The Dose

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.

Health care is about so much more than medical tests or treatments. But, too often, health care providers forget to ask patients what they think would make them feel better. Community health workers can help people take charge of their own health. Often living in the same communities and coming from similar backgrounds, they are able to share life experience with their clients and engender trust. On this episode of The Dose, we talk about one community health worker program, IMPaCT, that is helping some of the poorest and sickest Americans meet their health and social needs. As the COVID-19 pandemic upends all our lives, this idea of putting patients in charge — rather than telling them what to do — has particular resonance. Listen to our conversation with guest Shreya Kangovi, a primary care doctor and professor at the University of Pennsylvania, and then subscribe wherever you find your podcasts.

Getting and staying healthy depends on more than just medical care. In some instances, a patient also needs legal services. What if doctors could "refer" their patients to lawyers for help in dealing with a housing dispute, immigration status, or any number of legal issues? On this episode of The Dose, we hear from Norma Tinubu and Emily Foote about how attorneys from the New York Legal Assistance Group work with health care providers at NYC Health + Hospitals, the largest public health care system in the U.S. Through this medical-legal partnership, some of the city's poorest patients can get the support they need to resolve legal problems that, if ignored, could take a toll on their health.

Earlier this week, Germany became one of the first countries to start easing COVID-19 restrictions. That's because its initial response to the pandemic helped keep the death rate low. Germany: Caught the coronavirus early Does lots of testing Has a robust health care system. As the pressure mounts to reopen economies across the globe, other countries may have something to learn. On this episode of The Dose, Michael Laxy, a health economics researcher at the Helmholtz Center in Munich, talks about the German approach.

The coronavirus pandemic is impacting everyone, but the older you are, the more severe the health consequences. The recommendation is stay home, away from other people. What does that mean for an older person managing a chronic health condition (like diabetes) and needs to fill an insulin prescription? What about someone who may be used to seeing their grandchildren every weekend, and is not able to because they could be risking their health? On this episode of The Dose, the Commonwealth Fund's Gretchen Jacobson, vice president of the Medicare program, lays out just how tough COVID-19 has made life for older Americans.

The coronavirus pandemic is wreaking unprecedented havoc around the globe. So many of us are searching for information to keep ourselves and our loved ones safe – but how do we know whom to trust? On this episode of The Dose, the Commonwealth Fund's Eric Schneider, M.D., helps us make sense of what we know about COVID-19 so far: We know physical distancing works, even though it is challenging to adapt to this new way of living We don't know how long we'll have to adapt –so Dr. Schneider, offers some strategies on how to cope with the unknown.

Ten years ago, it took a monumental effort to pass the ACA, or Obamacare. As a result, today, no American is denied health insurance because of a pre-existing medical condition, and 20 million people who previously lacked coverage now have it. On this episode of The Dose, The Commonwealth Fund's Liz Fowler, who was one of the key architects of Obamacare, talks about the behind-the-scenes effort it took to get the law passed.

Fear of a coronavirus epidemic is rippling through the country faster than the disease is spreading – and the U.S. health care system may be unprepared to deal with the crisis. On this episode of The Dose, The Commonwealth Fund's David Blumenthal, M.D., and Sara Collins, break down how gaps in our health system are placing the entire population at risk in the current outbreak. People who worry they are sick with the COVID-19 virus need to seek immediate medical care. But in the U.S., 30 million people don't have health insurance. Another 44 million have such bare-bones coverage that they are always worried about the costs of getting care. While Medicaid has come to the rescue in past catastrophes like 9/11 and Hurricane Katrina, recent changes to the program mean that millions of Americans living in poverty may not be able to access needed care.

Nearly 700,000 Americans have died of AIDS since the beginning of the epidemic in the 1980s, and more than 1.1 million are living with HIV today. Advances in medical science have provided people with access to highly effective treatments for HIV. But is it possible to eliminate the disease altogether? Some cities are trying. On this episode of The Dose, Grant Colfax and Susan Buchbinder of San Francisco's public health department talk about how the city is trying to eliminate HIV. Through a range of projects, from increasing the uptake of preventive medicine to running mobile clinics to serve hard-to-reach patients, the city is making progress toward its goal of getting to zero HIV infections, deaths, and stigma.