Exploring a new frontier in healthcare technology: Non-fungible tokens for secure health data management in a post-pandemic world?

Managing health data as non-fungible tokens (NFTs) could give patients full ownership of personal health data, resulting in better patient care and research outcomes.

Peer-Reviewed Publication

SINGHEALTH

Singapore, 24 April 2023 – Digital transformation in healthcare has been greatly catalysed by the COVID-19 pandemic, which resulted in the accelerated adoption of digital health solutions such as telemedicine, remote monitoring and the Internet of Medical Things (IoMT), robotics and artificial intelligence (AI). This caused an upward surge in the generation and flow of health data, which is expected to continue as healthcare providers and patients grow more accustomed to digital solutions, and healthcare systems gear up with emerging technologies to tackle the challenges of the future.

With this increase in digital health data, a team of clinician innovators from SingHealth anticipate a growing need for privacy-preserving solutions to empower patients to take greater ownership of their health and to enhance the applications of data for medical research and clinical care purposes. In a recently published editorial piece in the prestigious journal Nature Medicine[1], the team explored the use of non-fungible tokens (NFTs) as a potential data management solution to bridge this gap and revolutionise data exchange in healthcare.

An NFT is a unique digital data unit stored on the blockchain, under a single ownership that is irreplaceable, and which can be traded. Like digital assets that are traded as commercial NFTs today, health data can be minted, exchanged and stored using blockchain technology, bearing the same features of uniqueness, transparency and interoperability. This means that patients will be able to own their personal health data and exchange it as digital assets with multiple stakeholders, such as healthcare providers, using the same blockchain technology. Similar to how cryptocurrencies are traded with mobile wallets, each patient can own, store and share their health data in the form of NFTs using a health wallet hosted on a secure web-based or smartphone application, making this mode of data management easily accessible, yet secure and private.

The key difference between existing commercial NFT marketplaces and a blockchain ledger dedicated to the exchange of health data is that the health data ledger can be programmed to disallow public viewing of its data. When a patient needs to share their health data with a healthcare provider, they can give the healthcare provider access to and allow them to view the required information. This preserves patient privacy, only allowing data owners – the patients themselves – to permit the access and sharing of their personal health data.

Empowering Patients and Improving Care

Presently, patient data is safe kept and shared when necessary by institutions such as healthcare providers, research institutes, insurance companies and government bodies. Transiting to the use of NFTs will require a paradigm shift in mindset for patients and caregivers. Managing health data as NFTs will give the full ownership of personal health data to patients, entrusting them with the responsibility of storing the data and sharing it when necessary. This ensures accurate and complete health information from each individual, and empowers them to engage in their health journey more proactively, which has shown to produce better healthcare outcomes in the long run.

Patient ownership of health data may also allow for greater fluidity of healthcare information. Currently, patient data is protected under strict data privacy rules. The use of NFTs will shift the onus of sharing individual patient data to each patient, thus fostering a closer relationship between the healthcare provider and the patient.  

Ensuring Data Authenticity for Better Research Outcomes

When personal health data is owned by patients, any unauthorised access and use of data stored in personal health applications and institutional databases can be mitigated, as the owner of every piece of data has to give permission before it is shared. This gives patients full autonomy over their personal health data and who they wish to share it with, for research or any other purposes.

In addition, sharing health data as NFTs ensures complete transparency and accuracy of healthcare research data, due to the traceable and unalterable nature of the blockchain. This means that researchers can be certain of the authenticity of data being used in their research, leading to greater data integrity and better research outcomes.

The same technology can also be applied to other areas of healthcare, such as pharmaceuticals, where every drug produced can be encoded and stored on a blockchain ledger. From point of production to delivery to the end-user, the drug can be tracked throughout the entire supply chain. This enables drug verification to prevent counterfeit drugs, as well as prevents the misuse of drugs by healthcare providers and patients.

Dr Teo Zhen Ling, the lead author of the paper and Ophthalmology Resident, Singapore National Eye Centre said: “Using NFTs and blockchain technology to build a secure healthcare data exchange platform will greatly impact the way data is handled in both healthcare research and clinical pathways. At present, we see great potential for its application in areas such as clinical and pharmaceutical trials, where the ability to verify the authenticity of patient data is extremely vital to the accuracy of research findings. It will also enable us to ensure patient compliance in research trials where IoMT is being used to monitor and collect data on health activity and vital signs. Importantly, beyond research settings, the ability for patients to access and own their data supports patient autonomy and increases patients’ engagement in their own care.”

Associate Professor Daniel Ting, Director, Artificial Intelligence Office, SingHealth and Head, AI and Digital Innovation, Singapore Eye Research Institute, who is also the senior and corresponding author of the paper, said: “In this age of healthcare digitalisation and Industry 4.0, the generation and exchange of health data is expected to grow exponentially. From securely obtaining patient data for diagnosis and treatment, to the verification of the origin of massive data sets, strategic applications of blockchain technology, or other alternative privacy-preserving or enhancing technologies, in healthcare can bring about a stronger and safer infrastructure for health data management. Over time, it will also herald a paradigm shift in patient care and healthcare research as digital technologies and their applications continue to gain sophistication and become more broadly utilised in different industries.”

