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Condition Of Education 2008 [May 30, 2008] Gene-Based Tests Need Better Monitoring [May 29, 2008] Reforming Health Care [May 28, 2008] Primer On How Private Health Insurance Works [May 27, 2008] President Bush Signs Genetic Nondiscrimination Legislation Into Law [May 23, 2008] “3T's” Roadmap to Transform U.S. Health Care [May 22, 2008] Evidence On The Costs And Benefits Of Health Information Technology [May 21, 2008] Nation's Long-Term Fiscal Outlook Unsustainable [May 20, 2008] Tutorial On Measuring Health Care Quality [May 19, 2008] Widening Of Socioeconomic Inequalities In U.S. Death Rates [May 16, 2008] Roadmap to Diversity For Medical Schools [May 15, 2008] Measuring Immigrant Assimilation In The United States [May 14, 2008] 2008-2009 Edition Of Occupational Outlook Handbook [May 13, 2008] Issue Module On Health Care In The 2008 Election [May 12, 2008] College Enrollment Data [May 9, 2008] Creating Safety Valves For Non-Urgent Care [May 8, 2008] 5th Annual HealthGrades Patient Safety In American Hospitals Study [May 7, 2008] Evaluating Distance Learning In Health Informatics Education [May 6, 2008] House Ready To Clear Another Extension Of Higher Education Act [May 5, 2008] Consumer-Directed Telemedicine Solutions Lower Costs [May 2, 2008] Food Safety In Jeopardy In U.S. [May 1, 2008] Health And Economic Mobility [April 30, 2008] Debate Over The Use Of Dental Therapists [April 29, 2008] Mid-Career Investigator Awards Available From NIH [April 28, 2008] Identifying Waste In Health Care Spending [April 25, 2008] Racial And Ethnic Disparities Linked To Physician Practice Resources [April 24, 2008] RWJF To Fund Expansion Of Pipeline Of Nursing Students [April 23, 2008] Is The U.S. Heading Toward Socialized Medicine? [April 22, 2008] Overhauling The U.S. Health Care System [April 21, 2008] NEJM Examines Physician Workforce Shortage [April 18, 2008] AHRQ Web Resource Features 100 Examples Of Health Innovations And Tools [April 17, 2008] Retooling For An Aging America: Building The Health Care Workforce [April 16, 2008] NIH Seeks Comments On Strategic Plan [April 15, 2008] Comments Invited For Healthy People 2020 Framework [April 14, 2008] The Economic Burden Of Providing Health Insurance [April 4, 2008] Studying The Labor Market Using BLS Labor Dynamics Data [April 3, 2008] Transforming Today's Health Care Workforce To Meet Tomorrow's Demands [April 2, 2008] The Relationship Of Social Networks To Disease [April 1, 2008] The Condition of Education is a congressionally mandated report that provides an annual portrait of education in the U.S. The 43 indicators included in the 2008 report cover all aspects of education from early childhood through postsecondary education and from student achievements to school environment and resources. An example of an indicator is Trends in Graduate and First-Professional Enrollments. The various indicators can be accessed by clicking http://nces.ed.gov/programs/coe/ . Gene-Based Tests Need Better Monitoring A new report on genetic testing calls for the creation of improved public health surveillance databases and health information technologies to monitor the use of gene-based tests and their impact on patient outcomes. Infrastructure to Monitor Utilization and Outcomes of Gene-based Applications: An Assessment found current public health monitoring systems lack the capability to monitor the use or outcomes of gene-based tests and treatments. More than 1,000 gene-based tests are available to consumers via their clinicians and many more are expected to become available in the near future. Some tests are marketed directly to consumers, though many are only recommended for individuals with certain risk factors. The Federal Trade Commission has issued a consumer alert on at-home genetic testing and urges consumers to be skeptical of claims made by companies that are marketing these tests directly to consumers. The report can be accessed by clicking http://effectivehealthcare.ahrq.gov/repFiles/GenomicsDatabase.pdf . On May 22, Brookings and the Cleveland Clinic hosted an Opportunity 08 forum on reforming health care. With health care weighing heavily on the voting public's mind, this forum provided voters in Ohio and across the nation with an in-depth policy discussion on the challenges—and possible solutions—that will confront the next U.S. president. Topics included ways to improve the cost, quality, and availability of health care. A video of the event can be accessed by clicking http://www.brookings.edu/multimedia/video/2008/0522_healthcare.aspx . Primer On How Private Health Insurance Works