Monday, October 04, 2021

Alberta Premier Kenney's approval rating plummets in new Think HQ poll



Tyson Fedor
CTV News Calgary Video Journalist
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Updated Oct. 4, 2021 

CALGARY -

A Think HQ poll released Monday suggests Premier Jason Kenney is continuing to see a decline in approval of his leadership in Alberta.

More than 1,100 respondents gave their opinion on the Kenney's leadership, with only 22 percent of offering any degree of approval for the first-term premier.

Of the respondents, 77 per cent disapprove of Kenney’s leadership, while 61 per cent of those strongly disapprove.

Think HQ’s results indicate a sharp decline in support, which is down 16 percentage points from July, when Kenney received an uptick in support following the removal of all public health restrictions.

“Jason Kenney for one thing, because of his personality, is unlikely to willingly hang up his hat,” said John Church, a political scientist at the University of Alberta. “Jason Kenney is a different animal than any other political leaders we’ve had in the province.”

Kenney’s highest approval rating, accordin to Think HQ, sat around 56 per cent following his election victory in 2019.

“Jason Kenney is a leader on life-support, and his prognosis is not good,” said Think HQ president Marc Henry.

“We have not seen a sitting premier with numbers this low in almost a decade.”

The last Alberta premier to sink to these depths in terms of public support was Alison Redford.

She recorded an approval rating of only 18 per cent in March 2014, shortly before resigning.

CTV News contacted Redford for a response to this poll.

“I am not commenting on this matter,” stated Redford.

Henry says even in stronghold regions like rural Alberta, Kenney’s approval rating does not eclipse 30 per cent.

Henry adds men are now equally unsupportive of Kenney as women.

“Ralph Klein, he resigned when his numbers dropped below 50 per cent,” said Church.

“(Kenney's) core political base in Alberta is very unhappy with him and they are the ones that have been pushing the hardest for his removal as leader of the party at this point."

Among respondents who voted UCP in the last provincial election, only 39 per cent say they approve of Kenney’s performance since.

The UCP has had to deal in recent weeks with party infighting from caucus members and from constituency associations, some of which had called for an early leadership review.

UCP officials have confirmed a leadership review, scheduled for next fall, was moved to spring 2022.

It will take place at the party’s annual general meeting in Edmonton on April 8 and 9, 2022.

The latest Think HQ poll was conducted between Sept. 29 and Oct. 1 and has a margin of error of +/- 2.9 per cent.


Braid: Kenney's UCP leadership on 'life-support,' according to pollster's latest survey

The 'political gamble' in July 'is now taking a punishing toll both politically for the leader and in real human costs for Albertans and the health-care system'

Author of the article: Don Braid • Calgary Herald
Publishing date: Oct 04, 2021 •
Premier Jason Kenney provided an update on COVID-19 and the ongoing work to protect public health at the McDougall Centre in Calgary on Tuesday, September 28, 2021
. PHOTO BY DARREN MAKOWICHUK/POSTMEDIA

Premier Jason Kenney’s approval rating is now very close to the level marked BASEMENT EXIT.



Only 22 per cent of Albertans support him, while 77 per cent disapprove of his performance, according to a new poll from Marc Henry’s ThinkHQ.



The brutal result could see UCP riding boards ramp up efforts to force him out before the leadership review now set for next April.

Even the meagre approval appears soft. Of the 22 per cent who support Kenney, only six per cent are ardent backers while 16 per cent say they “somewhat” approve.

Of the 77 per cent who disapprove, 61 per cent do so strongly.

NDP Leader Rachel Notley, meanwhile, gets 50 per cent approval and 47 per cent disapproval.

Kenney’s approval is lowest in Edmonton (no surprise there), but it’s identically awful in Calgary, at 19 per cent in both cities.

With numbers like that, the NDP could win the province with little help from rural Alberta.

But Notley might get more than expected. Kenney’s approval outside the big cities is nowhere higher than 30 per cent.

The premier enjoyed a popularity jump in July when COVID-19 rates were low and many people wanted to believe his promise of Alberta’s “best summer ever.”

But when cases surged in September and the government lay dormant, Kenney quickly crashed 16 percentage points to his current dismal standing.

ThinkHQ president Henry recalls what happened to Progressive Conservative Premier Alison Redford on March 19, 2014.

She stood at 18 per cent popularity — and had seen the poll that day — when she announced her resignation in the legislature rotunda.

Ralph Klein stood at 17 per cent in the spring of 1992, largely because of a fierce scandal over MLA pensions. Some ex-MLAs were getting more retirement pay than their salaries.

Klein abolished the pension plan and went on to win a majority, with three more to come later.