As with the introduction of any new technology, there are many important considerations to make and obstacles to overcome. Exploring the potential adoption of NFTs as an alternative privacy-preserving technology in healthcare is no different. These include assessing the ability to establish the proper technological infrastructure, such as a blockchain-enabled ‘biodata’ platform, as well as putting in place different forms of safeguard to ensure data security and mitigate risks such as theft of NFTs – which is not unheard of in the commercial NFT market. Nonetheless, NFTs in healthcare have many exciting potential benefits and could revolutionise the management of health data in time to come.

About Singapore Health Services (SingHealth)

SingHealth, Singapore’s largest public healthcare cluster, is committed to providing affordable, accessible and quality healthcare to patients. With a network of acute hospitals, national specialty centres, polyclinics and community hospitals offering over 40 clinical specialties, it delivers comprehensive, multi-disciplinary and integrated care. Beyond hospital walls, SingHealth partners community care providers to enable the population to keep well, get well and live well. As part of the SingHealth Duke-NUS Academic Medical Centre, SingHealth also focuses on advancing education and research to continuously improve care outcomes for patients. For more information, please visit: www.singhealth.com.sg

Members of the SingHealth group

Hospitals (Tertiary Specialty Care):

Singapore General Hospital, Changi General Hospital, Sengkang General Hospital and KK Women's and Children's Hospital

National Specialty Centres (Tertiary Specialty Care):

National Cancer Centre Singapore, National Dental Centre Singapore, National Heart Centre Singapore, National Neuroscience Institute, and Singapore National Eye Centre

SingHealth Polyclinics (Primary Care):

Bedok, Bukit Merah, Marine Parade, Outram, Pasir Ris, Punggol, Sengkang, Tampines, Eunos, Tampines North (expected completion: 2023) and Kaki Bukit (expected completion: 2025)

SingHealth Community Hospitals (Intermediate and Long-term Care):

Bright Vision Hospital, Sengkang Community Hospital, and Outram Community Hospital

[1] Teo, Z.L., Ting, D.S.W. Non-fungible tokens for the management of health data. Nat Med (2023). https://doi.org/10.1038/s41591-022-02125-2

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JOURNAL

Nature Medicine

DOI

10.1038/s41591-022-02125-2 

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Non-fungible tokens for the management of health data

FOR PROFIT HEALTHCARE U$A

New findings show private equity investments in healthcare may not lower costs or improve quality of care

A research team supervised by a health policy researcher at the University of Chicago has found that increasingly common private equity investments in healthcare are generally associated with higher costs to patients and payers.

Peer-Reviewed Publication

UNIVERSITY OF CHICAGO MEDICAL CENTER

A research team supervised by a health policy researcher at the University of Chicago has found that increasingly common private equity investments in healthcare are generally associated with higher costs to patients and payers. That’s according to a new study published July 19 in The BMJ. The study is thought to be the first systematic review of global private equity ownership trends in medical settings.

“Over the last few decades, private equity activity in healthcare has exploded, with financial institutions buying up hospitals, nursing homes and fertility clinics — pretty much every area of healthcare,” said Joseph Dov Bruch, PhD, Assistant Professor of Public Health Sciences at UChicago, who is the study’s co-senior author. “News reports have highlighted increasing investment by private equity and a number of studies have set out to examine the phenomenon, but until now there has been no large systematic review of global private equity activity in healthcare. This study is intended to fill that gap.”

Private equity funding can come from multiple types of institutions, with different firms implementing varying investment strategies. As a result, Bruch said, the team wanted to review broad trends to gauge impact on the healthcare sector as a whole rather than limiting analysis to a specific setting.

Although the influence of the financial sector has grown across many fields, “private equity is uniquely interested in healthcare because of the many loopholes and cost-cutting strategies that exist within this industry,” said Bruch.

Performing a global search, Bruch and his research team found 55 previous academic research studies that investigated private equity in healthcare and performed a systematic review across four dimensions: healthcare quality, cost to payers and patients, cost to healthcare operators and health outcomes. They found that in every studied healthcare setting, private equity acquisitions have increased in prevalence since 2000. Across the four dimensions, private equity investment was most closely associated with up to a 32 percent increase in costs for payers and patients. Private equity ownership was also associated with mixed to harmful effects on healthcare quality, while the impact on health outcomes and operator costs was inconclusive.

Proponents of private equity have argued the cash infusions from financial firms provide direct downstream benefits for patients. However, this hypothesis was not supported by the results of the team’s review. The authors did not identify any consistently beneficial impacts of private equity ownership.

“The fact that we are not seeing improvements means we’re not seeing clear indications that private equity makes healthcare more efficient by reducing administrative burden, streamlining processes or offering technology advances,” said Bruch.

The researchers hope the study will make healthcare providers, policymakers and members of the public more aware of the growing influence of the financial sector in the healthcare system. In addition, the team said, healthcare providers may need to pay more attention to the financial burden placed on patients. And the researchers said they believe their findings may spark greater policymaker discussion on antitrust regulation and corporate practice of medicine laws.

While patients may not be able to identify specific changes in the care they receive, Bruch said it is good to be aware that one’s hospital, nursing home, doctor’s office or fertility treatment center may be owned by private equity and that these firms have specific financial targets that may inform care decisions.

