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New York Times
17-04-2025
- Health
- New York Times
Measles Outbreaks in Canada and Mexico Bring Grim Prognosis
As the United States struggles to contain a resurgence of measles that has swept through swaths of the Southwest, neighboring countries are responding to their own outbreaks. Canada has reported more than 730 cases this year, making this one of the worst measles outbreaks in the country since it declared the virus 'eliminated' in 1998. Mexico has seen at least 360 measles cases and one death, most of them in the northern state of Chihuahua, according to Mexican health authorities. Many of the communities grappling with measles have large Mennonite populations that public health officials have linked to outbreaks. The multinational resurgence has concerned epidemiologists, who fear that simultaneous outbreaks near the U.S. border will make it more difficult to contain the virus. 'It's just a line on the map that separates them — we share air, we share space,' said Lisa Lee, an epidemiologist at Virginia Tech. Falling vaccination rates have left the United States more vulnerable to the highly contagious virus, she added. 'If we don't have a buffer or herd immunity to keep the virus out,' she said, 'we will be at risk as long as any of our neighbors are at risk.' The outbreak in the Southwest shows no signs of slowing. Since late January, the virus has sickened more than 560 people in Texas, 63 people in neighboring New Mexico, and a dozen people in Oklahoma. More than 30 cases have been reported in Kansas, which public health officials believe may be linked to the Texas outbreak. Alarmed, officials in several states have issued warnings to their residents. The governor of Nebraska released a measles response plan though the state hasn't yet reported any cases. New York State officials earlier this month issued a travel advisory about trips to Ontario and several U.S. states, warning that measles is 'only a car ride away.' The virus has spread so widely in North America this year that the Pan American Health Organization published an alert in late February, warning that the region's elimination status was at risk if nations did not strengthen their vaccination and outbreak response efforts. A risk assessment by the organization concluded that measles posed a 'high' risk to public health in the Americas. The outbreak in Canada, which began in late 2024, has been 'disproportionately affecting' people from Anabaptist communities, including Mennonite and Amish people, and can be traced back to a large Mennonite gathering people in the fall, according to the Ontario Ministry of Health. The largest outbreak in the United States began in a Mennonite community on the western edge of Texas. Areas with smaller outbreaks, like Oklahoma and Southwest Kansas, also have sizable Mennonite communities, according to Steven Nolt, who studies Mennonite and Amish groups at Elizabethtown College in Pennsylvania. There is no religious doctrine in the Mennonite faith that bars vaccination; however, many in the community avoid interacting with the medical system and adhere to a long tradition of natural remedies. Highly contagious viruses, like measles, take root in close-knit, undervaccinated communities. In 2019, measles spread through a large Orthodox Jewish population in what became the largest outbreak in recent U.S. history. Even if the virus doesn't break into the broader community, measles can infect hundreds by hopping between pockets of vulnerable people. Outbreaks have the potential to spread over country borders and hundreds of miles if the virus finds a network of unvaccinated communities. That appears to be part of the story in the current measles resurgence. The virus was first brought into a Mennonite community in Chihuahua by a 9-year-old boy who visited Texas with his family, according to Rodolfo Cortés, a spokesman with the state's health ministry. Mennonite groups across North America are extremely interconnected, Dr. Nolt said. While he's unaware of large, organized gatherings between the groups, he said that Mennonites will often cross borders to visit extended family. While no firm link has been established to the Canadian cases, the same virus type has been detected in all three countries, according to data presented this week at a Centers for Disease Control and Prevention meeting. Measles cases have not been confined to Mennonite communities, however. More than half of U.S. states have reported at least one case this year, and there have been outbreaks in Ohio and Indiana with no known connections to other outbreaks. In a public meeting Tuesday, David Sugerman, a C.D.C. senior scientist, said recent threats to local public health funding meant the agency was now 'scraping to find the resources' to support Texas and other states grappling with outbreaks. On average, each measles case costs between $30,000 and $50,000 in public health response work, he said. While there have for decades been insular, undervaccinated communities, Dr. Lee said the people surrounding those groups have generally had high immunization rates. But in recent years, national childhood vaccination rates have fallen. 'That ring around those groups are not protected.' she said. 'And so there is, for lack of better words, leakage out into communities.'
Yahoo
04-04-2025
- Health
- Yahoo
In SC, the caregivers may see half of what Medicaid pays for home care. A bill would change that.