Recoveries do happen and Kenney has until the spring of 2023 to regain approval — if his party gives him the chance.

Henry doesn’t like the premier’s odds for a comeback.

“Jason Kenney is a leader on life-support, and his prognosis is not good,” he said in comments on the polling.

Redford’s 18 per cent, he says, was only “a ‘margin of error’ difference from Kenney’s results today.”

The “political gamble” in July “is now taking a punishing toll both politically for the leader and in real human costs for Albertans and the health-care system.”

Alberta Premier Jason Kenney attends a Canada Day event in Parkland in southeast Calgary on Thursday, July 1, 2021.
Jim Wells/Postmedia

Henry notes that the UCP was sewn together from two often antagonistic conservative parties that wanted to beat the NDP, but now “the creature is tearing itself apart at the stitches.”

At the party level, the opposition didn’t die just because Kenney faced down a caucus revolt on Sept. 22.

As of last Friday, 10 riding associations had agreed to a motion calling for a leadership vote before March 1.

Twenty-two must sign on to force the timeline on the party executive, which is famously, although perhaps not permanently, loyal to Kenney.

The motion also calls for the appointment of two riding presidents to the leadership election committee, and for an outside accounting and auditing firm to count votes and control electronic voting.

That’s a sharp echo of the scandals from the leadership campaign that elected Kenney.

The party executive, while appearing to compromise with the April review, actually ignored all three demands in the motion.

Then there’s money — the grease of every election machine.

The NDP has vastly outstripped the UCP in fundraising all this year.

In the first quarter, for instance, Kenney’s party raised $591,000, the NDP $1.1 million. The trend continued in the second quarter.

The third quarter ended Sept. 30. Although results aren’t yet official or announced, the NDP says it collected $1.3 million.


If the UCP falls far short again, as seems very likely, this premier will stand on one shaky basement pedestal.

Don Braid’s column appears regularly in the Calgary Herald.



Exposure to deadly urban heat worldwide has tripled in recent decades, says study

Exposure to deadly urban heat worldwide has tripled in recent decades, says study
Annual municipality-level increases in the rate of urban population exposure to extreme
 heat, 1983-2016. Credit: Adapted from Tuholske et al., PNAS, 2021

A new study of more than 13,000 cities worldwide has found that the number of person-days in which inhabitants are exposed to extreme combinations of heat and humidity has tripled since the 1980s. The authors say the trend, which now affects nearly a quarter of the world's population, is the combined result of both rising temperatures and booming urban population growth. The study was published today in the Proceedings of the National Academy of Sciences.

Over recent decades, hundreds of millions have moved from rural areas to cities, which now hold more than half the world's population. There, temperatures are generally higher than in the countryside, because of sparse vegetation and abundant concrete, asphalt and other impermeable surfaces that tend to trap and concentrate —the so-called .

"This has broad effects," said the study's lead author, Cascade Tuholske, a postdoctoral researcher at Columbia University's Earth Institute. "It increases morbidity and mortality. It impacts people's ability to work, and results in lower economic output. It exacerbates pre-existing ."

The researchers combined infrared satellite imagery and readings from thousands of ground instruments to determine maximum daily heat and humidity readings in 13,115 cities, from 1983 to 2016. They defined extreme heat as 30 degrees Centigrade on the so-called "wet-bulb globe temperature" scale, a measurement that takes into account the multiplier effect of high humidity on human physiology. A wet-bulb reading of 30 is the rough equivalent of 106 degrees Fahrenheit on the so-called "real feel" heat index—the point at which even most healthy people find it hard to function outside for long, and the unhealthy might become very ill or even die.

To come up with a measure of person-days spent in such conditions, the researchers matched up the  with statistics on the cities' populations over the same time period. The population data was provided in part by Columbia's Center for International Earth Science Information Network, where Tuholske is based.

The analysis revealed that the number of person-days in which  were exposed went from 40 billion per year in 1983 to 119 billion in 2016—a threefold increase. By 2016, 1.7 billion people were being subjected to such conditions on multiple days.

Sheer urban population growth accounted for two-thirds of the exposure spike, while actual warming contributed a third. That said, the proportions varied from region to region and city to city.

The most-affected cities tend to cluster in the low latitudes, but other areas are being affected, too. The worst-hit city in terms of person-days was Dhaka, the fast-growing capital of Bangladesh; it saw an increase of 575 million person-days of extreme heat over the study period. Its ballooning population alone—4 million in 1983, to 22 million today—caused 80 percent of the increased exposure. This does not mean that Dhaka did not see substantial warming—only that population growth was even more rapid. Other big cities showing similar population-heavy trends include Shanghai and Guangzhou, China; Yangon, Myanmar; Bangkok; Dubai; Hanoi; Khartoum; and various cities in Pakistan, India and the Arabian Peninsula.

