STAT health news: UnitedHealth survey, pregnancy, Oropouche

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Good morning! In the midst of today’s news, two items about pregnancy that are interesting and creepy to read together. Plus two itchy bits of mosquito news from STAT’s Helen Branswell.

Healthcare colossus: UnitedHealth promised it wouldn’t happen. It wasn’t.

Take our money, the company said. We handle the business side while you take care of your patients, it said. Together we can create a future in which primary care is leading, the report says. Those were the promises UnitedHealth Group made in 2014 to ProHealth Physicians, a renowned primary care network in Connecticut with more than 50 clinics across the state.

But doctors say the promises have not been kept. Ten years later, the group is a shadow of its former self. “People can’t get the care they need,” said Sharon Maloney, whose husband was unable to get into his doctor’s office for three days, setting off a chain of events that led to his death.

In Part 3 of STAT’s investigative series on UnitedHealth Group’s physician empire, reporters detail how the story unfolded at ProHealth. My colleagues spoke with more than fifteen former physicians, current and former patients, and experts. They also obtained documents through public records requests.

Read the story. And if you haven’t already, go back to Part 1 and Part 2.

CDC announces $118.5 million to investigate maternal deaths

The Biden administration announced Yesterday, the CDC announced it will invest $118.5 million over five years to help identify and prevent pregnancy-related deaths. Specifically, the funds will go toward expanding a system of maternal mortality review boards from 46 to 52 states and U.S. territories. The groups review deaths within each state or territory that occur within a year of the end of a pregnancy to determine whether the deaths were preventable, and make recommendations on how the deaths can be prevented in the future. Funds will also be used to implement the White House Blueprint for addressing the maternal health crisis, the announcement said.

Maternal mortality is difficult to measure, but according to all experts, the US is in the middle of a crisis. It remains to be seen how additional funding from the federal government will impact the work of MMRCs. “Reporting these findings has increasingly become a political issue, and there have been attempts to suppress their findings,” researcher Greg Roth told STAT’s Nalis Merelli last summer. Between 2017 and 2019, only 36 state groups reported their findings to the CDC.

Can you imagine having your tubes tied and still getting pregnant?

It happens in about 3 to 5% of people who undergo tubal sterilization, according to new estimates published yesterday in NEJM evidence. Researchers used data from the National Survey of Family Growth collected in waves over the past two decades. Among women surveyed between 2013 and 2015, researchers estimate that about 2.9% of those who had their tubes tied became pregnant within a year. But an estimated 8.4% had become pregnant within ten years of the procedure.

The results indicate “non-trivial” pregnancy rates after the apparently permanent procedure, the authors write. It’s good to know, because data from the same study shows that about a third of women have the surgery at age 44.

What is the Oropouche virus, should I worry about it and how do I pronounce it?

Twenty-one people in the US contracted the Oropouche virus during trips to Cuba over the summer, the CDC reported yesterday. The island country is experiencing its first recorded outbreak of the virus, which has also spread in several South American countries. But what exactly is the Oropouche virus?

As usual, STAT’s Helen Branswell has us covered. The virus is spread through biting insects, specifically one type of mosquito, a small fly, and one type of midge. About 60% of people who become infected will develop symptoms such as fever, severe headache, chills, muscle aches and joint pain. And there is no vaccine or specific drug treatment for the virus, so the best way to avoid it, as Helen writes, is to avoid getting bitten.

Find out everything you need to know about the virus, including how to pronounce its name.

Rare mosquito-borne encephalitis is found in four states, with one death

More mosquito news: New Hampshire has recorded the nation’s numbers first death this year from eastern equine encephalitis, a rare but dangerous disease that spreads through the bite of infected mosquitoes. The CDC says it has been notified of four human infections so far in 2024, with Wisconsin, Massachusetts and New Jersey also reporting cases. All four involve neuroinvasive disease, meaning the virus has entered the brain. About 30% of Triple E cases are fatal and survivors often have long-term neurological problems. Massachusetts has started mosquito spraying in some communities and is urging people to stay indoors from dusk to dawn to avoid being bitten.

Triple E infections usually occur in late summer and early fall, before cool temperatures kill the mosquitoes that spread it. The virus is most prevalent along the Gulf Coast, in the Atlantic states and around the Great Lakes. The number of cases varies from year to year, although in most years fewer than 10 cases are reported. However, a record 38 cases were reported in 2019.

—Helen Branswell

NIH allows Native Americans to study substance use in their own communities

The National Institutes of Health has announced plans to spend more than a quarter of a billion dollars on research on substance use and drug overdoses among Native tribes across the country. But there’s a community-driven twist: Tribes and tribal organizations get to design and conduct the research themselves.

Of course, major initiatives that promise to serve indigenous people may be difficult to implement, given the federal government’s record of violence and broken promises — and the broader mistrust of research projects focused on historically marginalized communities, reports Lev Facher from STAT.

But that context is the “foundation of this program,” says Kathy Etz, director of Native American Programs at the National Institute on Drug Abuse. “Tribes want to lead research, they want to be directly funded to lead research, and they want the research to reflect the priorities of their communities,” she said. “What we’re doing here is supporting tribes and Native American organizations to do what they want.” Read more from Lev.

What we read

• What mental health protection measures exist in your country? Pro Publica

• America doubles sewer surveillance, The Atlantic Ocean

• Medicare’s new transitional coverage program for emerging technologies doesn’t go far enough, STAT
• Polio vaccines are arriving in Gaza, but distributing them is the next challenge. New York Times
• Exclusive: Centene Eliminates Broker Commissions for Medicare Drug Plans, STAT