Lisa Lee, a home health care worker in Camden, came to the Statehouse on Tuesday, April 1, 2025, to advocate for a bill that would raise wages for herself and other workers. (Photo by Skylar Laird/SC Daily Gazette) COLUMBIA — For every hour Lisa Lee works caring for people in their homes, her employer receives $25 per hour. In 10 years of work, she has never gotten more than $15 per hour. Lee's employer, like all home health providers in the state, gets funding through Medicaid reimbursements for home care waivers. Under state law, providers have no requirement to pay care workers more than the federal minimum wage of $7.25 per hour. The portion of the reimbursement that doesn't go to workers is set aside for administrative costs. That often means roughly half of what taxpayers provide for services goes toward bureaucracy instead of the caregiver, and that's not right, said Maria Reyes, South Carolina's organizing director for the National Domestic Workers Alliance. The low wages are causing health care workers to flee the field for higher-paying jobs, at a time when South Carolina's aging population needs more caregivers, not less. To stem the exodus, the state should limit how much providers can take from the workers doing the job, she said. A bill introduced in the Statehouse last week would require providers to pass on at least 70% of their reimbursement rate to care workers. That's $17.50 per hour at the current rate of $25 per hour. Home health workers are tasked with doing whatever a person needs on a daily basis, such as bathing them, giving them medication or helping them move around the house. Beyond that, health workers are often a friend and source of comfort for their clients, Reyes said. 'You're not just washing someone. You're not just feeding someone. You're not just giving meds,' she said. 'You're that person's person while you're there.' In 2023, the median wage for home health care workers in the state was $13.62 per hour, according to PHI, a national nonprofit that promotes care for the elderly and people with disabilities. For a person working 40 hours a week, that would equate to a yearly salary of about $28,300 per year. There have been times when Lee, who lives and works in Camden, has had to choose between asking her boss for an advance to pay for gas or walking to her clients' houses because she couldn't afford to fill up her car's tank, she said. 'I shouldn't have to ask my boss for help,' Lee said, adding she should be able to pay for it herself. Trying to make some more money, she took on more clients. But the more people she cared for, the less time she had to spend with each of them. She can't afford to take sick days or vacation, since her job offered no paid time off, she said. 'These are the sacrifices I make because I love what I do,' said Lee, who declined to name her employer. 'But home health care workers are neglecting their own needs.' Sen. Darrell Jackson, the bill's sponsor, credits a home health care worker with keeping his father alive for an extra several years two decades ago while he was in hospice at home. Knowing his father was getting the care he needed took some stress off Jackson and his family, he said. But with low pay driving people out of the profession and into other work, not everyone gets that chance, said the Hopkins Democrat. That was why he sponsored the bill, which has yet to receive a committee hearing. He's also pushing for a clause in the state budget that has the same effect. 'When you look at their average pay, it is pretty ridiculous,' Jackson said. Families who can't find a home health care worker often have to take on the responsibilities of round-the-clock care themselves, sometimes at great personal sacrifice, said Reyes, who lives in Columbia. Her father qualified for a home health worker under Medicaid in 2022 as his health declined from congestive heart failure, but no local agencies had enough workers to help him, she said. Instead, her niece quit her job and moved from North Carolina, and her brother retired early to take care of him, Reyes said. 'The whole point of us applying for the waiver was for us to get a break, for us to have someone directly for my dad,' Reyes said. 'Unfortunately, we never got the chance.' Her father died while still on a waiting list for a worker. As of last July, nearly 20,000 people were on a waiting list to receive a waiver, according to the state's Medicaid agency. As the state's population ages, the number of people looking for at-home care is expected to grow. In the next decade, the state is projected to need nearly 11,000 more home health care workers than it already has, which is more than any other health care job, according to the state Department of Employment and Workforce. How many people can get services depends on whether the state has the money to reimburse providers for their care. The House's initial spending plan includes $5 million to increase the number of slots available for Home and Community-Based Services waivers, which pay for home health care workers to take care of people. Getting more people the help they need is great, Reyes said. But increasing the number of people eligible for a home health care worker without taking steps to improve pay and conditions for the workers will likely only make the problem worse, she said.
Yahoo
04-04-2025
- General
- Yahoo
Why We Need the Nation's First Public Housing Museum
Opening this week in Chicago, the National Public Housing Museum wants to reinvigorate our interest in collective well-being by tackling dominant narratives—of crime, poverty, and eventual destruction—head on. A 1936 advertisement for the New York City Housing Authority depicts the clamor of city life: a jumble of line drawings depict a leaping alley cat, trash can, train, and fire escape. Bold text in a quintessential Art Deco font plastered diagonally across the image reads, "Must we always have this? Why not HOUSING?," addressing both the energy and desperation of urban life in 1930s America. Funded by the Works Progress Administration, the ad was of a time when the federal government created massive public works projects across America to uplift the poor during the Great Depression. Though that era is now long over, the ad still feels relevant. We've reached a record high of unhoused people across the country: new housing construction is slow, rent costs burden more than 50 percent of Americans, and building housing is only getting more expensive. We may have driverless taxis coasting through cities and technology that delivers anything you desire in a matter of hours…but why not housing, indeed? The advertisement is one of many artifacts on display at the new National Public Housing Museum (NPHM) in Chicago, the country's only museum devoted to U.S. public housing, which opens April 4. Unlike other types of history museums which seek to keep the past alive, the NPHM is in a unique position because public housing itself isn't, technically, extinct. People still inhabit public housing developments built across the country after the U.S. Congress boldly declared in 1935 that housing is a human right. As such, the NPHM is doing something a bit different. They're not preserving objects and artifacts to encase public housing in amber; instead, the space squarely seeks to reinvigorate our interest in collective well-being by tackling public housing's dominant narrative—one of crime, poverty, and eventual destruction—head on. Located in Chicago's Little Italy neighborhood, the NPHM is housed in the remaining structure that was once part of the Jane Addams Homes—a 1937 low-rise public housing development that was mostly demolished beginning in 2002. According to NPHM executive director Lisa Lee, the building itself is the museum's biggest artifact, saved by a group of former public housing residents when the City of Chicago embarked on its 1999 Plan for Transformation that got rid of 18,000 public housing units and displaced more than 16,000 people. At that point, it had been the largest net loss of affordable housing in the entire United States, says Lee. See the full story on Why We Need the Nation's First Public Housing MuseumRelated stories: You Can Plug This $19K Backyard Office Into an Outlet "We're Going to Have Something Worse": What Dr. Lucy Jones Says Will Make L.A. More Fire Resilient The Push for Government-Run Grocery Stores—and Everything Else You Need to Know About This Week