“Private equity has been made to be a bogeyman,” said Bruch. “It certainly is an important financial actor growing in activity, and evidence suggests it should raise important concerns for patients, but it is a symptom of a health system that is becoming increasingly financialized.”

The team is continuing their research to examine the role of venture capital, management consultants, financial lenders and real estate investment trusts in healthcare.

The study, “Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review,” was published in The BMJ in July 2023. Study co-authors include Alexander Borsa of Columbia University, Geronimo Bejarano of the University of Texas, and Moriah Ellen of the University of Toronto and the Ben-Gurion University of the Negev.

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JOURNAL

BMJ

DOI

10.1136/bmj-2023-075244 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review

ARTICLE PUBLICATION DATE

19-Jul-2023

Longevity: from a billionaire’s turf to a universal healthcare

PROMOTING UNIVERSAL HEALTHCARE 

WHICH THE U$A DOES NOT HAVE

Longevity is gaining momentum and it’s time for healthcare to catch up

Author: Eleanor Garth |February 2, 2024

LongeVC’s Sergey Jakimov discusses how longevity’s ideas are taking root in society – but there is still work to be done to bring healthcare up to speed.


Sergey Jakimov is a founding partner of LongeVC, a venture capital company that supports early-stage biotech and longevity-focused founders and startups. While he is obviously an entrepreneur, he always has an eye on the ethical implications of biotech and longevity-focused initiatives.

While he firmly believes in human uniqueness, individuality and purpose, today’s article views us as functional units within society – this perspective is intentional, aiming to explore broader societal implications.

Longevity: from a billionaire’s turf to a universal healthcare, part 1
by Sergey Jakimov

I wanted to start this pieceon a positive note, which is that the overall understanding of what it takes to live a longer life of better quality is slowly making its way into the awareness of average members of our global society.

The portrait of that “average” person may differ, but for simplicity, we can generally describe them as someone with no professional experience or education in the healthcare industry; they consume mainstream media and generally know what is and is not good for them.

This is a generalistic and oversimplified view, but I think you’ll realize, as I did, that this basic understanding that most people have of their health is, surprisingly, the answer to a more complex set of issues in longevity.

How does this basic understanding of a good or bad lifestyle manifest in our life choices? Through straightforward, and at times unpleasant, inclinations and prolonged calculated patterns of behavior – systematically going for a walk instead of staying on the couch, choosing vegetables over fast food, etc. Some of these choices also became easier to make – different wearables and apps make lifestyle choices more manageable, motivating us to move fast, sleep, and care for ourselves, for example. In fact, some of us are much bigger longevity enthusiasts than we thought – we just call it by a different name. Wellness. Health. Good habits.

Regardless of the term, this is a good start for the broader adoption of the term longevity. This pattern of making a series of “healthy” lifestyle choices is vital. It’s a good start because it is a basic (read: easily understandable) longevity narrative. And it is happening “now” – indeed, it is already rooted in the lives of an increasing number of members of our society. It is, thus, an excellent and promising pattern for our overall adoption of longevity.

Longevity is non-existent in the mainstream healthcare system


However, looking further away from the world of trackers, counting steps, and consuming broccoli, it appears that longevity isn’t taking root yet in the healthcare system. Finding longevity-centred narratives, frameworks, methodologies, or approaches is hard. Most practicing physicians are unaware of the term, and general hospitals lack structured longevity programs.

Sergey Jakimov is a founding partner of LongeVC

We need to manage our expectations of the average healthcare system, and first, we must understand its purpose. Healthcare systems and, most importantly, their patient-facing care parts are heavily standardised, protocoled, high-throughput triaging machines geared towards one goal only: being able to efficiently process large populations with various conditions, efficiently filtering the patients, and assigning them, with little to no level of personalisation, to the most fitting treatment regimen. In all their pragmatic nature, one might even claim that they are not there to save every patient but rather to demonstrate a reasonable success rate in recovering a significant portion of them.

Frankly, this feature is one of the primary reasons why any increasingly personalised healthcare debate always fails within the framework of the traditional high-throughput healthcare system. There is insufficient time, resources, and willingness to treat everyone differently. It was also never a goal to begin with.

The way a traditional healthcare framework approaches a patient’s health condition is also fundamentally different from the longevity narrative. It is hugely reactive instead of proactive (e.g., focused on prevention). For the process-oriented and protocol-driven triage system to attend to the patient, one must be substantially ill or, at the very least, reasonably suspect that they are sick. Otherwise, why bother with a healthy individual?

It is true that state screening programs for breast, colon, ovarian, and other cancers partially disprove this claim; they also reduce the disease burden in certain illnesses that, if discovered late, will render a person obsolete and unrecoverable.

As a result, the picture seems grim. We are units in society, and unit economics is against us. We need efficient care, which means reducing personalisation and treating diseases rather than preventing them.

Time for change

While longevity gains momentum among individuals through healthier lifestyle choices and technological aids, its presence in the healthcare system remains minimal. The current healthcare paradigm, which is heavily focused on reactive treatment rather than proactive prevention, is misaligned with the principles of longevity. This disconnect presents a critical challenge: how do we bridge the gap between individual health initiatives and a healthcare system yet to embrace the longevity narrative fully?

