More than 100 million Americans struggle with chronic pain, according to one Institute of Medicine estimate, at an annual cost of as much as $635 billion in treatment and lost productivity. Further, the misuse of potent opioid painkillers, while increasing risk of addiction and abuse, can confuse the conversation around appropriate chronic pain management. This Forum brought together a panel of experts to discuss the causes, treatment and impact of chronic pain, exploring the neuroscience...

Health care has emerged as a hotly debated issue of the 2016 presidential election, with the Republican and Democratic presidential nominees expressing starkly different views on the Affordable Care Act (ACA). While approximately 20 million people have gained healthcare coverage since the law’s passage, implementation has been marred by setbacks, including the withdrawal of some major insurers from the ACA marketplace. A new poll by POLITICO and the Harvard T.H. Chan School of Public Health...

According to the CDC, nearly 29 million U.S. women and 16 million U.S. men have experienced severe physical violence by an intimate partner at some point in their lifetime. Most of those experiences occur before the age of twenty-five. The evidence is clear that domestic violence takes a physical and emotional toll on individuals, families and communities. Those exposed both directly and indirectly are at a greater risk of mental health disorders, infectious and chronic diseases and death....

Quality child care can help children develop lasting social, emotional, and learning skills and can promote healthy eating and play. But high-quality care, whether it comes from a nanny, a sitter, a daycare, or a preschool, can be difficult to find—and to afford. Drawing on the findings of a newly released poll by NPR, the Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health, this Forum event brought together a panel of experts to discuss parents’ priorities and...

With more than 23,100 cases of Zika in the continental U.S. and U.S. territories — including four newly reported non-travel cases in Miami-Dade County, Fla — this Forum continued a conversation begun in March 2016 to discuss the risks and response to the spreading Zika virus. The focus was on the U.S. and Caribbean, as well as other regions experiencing increases in cases. Public health experts examined our deepening understanding of how the virus works and how its spread may be controlled;...

More than 30 million Americans — women and men, children and adults — grapple with eating disorders. These complex illnesses, which include anorexia, bulimia, and binge eating disorder, severely undermine health and cost lives. This event explored the many dimensions to eating disorders, including their biological bases, risk factors and treatment options. What role does body image play, and how do industries, such as fashion and advertising, often promulgate unrealistic societal standards of...

Experts take on the concerns most expressed by American employees in a poll done by NPR, the Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health. The panelists also describe lessons learned from employers that cultivate healthy environments – to see if there are feasible measures to produce a more accessible, supportive, healthier workplace. Presented July 11, 2016 in Collaboration with The Robert Wood Johnson Foundation and NPR. Watch the entire series from The...

People die each day waiting on lists for lifesaving organs, and the rise of chronic diseases such as diabetes only increases the demand. With the need for scientific innovation and donor support becoming ever more critical, this Forum explored biomedical advances that promise to address the scarcity, as well as the efforts of medical leaders, advocates and policymakers to reduce the numbers waiting for transplants. Through 3-D printing, scaffolding, chips and other innovations, scientists...

Driving while under the influence of drugs or alcohol has long been established as a public safety hazard. But what about hitting the road while fatigued? An estimated average of 83,000 accidents involving drowsy driving occurred annually between 2005 and 2009, according to the National Highway Traffic Safety Administration (NHTSA), and some estimates are even higher. These accidents cost lives, cause injuries, and damage property. This Forum event explored the risks, impacts and prevention...

A series of terrorist attacks — including recent bombings in Belgium — has shaken the public’s sense of security as they go about the most mundane tasks of daily life. Images of carnage at subway stations, restaurants, workplaces, concerts and sporting events have flashed across the world’s social media and traditional news outlets. Afterwards, questions inevitably surface about what could have been done to prevent attacks in the first place, while people are encouraged to carry on with their...

Over the last two years, we have seen major expansions in health care coverage through both federal and state insurance exchanges, as well as by expanding Medicaid coverage. This Forum examined whether these efforts to extend coverage have improved the health care experiences of low-income Americans and have narrowed the gap in access to high-quality care between themselves and other Americans. The discussion drew on the findings of a new poll by NPR, the Robert Wood Johnson Foundation, and...

This Forum explored the challenges and complexities of drug trials, and how they impact disease treatment and prevention — particularly for conditions that currently have little or no therapeutic options. As a case study, the panel discussed Alzheimer’s and several drugs in development for that disease, but also addressed broader concerns related to the pharmaceutical testing pipeline for unmet medical needs as a whole. This event was presented April 15, 2016 in partnership with HHMI Tangled...

