Why domestic violence is a public health problem

From: POLITICO Pulse - Tuesday Mar 21,2023 02:02 pm
Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
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By Krista Mahr and Daniel Payne

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Driving the Day

A group of women on a dark street write

More than 60 percent of domestic violence victims have health care needs related to their trauma. | AP Photo

ONE IN FOUR — “One in 4 women and 1 in 10 men will experience sexual violence, physical violence or stalking during their lifetime, and they have all reported some form of impact to their health.”

That’s what Shawndell Dawson, director of the new Office of Family Violence Prevention and Services, told Krista on Monday, the day HHS announced the office's formation.

Krista spoke to Dawson, who previously served as head of the HHS' Division of Family Violence Prevention and Services, about the long-term health impacts of domestic violence and how the new office can improve services to survivors. The interview has been edited for length and clarity.

Why is domestic violence a public health problem? 

Our National Domestic Violence Hotline did a survey of over 9,000 survivors last year, and 62.2 percent of them reported health needs related to their experiences of abuse.

Often experiences of both physical and mental health trauma can have lifelong health consequences from chronic pain, to traumatic brain injury, to barriers to treating chronic health conditions like diabetes. … There's research that has shown that experiences of violence and trauma can change your DNA and be passed from parent to child.

Why did HHS decide it was necessary to create this dedicated office?

This office will enable the government to serve as advisers to HHS leaders on more integrated service models around violence and abuse. That means engaging with child support agencies to facilitate safe access to child support for domestic violence survivors and their children, working with Headstart programs that are serving young children experiencing and witnessing violence, trauma and abuse at home and continuing to work with HRSA health centers around screening and assessment of domestic violence.

What’s the out-of-the-gate priority for you as the new director?

The first priority is to release a HHS-ACF [Administration for Children and Families] strategy on preventing and responding to domestic violence across health and social services. Now is the time to ensure that each agency within ACF and HHS has the resources to be able to recognize domestic violence, partner with domestic violence programs, and respond in ways that are trauma informed and help facilitate safe access to services.

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TODAY ON OUR PULSE CHECK PODCAST, host Ben Leonard talks with reporter Rachel Bluth about California's plan to partner with Civica, a Utah-based generic pharmaceutical company, to start producing California-branded insulin in a bid to make the drug more affordable. The new insulin, which will cost $30 for a 10 mL vial, is awaiting FDA approval.

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Did you know that the three largest PBMs blocked access to more than 1,150 medicines last year? That includes medicines that could lower your costs at the pharmacy. Pharmacy benefit managers are putting their profits before you. Haven't heard about this? That’s by design.

 
Coronavirus

President Joe Biden speaks in the East Room of the White House.

President Joe Biden signed a bill to declassify intelligence related to Covid-19's origins. | Evan Vucci/AP Photo

BIDEN TO RELEASE COVID ORIGINS INTEL — President Joe Biden signed into law Monday a bill to declassify intelligence on the origins of Covid-19, offering the public a chance to review information that government agencies say is inconclusive, POLITICO’s Carmen Paun reports.

How we got here: Sens. Josh Hawley (R-Mo.) and Mike Braun (R-Ind.) introduced the Covid-19 Origin Act during the 117th Congress, with Rep. Mike Gallagher (R-Wis.) sponsoring the companion measure in the House. Although Hawley’s measure passed the Senate unanimously in May 2021, the House never considered it.

The latest version of the bill was introduced this year following reports that the Energy Department had concluded the Covid pandemic likely originated from a Chinese lab leak — just days after FBI Director Christopher Wray made a similar public statement about the virus’ start.

The bill was passed unanimously by the Senate on March 1 and the House, where it passed unanimously on March 10.

Why it matters: Biden’s signature is a step further in providing transparency about what the U.S. knows about how the pandemic started.

The U.S. intelligence community is split about the pandemic’s origin, with other agencies supporting the theory that an animal transmitted the virus to people.

A determination that the virus leaked from the Chinese lab would further strain the U.S.-China relationship and erode trust in leading scientists who argued for the natural-origin hypothesis.

What’s next: U.S. intelligence agencies will redact their data to protect sources and methods before sharing it with Congress.