A primer from the Henry J. Kaiser Family Foundation provides a basic overview of private coverage for health care. It begins by describing what is meant by private health coverage and continues with discussions of the types of organizations that provide it, key attributes, and how it is regulated. The paper addresses private health coverage purchased by individuals and employers and does not address public benefit programs such as Medicare and Medicaid. The primer can be accessed by clicking http://www.kff.org/insurance/upload/7766.pdf . President Bush Signs Genetic Nondiscrimination Legislation Into Law On May 21, President Bush signed into law a bill HR 493, the Genetic Information Nondiscrimination Act that prohibits discrimination based on the results of genetic tests. Under the bill, employers cannot make decisions about whether to hire potential employees or fire or promote employees based on the results of genetic tests. In addition, health insurers cannot deny coverage to potential members or charge higher premiums to members because of genetic test results. The House this month voted 414-1 to approve the bill, while the Senate last month approved the legislation 95-0. “3T's” Roadmap to Transform U.S. Health Care The ongoing significant investment in basic science and clinical discovery in the United States continues to produce impressive results, however, this nation struggles to deliver high-quality care and improved health outcomes due to the systematic failure of discoveries to reach patients in a timely fashion. Despite expenditures that reached $2 trillion or more than $6000 per capita in 2005, the United States will continue to fail to leverage fully new clinical discoveries into improved health outcomes unless there is an accelerated transformation of the health care system. The research enterprise cannot achieve this alone. A model proposed by staff at the Agency for Healthcare Research and Quality (AHRQ) to transform the US health care system is intended to accelerate the pace at which innovations are implemented in clinical settings by addressing the "how" of health care delivery. This item appeared in the May 21, 2008 issue of the Journal of the American Medical Association on pages 2319-2321. Evidence On The Costs And Benefits Of Health Information Technology Health information technology (health IT) has the potential to transform the practice of health care by reducing costs and improving quality. In a new paper, the Congressional Budget Office (CBO) examines the evidence on the costs and benefits of health information technology, possible barriers to a broader distribution and use of it in hospitals and clinicians' offices, and possible options for the federal government to promote use of health IT. In keeping with CBO's mandate to provide objective, impartial analysis, the paper makes no policy recommendations. The document can be accessed by clicking http://www.cbo.gov/ftpdocs/91xx/doc9168/05-20-HealthIT.pdf . Nation's Long-Term Fiscal Outlook Unsustainable Since 1992, the Government Accountability Office (GAO) has published long-term fiscal simulations of what might happen to federal deficits and debt levels under varying policy assumptions. Simulations were updated with the Trustees 2008 intermediate projections and continue to indicate that the long-term federal fiscal outlook remains unsustainable. Despite some improvement in the long-term outlook for federal health and retirement spending, the federal government still faces large and growing structural deficits driven primarily by rising health care costs and known demographic trends. The oldest members of the baby boom generation are eligible for Social Security retirement benefits and will be eligible for Medicare benefits in less than three years. The real driver of the long-term fiscal outlook is health care spending. Medicare and Medicaid are both large and projected to continue growing rapidly in the future. The report can be accessed by clicking http://www.gao.gov/new.items/d08783r.pdf . Tutorial On Measuring Health Care Quality [May 19, 2008] Widening Of Socioeconomic Inequalities In U.S. Death Rates An article published recently in the Public Library of Science (PLoS) states that socioeconomic inequalities in death rates from all causes combined widened from 1960 until 1990 in the U.S., largely because cardiovascular death rates decreased more slowly in lower than in higher socioeconomic groups. Socioeconomic inequalities in mortality are increasing rapidly due to continued progress by educated white and black men and white women, and stable or worsening trends among the least