On the other hand, some other  saw close to half or more of their exposure caused by warming climate alone versus population growth. These included Baghdad, Cairo, Kuwait City, Lagos, Kolkata, Mumbai, and other big cities in India and Bangladesh. The populations of European cities have been relatively static, so increases in exposure there were driven almost exclusively by increased warmth. The researchers found that 17 percent of the cities studied added an entire month of extreme-heat days over the 34-year study period.

"A lot of these cities show the pattern of how human civilization has evolved over the past 15,000 years," said Tuholske, pointing out that many are located in warm climates where humidity is delivered by big river systems. This made them attractive for farming and eventually urbanization. "The Nile, the Tigris-Euphrates, the Ganges. There is a pattern to the places where we wanted to be," he said. "Now, those areas may become uninhabitable. Are people really going to want to live there?"

Exposure to deadly urban heat worldwide has tripled in recent decades, says study
This interactive map allows users to zoom in on more than 13,000 individual cities for
 data on increases in person-day exposure to extreme heat and humidity, and the
 factors involved. For the live version, go to: https://bit.ly/3uj23Ty. 
Credit: Adapted from Tuholske et al., PNAS, 2021. 
Interactive graphics by Jeremy Hinsdale/Earth Institute

In the United States, about 40 sizable cities have seen rapidly growing exposure, mainly clustered in Texas and the Gulf Coast. In many, the causes of the rises have been varying combinations of both increasing population and increasing heat. These include Houston, Dallas-Fort Worth, San Antonio and Austin, Tex., along with Pensacola and other cities in Florida. In some, population growth is the main driver. These include Las Vegas; Savannah, Ga.; and Charleston, S.C. In others, it is almost exclusively fast-rising heat: Baton Rouge, La.; Gulfport, Miss.; and Lake Charles and Houma, La. One major outlier: the bayside  of Providence, R.I., where rising exposure was 93 percent due to warmer, more humid weather.

Because the period covered by the study ran only through 2016, the data did not include the series of record heat waves that raked the U.S. Northwest and southern Canada this summer, killing hundreds of people.

The study is not the first to document the dangers of excessive urban heat; among others, last year a separate Earth Institute team showed that combinations of heat and humidity literally beyond the limits of outdoor human survival have been briefly popping up around the world. The newer study led by Tuholske adds to the picture by quantifying on a granular level how many people are being affected in each location, and the degree to which exposure is being driven by  versus climate. The authors say this information should help urban planners come up with better-targeted strategies to help citizens adapt.

Kristina Dahl, a climate researcher at the Union of Concerned Scientists, said the study "could serve as a starting point for identifying ways to to address local heat issues," such as planting trees and modifying rooftops with lighter colors or vegetation so they don't trap so much heat. "This study shows that it will take considerable, conscientious investments to ensure that cities remain livable in the face of a warming climate," she added.

The other authors of the study are Kelly Caylor, Chris Funk, Stuart Sweeney and Pete Peterson of the University of California, Santa Barbara; Andrew Verdin and Kathryn Grace of the University of Minnesota Twin Cities; and Tom Evans of the University of ArizonaNew heat exposure model can protect citizens

More information: Global urban population exposure to extreme heat, Proceedings of the National Academy of Sciences (2021). doi.org/10.1073/pnas.2024792118

Journal information: Proceedings of the National Academy of Sciences 

Provided by Earth Institute at Columbia University 

 

Study explores how a robot's inner speech affects a human user's trust

Study explores how a robot’s inner speech affects a human user's trust
An interactive session where a participant collaborates with a robot as the
 robot also talks to itself. A virtual table is represented in the tablet, and
 the participant and the robot are setting up the table together. 
Credit: Pipitone et al.

Trust is a very important aspect of human-robot interactions, as it could play a crucial role in the widespread implementation of robots in real-world settings. Nonetheless, trust is a considerably complex construct that can depend on psychological and environmental factors.

Psychological theories often describe trust, either as a stable trait that can be shaped by early life experiences or as an evolving state of mind that can be affected by numerous cognitive, emotional and social factors. Most researchers agree that trust is generally characterized by two features:  and expectations about a trustee and the readiness to become vulnerable and accept the possible risks associated with trusting others.

Researchers at University of Palermo have recently carried out a study investigating the effects of a 's inner speech on a user's trust in it. In their paper, pre-published on arXiv, the team present findings of an experiment using a robot that can talk to itself out loud in a way that resembles humans' inner speech.

