Good morning. Today's word count is 776, or a 3-minute read.
Illustration: Sarah Grillo/Axios
Rural America is stuck in a cycle of increasingly vulnerable patients with declining access to health care.
Why it matters: Rural patients often can't afford care, are being hounded by hospitals and collection agencies over their unpaid bills, and are facing the reality of life in communities where the last hospital has closed.
Rural Americans tend to be older, sicker and lower-income than urban Americans. They suffer from higher rates of obesity, mental health issues, diabetes, cancer and opioid addiction, as my colleagues Stef Kight and Juliet Bartz reported.
What they're saying: "Rural hospitals have long been right there on the edge on average, and we’re seeing more and more of them flip over to red," said Mark Holmes, a professor at UNC-Chapel Hill and director of the Cecil G. Sheps Center for Health Services Research.
And hospital closures often exacerbate the problems communities were already facing.
Illustration: Lazaro Gamio/Axios
Juul's competitors are attracting customers with cheaper products and fruity flavors that Juul no longer sells in retail stories, CNBC reports.
The big picture: When Juul decided to self-regulate in response to mounting FDA concerns, its rivals pounced on the opportunity to boost their own sales.
My thought bubble: If we're going to get a grasp on the teen vaping epidemic, relying on Juul to self-regulate isn't going to work. The market is obviously too lucrative.
Government health experts were told not to post anything related to mental health, violence or mass shootings without prior approval following this month's El Paso and Dayton shootings, the Washington Post reports.
Context: The Obama administration didn't make similar stipulations regarding health agencies' communication following mass shootings, per WashPost.
The other side: "It's the department's long-standing practice to not get ahead of the president's remarks," HHS spokeswoman Caitlin Oakley told the Post. "Any suggestions that this was a formal policy put in place related to social media, or meant to stymie work on this issue, are factually inaccurate."
More than 1 in 10 American adults had diagnosed diabetes in 2018, and of those, 13.2% didn't take their medication as prescribed in order to reduce their prescription drug costs, according to a new CDC brief.
Details: Adults younger than 65 — so ineligible for Medicare — were more likely to not take their diabetes medicine as prescribed than adults older than 65.
Why it matters: We've all heard how insulin is increasingly unaffordable. Here are the statistical consequences, which translate into very real health consequences for patients who aren't taking their medicine.
The drug industry's lobbying group will sit down with Trump administration officials on Aug. 26 to discuss the federal proposal that would import lower prices used by European countries for certain drugs in Medicare, according to federal meeting records.
Between the lines: A PhRMA spokesperson would not say who would be there or what topics would be discussed, but the group loathes the concept, Axios' Bob Herman reports.