The Affordable Care Act might have done more than provide more Americans with health insurance: New research suggests accompanying expansions in Medicaid may be linked to higher numbers of low-income people having jobs or going to school. That’s what happened after Michigan expanded its Medicaid under new rules from the Affordable Care Act. Researchers surveyed more than 3,000 low-income people with Healthy Michigan Plan coverage in 2016 and again about a year later. During that time, there was an overall 6-point increase in the percentage of study participants who had jobs or were in school, which was higher than employment gains in the general population over the same period. Even larger increases in employment and school enrollment were seen among study participants who were black (nearly 11 points), men (6.7 points), people aged 35 to 50 (8 points) and those with the lowest incomes (9 points), according to the University of Michigan study. “While on a statewide level, both in the general population and the low-income population, employment levels didn’t change much between 2016 and 2017, we saw a clear increase in employment or student status among those in the Healthy Michigan Plan, even among those with health conditions who we might think would need more time to achieve this,” said study author Dr. Renuka Tipirneni, an assistant professor of internal medicine at Michigan. While…  read on >

Allowing pharmacists to provide the opioid overdose drug naloxone without a prescription led to a huge increase in dispensing of the lifesaving drug in Ohio. Ohio state lawmakers gave that permission in 2015. Since then, there’s been a 2,328% increase in naloxone dispensing, according to University of Cincinnati researchers. The study also found that counties with low-employment rates had 18% more naloxone dispensed per month than high-employment counties. The findings were published online Jan. 31 in JAMA Network Open. “Our study shows that this change in the Ohio law allowed pharmacists to have more opportunity to participate in the management of patients addicted to opioids,” said lead researcher Pam Heaton, a professor of pharmacy practice. Most states allow pharmacists to dispense naloxone (commonly known as Narcan) without a prescription. As of May 2019, about 75% of Ohio’s community pharmacies were registered to do so. Heaton said the dispensing rate in low-employment counties probably owes to the fact that the local pharmacy is often the only health care contact for people there. “We do not know whether the naloxone was for personal use, a family member or a friend, because the law was written to specifically allow access,” she said in a university news release. Heaton also noted that the study focused on access and didn’t examine the impact of increased naloxone distribution on the rate…  read on >

Mothers who smoke during pregnancy put their infants at increased risk of fractures in their first year of life, researchers warn. The study looked at more than 1.6 million people who were born in Sweden between 1983 and 2000, and followed for an average of 21 years. Over that time, nearly 378,000 fractures were recorded. But the rate among those whose moms smoked during pregnancy was higher than among those whose mothers didn’t smoke. And the more a woman smoked while pregnant, the greater her child’s fracture risk, the findings showed. Those whose mothers smoked one to nine cigarettes a day had a 20% higher risk, while 10 cigarettes or more per day brought a 41% higher risk. While smoking during pregnancy increased fracture risk during an infant’s first year, it was not associated with a higher risk later in life. This suggests that smoking during pregnancy has only a short-term impact on bone health, according to the authors of the study published Jan. 29 in the BMJ. Epidemiologists Judith Brand and Scott Montgomery, of the School of Medical Sciences at Orebro University in Sweden, led the study. They pointed out that their observational study doesn’t prove cause and effect. In addition, they noted that the findings also have some limitations, including the possibility that some women would not admit to smoking during pregnancy or…  read on >