"Our recent paper is an outcome of the research we carried out at the RoboticsLab, at the University of Palermo," Arianna Pipitone, one of the researchers who carried out the study, told TechXplore. "The research explores the possibility of providing a robot with inner speech. In one of our previous works, we demonstrated that a robot's performance, in terms of transparency and robustness, improves when the robot talks to itself."

In their previous work, the researchers showed that a robot's performance can improve when it talks to itself. In their new work, they set out to investigate whether this ability to talk to itself can affect how users perceive a robot's trustworthiness and anthropomorphism (i.e., the extent to which it exhibits human characteristics).

The recent study was carried out on a group of 27 participants. Each of these participants were asked to complete the same questionnaire twice: before interacting with the robot and after they interacted with it.

"During the interactive session, the robot talked to itself," Pipitone explained. "The questionnaire we administered to participants is based on both the well-known inner speech scales (such as the Self Talk Scale) and the Godspeed test, which measure the aforementioned cues. By comparing questionnaires' results from the two different phases, we can observe how the robot's cues vary from the participants' perspective after the interaction, so inferring the effects of inner speech on them."

Understanding a robot's decision-making processes and why it performs specific behaviors is not always easy. The ability to talk to itself while completing a given task could thus make a robot more transparent, allowing its users to understand the different processes, considerations and calculations that lead to specific conclusions.

"Inner speech is a sort of explainable log," Pipitone explained. "Moreover, by inner speech, the robot could evaluate different strategies in collaboration with the human partner, leading to the fulfillment of specific goals. All these improvements make the robot more pleasant for people, and as shown, enhance the robot's trustworthiness and anthropomorphism."

Overall, Pipitone and her colleagues found that participants reported trusting the robot more after they interacted with it. In addition, they felt that the robot's ability to talk to itself out loud made it more human-like, or anthropomorphic.

In the future, the robotic inner speech mechanism developed by this team of researchers could help to make both existing and emerging robots more human-like, potentially encouraging more users to  these robots and introduce them in their households or workplaces. Meanwhile, Pipitone and her colleagues plan to conduct further studies to confirm the validity of the initial results they collected.

"We now want to complete the experimental session by involving a large number of participants, to validate our initial results," Pipitone said. "Moreover, we want to compare the results from the interactive sessions during which the robot does not talk to itself, for refining the effective inner speech contribution on the cues. We will analyze many other features, such as the robot's emotions by inner speech. The human's inner  plays a fundamental role in self-regulation, learning, focusing, so we would like to investigate these aspects."Pepper the robot talks to itself to improve its interactions with people

More information: Arianna Pipitone et al, Robot's inner speech effects on trust and anthropomorphic cues in human-robot cooperation. arXiv:2109.09388v1 [cs.RO], arxiv.org/abs/2109.09388

Arianna Pipitone et al, What robots want? Hearing the inner voice of a robot, iScience (2021). DOI: 10.1016/j.isci.2021.102371

Journal information: iScience 

© 2021 Science X Network

Los Alamos scientists take top prizes in national competition to help improve electrical grid


Artificial intelligence-driven algorithms could help keep the lights on

Grant and Award Announcement

DOE/LOS ALAMOS NATIONAL LABORATORY

Artificial intelligence-driven algorithms could help keep the lights on 

IMAGE: LOS ALAMOS NATIONAL LABORATORY SCIENTISTS HASSAN HIJAZI (LEFT) AND CARLETON COFFRIN (RIGHT) DEVELOPED ALGORITHMS THAT TOOK TOP PRIZES IN A NATIONAL COMPETITION TO HELP IMPROVE THE RESILIENCY OF THE ELECTRICAL GRID. view more 

CREDIT: LOS ALAMOS NATIONAL LABORATORY

Los Alamos, N.M., October 4, 2021—Two scientists at Los Alamos National Laboratory took top prizes in a national competition for developing algorithms to help improve the resiliency and efficiency of the electrical grid. The algorithm developed by Hassan Hijazi of the Applied Mathematics and Plasma Physics Group took first place in all four divisions, while the one developed by Carleton Coffrin of the Laboratory’s Information Systems and Modeling Group placed second in two of the four divisions. Their work outperformed 14 other entries in the competition funded by Advanced Research Projects Agency–Energy (ARPA-E), a United States government agency that promotes and funds research and development of advanced energy technologies.

“Grid security is a national security issue, which is why this is important work for Los Alamos,” said Nancy Jo Nicholas, associate Laboratory director for Global Security at Los Alamos. “Every five minutes, optimization problems arise in the U.S. electrical grid that require a mathematical solution. Hassan’s and Carleton’s achievement will help advance national efforts to create a more reliable, resilient, and secure electrical grid.”

Both Hijazi’s and Coffrin’s algorithms use artificial intelligence to find ways to improve grid performance. Coffrin’s code is open-source and available through GitHub. Hijazi competed in his individual capacity.

