Among the issues that affect Americans, health care is one of the most important and one of the most complex and evolving as new technologies, public policies, and issues emerge. brought new problems to the fore.
Health care is the third most pressing issue in this presidential election year, according to WisconSays data collected as part of this year’s Main Street Agenda, which the La Follette School of Public Affairs at the UW -Madison uses it to highlight what’s important to Wisconsin throughout the year. 2024.
In this nationally representative survey, 54% of respondents reported health care as a big or very big problem for Wisconsin; 69% feel this way about health care as a problem for the country. This sentiment is echoed across the country with 58% of Democrats and 54% of Republicans seeing it as a problem or very big problem for the country. There is also a slight divide between urban (54%) and rural (53%) residents.
One of the biggest issues in the last presidential election was the public health crisis of COVID-19. Today, what health care issues are Wisconsinites concerned about? Health care costs? Access to (quality of) health care? Or other aspects of health care policy, such as prescription drug costs, hospital consolidation, changes in legal cannabis markets, or changes in access to reproductive health care? Another concern shared by many across the country surrounds the ongoing opioid crisis.
A test of the opioid crisis is an already strained health system
Thirty years and more than a million deaths in the US later, this absolute disaster is on the minds of people across the country regardless of their circumstances, with far-reaching consequences. across demographics including gender, race, ethnicity and geography.
Opioids release powerful endorphins from your brain’s reward centers, making them highly addictive. Opioid overdose can lead to depression and death if not treated in time with naloxone (Narcan) and additional medical attention. Most opioid overdoses occur from prescription opioids (eg, oxycodone) or illegal opioids (eg, heroin or fentanyl).
By 2022, more than 80,000 Americans will die from opioids. It was the highest annual death toll from the drug, and the number of deaths from opioids has nearly quadrupled over the past decade. About 1,500 Wisconsinites lost their lives to opioids in 2022, nearly 20% more than two years earlier.
The effects of the epidemic on our society and health care system reach far beyond excess mortality. Another understudied aspect of the opioid crisis is its impact on women, infants and children.
Opioids have significant impacts on society and public health
Opioid use during pregnancy can lead to neonatal abstinence syndrome (NAS), a condition of withdrawal at birth. The number of babies born with NAS increased more than fivefold from 2004 to 2016 in the US.
Another collaborative project I am doing with the La Follette School and the Center for Poverty Research investigates the prevalence of opioid exposure during pregnancy and its effects on infant outcomes, early childhood development, and involvement in child protection services.
Our research found that nearly two percent of children born to Medicaid recipients in Wisconsin from 2010 to 2019 received a NAS diagnosis. We also found, using our broad definition, that 20 percent of expectant mothers with Medicaid had exposure to opioids.
Opioid exposure is also associated with adverse infant health outcomes such as low birth weight, small for gestational age, neonatal intensive care unit placement, and referral to child protective services. These effects are more pronounced for exposures from opioids used for the treatment of opioid use disorder and illegal opioids than traditional opioids.
We are also studying the relationship between opioid exposure during pregnancy and health and development among young children. Our preliminary results suggest that exposure to opioids of more than 90 days is associated with an increased risk of being diagnosed with intellectual and cognitive disabilities at 5 years.
In addition to the effects on infants and children, these data suggest that the opioid crisis is also expanding the already underfunded health care system, not to mention administrative burdens. of child welfare, emergency response, law enforcement and the judicial system. Policymakers and public health experts have come up with many promising ways to combat the epidemic, but like a game of Whac-a-Mole, new aspects of the crisis Many of the latest concerns involve deadly illegal opioids.
It is too early to say whether the data showing a decrease in mortality is statistically significant
Earlier data from the CDC indicate that opioid-related deaths may decrease slightly by 2023, but these estimates are tentative and equate to more than 80,000 deaths in a single year. It is too early to call it a victory.
At the same time, about $ 55 billion will be distributed to local and regional governments as part of the high levels of opioids with companies most responsible for the crisis. Some of these funds have already reached governments, with the mandate that they must spend at least 85% on treatment and prevention. Wisconsin will receive $ 750 million, while the 87 local governments involved in the case receive 70% of the funds to help solve this problem.
With wealth comes hope. But the opioid crisis is an ever-changing issue where increasingly dangerous opioids like fentanyl have raised the stakes. Other lethal substances often combined with opioids, including Xylazine (“tranq”), a powerful non-opioid sedative, have made solving this problem even more difficult. There is no one-size-fits-all solution.
Hunting should not cause pride.Wisconsin has a stable and growing population of sandhill cranes.
It is important that we combine distributed funding with targeted solutions, based on sound, evidence-based research, that support different aspects of the crisis: preventing opioid abuse and dependence, reducing diversion, improve access to opioid addiction treatment, and harm reduction, with rights for diverse populations, including early intervention for pregnant women with opioid use disorders.
Wisconsinites believe that health care is a critical issue for our state and country. If we can’t reverse opioids, health care will become an even bigger public concern since so many of our citizens have been directly or indirectly affected by the opioid crisis.
Christine Durrance is a professor at the La Follette School of Public Affairs at the University of Wisconsin-Madison who studies health economics and policy, with special interests in risky behaviors, including substance abuse and the opioid crisis; maternal, infant, and reproductive health; child abuse and domestic violence; and competition in health care markets. Most of his work focuses on vulnerable people.
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