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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Now the government is funding gun violence research, but it's years behind

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

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Hello, good morning. Here’s how the aftermath of the tragic Uvalde shooting is playing out on Capitol Hill: Talks of bipartisan action resume, pessimism abounds.

Today’s edition: Oklahoma’s governor signs the nation’s most restrictive abortion ban, effective immediately. The Food and Drug Administration comes under fire over baby formula shortage. But first …

Findings from gun violence research could come as soon as this fall

The country is playing catch-up on gun violence research.

In late 2019, Congress reached a deal to fund research on gun violence for the first time in over two decades. Since then, lawmakers have allocated $25 million — split evenly between the Centers for Disease Control and Prevention and the National Institutes of Health — each year.

Researchers are racing to learn more about the problem, its causes and what prevention strategies work after years of relying mainly on donations and private funding. Some initial findings from CDC-funded studies could be released as soon as this fall. The mass shootings at Robb Elementary School in Uvalde, Tex. and a Buffalo supermarket underscore the urgency, advocates say.

“It’s really important that we understand the root causes of gun violence so we can truly understand what a public health approach can be to effectively prevent gun death and injury in this country,” said Christian Heyne, the vice president of policy at Brady, a gun violence prevention organization. 

So, how are the new research dollars being spent? The Health 202 dug in.

How we got here

Here’s the quick digest: Lawmakers stopped providing funding to study gun violence in 1996. That’s largely because of a provision passed in each spending bill that forbade the CDC’s funding from being used to advocate for gun control. The measure, known as the so-called Dickey Amendment, had a chilling effect on research. 

In 2018, Congress clarified that the federal government can study gun violence, as long as it doesn’t promote gun control. Soon after, lawmakers began funding research.

At the CDC

The nation’s public health agency says it’s focusing its dollars on improving data collection, conducting research and fostering collaboration. In fiscal year 2020, the agency funded 16 awards to prevent firearm violence and injuries. Results from some of the studies could come as early as this fall. 

Here’s a brief snapshot of where the dollars are going: 

  • A project to develop and evaluate ShootSafe, a website aimed at teaching children how to safely engage with firearms to reduce unintentional injuries
  • Evaluating the effectiveness of a bystander intervention in 50 4-H Shooting Sports Club communities
  • Funding programs in 10 state health departments to provide near real-time data on emergency department visits for nonfatal firearm injuries

One issue is there’s not a lot of quality data out there, Andrew Morral, a senior behavioral scientist at the RAND Corporation, told The Health 202. That’s an issue he’s trying to fix and received a CDC grant to craft gun ownership rates by state and other demographics, and then use the data to better understand the effects of state gun laws.

At the NIH

Over the past two years, the agency says it’s put more money toward firearms research than the $12.5 million from Congress. For fiscal year 2020, the total investment was over $14 million. For fiscal year 2021, that number was roughly $19 million

Here’s a brief snapshot of where the dollars are going:

  • An evaluation of where and why people use places, like firearm retailers and ranges, to store guns outside their home
  • A nationwide study of the impact of school safety strategies on school shootings and student disciplinary action in K-12 public schools
  • An examination of whether repurposing vacant lots, such as creating community gardens or parks, in Detroit is a way to prevent gun violence

More money?

Some gun violence prevention advocates have already been itching for more research dollars. Expect those calls to grow louder as the appropriations cycle nears. 

Last year, Brady and other groups requested $60 million, said Heyne, who anticipates pushing for at least that amount this year. Some Democrats have pushed for $50 million in recent years and blamed Republicans for the lower number. 

Some longtime researchers agree. “It's very important to have restarted it. Is it enough? Absolutely not,” said Mark Rosenberg, who served as the first permanent director of the CDC’s National Center for Injury Prevention and Control. 

Reproductive wars

Okla. governor signs strictest abortion bill in the nation

Oklahoma Gov. Kevin Stitt (R) signed a measure into law yesterday that bans almost all abortions in the state from the moment of “fertilization.” It went into effect immediately.

The law yet again fundamentally changes the landscape of abortion access in America. Millions of women will have to travel hundreds of miles for the procedure, since Oklahoma had been a refuge for some women from Texas, where a roughly six-week ban went into effect last year. 

The Oklahoma law is similar in its enforcement mechanism to the one that was signed into law in Texas, which relies on private citizens to file lawsuits against anyone who knowingly aids or performs an abortion. Women who seek or have had an abortion cannot be sued

  • The new law makes exceptions for medical emergencies, and for pregnancies resulting from sexual assault or incest that are reported to law enforcement.
  • “I promised Oklahomans that as governor I would sign every piece of pro-life legislation that came across my desk and I am proud to keep that promise today,” Stitt said in a statement.

