Econometrica: Black Lives Matter

Econometrica: Black Lives Matter

"We must be the change we wish to see in the world."

— Mahatma Gandhi

The events unfolding over the last several months have been extremely difficult to watch. The killing of George Floyd in Minneapolis set off a wave of protest and introspection about race in America, much of which is long overdue. The COVID-19 pandemic continues to ravage the Nation, particularly in long-neglected Black communities.

It is clear that we are experiencing a pivotal point in our Nation’s history. Econometrica actively stands with the Black community, our colleagues, their families, and clients in the fight against racism, injustice, and inequality. We stand with our community and firmly declare Black Lives Matter, today and every day.

Econometrica will continue to strive to create and maintain a diverse and welcoming workplace, something that is pivotal to our high-quality work, mission, and success. Our colleagues deserve it, and our clients and partners expect it. We must not lose sight of these issues, today or in the future; we must instead work to make a positive impact on the world. There is still much work to be done, but we are filled with hope as the world comes together in solidarity.

We encourage everyone to support each other with kindness and patience. A few of the many ways to get involved include signing petitions that promote change, donating to causes that are important to you, and taking time to learn more about issues relating to racial discrimination.

Please stay safe and stay strong. We are with you.

I wish I could say that racism and prejudice were only distant memories. We must dissent from the indifference. We must dissent from the apathy. We must dissent from the fear, the hatred and the mistrust… We must dissent because America can do better, because America has no choice but to do better.

— Thurgood Marshall

Cyrus Baghelai
President/CEO

Request for Proposals: Econometrica Seeks Qualified Firms and Consultants for Housing Efforts

Request for Proposals: Econometrica Seeks Qualified Firms and Consultants for Housing Efforts

Physical Needs Assessment, Energy Audit & Strategic Planning Services

Econometrica, Inc., is seeking firms and consultants capable of performing public housing physical needs assessments (PNAs) and providing technical assistance to public housing agencies (PHAs) on strategic planning and repositioning of physical assets. Econometrica anticipates making multiple awards. Proposal responses are due by July 8, 2020. Please review the request for proposals for additional information about this opportunity, instructions for submitting questions, and guidance in developing and submitting your proposal.

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Econometrica: Black Lives Matter

Econometrica: Black Lives Matter

Econometrica actively stands with the Black community, our colleagues, their families, and clients in the fight against racism, injustice, and inequality.

Opioid Use Disorder and the Medicare/Medicaid Population

Opioid Use Disorder and the Medicare/Medicaid Population

The United States has long been engulfed in an opioid epidemic that stemmed from increased prescribing of opioids in the 1990s and is characterized today by use of synthetic opioids, like fentanyl, as well as illicit opioids such as heroin.[1] By 2017, there were 58 opioid prescriptions written for every 100 Americans.[2] This rise in opioid use has led to an increased prevalence of Opioid Use Disorder (OUD) in a variety of populations.

OUD—which may involve the misuse of prescribed opioid medications, diverted opioid medications, or illicitly obtained heroin—is typically a chronic, relapsing illness associated with significant rates of morbidity and mortality.[3] The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, describes OUD as a “pattern of opioid use leading to problems or distress,” with at least two of the following occurring within a 12-month period:[4]

  1. Taking larger amounts or taking drugs over a longer period than intended.
  2. Persistent desire or unsuccessful effort to cut down or control opioid use.
  3. Spending a great deal of time obtaining or using the opioid or recovering from its effects.
  4. Craving, or a strong desire or urge to use opioids.
  5. Problems fulfilling obligations at work, school, or home.
  6. Continued opioid use despite having recurring social or interpersonal problems.
  7. Giving up or reducing activities because of opioid use.
  8. Using opioids in physically hazardous situations.
  9. Continued opioid use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids.
  10. Increased tolerance (i.e., need for increased amounts, or diminished effect with continued use of the same amount).
  11. Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

Although OUD is similar to other substance use disorders, there are many unique features, including risk of physical dependence in as little as 4 to 8 weeks and severe symptoms such as chills, cramps, vomiting, and insomnia during withdrawal.[3] Despite its unique features, the factors contributing to OUD are very general and can include ease of access, environmental and genetic factors, social support system, addictivity of the drug, and early use.