The contest is part of an effort to identify emerging grid optimization algorithms and to accelerate the adoption of these algorithms by industry. It requires competitors to demonstrate the applicability and strength of new algorithms across a wide range of system operating conditions. Groups from other national laboratories, academia, and industry all took part in the competition.

The success of Coffrin’s artificial intelligence methods in this competition were made possible by the Laboratory’s long-term strategic investment in foundational mathematical methods through the Advanced Network Science Initiative.

About Los Alamos National Laboratory
Los Alamos National Laboratory, a multidisciplinary research institution engaged in strategic science on behalf of national security, is managed by Triad, a public service oriented, national security science organization equally owned by its three founding members: Battelle Memorial Institute (Battelle), the Texas A&M University System (TAMUS), and the Regents of the University of California (UC) for the Department of Energy’s National Nuclear Security Administration.

Los Alamos enhances national security by ensuring the safety and reliability of the U.S. nuclear stockpile, developing technologies to reduce threats from weapons of mass destruction, and solving problems related to energy, environment, infrastructure, health, and global security concerns.
LA-UR-21-29639

#WATERISLIFE    #WATERISSACRED

Canadian scientist receives University of Oklahoma International Water Prize

Grant and Award Announcement

UNIVERSITY OF OKLAHOMA

Cultural anthropologist Dawn Martin-Hill, Ph.D., 

IMAGE: DAWN MARTIN-HILL, PH.D., HAS BEEN NAMED THE 2022 UNIVERSITY OF OKLAHOMA INTERNATIONAL WATER PRIZE RECIPIENT FOR HER COMMITMENT TO IMPROVING WATER SECURITY FOR THE PEOPLE OF THE SIX NATIONS OF THE GRAND RIVER, THE LARGEST NATIVE RESERVE IN CANADA. MARTIN-HILL, AN ASSOCIATE PROFESSOR AT MCMASTER UNIVERSITY IN ONTARIO, CANADA, WAS RECOGNIZED AT THE OU INTERNATIONAL WATER SYMPOSIUM FOR HER CONTRIBUTIONS TO UNDERSTANDING HOW WATER QUALITY AND SECURITY ARE LINKED TO INDIGENOUS COMMUNITY CULTURE, LIVELIHOOD AND HEALTH. view more 

CREDIT: UNIVERSITY OF OKLAHOMA

Cultural anthropologist Dawn Martin-Hill, Ph.D., has been named the 2022 University of Oklahoma International Water Prize recipient for her commitment to improving water security for the people of the Six Nations of the Grand River, the largest Native reserve in Canada.

Martin-Hill, an associate professor at McMaster University in Ontario, Canada, was recognized at the OU International WaTER Symposium for her contributions to understanding how water quality and security are linked to Indigenous community culture, livelihood and health.

Jim Chamberlain, Ph.D., interim director of the OU WaTER Center, says “Dr. Martin-Hill is deeply committed to bringing water to the underserved in North America. We had five excellent nominees for this prize and a panel of her peers determined that Dr. Martin-Hill’s work stood out as exemplary and representative of the WaTER Center’s mission to bring water and sanitation to communities in need.”

The symposium brings together a group of expert panelists from across the world with multiple disciplines whose work is based on the U.N. Sustainable Development Goal of providing water security to emerging regions. They nominate and select a prize recipient who is honored at the following year’s conference and awarded a waterdrop sculpture and $25,000.

Martin-Hill’s research examines the impact of contamination and water scarcity on humans, fish and wildlife at Six Nations of the Grand River. She says the community’s water treatment plant pipeline reaches only 10% of the community, yet the reservation is surrounded by major cities Toronto, Hamilton and Brantford, she says.

“Those cities have access to clean water and we do not. I would like to see that changed,” Martin-Hill said.

OU senior vice president and provost André-Denis Wright, Ph.D., gave opening remarks at the virtual symposium. During his speech, he noted that he has both professional and personal appreciation for the work done by the OU WaTER Center.

“The International Water Prize makes OU unique in that it honors someone in the field of water who specifically works on water security on behalf of disadvantaged communities in the U.S. and abroad. I was born and raised in one of those disadvantaged communities outside of Halifax, Nova Scotia, Canada. I was 16 before we had running water in our home – indoor plumbing, steady electricity and public transport. My mom carried water daily from a well that we shared with five other families,” Wright said.  

Martin-Hill will give the address at the International WaTER Conference set for Sept. 26-28, 2022, in Norman, Oklahoma (USA). 

Learn more about previous recipients and the Gallogly College of Engineering Water Center at the University of Oklahoma.

