Health Highlights: Jan. 21, 2014

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Many Poor Americans Getting Medicaid Coverage Under Obamacare

Large numbers of poor Americans are signing up for Medicaid through an expansion of the program under the Affordable Care Act, and most of these people were previously uninsured, The New York Times reports.

West Virginia is one of the states where Medicaid coverage has been expanded under Obamacare. More than 75,000 people in the state — which has one of the shortest life spans and poverty rates in the country — have enrolled in Medicaid. That’s reduced the number of uninsured people in the state by about a third.

Uninsured people tend to have worse health and to die younger than those with insurance, and some experts believe that having insurance would help improve the health of poor Americans, but there is debate about this, The Times reported.

For example, one study found that a lack of access to medical care accounts for only 10 percent of premature deaths in the United States, while behavioral factors such as smoking and poor eating habits account for 40 percent. Genetics, along with social and environmental factors account for the remainder.

A study in Oregon examined what occurs when people suddenly get Medicaid coverage and found that there was little change in their physical health. However, there were major improvements in their mental health, including a sharp decline in depression, The Times reported.

Poor people in West Virginia agree that having access to insurance through Medicaid has benefited their mental health. They said they feel relief that they are now protected from medical bills that can ruin their finances, and talk about reclaiming their dignity after years of being turned away from doctors’ offices due to a lack of insurance.

“You see it in their faces,” Janie Hovatter, a patient advocate at Cabin Creek Health Systems a health clinic in southern West Virginia, told The Times. “They just kind of relax.”

Access to vital medications through new Medicare coverage will make a crucial difference for many patients who’ve had to choose between medicine and food, said Gina Justice, a social worker with the Mingo County Diabetes Coalition in West Virginia.

“If you can take away that stress because now you’ve got a medical card, then you can focus on healthier eating that will help with these medical issues,” she told The Times.

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Family Members Often Make Medical Decisions for Elderly Patients: Study

Family members have to make medical decisions for nearly half of elderly Americans in hospital, and daughters make those decisions in nearly 60 percent of such cases, a new study says.

The findings reveal a major problem because U.S. hospitals aren’t organized to include family members in the care of older patients, according to lead author Dr. Alexia Torke, an associate professor of medicine at Indiana University.

“The way hospitals are structured right now is they are set up for patients who can make their own decisions,” she said, NBC News reported. “Physicians talk to patients during daily bedside rounds when the family isn’t there.”

Torke noted that hospitals typically regard patients’ family members as visitors and often fail to keep patients’ families updated about their loved one’s health status.

“Hospital structure needs to change so that families are an integral part of care,” Torke said. “And hospitals should be calling them on a daily basis since nearly half the time families need to be a part of the care team.”

The researchers interviewed doctors caring for more than 1,000 elderly patients at two Midwestern hospitals who needed to make at least one major medical decision within 48 hours of being hospitalized, NBC News reported.

More than 47 percent of those patients needed a family member to help them make decisions and 23 percent had all of their decisions made by a family member. Daughters made the decisions in 59 percent of cases, followed by sons at 25 percent and spouses at 21 percent.

The study, published Monday in JAMA Internal Medicine, also found that only 7.4 percent of the elderly patients had a living will and only 25 percent had a health care representative listed in their medical record, NBC News reported.

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Chinese Health Worker Dies From Bird Flu, Upping Fears of Person-to-Person Spread

The H7N9 bird flu virus has killed a medical worker at a hospital in Shanghai, China and there are concerns that the virus may have spread from person to person.

Officials said that the 31-year-old man died on Jan. 18 and also noted that there have been seven cases of H7N9 infection in people so far this year, Bloomberg News reported.

Human cases of H7N9 were first reported in China in March, 2013 and peaked in April before live poultry markets were closed in order to limit people’s exposure to the virus. Since the start of the outbreak, there have been 199 laboratory-confirmed cases and 52 deaths, according to the World Health Organization.

“It’s always a concern when health workers die,” WHO spokesman Gregory Hartl told Bloomberg. “Hospitals and other medical facilities are a flash point for human-to-human transmission. We would be very much wanting to follow up in as much detail as possible on this case.”

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