The bird flu mystery that might never get solved

Is it just me, or was it dark at, like, 2:30 pm in Boston yesterday? “Winter is coming,” as George R. R. Martin’s House Stark says. “If it must / be winter, let it be absolutely winter,” as poet Linda Gregg says. Less than three weeks until 2025.

A health care critic on being cited in Luigi Mangione’s manifesto

The suspected killer of UnitedHealthcare’s CEO, a 26-year-old named Luigi Mangione, cites two prominent critics of the U.S. health care system in his handwritten manifesto: journalist Elisabeth Rosenthal and filmmaker Michael Moore. Writing about the broader health care system, Mangione noted that “many have illuminated the corruption and greed (e.g.: Rosenthal, Moore), decades ago and the problems simply remain.”

Rosenthal, a senior contributing editor at KFF Health News and author of the 2017 bestseller “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back,” was unaware of the manifesto’s contents until STAT reached out to her. “This is a terrible, tragic murder, and it shouldn’t have happened,” she said in an interview. “That being said, I’ve basically spent the last decade of my life hearing from and reporting on patients who are deeply frustrated and angry with a health system that doesn’t serve their needs.” Read more about the manifesto from STAT’s Bob Herman and Tara Bannow.

Higher life expectancy is one thing. Health is another

Across the world, life expectancies are increasing. In 2000, the global average was just under 67 years. By 2019, it was 73. But those added years aren’t always spent in good health. A study published yesterday in JAMA Network Open found that the gap between the end of someone’s healthy years and when they die — known as a healthspan-lifespan gap — has increased globally over the past two decades. Among 183 WHO member states, that gap has grown to almost 10 years long, meaning 10 years at the end of life dealing with disease. And that gap is, on average, more than two years longer for women than for men.

Researchers analyzed data from the WHO Global Health Observatory to calculate healthspan-lifespan gaps. They found that Americans see the largest gap among the 183 countries analyzed — around 12 years. Part of the problem, the authors note, is paradoxical: With reduced acute mortality, people who might have died of certain diseases in earlier decades now survive, but with an increased chronic burden.

A bird flu mystery might never get solved

For the past week, STAT’s Helen Branswell has been tracking what we know about a child in California with a possible case of bird flu. But the case may go cold, she reports. Officials still don’t know if the child definitely had H5N1 bird flu — it could have been a seasonal flu — nor do they know how the virus was contracted. A parent told a doctor that the child drank raw milk from a company, Raw Milk LLC, that has had products test positive for H5N1.

If the child is confirmed to have been infected through milk consumption, it will be the first such case recorded in the U.S. But don’t hold your breath: Lisa Santora, a public health officer for Marin County, acknowledged to Helen that there’s a decent chance the infection will not be confirmed. Read more.

The emerging arms race over insurance denials

Health insurers are already using artificial intelligence to determine coverage. But a new crop of startups is looking to harness the power of AI to combat insurance denials that block access to medical services. These companies promise to help automate appeals for providers and patients, making it much faster and easier to contest denials that often go unchallenged. It’s potentially game-changing because when people do appeal, they’re often successful.

“Of all the players in the health care space, the patients are the ones who are impacted the most and also have the least amount of resources,” said software engineer Holden Karau, whose company is at the forefront of this effort. Read more from STAT’s Casey Ross.

How Texas could undermine its own medical system

Beginning this fall, there’s a new question that hospitals across Texas are required to ask each patient: “Are you a U.S. citizen?” Patients aren’t technically obligated to respond, but there’s no questioning the mood that such an inquiry creates. “It turns a place of refuge into a checkpoint,” writes pre-med student Akshara Ramasamy in a new First Opinion essay.

Ramasamy spent much of her childhood in Texas worrying about her family’s legal status as visa-holders. But she also spent a lot of time as a young patient in hospitals, where she felt safe from those worries. As she looks to continue her medical education in her home state, Ramasamy’s dual perspective puts her in a complicated position. “In a world where hospitals are forced to inquire about citizenship, what am I actually promising?” she writes. “It feels as though I am vowing to do no harm only if the patient can prove their lawful place in this country. The trust at the core of the patient-provider relationship fractures under the weight of that stipulation.” Read more.

Childhood vaccinations are decreasing across the pond, too

Uptake of five key childhood vaccines decreased in the U.K. between 2019 and 2023, according to a study published yesterday in The BMJ. Researchers analyzed vaccination rates at general practices across the country for the first and second dose of the MMR vaccine, as well as rotavirus vaccine, pneumococcal conjugate booster, and a six-in-one shot that covers diphtheria, tetanus, polio, and more.

But the rate of uptake isn’t declining equally across the board. At clinics in more socioeconomically disadvantaged areas, fewer children received vaccines than in better-resourced areas, and that absolute difference only increased over the study period. The authors point to reduced access and acceptability as potential factors at play in the disparities.

The study was published just days after, here in the U.S., President-elect Donald Trump suggested that he shares some of Robert F. Kennedy Jr.’s concerns about common childhood vaccines (which, to be clear, are scientifically unsubstantiated).

What we’re reading

• Hospitals gave patients meds during childbirth, then reported them for positive drug tests, Marshall Project

• The perimenopause gold rush, The Cut

• FDA’s proposed ban of electric shock devices has taken too long, autism advocates say, STAT
• Montana Supreme Court upholds lower court ruling that allows gender-affirming care for minors, AP
• Biden officials take credit for ‘largest drop’ in overdose deaths. Experts are more cautious, STAT