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Adult Cancer Survivors At Increased Risk Of Psychological Distress
Long-term survivors of cancer that developed in adulthood are at increased risk of experiencing serious psychological distress, according to a report in the July 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Health Care Reform Debate Renews Focus On Insurance Coverage Of Abortion Care
The issue of whether government-subsidized health care programs should include coverage for abortion procedures is gaining attention as Congress continues drafting health care reform legislation, Time reports. Currently, the Hyde Amendment -- a legislative provision attached annually to major spending bills since 1976 -- prohibits states from using federal Medicaid funds to pay for abortion. All but 17 states have similar restrictions on their own funds. Although current versions of health reform legislation do not yet address the issue of abortion, congressional s involved in the process say that an explicit ban on abortion coverage could have "much further-reaching implications" than the Hyde Amendment. According to Time, the restrictions could deny abortion coverage to women whose private insurance plans currently cover the procedure. A 2002 Guttmacher Institute survey found that nearly 90% of private insurers cover abortion procedures. Under the legislation being worked on in three House committees, U.S. residents with incomes up to 400% of the poverty level -- about $88,000 annually for a family of four, or $43,000 for an individual -- would be eligible for government subsidies to help purchase coverage. However, antiabortion-rights lawmakers are pushing to prohibit those subsidies from being used to purchase health insurance policies that include abortion coverage, Time reports. Such restrictions would mean that women who currently have abortion coverage in their private plans would have to give up the benefit. According to Time, such a provision also "would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies."Pelosi Negotiating With House Dems Over ConcernsLast week, 19 House Democrats sent a letter to House Speaker Nancy Pelosi (D-Calif.) stating that they "cannot support any health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan." They also said that abortion "must be addressed clearly in the bill text" of the legislation. The signers of the letter include Reps. Bart Stupak (Mich.) and Charlie Melancon (La.), both members of the House Energy and Commerce Committee, one of the three panels with jurisdiction over health care reform. According to Time, Pelosi"s office is attempting to address the concerns through negotiations.Poll Shows Support for Reproductive Health CoverageMeanwhile, abortion-rights advocates are "pushing back" against those seeking to specifically exclude abortion coverage in health care reform legislation, Time reports. The National Women"s Law Center on Monday released results of a nationwide poll of 1,000 likely voters showing that 71% of respondents favor including reproductive services like birth control and abortion in health care reform (Tumulty, Time, 7/8). The poll also found that 72% would oppose exclusion of abortion coverage from any national health care plan (Eaton, Plain Dealer, 7/7). In addition, 75% of respondents said that an independent commission, not Congress, should determine what medical services are included in the basic benefits offered under health reform. Congress also is weighing giving that power to HHS Secretary Kathleen Sebelius (Time, 7/8).Judy Waxman, NWLC vice president, said that 80% of employer-based insurance plans provide coverage for abortion services, adding that "people will be angry if they don"t get to keep what they already have" under any public insurance option (Cleveland Plain Dealer, 7/7). Waxman said Congress should "refrain from practicing medicine and instead let medical professionals determine what health care services will be included in a benefits package" (Time, 7/8).
News of the day
Scottish Government Listens To Nursing Voice
The Scottish Government has announced a new approach to the modernisation of community nursing in Scotland, but having listened to the grave concerns of the Royal College of Nursing in Scotland, the specialist skills of health visitors, district nurses and school nurses will not now be lost.
Sexual Health

Retail Clinics Less Likely To Be Located In Underserved Communities

Despite reports indicating that placement of retail clinics are determined by physician shortages and higher uninsured populations, these clinics appear to be located in more advantaged neighborhoods, according to a report in the May 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. "Retail clinics are medical clinics located within larger retail outlets that are usually staffed by nurse practitioners and supervised by an off-site physician," according to background information in the article. Retail clinics usually focus on urgent care and routine preventive services, such as immunizations. These facilities tend to be open on nights and weekends, usually provide service without appointments and tend to have lower prices than those charged by primary care physicians or emergency departments. Craig Evan Pollack, M.D., M.H.S. and Katrina Armstrong, M.D., M.S.C.E., of the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, mapped locations of retail clinics as of July 2008 and linked them to the 2000 U.S. Census and 2008 Health Res and Services Administration data to determine if the clinics are typically located in areas with higher medical need. "A total of 930 retail clinics were geocoded to the continental United States. Eighteen states (37 percent) had no retail clinics, and 17 states (35 percent) had 25 or more clinics," the authors write. Five states had more than 50 clinics including Florida (112), California (90), Texas (85), Illinois (58) and Georgia (56). Retail clinics were located in 908 census tracts within 247 counties. Ninety-six percent of counties with retail clinics were classified as metropolitan areas. "Counties with retail clinics had lower rates of uninsured individuals (12.1 percent vs. 13.3 percent)," the authors write. "Compared with census tracts without retail clinics, those tracts with retail clinics had a lower percentage of black and Hispanic individuals, fewer rental units and lower rates of poverty. In addition, the census tracts had residents with higher median incomes and higher rates of home ownership." "If retail clinics are determined to be a valuable and effective of care, rethinking the distribution of these clinics may be an important avenue for improving their potential societal benefit," the authors conclude. "With nearly a third of chain stores located in medically underserved areas, the future expansion of retail clinics into existing stores could potentially improve access for underserved populations." Arch Intern Med. 2009;169[10]:945-949. Journal of the American Medical Association


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