As I continue to prepare my upcoming series on health insurance, a recent article in perhaps the most respected medical journal in the world—the New England Journal of Medicine—sheds some light on one of the fundamental questions that underpins the entire concept of health insurance, which is: Does having health insurance actually make a difference in people’s health outcomes, including mortality? After all, if having health insurance really doesn't make a difference in how people fare after they get it, then the intense ongoing debate about the insurance market becomes largely irrelevant.
The article, “Health Insurance Coverage and Health — What the Recent Evidence Tells Us,” co-authored by noted Harvard surgeon and writer Atul Gawande, MD, MPH, is a scholarly analysis of the available data on the impact of health insurance on health outcomes. The article’s bottom line, to use a phrase the authors themselves use, is that any conclusion drawn on this subject must be nuanced. They conclude that health insurance does indeed produce positive health outcomes, but with qualifications. One of the problems in any such analysis is the relatively short-term nature of the available outcome data, during which time any health outcomes might be quite modest; many health effects, especially those that are preventive, take place over long periods of time. In my own field of cardiology, for example, we know without question that treating high blood pressure is beneficial, but the greatest effects are seen after years and even decades of treatment. A study that looked only at the six-month or one-year impact of treating high blood pressure might well find muted or no effects—despite the positive impact one sees after long-term treatment.
With that important proviso in mind, Dr. Gawande and his co-authors (all from Harvard) conclude that their analysis of the available data shows that obtaining health insurance improves the financial security of those gaining insurance (naturally enough) and reduces their anxiety regarding financial matters. Gaining health insurance also improves patients’ access to care and the use of preventive health services, which, over time, should eventually result in better health outcomes. And, the authors conclude, most available data indicate that people gaining health insurance experience an improved sense of well-being and self-reported health.
The data are much less clear as to whether people not only feel better but actually are better, the authors note. And as to the biggest question of all – does health insurance reduce mortality? – the authors give a nuanced answer, which I would characterize as “maybe.” The authors reference one study, for example, that suggested that if one gave 830 previously uninsured adults insurance coverage, then one life might be saved over the subsequent year. But other data they reference show no clear positive impact on subsequent mortality.
Finally, the authors emphasize that whatever benefits may follow expanding health insurance coverage come at a substantial financial cost to society and the economy.
That probably highlights the real quandary in which the citizens of this country find themselves, and why the debate about expanding health insurance under the Obama administration’s Affordable Care Act is so heated. While the increased costs associated with health insurance expansion are undeniable and undisputed, the benefits are less clear, especially in the short-term.
I hope that my upcoming series of columns on health insurance in ENews may help bring some additional light to this complicated issue. The articles should start appearing in September, once the new semester is in full swing.
Joshua Wynne, MD, MBA, MPH
UND Vice President for Health Affairs
Dean, UND School of Medicine and Health Sciences
Adrienne Salentiny, Ph.D., began employment on August 14 as an instructional designer in Education Resources, where her primary duties will involve curriculum design and teaching consultation for all SMHS programs. Her supervisor is Dr. Richard Van Eck. Adrienne has over a decade of experience as an instructional designer across the UND campus, including with the John D. Odegard School of Aerospace Sciences, the Division of Continuing Education, and the Center for Instructional Learning Technologies (CILT). Most recently, she managed the UND Environmental Training Institute, where she supervised the design, delivery, and evaluation of government-regulated emergency health and safety outreach training. She has taught as an adjunct professor in the fields of instructional design, learning design, and education at UND and other higher education institutions. Adrienne earned her B.S. in political science with a minor in computer information technology from the University of Oregon (’05) and her M.S. ('07) and Ph.D. ('12) in instructional design and technology from UND. Her husband, Dustin, is head of development at Iteris, Inc. The couple has one daughter.
Please join SMHS staff and faculty on Thursday, August 24, from 2 p.m. to 3:30 p.m. in Room E493 at the SMHS in Grand Forks to congratulate Facilities Systems Specialist Ralph Hutton on his retirement from the University. Cake and coffee will be served. All SMHS faculty and staff are welcome to attend.
The UND SMHS is a member of the Great Plains IDeA-CTR Network, which will hold its inaugural scientific meeting on Oct. 23–24, 2017, at the University of Nebraska Medical Center's Truhlsen Event Center in Omaha.
The Great Plains IDeA-CTR Network was created by a $20 million grant from the National Institutes of Health to the University of Nebraska Medical Center in Omaha (UNMC), the largest grant ever in the center’s history. Funding is provided through the Institutional Development Award (IDeA) program and the NIH’s National Institute of General Medical Studies. It will focus on developing early career researchers into independent scientists and increasing the infrastructure and other resources needed to support clinical/translational research (CTR) around the region.