US Dialysis facility closures linked to patient hospitalizations and deaths


Peer-Reviewed Publication

AMERICAN SOCIETY OF NEPHROLOGY

Highlights

  • Patients with kidney failure who were affected by dialysis facility closures between 2001 and 2014 experienced 7% to 9% higher rates of hospitalizations compared with similar patients at facilities that did not close.
  • Also, patients affected by closures may have faced an 8% higher risk of dying within 6 months.

Washington, DC (October 4, 2021) — Some experts fear that recent reforms instated by the Centers for Medicare and Medicaid Services may lead to the closure of some dialysis facilities that treat patients with kidney failure. When investigators analyzed data from past dialysis facility closures, they found that patients affected by the closures experienced higher rates of hospitalizations. The findings, which appear in an upcoming issue of JASN, highlight the need for policies that reduce the risk of dialysis facility closures to help safeguard patients’ health.

More than 500,000 patients in the United States receive dialysis for the treatment of kidney failure at 7,100 dialysis facilities. When a dialysis facility closes, a patient may have difficulty traveling to a new facility or may temporarily receive sub-optimal care as the staff of a new facility establishes rapport with the patient and addresses common challenges that occur during dialysis treatments.

A team led by Kevin Erickson, MD, MS (Baylor College of Medicine) examined dialysis facility closures between 2001 and 2014 to assess the effects of closures on patient health outcomes. The researchers identified 8,386 patients affected by 521 dialysis facility closures. In different models, patients who were affected by dialysis facility closures experienced 7% to 9% higher rates of hospitalizations compared with similar patients at facilities that did not close. Also, patients affected by closures may have faced an 8% higher risk of dying within 6 months.

“Ongoing efforts to contain high costs of in-center hemodialysis, including recent national policy reforms, could increase the risk that some dialysis facilities will close. It is important to understand how dialysis facility closures impact the health of patients,” said Dr. Erickson. “We previously demonstrated that hospital-based dialysis facilities, which disproportionately care for vulnerable patient populations, are at increased risk of closures. Facility closures could exacerbate inequities in U.S. dialysis care.”

Study co-authors include Jingbo Niu MD, DSc, Maryam Saeed, MD, and Wolfgang Winkelmayer MD, ScD.

Disclosures: Dr. Erickson provides consulting services for Acumen LLC.

The article, titled “Patient Health Outcomes Following Dialysis Facility Closures in the United States,” is available at https://jasn.asnjournals.org/content/32/10/2613.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the authors. ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, visit www.asn-online.org.

 

# # #

END FOR PROFIT CARE   #MEDICAREFORALL

Medicaid expansion closed health gaps for low-income adults across racial and ethnic groups, study shows


Michigan data show improvements in access to care and overall health, and could inform non-expansion states

Peer-Reviewed Publication

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

Michiganders from multiple racial and ethnic backgrounds say their health has improved and they have access to regular care through a doctor’s office, after enrolling in the state’s Medicaid expansion for low-income adults, a new study finds.

The improvements were especially pronounced among low-income white, Black and Latino Michiganders. Some improvements were seen among low-income members of the state’s sizable Arab-American and Chaldean population, and among those of other backgrounds.

The study, published in the October issue of Health Affairs, is based on three years of data from detailed surveys of enrollees in the Healthy Michigan Plan, which is available to low-income adults in Michigan. It was performed by a team from the University of Michigan Institute for Healthcare Policy and Innovation.

The Healthy Michigan Plan began covering low-income adults in spring 2014. Created under the Affordable Care Act, it now covers nearly one in 10 residents of the state. IHPI is conducting the required formal evaluation of the Healthy Michigan Plan for the Michigan Department of Health and Human Services and the Centers for Medicare and Medicaid Services, and has published multiple reports and papers on its impact.

“It’s striking to see the sizable gains across all groups in access to a regular source of care through a doctor’s office or clinic, rather than emergency rooms, urgent care centers and walk-in clinics, supporting our past findings that the Healthy Michigan Plan is fostering use of primary and preventive care,” said Susan Goold, M.D., MHSA, M.A., the study’s senior author and a professor of internal medicine at the U-M Medical School.

“Nearly all groups reported a steady decrease over three years in the percentage who said they were in fair or poor health,” she added. “We hope these findings will help inform other states’ discussions of Medicaid expansion.” Twelve states, with an estimated eligible population of 4 million people, have not expanded Medicaid.

Goold led a team that analyzed data from surveys conducted in 2016 through 2018, and included participants’ recollections of their health and health care access before they gained coverage through the Healthy Michigan Plan. The study’s first author is Melinda Lee, a recent graduate of the U-M College of Pharmacy who participated in an IHPI health equity fellowship program.