We realise that transformative changes are needed to integrate longevity into healthcare frameworks. In Part 2, we will explore the barriers and potential strategies to overcome them, furthering our journey towards a healthcare system that fully embraces and integrates the principles of longevity.

How longevity will arrive for everyone

Author: Eleanor Garth | Published on: February 2, 2024 |


LongeVC’s Sergey Jakimov says longevity needs to demystify, be understandable and be ready to use in healthcare.

LongeVC is a Switzerland-based venture capital company that supports early-stage biotech and longevity-focused founders and startups. Its founding partner, entrepreneur Sergey Jakimov, takes his responsibility to the sector seriously, and while he is keen to help shape the future of longevity biotech, he is equally focused on keeping a weather eye on the ethical implications of biotech and longevity-focused initiatives.

While Jakimov firmly believes in human uniqueness, individuality and purpose, today’s article views us as functional units within society – this perspective is intentional, aiming to explore broader societal implications.

Exploring the integration of longevity into healthcare systems reveals significant obstacles. Despite its promise and growing recognition in personal health practices, longevity encounters a complex terrain in mainstream healthcare’s structured, protocol-driven environment. Key challenges include high costs, limited awareness, and a lack of specific longevity treatments and physician training. This discussion centres on these issues, probing why healthcare systems have yet to fully adopt longevity and identifying steps towards a more proactive, health-oriented approach.

Putting the “sleep more, move more” level of essential self-care aside, real longevity medicine is currently not accessible to an average member of society despite its proven results. There are several reasons why.

First, high costs. As we speak, longevity care is a realm of high-end specialised boutique clinics that provide expensive care (think hundreds of thousands of US dollars), and they target high-net-worth patients who can afford it.

Second, there is low longevity literacy in patients – even in understanding the term “longevity.” Even if the care were made universally available, it might not even be used. Patients of all ages need to be educated on why medical care is pivoting towards health optimisation, not just disease treatment. And we need to start now, as the “do not fix what’s not broken” principle is tough to crack.

Third, there is the relative absence of proven longevity-purpose-designed drugs and regimens. This still, in some eyes, renders the discipline incomplete and not feasible for larger populations.

Fourth, there is a lack of physician training. While most doctors do not know what longevity means, becoming a longevity physician takes dedication. Fortunately, the Healthy Longevity Medicine Society (HLMS) is standardising and enabling systemic longevity physician education.

Sergey Jakimov is a founding partner of LongeVC

Lastly, readiness. Some societies are not simply ready for longevity. Though difficult to admit, universal longevity care in Norway, where social security, pensions, and well-being are at their highest, would have huge economic and moral consequences. Then, repeat it in Latvia, Romania, or Bulgaria, where the pensions mostly do not exceed a few hundred euros. The former seems viable; the latter seems like an evil joke.
How do we standardise and scale longevity?

Let us step back and think about how new innovations are adopted. Many of us have seen the “innovation adoption graph,” with early adopters leading and laggards catching up, but it does not explain how innovations get there. How do these new technologies stop being “new” and become part of the everyday? Through standardisation.

Standardisation is the way we live and use things. We’ve standardised safety – enter the ISO standard; we’ve standardised medical procedures and drug manufacturing – enter LASIK, surgical methodologies, GMP practises, etc. Another familiar example is how degrees, diplomas, and ECTS points standardise education. We have standardised food and welcomed quality control franchises. Standardisation of personalisation makes it accessible. If longevity care relies on our uniqueness, then uniqueness too needs to become a standard, repeatable norm.

Science, data, and efficacy are not enough to spread longevity medicine. Nor is the focus on treating only high-net-worth individuals. Standardisation and a focus on accessibility, on the other hand, should be.

There has been no attempt to imagine longevity as a turnkey solution or an end-to-end healthcare framework integrated into existing healthcare systems and usable within the same, or slightly adjusted, patient care culture.

Treatment innovations gain widespread adoption only when incorporated into Standard Operating Procedures (SOPs) and universal protocols. Immune checkpoint inhibitors (PD1, PDL1) and monoclonal antibody strategies exemplify this. Initially cutting-edge, these drugs have been integrated into standard cancer protocols, such as those for melanoma, and recognised for their efficacy as primary or adjuvant therapies. Thus, they transitioned from exclusive treatments for a few to accessible options for many.

Of course, introducing longevity into the traditional healthcare systems as an almost parallel continuum of care is much more complicated. After all, while the healthcare system reacts to a sick individual, longevity starts way earlier, with a clear, proactive stance. It does not, however, mean that the two cannot co-exist.

Integrating longevity into traditional healthcare will be multifaceted. Firstly, standardising longevity care protocols and frameworks is essential. Institutions like HLMS must lead in establishing these benchmarks. Secondly, medical education must expand to include longevity training and enhance physicians’ existing knowledge with proactive, preventive healthcare approaches.

