Journal Watch
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* Mark Barna

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/51/7/5.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/51/7/5.2/F1)

Even a minor injury can mean a high medical bill, but Medicaid expansion is helping lower medical debts, a study shows.

Photo by AndreyPopov, courtesy iStockphoto

## Medicaid expansion lowers medical debt

Expanding Medicaid eligibility to more people can lower medical debt for participants, a study in Louisiana finds.

Published in the July issue of APHA’s *American Journal of Public Health*, the study examined state Medicaid enrollment records of over 200,000 enrollees when expansion launched in July 2016. Using data from a credit-tracking company, researchers determined the debt of enrollees two years prior to expansion and three years after.

After three years, medical collections of enrollees declined 13.5%, and debt balances declined 43%.

## Pandemic linked to heart disease deaths

As COVID-19 deaths increased during the pandemic, so did deaths from chronic health conditions, a study in *AJPH*’s August issue finds.

Researchers examined 2020 data on U.S. deaths collected by the National Center for Health Statistics. They found that the number of excess deaths due to cardiovascular disease followed the trajectory of excess deaths from COVID- 19. During the first several months of the pandemic, excess deaths from diabetes, flu and other respiratory diseases also increased but then stabilized.

“The parallel trajectory of excess mortality from (cardiovascular disease) and COVID-19 over time reflects the fact that essential health services for noncommunicable diseases were reduced or disrupted during the COVID-19 pandemic, and the severer the pandemic, the heavier the impact,” researchers said.

## Pandemic disrupts abortion access

Abortions declined during the early months of the COVID-19 pandemic last year, a study in Louisiana finds.

Published in the August issue of *AJPH*, the study analyzed data from Louisiana abortion clinics and neighboring states between January 2018 and May 2020. From March to May, when COVID-19 restrictions were enacted, abortions declined in the state 31%. During that same time, abortions in neighboring states did not increase.

“There are health implications of the decreased number of abortions associated with pandemic onset,” the study said. “People unable to obtain clinic-based abortions postpone seeking abortion; attempt to self-manage their abortions, which may put them at legal risk; or continue their pregnancies, which increases risks of adverse health outcomes.”

## Bedbug pesticides widely misused

Bedbug pesticides are widely misused by professionals and the public alike, a study in *AJPH*’s August issue finds.

Using 2013-2017 data from the U.S. National Pesticide Information Center, researchers compared outcomes from licensed pesticide applicators and nonprofessionals. They found that misapplications were more than twice as likely to be reported in cases involving nonprofessional pesticide application, leading to human exposure. Researchers also found that about one-third of professional applications resulted in an unintended exposure, a spill or a misapplication of pesticide.

Harmful exposure to pesticides can lead to adverse health effects, including vomiting, nausea, headache and dizziness.

## Behaviors documented during police stops

During U.S. police encounters that end in a death, Black people are less likely to exhibit behavior that police may see as a threat, according to a study in a July *AJPH* special supplement.

For the study, researchers used the National Violent Death Reporting System, which tracks data on violent deaths. They found nearly 5,000 homicides in which NVDRS state workers had abstracted police and coroner’s reports on a fatal police encounter. The narratives on deaths among Black people were shorter and seldom referenced mental health or substance use histories, and were more likely to reference gang or criminal activity, the study found. Compared with whites, Blacks were less likely to be physically aggressive or escalate the encounter, or test positive for alcohol or drugs.

“The narratives suggest that Black legal intervention deaths, as compared with whites, are associated with characteristics that pose lower objective threat profiles for law enforcement,” researchers wrote.

The open access online supplement, which shares findings on mortality, was sponsored by the University of California-Los Angeles Fielding School of Public Health.

*To access studies and podcasts from AJPH, visit [ajph.org](http://ajph.org)*.

*   Copyright The Nation’s Health, American Public Health Association