Jonathan D. Geiger, Chester Fritz Distinguished Professor in the Department of Biomedical Sciences at the UND School of Medicine and Health Sciences, serves on the leadership team.
In addition to UNMC, the Nebraska institutions involved in the network include the University of Nebraska-Lincoln, University of Nebraska at Omaha, University of Nebraska at Kearney, and Boys Town National Research Hospital. Other participants are the University of North Dakota, North Dakota State University, the University of Kansas Medical Center, and the University of South Dakota.
The program will highlight presentations on clinical and translational research and resources, team science, community engagement activities, a mock study review panel, and more!
A reception will be held for University of North Dakota and University of South Dakota alumni on Saturday, November 4, 2017, in Boston, Mass. The reception will be held from 6:30 p.m. to 7:30 p.m. in the Dartmouth Room of Boston Marriott Copley Place, 110 Huntington Ave., in Boston, Mass.
Hors d’oeuvres and refreshments will be served. All UND / USD alumni and friends are welcome!
Please RSVP by October 9.
More information on this gathering is available here.
Joshua Wynne, M.D., M.B.A., M.P.H., University of North Dakota vice president for Health Affairs and dean of the School of Medicine and Health Sciences (SMHS), invites the community and all students, faculty, and staff at the School and the University to advocate healthful lifestyles by joining him for Joggin’ with Josh, an informal 5K, 10K, or one-mile walk, jog, or run on Thursday, September 7. This is a free public event. Everyone is welcome to participate, so please bring your family and friends.
A registration table will be located in the East Atrium of the School of Medicine and Health Sciences at the south entrance to the School, 1301 N. Columbia Rd. Event registration and T-shirt pickup starts at 4 p.m. The dean will speak to the group before the event, which starts at 4:30 p.m. To get a head start on your fellow participants, please complete the registration form available online and bring it with you to the SMHS on the day of the event. Forms will also be available in the SMHS East Atrium before the event.
Walkers, joggers, and runners are asked to gather on the patio outside the East Atrium before taking off on a route along the outskirts of campus. A water station will be located at the halfway point of the 5K, and water and healthful snacks will be available after the event.
The North Dakota Brain Injury Network (NDBIN) at the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences has received an increase of $100,000 in state funding for this fiscal year. The additional funding will be used to develop a statewide brain injury strategic plan under the newly formed Governor’s Advisory Council for Brain Injury.
The additional funding is provided through the North Dakota Department of Human Services (DHS). Rebecca Quinn, NDBIN program director, said the increase makes up about one third of NDBIN’s $292,000 budget. Last year NDBIN’s funding was reduced, so this year’s amount essentially restores the group's previous budget. “North Dakota’s brain injury services are still in the developmental phase,” Quinn said, “and the additional funds will help us develop a more strategic way to continue our education and outreach work.”
NDBIN was established in 2013 and works throughout North Dakota raising awareness of brain injury. The network assists individuals in navigating the service system and provides technical assistance in finding the right resources. Members hold an annual conference, “Mind Matters,” where brain injury survivors, family members, expert speakers, and healthcare providers discuss brain injury services and share best practices.
NDBIN is funded by a contract with the North Dakota Department of Human Services to provide information and support to individuals with brain injury and family members, and to assist them with navigating the service system.
The Evidence-Based Teaching (EBT) Group will meet at 2:00 p.m. on Monday, August 28, 2017, in SMHS room W202. Dr. Richard Van Eck, Associate Dean for Teaching and Learning, will present on the use of a threaded discussion strategy to build learner expertise.
Online or distance learning is often asynchronous in nature (i.e., students and instructors do not interact with each other at the same time and/or place), making it difficult to promote the same level of engagement and processing of content--as typically happens with synchronous learning. Threaded discussion boards theoretically allow for meaningful asynchronous discussion, but without careful planning such boards result in shallow discussion of ideas and a lack of social interaction and community that the best synchronous discussions often generate.
This session will give attendees an effective strategy for developing threaded discussions appropriate for online or face-to-face courses. This strategy was validated through a discourse analysis of student contributions over a five-week graduate course. The strategy, analysis suggests, leads to content and group leadership expertise for all students and illustrates how community is actually a necessary prerequisite for expertise. We will discuss the strategy, research on it, and applications to different courses.