This necessitates a network of institutions committed to such education. Finally, the economic benefits of longevity care must be demonstrated. By preventing diseases and promoting sustained, cost-effective care, longevity can reduce expenses for insurance providers, lessen state burdens for healthcare costs, and sustain a healthier, more economically active population. This approach benefits public healthcare and creates new financial opportunities in the private sector.
The reality of longevity adoption

In essence, longevity must shed its image as an unattainable sci-fi luxury and demonstrate its practicality within existing healthcare systems. It should complement, not disrupt, these systems, easing economic and health burdens. As a distinct discipline, it needs evident, standardised expertise, protocols, and frameworks. This demystification will facilitate its broader adoption and integration.

It is like astrophysicists constantly debunking myths about black holes and outer space and making complicated science digestible for the public. It is the job of current longevity advocates (eg., our job, including physicians, VCs, academia, non-profits, and others) to work on wrapping longevity into something integrable, understandable, and ready-to-use in our healthcare systems.

Longevity: ‘money-spinning cult’ or the future of health?
Author: Danny Sullivan | Published on: April 20, 2023 | Last updated: May 2, 2023


BBC presenter discovers that the longevity industry isn’t just about billionaires trying to cheat death.

This weekend, the BBC will air a special 30-minute technology feature that turns the spotlight on the world of longevity. The Forever Young? episode follows presenter Lara Lewington as she travels to California to meet the tech entrepreneurs and scientists attempting to slow, stop and reverse the aging process. Her journey covers many aspects of longevity – from discovering the concept of healthspan and how to improve it, meeting a tech entrepreneur spending $2m a year to reduce his biological age, and even longevity for dogs.

Longevity.Technology: While those already embedded in the field don’t need to be convinced about the value of targeting aging, most people remain blissfully unaware of the exciting work going on in longevity. But times are a-changin’. With mainstream global news channels like the BBC highlighting developments in the sector, more and more people are beginning to take an interest in the science of longevity. It’s always interesting to hear an outsider’s perspective on the field, so we caught up with Lewington to see what she made of her induction into the science – and business – of aging

.

Lara Lewington is a technology presenter for the BBC.

Lewington’s interest in longevity was first piqued by news stories that made the longevity field sound like it was purely a whim of US billionaires seeking the fountain of youth.

“I didn’t know whether I was going into the heart of some sort of money-spinning cult, or whether it was actually people who really cared about scientific development and wanted to lead their best lives,” she says. “Once I started looking into it, I realised it wasn’t anywhere near as sensational as some tech billionaires wanting to live forever. I learned that there was a whole industry out there.”
Longevity sector ‘more realistic’ than expected

The longevity ‘industry’ that Lewington describes is largely divided into two main areas.

“You’ve got the whole biotech side where it’s about a potential new frontier of medicine,” she says. “If they can pull that off and create something that works at a cellular level to stop or reverse aging, then, in terms of medical development, that’s enormous. But then there’s this whole other lifestyle side, where you have got some things that seem to be proven to work, and some other things people are doing that don’t seem proven yet.”

Lewington underwent several longevity tests.

In addition to visiting biotech companies like UNITY Biotechnology and dog longevity company Loyal, Lewington also spoke with leading scientists in the field, including Dr Eric Verdin at the Buck Institute for Research on Aging. The overwhelming feeling she gained from those conversation was that people working in the field are much more pragmatic than she thought they would be.

“It felt like everyone I spoke to was very realistic,” says Lewington. “A lot of things have worked in mice that then haven’t worked in humans, and everyone I talked to was very open and honest about that. Probably more so than I expected. Even people running smaller longevity biotechs seemed very measured, and it really felt like they were all in it together.”

Lifestyle is where it’s at… for now

The program also gets a clinical perspective from Dr Jordan Shlain, a practicing primary care doctor in San Francisco.

“Dr Shlain said he had lots of patients coming to him asking for longevity advice,” says Lewington. “And he said you first need to find out what they mean by longevity – what do they want to achieve? He also said it’s about lifestyle changes – not just a magic pill that will fix everything.”

“In fact, that seemed to be the conclusion from almost everybody: It will be great if we can create the drugs that do what they’re meant to, but ultimately, we need to live better lives.”

To further explore this link between lifestyle and longevity, Lewington met with multimillionaire tech entrepreneur Bryan Johnson, who recently made headlines with his plans to spend millions each year to reverse his biological age.

Lewington meets with Bryan Johnson at his home in California.

“I wasn’t sure whether I wanted to put Bryan in the programme or not, because I was moving away from the whole sensationalist idea of people wanting to live for a really long amount of time,” she says. “But I’m really pleased that I did because he’s making himself a human experiment. He’s testing lots of stuff – some will work, some won’t – but it’s a really interesting experiment. And he’s doing it while being monitored by 30 scientists, but he is still taking risks, of course.”

Bringing longevity into the mainstream

Lewington says that the lifestyle aspect of longevity permeated the entire field. As a non-drinker, she describes her joy at seeing unopened bottles of wine at a longevity event, and being fascinated meeting people who set their alarm clocks to go to bed, rather than to get up.

“I met with founders and people who are working on the science, and they still think that the most important thing we can be doing is to be looking after ourselves properly,” she says. “They weren’t talking about cryo chambers or ice baths – they were talking about making sure you exercise regularly, eat well and get your eight hours sleep. I came back feeling it’s just really important to live your healthiest life. And it’s as simple as that. Although it’s not always that simple to actually do it!”

