Axios

Hundreds of millions of people around the world lack reliable access to safe water — an escalating crisis with a potentially profound impact on their mental health.

Why it matters: Similar to food insecurity, water insecurity has been linked to depression, anxiety, and increased rates of violence — and is considered one of the greatest threats facing humans, several scientists tell Axios.

Elizabeth Holmes on Friday will learn her punishment for defrauding investors in her failed blood-testing company, Theranos.

Why it matters: This will be the culmination of a legal case that began more than four years ago, putting Silicon Valley's "fake it 'til you make it" culture on trial.

Nearly three years into the pandemic, demand for mental health services is swamping the psychology profession, according to a new report from the American Psychological Association.

By the numbers: Nearly half of 2,300 psychologists surveyed said they were unable to meet demand for treatment, while 60% said they have no more openings for new patients.

• Since 2020, diagnoses of trauma, obsessive-compulsive, substance-related and cognitive disorders continue to increase year over year, with more than a quarter of psychologists reporting an increase of patients experiencing persistent and severe mental illness.
• More than a third noted increases among patients who are transgender or have chronic illnesses. Close to 50% reported a jump in teenagers seeking mental health care.

Millions of Medicaid recipients are unaware that states will redetermine their eligibility for the program when the COVID-19 public health emergency ends — and fewer than one third know what other coverage options exist, according to an Urban Institute policy brief.

The big picture: Researchers say the onus is on state Medicaid agencies to increase outreach and simplify renewal processes to avoid unnecessary coverage losses.

Be smart: Temporary pandemic-era reforms that Congress passed in 2020 increased the share of federal Medicaid spending if states offered continuous coverage to enrollees, suspending the program's usual churn.

• Those policies will end when the public health emergency expires, as soon as April, potentially ushering in a spike in the uninsured rate.
• The loss of Medicaid coverage qualifies people to enroll in the federal marketplace for 2023 coverage past the Jan. 15 deadline.
• But an August report from HHS found most Medicaid enrollees who get stuck in the churn aren't able to enter the marketplace or get employer-based insurance.

Nearly 80% of respondents the Urban Institute surveyed said they weren't told how to navigate the process.

• More than 60% overall had heard "nothing at all" about the Medicaid redeterminations.
• The most common sources of information were news outlets or social media — not Medicaid agencies.

By the numbers: Close to 90 million people are enrolled in Medicaid and CHIP in the U.S., per CMS’ latest numbers. The Kaiser Family Foundation projects up to 15 million could lose coverage upon the emergency ending, regardless of eligibility.

• Less than a third of those projected to lose eligibility could qualify for marketplace premium tax credits, per HHS.
• Latinos are expected to incur the greatest loss, according to the HHS report, with nearly a third of Latino kids and young adults enrolled in Medicaid or CHIP slated to lose coverage.

Virtual reality is becoming a real-world health tool for everything from chronic pain and behavioral health problems on Earth to medical training for astronauts in space.

What's happening: Like the entire VR industry, health care's version has made significant strides in recent years.

Half of U.S. primary care physicians under the age of 55 say they're burned out and some anticipate leaving the profession in the next three years, per a new survey from the Commonwealth Fund.

Why it matters: It's the latest evidence of doctor shortages that could hamper efforts to reduce health disparities and fill gaps in care as the nation emerges from the pandemic.

What they found: Nearly two-thirds of young clinicians reported higher rates of emotional distress, but few of them are seeking out help or support.

• Just 16% of clinicians under the age of 55 reported seeking help, while 6% of primary care physicians over the age of 55 sought support.
• "Physicians often feel they are the ones who have to show strength in crisis and though they will tell their patients it's not a weakness to seek support, it's not always clear that they feel permission to do that themselves," said David Blumenthal, president of the Commonwealth Fund.

Go deeper: Burnout isn't limited to primary care physicians: A new report from the American Federation of Teachers, which represents nearly 200,000 health care workers, shows how staffing shortages are weighing on nurses and medical workers.

• There were 55,000 fewer nurses working in 2021 than 2020, according to Bureau of Labor Statistics data cited in the report.
• "The staffing shortages put a tremendous amount of strain on tired and overworked bedside caregivers," the report states.
• The union recommends safe staffing requirements for nurses, investment in financial aid and scholarships for health workers and raising entry-level salaries to attract workers.
• The Commonwealth Fund survey recommends increasing Medicare and Medicaid reimbursement for primary care services.

What's next: Provider groups are asking Congress for financial relief in the lame duck session, but it's unclear which requests will be accommodated.

ZAATARI REFUGEE CAMP, JORDAN — A whole generation of Syrian refugees are living out their lives — working, getting married, having children — in a camp that was supposed to be a temporary refuge while they fled their country’s civil war.

Why it matters: This camp is not a sustainable long-term option. It was never designed to be one, and the makeshift facilities here are nearing the end of their lifespan — but there are still roughly 80,000 Syrians with nowhere else to call home.

