americans are experiencing the anxiety and sadness of the pandemic differently than people in other countries, and how this is tied to economic concerns like food, jobs, and housing.

Health care is always important for voters, but this year, it is at the top of everyone's mind. The health needs and economic costs of COVID-19, and protections for people with pre-existing health conditions tie for first place in the Commonwealth Fund's latest poll on which health care issue matters most to voters in the 2020 election. Voters are also worried about health care costs, the safety of voting in person, and whether or not their vote would be counted if they vote by mail. Then there's the question of which candidate – Former Vice President Biden or President Trump – would address voters' health care concerns. To learn what they said, and unpack some of the poll's key findings, listen to the latest episode of The Dose with the Commonwealth Fund's Sara Collins.

Hospitals in the U.S. started preparing for COVID-19 as early as January, but it wasn't until Italian doctors started tweeting in March that they had to decide which patients would get ventilators that Michael Apkon realized the severity of the crisis. On the latest episode of The Dose, Apkon, President and CEO of Tufts Medical Center in Boston, takes listeners on one hospital's journey through the harrowing past six months of dealing with the pandemic. Apkon recounts conversations with former colleagues from his time running a hospital in Canada, and reflects on how the fundamental differences between the U.S. and Canada's approach to health care contributed to two very different responses to COVID-19. Over the next few weeks, The Dose will be covering how the pandemic and other health care issues are playing out in the 2020 Presidential election. Listen to today's show, and then subscribe wherever you find your podcasts.

***Originally Aired Nov 2019*** Bias in medicine – based on race and sex – is a well-documented problem. It's a problem because the health care system has historically marginalized the medical concerns of people of color and women, which has led to worse health outcomes. On this episode of The Dose, host Shanoor Seervai discusses ways to tackle bias in health care with Ann-Gel Palermo, who works on diversity and inclusion at New York's Icahn School of Medicine at Mount Sinai, and Joia Crear-Perry, who founded the National Birth Equity Birth Collaborative to address racial disparities in health care. They explain that bias is not just a concern at the individual provider level; it's actually baked into the system, starting in medical school. While fundamental change will be an uphill battle, they say, the fight is critical to ensuring that all patients are treated fairly when they seek care.

***Originally Aired Feb 2020*** More than 800 women across the globe die each day from complications related to pregnancy. Some of them bleed to death. Some of them develop infections or severe life-long medical conditions because they are delivering their babies in unsafe environments. Many of these deaths could be prevented if more young people had access to birth control and other reproductive health care. Pathfinder International is a nonprofit working with communities in 20 countries to make this a reality. On this episode of The Dose, Pathfinder CEO Lois Quam, a member of the Commonwealth Fund's board, recounts some of the stories she's heard from young people around the world. Quam tells host Shanoor Seervai about the challenges they face in deciding whether and when to have children — and how their lives change when they are able to make this choice.

***Originally Aired Oct 2019*** African American women die of pregnancy-related causes at three times the rate for white women, even after accounting for income, education, and access to other resources. What is it about being born black in America that leads to such outcomes? To answer this question, Shanoor Seervai interviews Kennetha Gaines, clinical nurse manager for UCSF Health in San Francisco, for the latest episode of The Dose podcast. Gaines, a Pozen Commonwealth Fund Fellow in Minority Health at Yale University, speaks candidly about her personal experiences and her work to transform the way health care providers treat black women. Does the health care system treat people differently based on race? Tell us what you think – send an email to thedose@commonwealthfund.org.

When the pandemic hit, millions of Americans found themselves in a tight spot – practice social distancing to avoid COVID-19, but what if you have a health condition that requires seeing a doctor? Technology could transform the way people access health care, and the U.S. has made huge investments in this over the past decade. But, as health technology expert Aneesh Chopra explains on the latest episode of The Dose, we still haven't realized the full potential of digitization when it comes to delivering health care.

On June 12, the Trump administration eliminated federal protections against discrimination in health care for transgender people. This means that transgender Americans can be denied access to health coverage and care – simply because they are trans. With the U.S. still grappling with COVID-19, the decision could make it more difficult for trans people to seek testing or treatment for the disease. And it deepens the health risks for a population already facing barriers to care. The Commonwealth Fund's Corinne Lewis, Yaphet Getachew, and Mekdes Tsega talk about the implications of the new rule, particularly for trans people of color, on this episode of The Dose podcast.

COVID-19 cases in the U.S. are climbing again, and data show that Black and Latinx Americans are contracting and dying of COVID-19 at higher rates than white Americans. The reasons for are complex, including: people of color are more likely to be poor, work in industries that expose them to the virus, live in crowded spaces, and have chronic health conditions. Then there's race -- the discrimination and violence that people of color experience on a daily basis puts their health at risk, further exposing them to the coronavirus. Against the backdrop of a nationwide reckoning over police brutality against people of color, Dora Hughes, a professor of health policy at George Washington University, talks about the disproportionate impact of the pandemic on Black and Latinx people, and what policymakers could do to address these racial inequities.

Every day, primary care providers are on the front lines of the COVID-19 pandemic, treating sick patients even as they worry about bringing the virus home to their families. Many still lack adequate protective gear, and many worry about the financial stability of their practices. With the U.S. starting to reopen, we need our primary care practices to keep their lights on — not only to test and treat people with mild symptoms but also to address health concerns that people have neglected while staying home. On this episode of The Dose podcast, health policy expert Farzad Mostashari, M.D., who advises and supports hundreds of primary care practices across the country, explains what it will take to ensure doctors can continue caring for Americans throughout the pandemic.