Through the program, Lewington hopes to help bring the longevity message to a more mainstream audience.

“I’m trying to take away that sensationalist view of longevity being about living to 150, because there’s actual real stuff out there that can help people increase their healthspan to live the later years of their lives better – and that’s probably a more realistic aim,” she says. “Yes, it may end up resulting in a few extra years of life, but I think it’s more about getting people to understand that there is work happening that may mean those final years or decades of our lives don’t have to be so difficult.”

FOR PROFIT HEALTHCARE

New West Health-Gallup poll: 114 million Americans think the US healthcare system is failing them

1 in 3 Americans say healthcare in America deserves an F for affordability

Reports and Proceedings

WEST HEALTH INSTITUTE

 

IMAGE: WEST HEALTH-GALLUP HEALTHCARE IN AMERICA REPORT view more 

CREDIT: 2022 GALLUP

WASHINGTON, D.C. — Oct. 6, 2022 — Nearly half the country (44%), or about 114 million Americans, give poor (30%) or failing (14%) grades to the U.S. healthcare system, percentages that climb higher and grow even more negative when it comes to affordability and health equity, according to a new report from West Health and Gallup, the polling organization.

The 2022 West Health-Gallup Healthcare in America Report asked a nationally representative sample of more than 5,500 Americans to provide a letter grade (A-excellent, B-good, C-satisfactory, D-poor and F-fail) for the healthcare system overall and to give individual grades for affordability, equity, accessibility and quality of care.

High marks were in short supply across the board, with the healthcare system getting an average grade of C-minus. Women and Hispanic and Asian Americans were more negative, with about half of each group assigning it a grade of D or F compared to about 40% of males, and 43% of White and Black Americans.

Nothing, however, earned more failing grades than affordability, which for three-quarters of Americans — an estimated 190 million adults — deserved no higher than a D (41%) or F (33%), for an average grade of D-minus. A top grade of A was virtually nonexistent (1%), only 6% went as high as a B, and 19% gave it a middling grade of C. The negative feelings about healthcare affordability were strikingly similar across gender, age, race, household income and political persuasion.

“After years of higher prices, growing inequities, skipping treatments, getting sicker, or borrowing money to pay medical bills, it’s no wonder so many Americans view the health system so poorly,” said Timothy A. Lash, President, West Health. “This new report should send a strong message to policymakers that despite the healthcare provisions in the Inflation Reduction Act, most of which will not take effect for some time, there is still immediate work to be done to lower healthcare prices.”

Report Card on Healthcare Equity, Access and Quality of Care

Two-thirds of Black Americans (66%) and a similar percentage of Asian Americans (64%) gave a D or F for equity, the ability of every person to get quality care when they need it regardless of personal characteristics. That’s more than the 55% of Hispanic Americans and 53% of White Americans who deemed health equity to be poor or failing. Black, Hispanic and Asian Americans and women were also more critical when it came to access to care. More than 40% of each of these groups gave access Ds and Fs, compared to about a third of White Americans and men.

Quality of care was the only aspect of the healthcare system that received more positive than negative marks, though it was still only able to earn an overall grade of C-plus. Less than half (47%) gave it an A or B grade, but a significant gender divide emerged, with women much less likely to give high grades for quality than men (38% vs. 57%). Black and Hispanic Americans were more negative on quality and less likely to give top marks than the general population (36% each vs. 47% overall).

Making the Grade — Why Do So Many Americans View Healthcare So Poorly?

Millions of Americans struggle every day in the face of a high-cost healthcare system, a struggle that not only results in a bad report card but in negative real-life consequences. Nearly one in five Americans say they or a family member had a health problem worsen after being unable to pay for needed care and an estimated 70 million people (27%) report that if they needed quality care today, they would not be able to afford it.

“What I’ve done instead is ration healthcare…medicine. Using less to make it last. Using less than was prescribed in order to make it last longer...Things weren’t as good as they could have been if I’d been using it...the way I should have been,” said 71-year-old Anne Courtney Davis from Ohio, one of the survey respondents.

Additional Key Findings

• 66% of Americans say their household pays too much relative to the quality of care that it receives, up six points compared to April of last year. 
• Half the country, about 129 million people, lack confidence they will be able to afford healthcare as they age.
• Two in three Americans under 65 are worried Medicare will not exist when they turn 65, and 3 in 4 adults 62 or younger say the same about Social Security.
• 17% cut back on healthcare services to pay for other household goods with women more likely to do so than men (about 50% more likely); and Black (23%) and Hispanic (24%) Americans 53% and 60% more likely than White adults (15%). 
• Six in 10 Americans report that cost is an extremely important or important factor when considering a recommended medical procedure or medication.
• People 50 to 64 are nearly twice as likely to say cost is extremely important as those over 65 (29% vs. 16%) — rates that run even higher for Black (39%) and Hispanic adults (41%).

“While America’s grading of the U.S. healthcare system is troubling, it provides a roadmap for healthcare systems and policymakers to invest and fix areas with the greatest impact to shift sentiment,” said Dan Witters, Research Director for the Gallup National Health and Well-Being Index. “What we must remember is that there are actual people behind these grades and that too many Americans are persistently struggling to access and afford quality healthcare.”