Looking at the rate of opioid prescribing among Medicare and Medicaid beneficiaries can help us gain an understanding of the development of OUD in America. In 2018, the Centers for Medicare & Medicaid Services (CMS) analyzed the prevalence of OUD among beneficiaries and reported that 6 out of every 1,000 Medicare beneficiaries and 8.7 of every 1,000 Medicaid beneficiaries suffer from OUD.[5] Using data from 2006 to 2015, another CMS study found that 23.5 percent of dual-eligible beneficiaries in 2015 had a substance use disorder.[6] For the Medicaid-only population, there were 31 million opioid claims in 2017, and opioid prescriptions represented 4.57 percent of all Medicaid prescription claims.[7] One year earlier, in 2016, 14.4 million of the 43.6 million Medicare-only beneficiaries enrolled in Part D received opioids.[8]

The national data for OUD and opioid prescriptions is presented here to provide the foundation for a larger discussion around OUD in the United States. Over the course of this series of newsletters, we will dive into topics such as OUD treatment options, how COVID-19 is impacting treatment centers across the country, and much more. To read more of our OUD coverage, please click here.

 

[1] Centers for Disease Control and Prevention (CDC). (2020). Opioid overdose: Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html.

[2] CDC. (2020). Opioid overdose: Prescribing practices. Retrieved from https://www.cdc.gov/drugoverdose/data/prescribing/ prescribing-practices.html.

[3] Strain, E. (2020). Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis. UpToDate. Retrieved from https://www.uptodate.com/contents/opioid-use-disorder-epidemiology-pharmacology-clinical-manifestations-course-screening-assessment-and-diagnosis.

[4] American Psychiatric Association. (2018). Opioid use disorder. Retrieved from https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder.

[5] CMS. (2018, June 11). CMS opioids roadmap. CMS.gov Blog. Retrieved from https://www.cms.gov/blog/cms-opioids-roadmap.

[6] Anderson, K. K., Hendrick, F., & McClair, V. (2018, October). Data analysis brief: National trends in high-dose chronic opioid utilization among dually eligible and Medicare-only beneficiaries (2006-2015). Retrieved from https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/ Medicare-Medicaid-Coordination-Office/DataStatisticalResources/Downloads/OpioidsDataBrief_2006-2015_10242018.pdf.

[7] CMS. (2019). Medicaid State Opioid Prescribing Mapping Tool. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/OpioidMap_Medicaid_State.

[8] Office of Inspector General. (2017, July). Opioids in Medicare Part D: Concerns about extreme use and questionable prescribing [OEI-02-17-00250]. U.S. Department of Health & Human Services. Retrieved from https://oig.hhs.gov/oei/reports/oei-02-17-00250.pdf.

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Econometrica: Black Lives Matter

Econometrica: Black Lives Matter

Econometrica actively stands with the Black community, our colleagues, their families, and clients in the fight against racism, injustice, and inequality.

Healthy Eating and Kids: A Q&A With a Pediatrics Registered Dietitian

Healthy Eating and Kids: A Q&A With a Pediatrics Registered Dietitian

Healthy Eating and Kids: A Q&A With a Pediatrics Registered Dietitian

Bethesda, MD, April 2020

To celebrate today’s Tasty Tuesday for Every Kid Healthy Week, we interviewed a pediatric Registered Dietitian. Carol Henderson, a member of Econometrica’s Health Group, is a pediatrics Registered Dietitian who has worked with children and teens and their families for dozens of years. In particular, she worked with infants and children with feeding and growth issues and children diagnosed with chronic conditions and diseases, such as cystic fibrosis, diabetes, juvenile arthritis, gastrointestinal disorders, and severe food allergies.

Interviewer: I wonder if you could tell us a little bit about what it is like working as a pediatric dietitian and what you want to accomplish when working with children and their families?

