Transgender Awareness Week

Transgender Awareness Week falls between November 12-19 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

 Transgender Pride Flag

Transgender Pride Flag

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is knowledgeable of transgender health issues can be a hurdle itself; some healthcare professionals may believe that there is something wrong with someone because they are transgender—they are wrong. Even after finding a knowledgeable and sympathetic doctor, insurance may not cover the cost of treatment. Many transgender people are on a dosage of hormones which can affect one’s blood pressure, blood sugar, or in rare cases contribute to cancer. Some cancers found in transgender people can appear atypical—trans men are at risk for ovarian and cervical cancers, and trans women can be diagnosed with prostate cancer.

Transgender/gender non-conforming people experience gender dysphoria, a clinically significant distress recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) caused by a person’s assigned birth gender differing from the one with which they identify. This leads to increased depression among the transgender community, which can be exacerbated by being rejected by family and friends, abuse/violence, or experiencing discrimination.

According to the U.S. Department of Health and Human Services, the Affordable Care Act (ACA) protects against discrimination based on gender identity. Despite these protections, over 27% of transgender/gender non-conforming people report having been denied healthcare. Even paperwork can be a barrier to access for transgender individuals as standard forms often only list “male” or “female.” Nearly 21% of transgender people in the US report being subjected to harsh or abusive language from a healthcare professional, and an almost equal amount say healthcare providers have blamed them for their own health conditions. Transgender people report the highest rates of discrimination and barriers to care among the LGBT community.

Transgender rights and protections have been scaled back by the Trump administration. The Department of Justice announced in October 2017 that civil rights laws do not protect transgender people in the workplace, reversing a guideline instituted by President Obama on Title VII of the Civil Rights Act. Earlier last year, the Department of Education rescinded Obama’s Title IX guidance for transgender/gender non-conforming people in schools. Critics of these changes to remove protections from an already vulnerable population call the new guidelines “license to discriminate” while supporters claim it is their “religious liberty” to deny services or access to individuals based on belief.

According to a drafted memo from the Department of Health and Human Resources from October 2018, there are plans to define a person’s gender as immutable from birth—invalidating the experience and gender transitions of transgender people while going against established biological understandings of gender, including intersex individuals (people born with any of variations in sex characteristics including chromosomes, gonads, sex hormones, or genitals that do not fit the typical definitions for male or female bodies). Critics decry these actions by the Trump administration as attempts to “erase” the transgender community for politically motivated purposes that could have a major effect on people’s health and lives.

Human Rights Campaign (HRC) has information on finding insurance for transgender-related healthcare. To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. We also have listings for recreational camps/retreats and academic scholarships for LGBT youth and their families. NeedyMeds’ unique crowdfunding platform HEALfundr is also available for individuals trying to raise funds for their transition. If you know any programs assisting transgender/gender non-conforming people that we don’t have listed on our site, leave a comment and let us know about it.

Don’t Risk a Fall – Know Your Medicines

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It will come as no surprise to many that the 65+ year old crowd – aging baby boomers and older adults – are taking a lot of over-the counter (OTC) and prescription medicines, along with vitamins, dietary supplements and herbal remedies. As many as 55 million Americans will be older than age 65 by 2020.

With the population of older adults soaring in the coming years, the prevalence of patients with chronic disease – who often take numerous prescription medications daily – is likely to increase as well.  Add in those over 65 taking medicines for occasional or chronic pain — in sheer numbers, it’s pretty staggering, putting them at significantly higher risk for drug-drug and drug–alcohol interactions, adverse events, medication errors and falls.

One of the major risk factors for falls is medications and their adverse effects. According to CDC, falls are the number one cause of injury and deaths from injury among older Americans. One in four Americans aged 65+ falls each year. Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.

Consider:

  • Older adults use more medications, including prescription, OTC, and supplements, than any other age group in the United States.
  • Older adults often use multiple medications, increasing the risk of drug–drug interactions, mix-ups, and the potential for harmful adverse effects.
  • Older adults tend to receive prescriptions from different health care providers. This can make it more difficult to track medications and identify drug–drug interactions, harmful doses, and unnecessary or ineffective medications.
  • Chronic conditions such as diabetes, high blood pressure, arthritis, and cancer are more common in older adults and often require a more complex medication management regimen.
  • Age-related changes, such as weight loss, decreased body fluid, and increased fatty tissue, can alter the way drugs are distributed and concentrated in the body.

Falls are Common & Costly

Falls threaten older adults’ safety, quality of life and independence, while generating enormous economic and personal costs. According to the National Council on Aging (NCOA), 1 in 4 Americans aged 65+ falls every year, making falls the leading cause of fatal and non-fatal injuries for older Americans:

  • Every 11 seconds, an older adult is treated in the emergency room for a fall.
  • Every 19 minutes, an older adult dies from a fall.
  • In 2015, the total cost of fall injuries was $50 billion (75% paid by Medicare and Medicaid).
  • This total cost may reach $67.7 billion by 2020.
  • Even falls without injury can cause fear of falling, leading to physical decline, depression, and social isolation.