educated. The article can be accessed by clicking http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0002181 . Roadmap to Diversity For Medical Schools Roadmap to Diversity: Key Legal and Educational Policy Foundations for Medical Schools is the first in a series of publications to be produced by the Association of American Medical Colleges (AAMC) Holistic Review Project to help medical schools align admissions to mission, and establish and implement institution-specific, diversity-related policies that will advance their core educational goals with minimal legal risk. To achieve successfully the educational and health care related benefits that come from a diverse student body requires school-wide, concerted efforts. Therefore, the AAMC encourages medical schools to use this publication as a tool to guide collaboration and discussions among their institution's leadership; faculty; admissions, minority affairs, financial aid, and recruitment officers; legal counsel; students; and others engaged in and affected by diversity-related issues. The publication can be accessed by clicking https://services.aamc.org/Publications/showfile.cfm?file=version109.pdf&prd_id=219&prv_id=275&pdf_id=10 . Measuring Immigrant Assimilation In The United States The immigrant population of the United States has nearly quadrupled since 1970 and doubled since 1990. Today's immigrant pool represents a pipeline for students pursuing higher education tomorrow. A new report from the Manhattan Institute introduces a quantitative index that measures the degree of similarity between native- and foreign-born adults in the United States. It is the ability to distinguish the latter group from the former that it is meant by the term “assimilation.” The Index of Immigrant Assimilation relies on Census Bureau data available in some form since 1900 and as current as the year before last. The index reveals great diversity in the experiences of individual immigrant groups, which differ from each other almost as much as they differ from the native-born. They vary significantly in the extent to which their earnings have increased, their rate of learning the English language, and progress toward citizenship. Mexican immigrants, the largest group and the focus of most current immigration policy debates, have assimilated slowly, but their experience is not representative of the entire immigrant population. The report can be accessed by clicking http://www.manhattan-institute.org/html/cr_53.htm . 2008-2009 Edition Of Occupational Outlook Handbook The Occupational Outlook Handbook is a nationally recognized source of career information that is designed to provide valuable assistance to individuals making decisions about their future work lives. The Handbook is revised every two years and the 2008-2009 edition is available. A Table of Occupations can be accessed by clicking http://stats.bls.gov/opub/ooq/2008/spring/art03.pdf . Health occupations are on pages 14-19 of the 38-page document. Issue Module On Health Care In The 2008 Election An issue module by the Kaiser Family Foundation provides information on health care in the 2008 election, including public concerns about health care and the candidates' reform proposals. It also offers links to key resources for additional research, including public opinion surveys as well as summaries and analyses of presidential candidates' positions and health care proposals. The module can be accessed by clicking http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=892 . College enrollment hit a projected record level of 18.0 million in fall 2007 in the United States. College enrollment is expected to continue setting new records throughout the fall 2008 through fall 2016 period. Data can be accessed by clicking http://nces.ed.gov/programs/digest/d07/tables/dt07_003.asp . Creating Safety Valves For Non-Urgent Care Faced with more patients seeking care for non-emergencies, safety net hospital emergency departments are working to redirect patients to outpatient clinics, community health centers, and private physicians with varied results, according to a study released yesterday by the Center for Studying Health System Change's (HSC). Low-income, uninsured, and Medicaid patients often turn to emergency departments (EDs) for care because they lack timely access to care in other settings, according to the study. The growing reluctance of physicians and dentists to serve Medicaid and uninsured patients, along with shortages of primary care physicians and certain specialists such as psychiatrists in some communities make obtaining clinic or physician appointments increasingly difficult. Many safety net hospitals-the public and not-for-profit hospitals serving large proportions of low-income, uninsured and Medicaid patients-have primary and specialty care clinics that are key sources of care for low-income people, yet waits for appointments can be several months. The Issue Brief can be accessed by clicking http://www.hschange.org/CONTENT/983/ . 