Carol: The primary goal when working as a dietitian with pediatric patients who are sick is to ensure adequate, proportional growth throughout childhood. Some children need to grow bigger and become stronger and some need to minimize their growth over time. Pediatric dietitians also evaluate a child’s activity level, daily schedule, parent/caregiver roles, timing of meals and mealtime environment, food availability, meal preparation, and sleep patterns to gauge an individual’s nutritional needs. These actions align with each of the daily themes we are celebrating during Every Kid Healthy Week:

  • Mindfulness Monday. Preparing healthy meals for a family is an investment that not only requires time, commitment, but also a state of mindfulness—a sense of calm that is needed to prepare meals, even during chaotic family times. Taking time out once a week to inventory foods on hand and create a shopping list may make it easier to put meals on the table.
  • Tasty Tuesday. Today, which is Nutrition and Healthy Eating day, is a good time to assess the nutritional quality of the snacks your child/children are eating and how often they snack throughout the day. It is important to develop healthy feeding habits (have set times for meal and snack intervals—especially for young children) so they can achieve their nutritional intake goals every day.
  • Earth Day Wellness Wednesday. Have you every quizzed your child to see where they think different food ingredients come from? This activity can turn into a project. You can select an ingredient in a dish you are preparing and ask if it comes from an animal, plant, or is it a mineral and go from there!
  • Thoughtful Thursday. Kids react to their environment and learn from others. Therefore, creating a pleasant environment where your child can sit and eat meals at regular intervals and interact with other family members contributes to their social and physical well-being.
  • Fitness Friday. Kids wiggle, squirm, run, and love to play—all things that contribute to their development. It is your job as parents/caregivers to find outlets for children to keep them active.

Interviewer: How did you pick dietetics as a profession?

Carol: Dietetics found me! I was going to become a high school chemistry teacher. In college, I conducted my junior year teaching practicum in a local high school. A small group of students in one chemistry class thought it would be hilarious to capitalize on my untested teaching skills, so they combined all the reagents (acids and bases) that lined the lab benches and blew up the chem lab. Everyone evacuated safely and I stood in the middle of the chem lab while the sprinklers were raining down on me and said, “I don’t ever want to be a chemistry teacher!” Because chemistry is such an integral part of food science and dietetics, I found a new calling.

Interviewer: There are so many different paths you could have undertaken with a dietetics degree, why pediatrics?

Carol: My oldest sister had just completed medical school and she received her residency “match” at Cincinnati Children’s Hospital. At the same time, I completed my Dietetic Internship at the Mayo Clinic in Minnesota, so we moved in together. A dietitian position opened at Cincinnati Children’s and I became one of two dietitians for a 750-bed hospital. That would not happen today. Nowadays, a children’s hospital of the same size would have more than 35 dietetic staff members. It has been a great blessing to have worked with children, teens, and their families as a pediatric dietitian and patient advocate for many decades.

Interviewer: Carol, do you have any parting thoughts you would like to share today?

Carol: The greatest gift I have received from working as a pediatric dietitian is the importance of play. Play consumes all children. I think as adults we should consume more play in our lives!

 

Interview edited for length and clarity. Thanks to Emma Wellington for conducting this interview.

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Econometrica: Black Lives Matter

Econometrica: Black Lives Matter

Econometrica actively stands with the Black community, our colleagues, their families, and clients in the fight against racism, injustice, and inequality.

Econometrica Launches New Course

Econometrica Launches New Course

Econometrica Launches New Course

Bethesda, MD, April 2020

Econometrica launched a new course about handwashing during the COVID-19 pandemic. Washing your hands regularly and thoroughly is the best thing, aside from social distancing, that you can do to protect yourself and your community from the spread of COVID-19. Adapted from guidance from the Centers for Disease Control and Prevention, the new course will focus on when and how you should wash your hands to stay healthy – a simple task, yet often misunderstood and performed poorly.

The new course is available at https://econometricainc.com/training/.

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Econometrica: Black Lives Matter

Econometrica: Black Lives Matter

Econometrica actively stands with the Black community, our colleagues, their families, and clients in the fight against racism, injustice, and inequality.