More about the findings

Before they got coverage, only 49% of the study population said they had a regular doctor’s office where they could get care, 23% regularly relied on walk-in care options including ERs, and more than 25% said they had no regular source of care. Black and Latino respondents were much more likely to use walk-in care locations, and white and Arab-American/Chaldean Michiganders were more likely to lack any regular source of care.

By 2018, 83% of Healthy Michigan Plan enrollees said they had a regular doctor’s office to go to. The percentage of Black Michiganders who said this had more than doubled, and the percentage of white, Latino and Arab-American/Chaldean respondents who said this had grown by double digits.

People who identified as members of another racial or ethnic group, or more than one group, also experienced a large jump in access to a doctor’s office; because of sample size the study does not include separate analyses of data for individuals with Asian American/Pacific Islander, Native American or mixed-race backgrounds.

When it came to their overall health status, the percentage of the entire survey population that said their health was fair or poor started at 30% in 2016, and fell to 25% in 2018.

Low-income Arab-American/Chaldean Michiganders were least likely to say they were in fair or poor health at the start, and did not show major change over time.

But the percentage of low-income Black, white and Latino Michiganders saying they were in fair or poor health declined steadily, with the biggest gains seen among Latinos (30% to 18%) followed by Black (33% to 25%) and white (30% to 27%) respondents. Those of other racial and ethnic backgrounds, or mixed backgrounds, were mostly likely to report being in fair or poor health in 2016, and though this number dropped from 2016 to 2017, it went back up in 2018.

The study also shows a decline between 2016 and 2018 in the average number of days of poor physical health in the past month among people in most of the racial and ethnic groups studied. There was no change in average days of poor mental health.

Goold notes that 20% of the study population had gotten coverage through conventional Medicaid before changing over to the Healthy Michigan Plan, while many of the rest had been uninsured.

In order to be eligible for the Healthy Michigan Plan, residents of the state of Michigan must have incomes less than 133% of the federal poverty rate (up to $17,700 in 2021 for a single individual).

Learn more about findings from IHPI’s evaluation of the Healthy Michigan Plan, which recently received approval from the state and federal government under a new evaluation design to guide continued work on this topic.

In addition to Goold and Lee, the study’s authors are Zachary Rowe of Friends of Parkside in Detroit, and HMP evaluation team members Erin Beathard, M.P.H., M.S.W., Matthias Kirch, M.S., Erica Solway, Ph.D., M.S.W., M.P.H., Renu Tipirneni, M.D., M.Sc., Minal Patel, Ph.D., M.P.H., and former team member Maryn Lewallen, M.P.H.

INCOME INEQUALITY KILLS

Excess deaths disproportionally occurred among Black, American Indian/Alaskan Native, and Latino males and females during the 2020 COVID-19 pandemic


Embargoed News from Annals of Internal Medicine

Peer-Reviewed Publication

AMERICAN COLLEGE OF PHYSICIANS

1. Excess deaths disproportionally occurred among Black, American Indian/Alaskan Native, and Latino males and females during the 2020 COVID-19 pandemic

Abstract: https://www.acpjournals.org/doi/10.7326/M21-2134     

URL goes live when the embargo lifts

A large study of surveillance data found that excess deaths during the 2020 COVID-19 pandemic disproportionately occurred among Black, American Indian (AI)/Alaskan Native (AN), and Latino males and females in the U.S., compared to White and Asian males and females. According to the authors, these overwhelming disparities highlight the urgent need to address long-standing structural inequities affecting health and longevity. The findings are published in Annals of Internal Medicine.

Researchers from the National Cancer Institute, the National Institute for Minority Health and Health Disparities, and the Pacific Institute for Research and Evaluation, used data from the CDC National Center for Health Statistics to estimate deaths by month, year, sex, age group, race/ethnicity, and cause from March 1, 2020 (the first full month of the COVID-19 pandemic in the U.S.) to December 31, 2020. They found that compared with the number expected, based on 2019 data, 477,200 excess deaths occurred during the study period: 74% from COVID-19. The remaining fraction were attributed to causes including diabetes, heart disease, cerebrovascular disease, and Alzheimer disease. Black, AI/AN, and Latino males and females had more than double the number of excess deaths than White and Asian males and females, after standardizing by population size.

According to the authors, differences in COVID-19 risk, hospitalization, and death by race/ethnicity can be attributed to structural and social determinants of health with established and deep roots in structural racism. Studies have shown that Black and Latino persons are more likely to have occupational exposure to COVID-19, live in multigenerational households and/or more densely populated neighborhoods, and have less access to health care and private transportation, compared to White persons. Prior to a successful mass-vaccination program, AI/AN reservation–based communities were at further risk for infection due to a lack of infrastructure and chronically underfunded health care facilities.