5th Annual HealthGrades Patient Safety In American Hospitals Study For a fifth year, HealthGrades has studied and publicly reported information on hospital patient safety. HealthGrades used AHRQ's patient safety indicators to identify patient safety incident (PSI) rates for every non-federal hospital in the country using three years of Medicare data (2004–2006). In addition to identifying the rates of PSIs, HealthGrades created a composite score to identify the best-performing hospitals in the U.S. during 2004 to 2006. These hospitals were named the 2008 HealthGrades Distinguished Hospitals for Patient Safety. Approximately 1.12 million total PSIs occurred in almost 41 million hospitalizations in the Medicare population, an almost three-percent incident rate, which is relatively unchanged from previous studies. These incidents were associated with almost $8.8 billion of excess cost during 2004 through 2006. The PSIs with the highest incidence rates were decubitus ulcer, failure to rescue, and post-operative respiratory failure and accounted for the majority of incidents (63.41%). Failure to rescue improved 11.11 percent during the study period, while both decubitus ulcer and post-operative respiratory failure worsened during the study period. The report can be accessed by clicking Evaluating Distance Learning In Health Informatics Education Distance learning in allied healthcare education, including health informatics education, is a reality. Individual courses and entire programs are being offered via this medium. With the current work force shortages in many of the allied health professions, educators are considering offering or currently offer distance learning with the hopes that this venue will boost the number of graduates entering the work force. A study was conducted to compare academic performance between distance-learning and on-campus health informatics students and the results were published in Perspectives in Health Information Management 2008 . A quantitative causal-comparative research design was utilized, and academic performance was measured by final GPA scores and Registered Health Information Administrator certification exam scores. This study shows that distance students perform academically as well as their on-campus counterparts when comparing final GPA scores and RHIA certification scores. The results support the use of distance learning in health informatics programs and provide documentation that these programs can successfully educate health informatics professionals. The study can be accessed by clicking http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_038130.html . House Ready To Clear Another Extension Of Higher Education Act The House is expected to clear yet another extension of the Higher Education Act today. The Senate passed the month-long extension (S 2929) on April 29, one day before the last one (PL 110-198) expired. It is the fifth extension this year. The Higher Education Act (PL 105-244), the primary law governing federal support for colleges and the students who attend them, has not had a full rewrite in a decade. Various sections have been revised since then. Leaders of the House Education and Labor Committee and the Senate Health, Education, Labor and Pensions Committee have been working informally to resolve differences between their broad reauthorization bills (HR 4137, S 1642) since the House passed its measure on February 7. The Senate passed its bill July 24, 2007. The extension, if cleared by the House and signed by President Bush, would give conferees until May 31 to clear an overhaul. Otherwise, more extensions may be needed. Consumer-Directed Telemedicine Solutions Lower Costs Consumer-driven telemedicine services such as Consult A Doctor offer powerful and timely solutions to the fractured U.S. health care system, according to the National Center for Policy Analysis and the Center for Health Transformation.
Up to 70 percent of doctor office visits are merely informational and unnecessary and could be avoided with a phone or e-mail consultation, according to the American Medical Association. However:
The use of information technology for diagnosis, treatment and monitoring of patients' conditions -- brings a new dimension to 21st century health care.