Note to Media If you wish to receive any additional information about the survey, including further demographic groups responses, please contact kristjan_archer@gallup.com.

 

Methodology

Results are based on surveys conducted June 21-30, 2022, with n=5,584 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia as a part of the Gallup Panel. For results based on these samples of national adults, the margin of sampling error at the 95% confidence level is +1.6 percentage points for response percentages around 50% and is +1.0 percentage points for response percentages around 10% or 90%, design effect included. For reported subgroups, the margin of error will be larger, typically ranging from ±3 to ±4 percentage points. All demographic group comparisons in the report are significant at p<.05 unless otherwise noted. Learn more about how the Gallup Panel works.

 

About West Health
Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego, and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org and follow @westhealth.

 

About Gallup
Gallup delivers analytics and advice to help leaders and organizations solve their most pressing problems. Combining more than 80 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of employees, customers, students and citizens than any other organization in the world.

 

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METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

Frontline healthcare workers more likely to test positive for SARS-CoV-2 despite PPEby King's College London

Credit: CC0 Public Domain

A new study published today in Lancet Public Health has found that front-line healthcare workers with adequate personal protective equipment (PPE) have a three-fold increased risk of a positive SARS-CoV-2 test, compared to the general population. Those with inadequate PPE had a further increase in risk. The study also found that healthcare workers from Black, Asian and minority ethnic (BAME) backgrounds were more likely to test positive.

Using the COVID Symptom Tracker App, researchers from King's College London and Harvard looked at data from 2,035,395 individuals and 99,795 front-line health-care workers in the UK and US. The prevalence of SARS-CoV-2 was 2747 cases per 100,000 front-line health-care workers compared with 242 cases per 100,000 people in the general community. A little over 20 percent of front-line health-care workers reported at least one symptom associated with SARS-CoV-2 infection compared with 14·4 percent of the general population; fatigue, loss of smell or taste, and hoarse voice were especially frequent.

BAME health-care workers were at an especially high risk of SARS-CoV-2 infection, with at least a fivefold increased risk of infection compared with the non-Hispanic white general community.

Professor Sebastien Ourselin, senior author from King's College London said: "The findings of our study have tremendous impact for healthcare workers and hospitals. The data is clear in revealing that there is still an elevated risk of SARS-CoV-2 infection despite availability of PPE.

"In particular we note that that the BAME community experience elevated risk of infection and in some cases lack access to adequate PPE, or frequently reuse equipment."

Researchers say their study not only shows the importance of adequate availability and use of PPE, but also the crucial need for additional strategies to protect healthcare workers, such as ensuring correct application and removal of PPE and avoiding reuse which was associated with increased risk. 

Differences were also noted in PPE adequacy according to race and ethnicity, with non- Hispanic white health-care workers more frequently reporting reuse of or inadequate access to PPE, even after adjusting for exposure to patients with COVID-19.

Joint first author Dr. Mark Graham from King's College London said: "The work is important in the context of the widely reported higher death rates amongst healthcare workers from BAME backgrounds. Hopefully a better understanding of the factors contributing to these disparities will inform efforts to better protect workers."

Dr. Claire Steves, lead clinical researcher from King's College London said: "I'm very pleased we have now introduced masks and social distancing where possible for all interactions in hospitals—to protect ourselves and the population we serve. We need to ensure this is reinforced and sustained throughout the health service—including in health care settings outside hospitals, for example in care homes.

"Additional protective strategies are equally as important, such as implementing social distancing among healthcare staff. Stricter protocols for socialising among healthcare staff also need to be considered."


Explore further COVID risk calculator aims to help keep BAME healthcare workers safer

Journal information: The Lancet Public Health

Provided by King's College London

High COVID-19 risk among health care workers, especially those from minority backgrounds
by Massachusetts General Hospital

Credit: CC0 Public Domain

New research indicates that at the peak of the COVID-19 pandemic in the U.S. and the U.K., frontline healthcare workers—particularly those from Black, Asian, and minority ethnic backgrounds—faced much higher risks of testing positive for COVID-19 than individuals in the general community. The study, which was conducted by a team led by researchers at Massachusetts General Hospital (MGH), is published in The Lancet Public Health.


Among 2,035,395 individuals in the community and 99,795 frontline healthcare workers who voluntarily used the COVID Symptom Study smartphone app developed by Zoe Global Ltd with scientific input from MGH and Kings College London, 5,545 new reports of a positive COVID-19 test were documented between March 24 and April 23, 2020.

Frontline healthcare workers had at least a threefold increased risk of COVID-19, after accounting for differences in testing frequency between frontline healthcare workers and the general community. Black, Asian, and minority ethnic healthcare workers appeared to be disproportionately affected, with a nearly twofold higher risk compared with white healthcare workers.

Also, frontline healthcare workers who reported inadequate availability of personal protective equipment (PPE) such as masks, gloves, and gowns, had an especially elevated risk; however, adequate availability of PPE did not seem to completely reduce risk among healthcare workers caring for patients with COVID-19.