The Evidence-Based Teaching group meets every three weeks at the same time. This group will host topics as determined by the expressed interest of its members. It is free and open to anyone—no RSVP needed! If you are interested in anything related to Evidence-Based Teaching (assessment, online learning, precepting, active learning, simulation, ADA compliance, or any topic you see fit), join us and let us know what you’d like to see at future meetings. If you have any questions or would like more information, please contact Shae Samuelson at email@example.com.
Stephanie Naoum, a representative from Turning Technology, will be at the UND School of Medicine and Health Sciences on August 31, 2017. She will be available from 11:00 a.m. to 12:30 p.m. in room E224 to answer questions from faculty already using clickers in the classroom, and help orient faculty and staff who would like to do so. Please RSVP to firstname.lastname@example.org or 777-6349 if you plan to attend.
U.S. Public Health Service (PHS) recently revised its policy for requiring that all PHS grantees, or those considering submitting grant applications to PHS, complete a mandatory education class. According to the new policy, all grantees working on research funded by PHS agencies must be trained in Conflict of Interest every four years. UND's Division of Research & Economic Development will be conducting PHS Conflict of Interest sessions on the following dates:
PHS grantees only need to attend one of the offered sessions. PHS agencies include:
Sessions will be coordinated by Barry Milavetz, Ph.D., Associate Vice President for Research & Economic Development
The Great Plains IDeA-CTR Network is pleased to announce that funding through a National Institutes of Health (NIH)/National Institute of General Medical Sciences grant is available to support two faculty who are in the early stages of their career.
To apply for the grant, send a letter of intent (maximum of two pages) to the Great Plains IDeA-CTR Network by Sept. 11, 2017. In your letter, please include: project title, principal investigator and mentor(s), participating institution(s), study aims, hypothesis, methods (brief overview of design, sample, measures, statistical analysis plan), and a statement addressing how the project advances clinical and translational research. Also, include a specific paragraph listing your training needs to support your research program. Finally, submit your NIH biosketch.
Up to 10 applicants will be invited to submit a full application. Those invited to submit full applications will be notified by Oct. 2, 2017. The RFA and requirements for invitees are detailed below. Please email your letter of intent and NIH biosketch as a single PDF document to the Great Plains IDeA-CTR Office at email@example.com.
Solicited applications will be due Nov. 20, 2017.
More information is available here.
The Center for Biomedical Research Excellence (CoBRE) for Host-Pathogen Interactions is inviting UND faculty, staff, and graduate and undergraduate students to attend the Annual Host-Pathogen CoBRE Symposium to be held at the University of North Dakota Gorecki Alumni Center on Monday, September 18, 2017. This event will bring together experts studying cellular and molecular mechanisms underlying host responses in acute infections and chronic disease conditions, and will include a poster session showcasing research carried out by UND faculty and UND graduate and undergraduate students.
Confirmed Speakers for the event are:
In addition, investigators from the University of North Dakota will present their research related to infection and immunity.
This event aims to promote interaction and collaboration among researchers in the area and provide opportunities for learning about cutting-edge tools, approaches, and resources to advance their research in broad areas of infection and inflammation as it applies to human disease.
The event, which runs from 8:30 a.m. to 5 p.m., is free; a continental breakfast and lunch will be provided. Prior registration is appreciated. The Gorecki Alumni Center is located at 3501 University Avenue in Grand Forks, N.D.
Compete to win a trip to New Orleans in 2018!
Do you excel at research or clinical evaluations? Have you come across an interesting case where your colleagues could benefit from your findings? Do you have any projects that promote patient safety or outcomes measurement? Don’t miss this opportunity to submit a medical abstract to the American College of Physicians - North Dakota State Chapter competition. The winner of the competition will be eligible to enter the National Poster Competition at the ACP's Internal Medicine Meeting, to be held in April 2018 in New Orleans, La.
This competition offers an exciting opportunity for Medical Students and Residents to present research and case reports at a prestigious event and to gain recognition from peers and internal medicine leaders. Abstracts/Posters could focus on any of the following categories: Clinical Vignette, Research Paper, and Quality Improvement / Patient Safety.
The poster competition will be held on Thursday, September 21, 2017, at the UND Medical Education Center in Fargo, N.D. Posters will be displayed at the ACP North Dakota Chapter Scientific Meeting on September 22, 2017, at the Hilton Garden Inn in Fargo.
Abstracts have a 450 word limit, excluding the title. See these guidelines for abstracts. The deadline for abstracts is August 25, 2017.
Please submit abstracts in MS Word format to Carla Mosser (firstname.lastname@example.org).