Food Safety In Jeopardy In U.S. Trust for America's Health (TFAH) released a new report yesterday that identifies major gaps in the nation's food safety system, including obsolete laws, misallocation of resources, and inconsistencies among major food safety agencies. Some problems outlined in the report, Fixing Food Safety: Protecting America's Food from Farm-to-Fork , include:
The report can be accessed by clicking http://healthyamericans.org/reports/foodsafety08/FoodSafety08.pdf . Ample evidence exists that health and wealth are related and it is possible that health helps drive — or hinder — economic mobility. A review from the Urban Institute considers the literature linking parents' health to children's economic mobility as well as the links between health (and health insurance costs) and labor market outcomes. It also examines literature on other pathways through which health may influence mobility, including potential links between poor childhood health and lowered educational achievement The paper can be accessed by clicking http://www.urban.org/UploadedPDF/1001161_Health.pdf . Debate Over The Use Of Dental Therapists In the April 28 issue of The New York Times, the debate over a program in Alaska that uses "dental therapists" to provide care to Alaska Natives who lack access to dentists was examined. Under the program, after dental therapists receive two years of "intensive training" at the University of Alaska-Anchorage, they can perform routine tooth extractions and fill cavities. Patients who need root canals and complex extractions must be referred to dentists. Dental therapists must be supervised by a dentist, either onsite or offsite through documents and X-rays. The therapists, who are allowed to practice only in Alaska and only on Alaska Natives, are paid about $60,000 annually -- one-half to one-third dentists' typical incomes -- through a federally funded program that provides dental care to 136,000 Alaska Natives throughout the state. The program, which aims to have 100 fully trained dentists on staff, so far has only 75 participants, and "the number of vacancies is growing." The American Dental Association and Alaska Dental Society oppose the program, indicating dentists -- who receive four years of post-collegiate training -- should be the only providers allowed to perform fillings and extractions. The two groups filed a lawsuit to block the program, but dropped the suit last summer after a state court judge issued a ruling critical of the dentists. Mid-Career Investigator Awards Available From NIH The goals of NIH-supported career development programs are to help ensure that diverse pools of highly trained scientists are available in adequate numbers and in appropriate research areas to address the nation's biomedical, behavioral and clinical research needs. The purpose of the Midcareer Investigator Award in Patient-Oriented Research is to provide support to mid-career health-professional doctorates or equivalent who are typically at the associate professor level or the equivalent for protected time to devote to patient-oriented research (POR) and to act as research mentors primarily for clinical residents, clinical fellows, and junior clinical faculty. The intent of this award is to enable mid-career clinician scientists to devote more time and to augment their capabilities in patient-oriented research and to enable mid-career clinical scientists to mentor new clinical investigators in the conduct of patient-oriented research. The closing date for applications is May 7, 2008 . Additional information can be accessed by clicking http://www.grants.gov/search/search.do?&mode=VIEW&flag2006=true&oppId=17507 . Identifying Waste In Health Care Spending In April 2008, PricewaterhouseCoopers hosted the 180° Health Forum in Washington D.C., bringing together representatives of government, regulatory bodies and the nation's largest hospitals and health systems, health insurers, and pharmaceutical and life sciences companies to seek new, collaborative approaches to solving some of the health system's most intractable problems. As part of its preparation for the 180° Health Forum, PricewaterhouseCoopers' Health Research Institute (HRI) interviewed more than 20 participants, reviewed more than 35 studies about waste and inefficiency in healthcare and surveyed 1,000 consumers to understand the public's perception of waste and inefficiency in the system. This research found that wasteful spending in the health system has been calculated at up to $1.2 trillion of the $2.2 trillion spent in the United States, more than half of all health spending. Defensive medicine, such as redundant, inappropriate or unnecessary tests and procedures, was identified as the biggest area of excess, followed by inefficient healthcare administration and the cost of care necessitated by conditions such as obesity, which can be considered preventable by lifestyle changes. PricewaterhouseCoopers' paper classified health system inefficiencies into three “wastebaskets” that are driving up costs:
