Brainstorm Health: Millennials and Primary Care, Climate Change and Mental Health, Pfizer Shakeup

October 9, 2018, 8:27 PM UTC

Happy Tuesday, readers. This is Sy.

Millennials are killing everything from car ownership to home ownership to beer to vacations to the institution of marriage itself, if the headlines are to be believed. (Full disclosure: I am a millennial.) So why not add another victim to the list? In this case, the primary care doctor.

A Kaiser Family Foundation (KFF) survey and followup analysis by Kaiser Health News found that 26% of 1,200 respondents said they didn’t have a go-to primary care physician. But, digging a bit deeper, the survey found sharp generational shifts fueling that trend: Nearly half (45%) of 18-to-29 year olds said they didn’t have a primary care doctor. That figure fell to 28% for Americans aged 30 to 49 and just 18% and 12%, respectively, for people in the 50-to-64 and 65-plus cohort.

Some of this can likely be explained by a divergence of needs. It’s not implausible to think that, the older you get, the more you may want to have the security of a personal medical professional versed in your health history.

But it also represents a sea change in thinking likely fostered by an increased emphasis on convenience (and, perhaps, increasingly transitory lifestyles), according to some experts. A same-day telehealth appointment in a stranger could prove more valuable to some than a long-standing relationship with a doctor who may not be available at the click of a button.

The broader question is: What long-term effects will this shift have on public health? People with chronic conditions, for instance, may benefit from the stability of a primary care doctor who can provide continuous (and, theoretically, more personalized) care. At the same time, Americans who live in the numerous areas with a shortage of doctors may have entirely understandable reasons for pursuing more transitory medical relationships.

Read on for the day’s news.


Digital health in the fight against infant HIV. A new paper published in the journal Lancet highlights the potential of digital health—specifically, the use of online and texting tech—to make early diagnoses of HIV in infants from developing nations. The researchers also pointed out the major sticking point for the technology: "How to convert these study findings into a scalable service for the population to benefit. All too often, evidence from such studies enters the realm of published research, but integration of the service into the health system lags—even by decades," wrote the study authors.


Pfizer's incoming CEO already plotting management shakeup. Albert Bourla, who will take over as Pfzier's chief executive in January, is beginning to make his mark. The company announced the exec roster that will be reporting to Bourla beginning next year—including the addition of a Chief Digital Officer who will be "responsible for creating and implementing a strategy that accelerates and improves our digital capabilities so we can deliver more value to patients," the firm says.


How climate change can affect Americans' mental health. A study published in the Proceedings of the National Academy of Sciences finds that climate change leading to more extreme, extended bouts of hot weather can take a serious toll on mental health, especially for women and low-income Americans. Environmental factors are among the "social determinants" of health that are often ignored in professional health care settings, and they tend to afflict marginalized and minority communities the most. (Los Angeles Times)


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