The American Civil Liberties Union:

Agency alert

Califf grilled on infant formula shortage

The head of the Food and Drug Administration faced fierce bipartisan questioning at a hearing on the infant formula shortage yesterday, which included accusations of a slow response to reports of possible contamination at an Abbott Nutrition facility in Sturgis, Mich., The Post’s Laura Reiley reports. 

FDA Commissioner Robert M. Califf acknowledged the agency's process took too long and that “some decisions in retrospect were not optimal.” He laid out a series of setbacks at a House Energy and Commerce subcommittee hearing that he said slowed his agency’s response. 

  • They include a covid-19 outbreak at the plant, and a whistleblower complaint alleging unsanitary conditions at the factory that didn’t reach FDA leadership for four months because of a “failure in the FDA’s mailroom.”

Critics say those setbacks underscore enduring structural problems at the agency that has long-since prioritized drugs and medicine over food safety, our colleagues Kimberly Kindy and Laura report. 

When a whistleblower sent a 34-page report to the FDA in October, the top official in charge of food safety didn’t see it. And he didn’t learn about the complaint until four months later. 

  • “It wasn’t sent to me, and it wasn’t shared with me internally. How does this happen?” Yiannas, who previously ran the food safety program for Walmart, the nation’s largest grocer, told The Washington Post. “There were early signals, and in any safety profession you want to take those seriously to stop the domino effect. That didn’t happen.”

More from Califf:

On the Hill

Senate Finance Committee releases discussion draft of new telehealth policies

The Senate Finance Committee is releasing a bipartisan draft this morning of its proposal to expand access and bolster support for telehealth services nationwide as the panel seeks to roll out a mental health package this summer.  

Here’s what the draft legislation would do:

  • Eliminate the in-person visit requirement for Medicare enrollees seeking telehealth services for mental health care.
  • Establish a “Telemental Health Bill of Rights” to inform those on Medicare about their right to receive remote health services and the approximate cost.
  • Require Medicare to publish guidance on how providers can improve access to telehealth services for patients with limited English proficiency and those with hearing or vision impairments.
On the move

The Senate HELP Committee voted to advance the nomination of Rita Landgraf for assistant secretary for aging at the Department of Health and Human Services, a position that also comes with the job of administrator of the Administration for Community Living

Landgraf previously served as cabinet secretary of the Delaware Department of Health and Social Services. Her nomination advanced in an 18-to-4 vote, with Sens. Rand Paul (R-Ky.), Tim Scott (R-S.C.), Tommy Tuberville (R-Ala.) and Jerry Moran (R-Kan.) as the dissenters. Her nomination now heads to the full Senate. 

White House prescriptions

White House launches first federally supported test-to-treat site

New this a.m.: The Biden administration is launching its first federally supported test-to-treat site as part of a larger initiative to expand public access to coronavirus testing and oral antiviral treatments as cases climb nationwide. 

The details: Individuals who visit the one-stop shop in Providence, R.I., will be able to take a coronavirus test, consult with a medical provider and, if needed, receive free oral antiviral pills, like Pfizer’s Paxlovid. The clinic also provides coronavirus vaccinations. 

Key context: There are more than 2,500 test-to-treat locations across the country at local pharmacies and community health centers. The administration is planning more federally supported sites in the coming weeks in places like New York and Illinois.

HHS names first acting deputy director of ARPA-H

A former program manager at the Defense Advanced Research Projects Agency will become second-in-command of an independent entity within the National Institutes of Health dedicated to advancing medical breakthroughs.

Adam H. Russell will serve as acting deputy director of the Advanced Research Projects Agency for Health, which President Biden has pitched as the biomedical version of DARPA, an agency known for developing emerging technology for military use.

In other health news

  • California, Florida, Kentucky and Oregon will extend their postpartum Medicaid and Children’s Health Insurance Program coverage from 60 days to a year.
  • Pfizer will sell nearly two dozen products, including its coronavirus vaccine and treatment, at nonprofit prices to 45 lower-income countries.
  • Long covid affects an estimated 1 in 5 adults in the United States who have been infected by the coronavirus, and a new study suggests vaccines may not prevent many of the illness’ symptoms, The Post’s Ariana Eunjung Cha reports.

Health reads

The Anti-Vaccine Movement’s New Frontier (By Moises Velasquez-Manoff | The New York Times)

Most in Senate GOP shun total abortion ban (By Marianne LeVine and Burgess Everett | Politico)

Viruses that were on hiatus during Covid are back — and behaving in unexpected ways (By Helen Branswell | Stat)

Sugar rush

Thanks for reading! See y'all tomorrow.

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