The impact of issues such as non-adherence to medical advice and prescriptions, alcohol abuse, smoking and obesity are exponential, and fall into all three baskets. Racial And Ethnic Disparities Linked To Physician Practice Resources Primary care physicians treating a disproportionate share of black and Latino patients typically earn less, see more patients, provide more charity care, treat more Medicaid patients, and receive lower private insurance payments, according to a national study funded by the Commonwealth Fund and published as a Web Exclusive in the journal Health Affairs . These same physicians also reported more problems providing high-quality care, ranging from inadequate time with their patients to difficulty obtaining specialty care. Conducted by researchers at the Center for Studying Health System Change (HSC), the study sheds new light on the pervasive racial and ethnic health disparities in the United States by looking beyond individual patient characteristics to community and physician practice resources. The study also examined how higher Medicaid payments might help physicians treating mostly minority patients provide high-quality care and reduce racial and ethnic disparities. RWJF To Fund Expansion Of Pipeline Of Nursing Students The Robert Wood Johnson Foundation (RWJF) and the American Association of Colleges of Nursing (AACN) announced on April 22 the creation of the RWJF New Careers in Nursing Scholarship Program, designed to alleviate the nation's nursing shortage by dramatically expanding the pipeline of students in accelerated nursing programs. Scholarships in the amount of $10,000 each will be awarded to 1500 entry-level nursing students over the next three years. Preference will be given to students from groups underrepresented in nursing or from a disadvantaged background. Is The U.S. Heading Toward Socialized Medicine? Amid a spirited campaign where health reform will be a leading issue, some have charged that proposals to restructure the nation's health care system represent dangerous steps that would move the United States toward a government-run health care system and socialized medicine. No reform proposal under serious consideration would result in either a purely government-run system or a free market that offers entirely unregulated and unsubsidized health care. All serious proposals are on a continuum between these extremes according to a new analysis in an issue paper by researchers at the Urban Institute. The issue paper can be accessed by clicking Overhauling The U.S. Health Care System The 14th Commonwealth Fund/ Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts for their perspective on health care delivery system reform. Survey participants call for fundamental change in the way the U.S. delivery system is organized, with one of nine favoring such reform. Favored policy strategies for reform include strengthening the primary care system, encouraging care coordination, and promoting care management of high-cost patients with complex conditions. Opinion leaders also cite payment reform as an important strategy to enhance primary care physicians' ability to provide coordinated, high-quality care as well as to help prevent costly hospitalizations. The data brief can be accessed by clicking NEJM Examines Physician Workforce Shortage In an article appearing in the April 17, 2008 issue of the New England Journal of Medicine entitled “Physician Workforce Crisis? Wrong Diagnosis, Wrong Prescription,” the authors question efforts by the Association of American Medical Colleges to increase the number of physicians in the U.S. According to them, the U.S. medical field should focus on the "largely disorganized and fragmented delivery system" -- which is plagued by lack of coordination, incomplete patient information, poor communication, uneven quality and rising costs -- rather than on increasing the number of doctors AHRQ Web Resource Features 100 Examples Of Health Innovations And Tools A new Web resource that allows users to learn, share, and adopt innovations in the delivery of health services was launched by the Agency for Healthcare Research and Quality. AHRQ's Health Care Innovations Exchange is the federal government's repository for successful health care innovations. It also includes useful descriptions of attempts at innovation that failed. The Web site is a tool for health care leaders, physicians, nurses, and other health professionals who seek to reduce health care disparities and improve health care overall. The Web site is being launched with 100 examples of innovations in the delivery of health care services and attempts at innovation. That number will increase as the site is updated every two weeks. Profile examples include an intensive care unit's successful efforts to shorten patient stays by setting and adhering to daily care goals; an initiative by geriatricians, nurse practitioners, and social workers to help seniors avoid institutional care by visiting seniors at home; and a patient/physician e-mail communication system that overcomes the inconvenience of automated phone systems and accommodates the difficult schedules of both the physician and the patient. The resource—called the Health Care Innovations Exchange—is available at www.innovations.ahrq.gov . Retooling For An Aging America: Building The Health Care Workforce The nation faces an impending health care crisis as the number of older patients with more complex health needs increasingly outpaces the number of health care providers with the knowledge and skills to care for them adequately. As the nation's baby boomers turn 65 and older and are living longer lives, fundamental changes in the health