"Although it is clear that healthcare workers on the front line of the fight against COVID-19 have an increased risk of infection, our country continues to face vexing shortages of PPE," said senior author Andrew T. Chan, MD, Ph.D., chief of the Clinical and Translational Epidemiology Unit at MGH and director of Cancer Epidemiology at the MGH Cancer Center. "Our results underscore the importance of providing adequate access to PPE and also suggest that systemic racism associated with inequalities to access to PPE likely contribute to the disproportionate risk of infection among minority frontline healthcare workers."

Dr. Chan hopes the study's findings bring greater awareness to the importance of ensuring an equitable supply chain of PPE and of developing additional strategies to protect all frontline healthcare workers. "This study demonstrates how the two major crises that the U.S. faces— the COVID-19 pandemic and systemic racism—are inextricably linked and need immediate attention," he added.


More information: Long H Nguyen et al, Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study, The Lancet Public Health (2020). DOI: 10.1016/S2468-2667(20)30164-X

Journal information: The Lancet Public Health

Provided by Massachusetts General Hospital 

 

34,000 healthcare professionals surveyed indicate they have higher bias against transgender people

Peer-Reviewed Publication

CELL PRESS

 

IMAGE: 

A SCREENSHOT OF THE TRANSGENDER IAT PROCEDURE

view more 

CREDIT: HELIYON/DERBYSHIRE ET AL.

By analyzing data from the Harvard Implicit Association Test—a widely accepted measure of a person’s attitudes toward people based on characteristics like race, gender, and sexuality—researchers find that healthcare professionals, and in particular nurses, are more biased against transgender people than are people who are not healthcare professionals. A questionnaire administered before and after the test shows that healthcare professionals are less likely to know transgender people personally and that nurses are more likely to conflate sex and gender identity. These results are reported November 3 in the journal Heliyon.

The Implicit Association Test works by asking participants to categorize groups of people with “good” words like “nice” or “laughter” and “bad” words like “nasty” or “rotten.” Its results are collected by a team of scientists as a part of Project Implicit since 1998 and are made available for use by the public and other researchers.

To specifically assess the attitudes of healthcare professionals towards transgender people, the researchers focused on a subset of the respondents from 2020 to 2022, including 11,996 nursing healthcare professionals and 22,443 non-nursing healthcare professionals. These responses were compared to 177,810 responses of non-healthcare professionals.

A person’s bias is reported as their “D-score,” which can range from -2 to 2, with higher scores indicating more anti-transgender views. The standard classification for this test lists values over 0.15 as “slightly biased,” and over 0.35 and 0.65 as “moderately” and “strongly” biased, respectively.

Non-healthcare professionals on average reported a D-score of 0.116, which is considered to mean that they have little to no bias. However, healthcare professionals (non-nursing), reported an elevated score of 0.149, which is on the edge of what is considered to be “slightly biased.” The average D-score for nursing healthcare professionals was 0.176, which falls clearly within the range of “slightly biased.”

The participants’ D-score assesses their implicit bias—their true beliefs which they may be too reluctant to share—but their explicit bias, or their self-reported views, were assessed by a questionnaire.

Nursing healthcare professionals were significantly more likely to agree with statements like “I believe a person can never change their gender” or “I think there is something wrong with a person who says they are neither a man nor a woman” compared to other healthcare professionals and non-healthcare professionals.

“Our finding that nurses have higher levels of implicit bias towards transgender people may be related to a tendency to conflate sex and gender identity, as shown by higher levels of agreement with transphobic statements that conflate these two distinct concepts,” write authors Daniel W. Derbyshire (@DWDerbyshire) of the University of Exeter and Tamsin Keay of Coventry University.

The questionnaire also asked about the participants’ relationships with transgender people in their daily lives. While healthcare professionals—including nurses and non-nurses—were more likely to have met a transgender person than non-healthcare professionals, they reported that they were less likely to have a transgender friend or family member.

“This suggests that healthcare professionals’ (both nurses and non-nurses) experience of interacting with transgender people may be largely confined to a work context,” write the authors.

The authors note that the participants in this test are limited to those who visited the Project Implicit website and chose to complete the test. “As such, the sample may be subject to sample selection bias in terms of the demographics and Implicit Association Test (IAT) results of participants,” write the authors. “However, it may be anticipated that people with particularly negative attitudes towards transgender people would avoid taking the Transgender IAT and the results presented here may therefore under-represent the extent of implicit bias towards transgender people.”

 

Images of transgender people used in the Implicit Association test

 

Images of cisgender people used in the Implicit Association test

CREDIT

Heliyon/Derbyshire et al.

Heliyon, Derbyshire et al. “Nurses’ Implicit and Explicit Attitudes towards Transgender People and the need for Trans-Affirming Care” https://cell.com/heliyon/fulltext/S2405-8440(23)07970-7

Heliyon (@HeliyonJournal), part of the Cell Press family, is an open access journal publishing scientifically accurate and valuable research across life, physical, social, and medical sciences journal. Visit https://www.cell.com/heliyon. To receive Cell Press media alerts, contact press@cell.com.

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JOURNAL

Heliyon

DOI

10.1016/j.heliyon.2023.e20762 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Nurses’ Implicit and Explicit Attitudes towards Transgender People and the need for Trans-Affirming Care

ARTICLE PUBLICATION DATE

3-Nov-2023