Think Before You Drink: Medications, and Alcohol Use

Drinking alcohol when you are taking some prescription medications is a health risk for many baby boomers (ages 51-69) and older adults. This practice can have far-reaching health effects.

Aging bodies don’t work well when some medications and alcohol are mixed — Even if you still feel at the top of your game, health-wise, aging can work against your health. The most obvious sign: Your body likely just doesn’t feel like it used to feel.  Older bodies work more slowly to clear medications and alcohol, which can make older adults more sensitive to their effects. There is also less tolerance to alcohol than do younger adults.  Memory problems, mood disorders, poor balance and coordination, and weakness are other age-related health challenges. Prescription medications can make these health issues worse, if the medications are misused, abused, and/or combined with alcohol.

These common prescription medications may display a label warning not to consume alcohol while taking them. Is your medication on this list?

  • Antibiotics
  • Anxiety or depression medication
  • Arthritis medication
  • Blood thinners
  • Cold and allergy medication
  • Diabetes medication
  • Epilepsy/seizure medication
  • Heart burn medication
  • Heart medication
  • High blood pressure medication
  • High cholesterol medication
  • Medication for enlarged prostate
  • Pain relievers
  • Sedatives or sleep aids

 

Communication is the Key: Avoiding Medication-Related Falls

Effective communication is a two-way street – messages sent which are clearly understood and actionable. If only it were that simple. Yet, there are some important questions consumers should ask their doctor and pharmacist  whenever prescription medicines are being considered as a part of treatment regimen. Additionally, it is important for healthcare professionals to initiate a dialogue with older patients at risk for falls. The following tips and questions for older adults, caregivers and healthcare professionals can help trigger this important conversation.

Older Adults and Caregivers

When you have questions about your medications and alcohol use, consider your local pharmacist and your physician or other prescriber your “go-to” sources of information [http://bemedwise.org/medication-safety/elderly-care]. Remember these 5 tips to help your health care professional help you safely manage your prescription medications:

  1. Tell your health care professional about all the medications you take—prescription, over-the-counter, vitamins, and herbal supplements.
  2. Read and follow all instructions on your medication’s label.
  3. Follow instructions provided by your health care professional about your medication.
  4. Report any side effects from your medication to your health care professional.
  5. Don’t stop taking your medication unless your health care professional says to stop.

Pharmacists, Physicians and other Prescribers

Effective communication is a two-way dialogue. If you are a health care professional looking to help raise your patient’s awareness about the potential for harmful interactions between prescription medication and alcohol use, start with a discussion. Use these tips:

  • Review the NIAAA recommended drinking guidelines with your patients.
  • Remind your older adult patients about the potential for increased sensitivity to medication and decreased tolerance for alcohol.
  • Explain that medication can linger in the body for hours and that alcohol can still interact with prescriptions long after taking them.
  • Discuss the importance of reading and understanding medication label instructions and warnings.

 

Here are suggested questions to get a conversation started with your older patients:

 

  1. Do you know how to read the labels on your prescription medications?
  2. Do you have questions about how to take your prescription medications?
  3. Do you drink alcohol? How much? How often?
  4. Can you stop drinking alcohol when you use this prescription medication?
  5. Do you understand the potential risks of drinking alcohol when you take your prescription medication?

 

(With permission from the American Pharmacists Association, this blog was adapted from Help older adults manage their meds with these resources and tips, Pharmacy Today, October 2017, and A time to focus on falls prevention,Pharmacy Today, February 2017.)

ACA Open Enrollment

The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its sixth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. Last year there was increased confusion surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration, leading to the U.S. uninsured rate to rise for the first time since 2014 and the largest single-year increase since 2008.

Open Enrollment period ran 90 days after November 1 until the end of January during the Obama administration but was cut to 45 days in 2017 unless you qualify for the Special Enrollment Period, extending the enrollment period by an additional 60 days. Further limiting access to enrollment, the healthcare.gov website has scheduled weekly 12-hour maintenance outages. Advertising and outreach budgets for Open Enrollment are also cut even more than last year.

