Disempowering the People, the Pharmacist Will See You Now, Vote by Maelstrom

Safe. More affordable. Easier to access. A new study in JAMA Network Open finds major benefits for women when pharmacists are allowed to prescribe contraception. Lead study author Dr. Maria Rodriguez of Oregon Health & Science University found that pharmacists can reach younger patients, those without a degree, and uninsured patients and provide women with longer prescriptions for hormonal birth control — just as safely as traditional doctor prescriptions. 

Why it matters: More than 19 million women of reproductive age in the U.S. live in contraceptive deserts, says Power to Decide, and that lack of options can lead to a cycle of disadvantage. Katy Bacon, our Director of Contraceptive Choice and Access, explains: “If someone is uninsured and living in a contraceptive desert, they might be more likely to have a pharmacy nearby than a doctor.” Pharmacies also have longer hours and don’t require appointments. As one woman in the study reported: “I don’t have health insurance, and this is a lot cheaper than going to a clinic. Doctor’s visit is $300 out of pocket, pharmacist filling prescriptions is $35.”

The U.S. has the highest child incarceration rate in the world: More than 800,000 are arrested each year and more than 40,000 are removed from their homes. This over-reliance on incarcerating youth is harmful, especially during a pandemic. It severs them from positive community supports and impedes their development.  

We spoke with National Juvenile Defender Center Executive Director Mary Ann Scali and Staff Attorney Sherika Shnider about the challenges children face in America's court system and what needs to be done to make the system more fair and communities safer. “Courts are seeing that young people don’t need to be held in cages, and that they thrive when they’re allowed to stay in their own communities. That gives all of us hope for what could come out of this crisis,” says Scali.

Related: More than 9,000 families in San Diego will have more than $40 million in old juvenile fees discharged, after a unanimous vote by the County Board of Supervisors, following the footsteps of neighboring Riverside County ($4.1 million) and Stanislaus County ($6.9 million).

This week Michigan voters learned they will get absentee ballot applications sent to their homes. “By mailing applications we have ensured that no Michigander has to choose between their health and their right to vote,” says Michigan Secretary of State Jocelyn Benson. While the news was not welcome by all, voting by mail has been shown to lift voter turnout and have little effect on partisan advantage. And Michigan would join five other states that mail ballots to registered voters. Colorado’s transition to voting by mail increased participation and included measures to protect the integrity of the system. And Republicans and Democrats alike have come out in support of voting by mail — it’s an option voters want, especially in the face of a pandemic, says our Executive Vice President of Advocacy Kevin Madden. 

Related: A vote-by-mail battle is currently playing out in Texas. “The Court finds the Grim Reaper's scepter of pandemic disease and death is far more serious than an unsupported fear of voter fraud in this sui generis experience. Indeed, if vote by mail fraud is real, logic dictates that all voting should be in person.”

ICYMI: Here’s more on the myths and facts surrounding voting by mail.

We continue our theme from last week of efforts to undermine the will of voters in the midst of a pandemic, this time in Maine. The Republican Party there is busy gathering signatures to kill ranked choice voting (RCV) for the presidential election. Since 2014, voters in Maine have expressed support for RCV and fought back multiple attempts to dismantle it. Sam Mar, our Vice President, breaks down the history here.

Follow him on Twitter (which is where this great timeline was conceived) for more on democracy and voting.

By Stuart Buck, Arnold Ventures Vice President of Research

“Blood thinners show promise for boosting the survival chances of the sickest covid patients,” reads a Washington Post headline from May 2020. The basis for this claim was a May 2020 article in which the researchers had analyzed data on 2,773 COVID patients at the Mount Sinai Health System in New York City. The headline claim is that among patients who were on ventilators, mortality was 62.7% for patients with no anti-coagulation drugs but a mere 29.1% for those given anti-coagulants. Sounds like a winner, right?

But there’s a hitch: The overall mortality rate for the two groups was basically equal at 22.8% and 22.5% respectively. How then was it possible to find a mortality benefit for the folks put on ventilators?

Here’s how: Patients who got anti-coagulants were far more likely to be put on a ventilator in the first place (29.8% versus 8.1%)!

Now, there is no data in the study on why doctors chose anti-coagulants for some patients but not others — we don’t know whether the anti-coagulants caused more people to be put on ventilators in the first place, or whether doctors chose to give additional medicines to the healthiest people on ventilators whereas others died too quickly. Either way, there is no basis for saying that anti-coagulants cause better survival.