The authors suggest that equitable vaccine distribution is needed to prevent further exacerbation of racial/ethnic disparities in COVID-19 risk and mortality. Inequities need to be addressed with urgency and cultural competence, as has been done by tribal communities.

NCI study highlights pandemic’s disproportionate impact on Black, American Indian/Alaska Native, and Latino adults


Peer-Reviewed Publication

NIH/NATIONAL CANCER INSTITUTE

The global COVID-19 pandemic has taken a toll on Black, American Indian/Alaska Native, and Latino individuals in the United States, causing more deaths by population size, both directly and indirectly, in these groups compared with white or Asian individuals. The findings, from a large surveillance study led by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), appeared October 5, 2021, in Annals of Internal Medicine.

“Focusing on COVID-19 deaths alone without examining total excess deaths—that is, deaths due to non-COVID-19 causes as well as to COVID-19—may underestimate the true impact of the pandemic,” said Meredith S. Shiels, Ph.D., M.H.S., senior investigator in the Infections and Immunoepidemiology Branch in NCI’s Division of Cancer Epidemiology and Genetics, who led the study. “These data highlight the profound impact of long-standing inequities.”

Scientists at NCI have a long history of tracking mortality trends in the United States, mainly focusing on cancer death rates. More recently, these investigators have been applying their expertise in analyzing national surveillance data to better understand the impact of the COVID-19 pandemic on excess deaths by racial and ethnic group.

In this new study, scientists from NCI, NIH’s National Institute on Minority Health and Health Disparities (NIMHD), and the Pacific Institute for Research and Evaluation used provisional death certificate data from the Centers for Disease Control and Prevention, along with population estimates from the U.S. Census Bureau, to compare excess deaths by race/ethnicity, sex, age group, and cause of death during March to December 2020 with data for the same months in 2019. Excess deaths are the number of deaths in a specific period of time over what would have been expected to occur based on deaths in the same months in previous years, after adjustment for population changes.

Dr. Shiels noted that because the study period did not include a full year of data, the investigators could not present the number of excess deaths as a rate. Instead, they calculated the number of excess deaths in each racial/ethnic group according to each group’s population size (i.e., deaths per 100,000 people).

Roughly 2.9 million people died in the United States between March 1, 2020, and December 31, 2020. Compared with the same period in 2019, there were 477,200 excess deaths, with 74% of them due to COVID-19. The scientists found that, after adjusting for age, the number of excess deaths by population size among Black, American Indian/Alaska Native, and Latino men and women were more than double those in white and Asian men and women.

Looking more closely at the excess deaths where COVID-19 was not listed as the cause, the scientists found that excess deaths by population were three to four times higher among Black and American Indian/Alaska Native men and women compared with white men and women. And Latino men and women had nearly two times the number of excess non-COVID-19 deaths by population, compared with white men and women.

These data do not explain the reasons for the excess non-COVID mortality. “It is possible that fear of seeking out health care during the pandemic or misattribution of causes of death from COVID-19 are responsible for a majority of the excess non-COVID-19 deaths,” said Dr. Shiels.

Excess deaths during the pandemic have resulted in growing disparities in overall U.S. mortality, with the disparities in age-standardized all-cause deaths increasing between 2019 and 2020 for Black and American Indian/Alaska Native men and women compared with white men and women. For example, in 2019, total mortality by population among Black men was 26% higher than in white men, but in 2020 it was 45% higher. Similarly, in 2019, total mortality by population among Black women was 15% higher than in white women, but in 2020 it was 32% higher.

“Our efforts at NIH to help mitigate these COVID disparities have been heavily focused on promoting testing and vaccine uptake through community-engaged research. However, vaccine hesitancy poses a real threat, so we are addressing the misinformation and distrust through collaborative partnerships with trusted community stakeholders,” said study coauthor Eliseo J. Pérez-Stable, M.D., director of NIMHD.

 

The study was funded by the Intramural Research Programs of NCI and NIMHD.

 

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About the National Cancer Institute (NCI): NCI leads the National Cancer Program and NIH’s efforts to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI website at cancer.gov or call NCI’s contact center, the Cancer Information Service, at 1-800-4-CANCER (1-800-422-6237).

 

About the National Institute on Minority Health and Health Disparities (NIMHD): NIMHD leads scientific research to improve minority health and eliminate health disparities by conducting and supporting research; planning, reviewing, coordinating, and evaluating all minority health and health disparities research at NIH; promoting and supporting the training of a diverse research workforce; translating and disseminating research information; and fostering collaborations and partnerships. For more information about NIMHD, visit https://www.nimhd.nih.gov.

 

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.gov.