care system need to take place and greater financial resources need to be committed to ensure they can receive high-quality care. Right now, the nation is not prepared to meet the social and health care needs of elderly people. The Institute of Medicine charged the ad hoc Committee on the Future Health Care Workforce for Older Americans to determine the health care needs of Americans over 65 years of age and to assess those needs through an analysis of the forces that shape the health care workforce, including education and training, models of care, and public and private programs. The result is a report entitled “ Retooling for an Aging America: Building the Health Care Workforce .” The report can be accessed by clicking http://www.nap.edu/catalog.php?record_id=12089#toc. NIH Seeks Comments On Strategic Plan The National Institutes of Health (NIH)'s National Center for Research Resources (NCRR) April 8 posted its draft strategic plan for 2009-2013 on Translating Research from Basic Discovery to Improved Patient Care and seeks public comment. The NCRR supports major programs for development of shared infrastructure and vital national resources, including primate and other animal facilities, instrumentation and biotechnology centers, research at minority institutions, regional centers of excellence, and clinical research resources such as the Clinical and Translational Science Awards. The deadline for public comments is April 23 . The draft plan can be accessed by clicking http://www.ncrr.nih.gov/strategic_plan/draft.pdf . Comments Invited For Healthy People 2020 Framework The Office of Disease Prevention and Health Promotion (ODPHP) is gathering public comment online at www.healthypeople.gov/hp2020/comments. At a series of six public meetings across the country, interested individuals and organizations are invited to present in person their comments on the framework for Healthy People 2020 . The Economic Burden Of Providing Health Insurance More than 60 percent of non-elderly Americans receive health-insurance (HI) coverage through employers, either as policyholders or as dependents. However, rising health-care costs are leading many to question the long-term viability of the employer-based insurance system. Concerns about the economic burden of providing HI are particularly acute for small businesses, which are both less likely than larger firms to offer HI and more sensitive to price when deciding to offer insurance. Small firms may have difficulty containing costs due to their limited bargaining power and their inability to hire experts skilled in negotiating with insurance companies. To understand these issues better, researchers from the Kauffman-RAND Institute for Entrepreneurship Public Policy (KRI) explored trends in the economic burden associated with HI provision as well as the distribution of this burden, for small and large businesses. The report can be accessed by clicking http://www.rand.org/pubs/technical_reports/2008/RAND_TR559.pdf . Studying The Labor Market Using BLS Labor Dynamics Data O ver the past five years, the Bureau of Labor Statistics ( BLS ) has released three new data products that measure the dynamics of the U.S. labor market. These data illustrate the fluid nature of the labor market by highlighting the millions of jobs that appear or disappear and the millions of individuals who become employed, become unemployed, or leave the labor force entirely every month. A recent article appearing in the Monthly Labor Review on this topic can be accessed by clicking http://stats.bls.gov/opub/mlr/2008/02/art1full.pdf . Transforming Today's Health Care Workforce To Meet Tomorrow's Demands A lecture series sponsored by the Institute of Medicine featured presentations on the topic of the health workforce. The publication that contains these lectures can be read online by clicking The Relationship Of Social Networks To Disease An article in the march 25 issue of PLoS Medicine states that o ne need look no further than Facebook to appreciate the significance and power of social networking. But social networking is about more than just friends reunited; it's a framework for understanding even the most basic of biological processes. Once the domain of social scientists—who have used social network analysis to study such diverse phenomena as kinship ties, organizational behavior, rumor spreading, and global air traffic—network theory has now entered the purview of health scientists. Network theory is concerned with mapping the links between entities and social network analysis is the application of that theory to the social sciences. Searching for more social and environmental explanations for the obesity epidemic in America, for example, Christakis and Fowler in an article in the July 26, 2007 issue of The New England Journal of Medicine showed that obesity can spread from person to person and that this spread depends on the nature of social ties: a person's chance of becoming obese increased by 171% if he or she had a mutual friend who had become obese (even if they lived far away). Their risk increased by 40% if it was their sibling or spouse who became obese. A presentation by Nicholas Christakis at the national Institutes of Health on march 20 can be accessed by clicking http://videocast.nih.gov/PastEvents.asp?c=998&s=11 .
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