 

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In Congress

CMS RESPONSE TO DATA BREACH IN THE CROSSHAIRS — The House GOP chairs of the Oversight and Energy and Commerce committees said Monday they’ll investigate the Centers for Medicare and Medicaid Services for its response to a data breach, POLITICO’s Nancy Vu reports.

The Oct. 8 ransomware attack put the personal data of more than 250,000 Medicare beneficiaries at risk. But lawmakers noted in a letter to CMS that it took the agency two months to determine that the attack was a “major incident” before it alerted Congress — during which time the attackers had access to sensitive information like Social Security numbers, banking information and Medicare identifiers.

CMS responds: The agency has received the letter from lawmakers and “will respond directly,” according to a CMS spokesperson. They also pointed to a December press release that outlined CMS' next steps, which included notifying beneficiaries of the breach and supplying them with an updated Medicare beneficiary identifier and free credit monitoring services.

 

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At the Agencies

BECERRA TO SPEAK ON INEQUITIES — HHS Secretary Xavier Becerra will speak today at a symposium held by the Urban Institute on health care inequities.

The event coincides with the 20th anniversary of a landmark report from the National Academies Press that laid bare how racial and ethnic disparities were consistent in quality of care even after adjusting for factors like income and insurance status.

Abortion

JACKSON DISSENTS — Justice Ketanji Brown Jackson dissented Monday as the Supreme Court wiped out a federal appeals court ruling that upheld the right of a minor to go to court to obtain permission to seek an abortion without parental notification, POLITICO’s Josh Gerstein and Alice Miranda Ollstein report.

The high court’s order directed the appeals court to vacate the judgment in the Missouri case and declare it moot as a result of the Supreme Court’s Dobbs ruling last June that overturned Roe v. Wade and ended the federal constitutional right to abortion.

Jackson penned a solo, four-page dissent arguing that the justices have become too liberal in granting requests from parties to nullify rulings issued by lower courts.

No other justice recorded any objection to the high court’s action.

 

STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.

 
 
Public Health

BIG OIL AND ‘CLIMATE HOMICIDE’ — Can petroleum producers be held criminally responsible for climate-related deaths that occurred after companies allegedly deceived the public about the dangers of burning fossil fuels?

A new academic paper says they can, CLIMATEWIRE’s Leslie Clark reports, and its authors say the novel legal theory — known as “climate homicide” — is already stirring interest from prosecutors.

The paper tries to make a case for criminal prosecution of companies that knew but publicly dismissed the dangers of global warming. The authors argue that criminal charges are routine “for far less culpable and lethal conduct.”

Reality check: Several lawyers who have handled civil and criminal cases say the theory is unworkable. They noted the bar for conviction in a criminal case is higher than in civil litigation: A criminal conviction requires convincing a jury of guilt beyond a reasonable doubt.

They also said oil companies could argue that their contribution to greenhouse gasses worldwide is “dwarfed by the increases in emissions we see out of China every couple months.”

Names in the News

Karen Mancera-Cuevas is now senior director of health equity at the National Health Council. She previously was deputy director for health promotion at the Illinois Department of Public Health.

What We're Reading

California wants Medicaid to cover six months’ rent for people without housing or at risk of losing their housing, the Los Angeles Times reports.

American car batteries exported to Mexico are making people sick, The New York Times reports.

STAT looks inside the collapse of a chain of ketamine clinics.

 

A message from PhRMA:

Insurers and their PBMs don’t want you to see that you could be paying more than they are for your medicines. Rebates and discounts can significantly lower what insurers and PBMs pay for medicines. These savings can reduce the cost of some brand medicines by 50% or more. But insurers and PBMs aren’t required to share those savings with you at the pharmacy counter.

They don’t want you to see that they use deductibles, coinsurance and other tactics to shift more costs on to you. Or that the three largest PBMs control 80% of the prescription drug market. Or that last year they blocked access to more than 1,150 medicines, including medicines that could have lowered costs for you at the pharmacy. 

PBMs and insurance practices are shrouded in secrecy,  they need to be held accountable.  

 
 

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