A soaring attendee list, jam-packed schedule and sessions with seemingly every corner of the health care spectrum from startup to banker to Big Tech have Axios wondering: Is HLTH eating the conference world?

Why it matters: CES, JPM and HIMSS were once the heaviest hitters in the health tech world — places where so much dealmaking happened, people resorted to taking meetings in bathrooms.

• HLTH's attendee list nearly tripled this year, with 9,000 people roaming the glamorous, dimly lit halls of the Venetian Expo — up from a roster of roughly 3,500 when the conference started in 2018.
• It's almost as if the new kid on the health care block is eating the conference world, in true Andreessen Horowitz fashion.

Zoom in: In addition to HLTH in November, the same conference organizers put on ViVE, pitched as "like HLTH, but for hospital CIOs" — otherwise known as the same people that would attend HIMSS.

What they're saying: All of Axios' Erin Brodwin's meetings at HLTH have ended with her asking the unofficial survey query: After all of this, are you going to any of those other three events? The answer is often a shrugged maybe or firm no accompanied by raised brows (as if Erin should know the answer). The reasons include:

• "All the investors are here," GSR Ventures partner Sunny Kumar told Axios on Monday.
• HLTH is all in one very, very large building, so there's no need to run around in the San Francisco rain — or take a bathroom meeting, pointed out Steven Wardell, a digital health consultant with the growth consulting firm Wardell Advisors.
• Market conditions mean tighter budgets overall, so people who bought tickets to HLTH six months ago may not want to shovel out thousands of additional dollars for another event happening within months.

The other side: Still, for those local to San Francisco or Las Vegas, conferences such as JPM or CES may still seem like a logical bet.

• "For me JPM means walking down the street," Redpoint Ventures principal Jacob Effron told Erin on Tuesday. "So yes, I'll be there."

Meanwhile, for what it's worth, Erin will be there too.

Amazon on Tuesday launched a new virtual care service called Amazon Clinic, which offers treatment with a few clicks and an out-of-pocket cost on par with a standard co-pay, for common medical conditions.

Why it matters: The move solidifies Amazon's intention to be a major player in the consumer-driven health care space, building out services and capabilities around their other offerings like Amazon Pharmacy and their recent purchase of OneMedical.

Most of the 4,000 specialized workers brought on by a national nonprofit to fortify public health departments during the pandemic are being let go, as time-limited funding needed to extend their contracts dries up.

Why it matters: The cuts are happening ahead of an expected winter surge in COVID, flu and RSV that could again tax health surveillance systems and a drained workforce of disease-trackers.

Health worker shortages are keeping hospitals from discharging patients for post-acute care and prompting pleas to Congress for per diem Medicare payments to cover the longer stays.

Why it matters: The requests add to a long list of health industry asks that Congress will have to sort through in the lame-duck session and underscore how the fallout from the pandemic is still rippling through the health care system.

This article originally appeared in Axios Finish Line, our nightly newsletter on life, leadership and wellness. Sign up here.

Humans have had pets for tens of thousands of years — but the research on whether dogs and other pets can actually boost our mental and physical health is still relatively new.

🖼️ The big picture: There are a slew of recent studies that have shown dog ownership can relieve stress and anxiety and push us to exercise more.

• Less than 10 minutes of playing with or petting a pup can improve your mood, lower stress levels, and even decrease heart rate and blood pressure, research has shown.
• Studies have also demonstrated that trained therapy dogs can bring comfort to veterans dealing with post-traumatic stress disorder or homesick college students.
• Dog owners also tend to walk about 20 minutes or 2,760 steps per day more than non-owners, according to one study. Getting a furry friend could especially help older adults for whom even a moderate increase in daily walking can significantly boost longevity.

🧠 Reality check: If you're not a pet person, or if you're allergic, not to worry.

• While there are real perks to dog ownership, many of the wide-ranging studies that looked at whether having a dog improves heart health or does away with depression didn't find conclusive links, notes Hal Herzog, a psychologist at Western Carolina University who studies the human-animal bond.
• "Not everybody is cut out to have a pet," says Herzog. And of course it's possible to be healthy and happy without pets in your life.

Case in point: Some 23 million people adopted pets during the pandemic, and as the world opened back up, many have had to reckon with the fact that pet ownership can be costly and limit freedom — and some have even returned their pets, the Washington Post reports.

🐕 Still, the overwhelming majority of pet parents say their pets make their lives better.

• 77% of people with pets seek comfort from their animals "somewhat often" or "very often," per a recent YouGov survey.
• 58% consider pets members of their families.

"Jeopardy!" legend Amy Schneider will testify Wednesday in the Ohio state legislature against a bill that would ban gender-affirming health care for minors in Ohio.

The big picture: Ohio is one of several states that have attempted to restrict access to gender-affirming medical care for transgender youth amid a wider slew of anti-trans legislation, even though medical associations like the American Medical Association oppose such measures and say that trans and nonbinary gender identities are "normal variations of human identity and expression."