The ongoing spread of the Zika virus — and its unconfirmed potential links to a birth defect called microcephaly — have raised worldwide alarms. This Forum examined what we know and don’t know about the virus, drawing parallels and lessons from another disease outbreak, Ebola, that we can apply to the Zika emergency. An expert panel discussed the current status of our understanding of the Zika virus and its health effects; containment strategies. Presented March 4, 2016 in Collaboration with...

The water crisis gripping Flint, Michigan has exposed thousands of children to unsafe lead levels, triggering a federal emergency declaration and national conversation about basic public health protections. Lead can be toxic to the brain, and children can be particularly vulnerable. However, the Flint example is not unique; other American cities, including the nation’s capitol, have faced lead contamination in water supplies. And research has pointed more generally to an expanding list of...

According to the U.S. Census Bureau, the country’s population aged 65 and over is projected to be more than 83 million in 2050 — almost double the estimated population of 43 million in 2012. This Forum examined how the growing, greying labor force impacts workplaces and economic and health security, including retirement savings efforts and systems such as Social Security and Medicare. The discussion also explored what it means to age productively and healthily, with a particular emphasis on...

This Forum event examined gun violence through a public health prism. Panelists talked about patterns of violence, including social forces such as the grinding violence, crime and poverty that disproportionately affect disadvantaged communities. Panelists also discussed President Obama’s recent announcements about gun violence prevention, prompted by a series of mass shootings as well as ongoing urban violence. And they explored dynamics at state and Congressional levels that are impacting...

This Forum explored what we know, and don’t know, about links between diet and cancer. Included in the discussion was the World Health Organization’s classification of processed meat as a “Group 1” carcinogen; the latest on what is known about fats and cancer; and the just-released Dietary Guidelines for Americans as they pertain to cancer and diet. Additionally, the panel discussed cancer prevention strategies. Part of The Dr. Lawrence H. and Roberta Cohn Forums, this event was presented...

The 2015 United Nations Climate Change Conference (COP21) in Paris has produced a landmark agreement to slow global warming. Among the conference’s discussions, though, the health impacts of climate change have featured less prominently on the agenda than other concerns. Yet, droughts, floods, heat waves, and air pollution related to climate change produce rippling effects that impact food production, infectious disease spread, chronic illnesses, and more. Dwindling resources force people to...

Without question, medical testing has saved lives and bettered patient care. But what happens when tests are inaccurate or unnecessary? The U.S. Food and Drug Administration (FDA) recently raised alarms about a growing class of tests designed and used in single laboratories, which are far less subject to regulatory enforcement than commercial test kits sold to multiple labs. The agency reviewed 20 case studies involving lab-developed tests (LDTs) and found evidence of patients at risk for...

A global scourge, human trafficking is a form of modern-day slavery that traps millions of people in lives of forced labor and sexual exploitation. Political instability and extremism leave people, especially women and children, vulnerable to predation. In this Forum, anti-trafficking and human rights experts convened to discuss the public health implications of the shadowy world of trafficking. What drives and sustains the industry? How are governments, NGOs, and other agencies fighting...

A full course of treatment with the blockbuster Hepatitis C drug Sovaldi costs $84,000 in the United States. A year on the new injectable cholesterol drugs Repatha and Praluent tops $14,000. The price of new cancer drugs now averages $10,000 per month, according to one estimate. Straining under the pressure, doctors, patients, and insurers are raising alarms over skyrocketing prices. Earlier this year, the American Society of Clinical Oncology released a new “value framework” for drugs that...

Staggering numbers of refugees and migrants are flooding into Europe, fleeing war and political instability and seeking safe haven and economic opportunity. They are risking their lives on perilous journeys into an uncertain future. Who are the refugees and migrants, and what forces are driving them from their homes? What will it take to meet their urgent and immediate needs for food and shelter, and what will be the long-term economic impact of the migration on the cities and countries where...

Since the death of Michael Brown in Ferguson, MO, last year, the U.S. has seen the growth of a new social movement that has focused national attention on policing tactics, criminal justice, and the continued health and social inequalities confronting black Americans today. Legislation that would require states to notify the U.S. Justice Department of all police shootings, fatal and non-fatal, has been introduced. President Obama made an historic visit to a federal prison to draw attention to...

For decades, statins have served as the “go-to” drug for patients with high cholesterol. Now, a new class of cholesterol-reducing drugs, PCSK9 inhibitors, just approved by the FDA, offers a possible alternative to statins. Adding to the changing landscape of cholesterol treatment are recommendations from the American Heart Association and American College of Cardiology, issued in 2013, that dramatically expanded the number of people who could potentially receive statins to prevent heart...

The vast majority of children in America play sports. But while about three out of four adults played sports when they were younger, only one in four still plays sports today, and men are more than twice as likely as women to play. Why do we give up sports as we grow older? A new poll conducted by NPR, Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health offers fresh insight into how and why adults and kids do — and don’t — play sports. What obstacles keep adults off...