RISE looks at recent headlines concerning social determinants of health (SDoH).
AHA unveils new hub on reducing disparities in health outcomes
The American Hospital Association (AHA) has introduced a new webpage, Reducing Disparities in Health Outcomes, which features new and familiar resources for members and their communities. As part of a larger strategy to help address health disparities, AHA said this page will be a hub for actionable resources and tools to assist hospitals and health systems on their journeys to transform care and improve health outcomes for all. Resources include information on health disparities, community collaboration, data collection and use, person-centered care, care delivery transformation, and maternal and child health.
CDC launches campaign to address youth substance use, mental health
The Centers for Disease Control and Prevention (CDC) has launched Free Mind, a new national campaign that provides youth ages 12-17 and their parents and caregivers with resources and information about substance use, mental health, and the connection between the two.
In 2024, more than 80,000 Americans died from a drug overdose. From 2020 to 2024, 75 percent of overdose deaths among youth ages 10–19 involved illegally made fentanyl. In addition, the number of teens reporting poor mental health has increased in the past decade. In 2023, 40 percent of high school students stopped regular activities because of persistent feelings of sadness or hopelessness, and one in five students seriously considered attempting suicide.
"Teens may use alcohol and other substances to help them cope with stress, anxiety, and depression," said Allison Arwady, M.D., director of the CDC National Center for Injury Prevention and Control, in the announcement. "Talking openly about mental health and substance use, and knowing when to get professional help, is critical to helping teens stay healthy. That's why this campaign supports youth, parents, and caregivers in having those conversations early, before an issue arises."
CDC spoke directly with youth about their knowledge and perceptions regarding substance use to develop messages, branding, and tactical strategies for Free Mind. The campaign addresses the connections between substance use and mental health, risk factors that contribute to drug use, and strategies to keep them safe. CDC has also created resources for parents and caregivers about the latest substance use and mental health challenges youth may face.
Task force recommends interventions to reduce unhealthy alcohol use in adults
The U.S. Preventive Services Task Force has released draft recommendations for screening and behavioral counseling interventions to reduce unhealthy alcohol use in adults.
Unhealthy alcohol use can range from risky or hazardous drinking, which is drinking too much at one time or overall, to alcohol use disorder, which is a pattern of regular drinking that causes distress or harm.
The task force recommends that health care professionals screen all adults, including those who are pregnant, for unhealthy alcohol use and provide brief counseling to those who engage in risky or hazardous drinking.
“Unhealthy alcohol use is common and is a leading cause of preventable death in the United States,” says task force member Jim Stevermer, M.D., M.S.P.H., in an announcement. “Fortunately, screening and brief counseling can help to detect and address risky or hazardous drinking in adults before a more serious problem develops.”
The task force also looked at evidence related to screening and counseling adolescents for unhealthy alcohol use but found limited evidence. “While adolescent alcohol use is a serious concern, there is not enough evidence to determine whether or not screening and counseling in primary care helps to reduce alcohol use in teens, so we are calling for more research,” says task force member John Ruiz, Ph.D. “In the absence of evidence, health care professionals should use their judgment when determining whether or not to screen their teen patients.”
The public can comment on the draft recommendations through Sept. 2.
Study: Adopted children face unequal access to health coverage based on adoption type
A study by the University of Maryland (UMD) School of Public Health, published in the August issue of Health Affairs, reveals major differences in coverage depending on adoption type (domestic or international) and citizenship status of the adoptive parent.
“Adopted children generally have more and different health needs—such as cognitive or physical difficulties—than non-adopted children. Previous studies, many of which did not differentiate between different types of adoptees, found adopted children were consistently insured,” said study co-author Jamie Fleishman in an announcement.
“Our study, which considered four types of adoptees, found a very high uninsured rate for some adopted children—particularly those adopted internationally by non-citizens living in the United States. The study found that almost one-third (30.7 percent) of the children in this group have no health insurance at all.”
The UMD researchers analyzed insurance coverage over five years (2018–2022,) comparing adopted and non-adopted children up to 17 years old who live with their head of household, using data from the American Community Survey (ACS), which includes over three million adopted and non-adopted children. The study distinguishes between international and domestic adoptions and further distinguishes international adoptees by householder citizenship, because international adoptees of U.S. citizens are, similar to a U.S.-born child, eligible for public insurance coverage such as Children’s Health Insurance Program (CHIP) or Medicaid.
“The findings clearly show that we must not treat adopted children as a single group. International adoptees and domestic adoptees are very different. The citizenship status and other factors such as the income of adoptive parents are also different. So, policies need to be tailored to these differences,” said Dahai Yue, co-author and assistant professor in SPH’s Department of Health Policy and Management. Yue was Fleishman’s MPH advisor.
The study compared four different groups of adopted children in the U.S. against a control group of non-adopted children: domestic adoptions, international adoptions by U.S. citizens, international adoptions by non-U.S. citizens, and children who live with a biological relative, such as a grandparent, who is not their biological parent.
Key findings from the report include:
Children adopted internationally by non-U.S. citizens living in the U.S.
- Almost one-third (30.7 percent) of this group has no health insurance at all.
- This group has lower rates of private health insurance (by 12.1 percentage points) and of public health insurance (by 9.1 percentage points) than other adoptee groups.
- The non-U.S. citizens adopting these children were also more likely to be the same race as the child, more likely to have an income below the federal poverty line, and less likely to own a home than other groups.
Other adopted and non-adopted children
- Children who are living with relatives other than their biological parents also have a significantly high uninsured rate (7.3 percent).
- Children who are the most likely to have private insurance coverage are children adopted domestically (56.2 percent), children adopted internationally by U.S. citizens (89.1 percent), and nonadopted children (63.8 percent).
- Children who are most likely to have public insurance coverage, such as Medicaid, are those adopted domestically and those who live with relatives other than their biological father or mother.
- International adoptees of U.S. citizens were the most insured compared to non-adopted children—in fact, they were more insured than non-adoptees.