New rules put out by the Trump administration this year allow ACA subsidies to be used for short-term, low-benefit insurance plans that can deny coverage based on pre-existing conditions. These plans often have lower premiums than plans that offer Essential Health Benefits, but these changes along with the repeal of the individual mandate have actually made premiums across the marketplace 6-16% higher than they would be otherwise. For many this drastically changes the Affordable Care Act and potentially changes the nominal Obamacare to “Trumpcare” despite protestations that any failures of the law remain the fault of the original authors regardless of the Trump administration’s enacted changes.

openPosterThumbSince federal resources are refraining from outreach, organizations such as Get America Covered are reaching out to combat misinformation and encourage enrollment. There is no longer a penalty for not having health insurance starting in 2019, but even healthy people can be faced with extraordinary costs for unforeseen health reasons—especially those without insurance. For those who have applied through insurance exchanges in previous years, they have to update their information and compare their options for 2019. If you have questions about signing up or want to talk through your options with a trained professional, free assistance can be reached by calling 1-800-318-2596 or visiting http://localhelp.healthcare.gov.

NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of healthcare rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

Breast Cancer Awareness Month

For more than 30 years, October has been National Breast Cancer Awareness Month in the U.S. Breast cancer is the second most common cancer among women, second only to skin cancer. With more than 240,000 women diagnosed each year, awareness can save lives through early detection and lowering risk.

The main risk factors of breast cancer include being a woman and being older, which means almost any woman can be diagnosed with no family history or other known risk factors. The Centers for Disease Control and Prevention (CDC) recommends healthy living habits such as maintaining a healthy weight, regular exercise, getting plenty of regular nighttime sleep, avoiding carcinogens, and encourages women to breastfeed their children. These steps may help to reduce one’s risk to breast cancer.

NBCAMThe US Preventive Service Task Force recommends that women between the ages of 50 to 74 should have a breast cancer screening called a mammogram every two years. Women in their 40s should begin consulting with a doctor about when to start and how often to get screened, often influenced by any family history of breast cancer. About 10% of breast cancer cases are found in women younger than 45 years old. Men can also get breast cancer, though it is rare; less than 1% of breast cancer diagnoses are found in men.

Breast cancer can present with a wide variety of symptoms or none at all. Symptoms can include a change in size or shape of one’s breast, pain in the area, nipple discharge other than breast milk, or a lump in the breast or underarm. These symptoms can be serious and a doctor should be consulted immediately. Mammograms cannot prevent breast cancer, but it is much easier to treat when detected early. More than 40,000 women die from breast cancer in the U.S. each year.

NeedyMeds has over 200 national, state, and local programs that help individuals diagnosed with or at risk for breast cancer.  These Diagnosis-Based Assistance programs provide financial assistance, mammogram screenings, medical equipment, prostheses, and more. We have a Diagnosis Information Page for Breast Cancer, a collaborative effort between NeedyMeds and the American Breast Cancer Foundation (ABCF). We also have records on more than 4,500 free, low-cost, or sliding scale medical clinics that offer women’s health services. Search your ZIP code and check for “Women’s Health” listed by Services to find locations near you. For assistance finding help near you, check the NeedyMeds website or call our toll-free helpline at 1-800-503-6897.

Improving Health Education & Literacy

Since 1999, October is Health Literacy Month. This week is also National Health Education Week. Health literacy is defined as the degree to which an individual has the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Being able to comprehend health information allows people to navigate the healthcare system, keep track of their medical history, competently engage in self-care, and understand probability of health risks.

Health literacy is the main form of defense against misinformation prevalent in our society. Knowledge of the facts is key to combat the influence of those who would fly in the face of medical and scientific studies on subjects such as vaccinations or family planning services.  Dangerous pseudoscience can be avoided, saving individuals money and suffering at the hands of those who either don’t know or don’t care. Despite this, only 12% of adults have “Proficient” health literacy according to the National Assessment of Adult Literacy. This means nearly nine out of ten American adults may lack the knowledge necessary to manage their health and prevent disease. Populations most likely to experience low health literacy are the elderly, racial and ethnic minorities, people with less than a high school-equivalent education, people with low-income, non-native English speakers, and individuals with compromised health status.

 

NeedyMeds’ BeMedWise Program also recognizes October as Talk About Your Medicines Month (TAYMM) as an opportunity to focus attention on the value that better medicine communication. For over 30 years, TAYMM has been a time to stimulate conversations between patients and their healthcare providers about all the types of medicines they may take, with a focus on what to know about a medication in terms of expected health outcomes, possible side effects, benefits and potential risks.

The primary responsibility of improving health literacy lies with health officials and the healthcare and public health systems. When faced with one’s own health or the health of a loved one, a person can inform themselves and hold a more active role in their health education. NeedyMeds has Diagnosis Information Pages to help individuals learn about conditions that they or a loved one have been diagnosed with. Many of our Diagnosis Information Pages are co-sponsored by partner organizations, offering their expertise to the information we offer and ensuring accurate and up-to-date resources for the diagnoses they focus on. We also list free and low-cost clinics, some of which offer health education services. Search your ZIP code for locations near you that offer Health Education under the Details column. For more information, call our toll-free helpline at 1-800-503-6897 Monday through Friday 9am to 5pm Eastern Time.

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