{"id":13526,"date":"2026-05-27T09:00:00","date_gmt":"2026-05-27T09:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=13526"},"modified":"2026-05-27T09:00:00","modified_gmt":"2026-05-27T09:00:00","slug":"readers-address-drugged-driving-suicide-prevention-worker-shortages","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=13526","title":{"rendered":"Readers Address Drugged Driving, Suicide Prevention, Worker Shortages"},"content":{"rendered":"

Letters to the Editor<\/a>\u00a0is a periodic feature. We\u00a0welcome all comments<\/a>\u00a0and will publish a selection. We edit for length and clarity and require full names.<\/em><\/p>\n

On the Road To Find Out<\/strong><\/p>\n

Your article \u201cEfforts To Understand the Nation\u2019s Drugged Driving Problem Stall Under Trump<\/a>\u201d (May 19) missed the mark.<\/p>\n

There is a real lack of data on drug-impaired driving across the country, but it\u2019s not due to federal policy. The fact is, science has not yet found a simple, accurate way to measure if someone is too high to drive. And many local police departments just lack the resources to test drivers for drugs.<\/p>\n

The National Highway Traffic Safety Administration under the Trump administration has prioritized countering drug-impaired driving. The agency continues to be a leading funder of drug-impairment research. To address state and local enforcement shortfalls, NHTSA provides ongoing funding, training, and resources. Unlike the previous administration, we\u2019ve vigorously engaged with law enforcement to encourage road stops to combat drug-impaired driving. And, while some employees voluntarily left the agency last year, NHTSA has ensured that staff resources remain focused on this priority.<\/p>\n

\u2014 Jonathan Morrison, administrator of the National Highway Traffic Safety Administration; Washington, D.C.<\/em><\/p>\n

Shining Light on Suicide Rates and Poverty<\/strong><\/p>\n

I am a professor of risk and policy analysis at Indiana University who recently read Aneri Pattani\u2019s piece entitled \u201cLow Wages, Empty Plates, Heavy Toll: Rethinking Suicide Prevention<\/a>\u201d (May 12). I found it gracefully written and emotionally moving in its use of real-world stories. But I think the scientific foundations of your piece are, at best, murky. Please let me explain why.<\/p>\n

There is no question that when we compare households of different income levels, the suicide rate is much higher in low-income households than in higher-income households. It is tempting to conclude that people living in a low-income household may be inclined to die by suicide because they lack sufficient resources to access life\u2019s necessities. This is what I take to be the premise of your piece, linking suicide prevention to the minimum wage law and policy around the Supplemental Nutrition Assistance Program.<\/p>\n

Scientifically, the cross-sectional household comparison does not establish a causal relationship between poverty and risk of suicide. The obvious reason is that there are many other possible explanations for the association: higher rates of mental illness in low-income households, higher rates of substance misuse in low-income households, lower levels of educational attainment in low-income households, and so forth. Poverty itself may be a causal factor, but these other variables matter and may be much more important than poverty per se.<\/p>\n

If poverty is a powerful cause of suicide, we should be able to discern changes in the rate of suicide during periods when the rate of poverty changes substantially. Take the period 2010 to 2019, when the U.S. poverty rate declined steadily and substantially (the period of recovery from the financial crisis and the Great Recession of 2007-09). In 2019 (the last year before the covid-19 pandemic), the overall poverty rate, 10.5% \u2014 and the elevated rates among Blacks and Hispanics \u2014 were the lowest recorded since federal poverty statistics began in 1960 (when it was about 22%). Yet the decade from 2010 to 2019 saw a surge in the nation\u2019s suicide rate. In fact, if you take the longer period of 2000 to 2022, you find steadily rising rates of suicide in the United States, yet virtually no change in overall poverty rates.<\/p>\n

Such temporal comparisons do not prove that poverty does not cause suicide. What they show is that poverty is not a highly potent cause of suicide. My guess is that poverty per se is a relatively minor cause of suicide, but even a minor causal role does not suggest that an increase in SNAP or Temporary Assistance for Needy Families benefits would reduce suicide.<\/p>\n

One final point is about the large means-tested safety net in the United States. You are on firm ground in raising questions about what the Trump administration is doing to the safety net. But your readers need to appreciate that U.S. taxpayers are supporting a $1 trillion-a-year suite of anti-poverty programs, excluding Social Security and Medicare. The largest of those programs are Medicaid, coupled with the Children\u2019s Health Insurance Program, and SNAP. But there are also the Affordable Care Act premium subsidies, the state block grants for TANF, childcare, job training, the Department of Housing and Urban Development\u2019s rental vouchers, Pell Grants, federal student loans, and more. The means-tested safety net is much larger than the defense spending and growing rapidly as a share of the federal budget.<\/p>\n

My view is that these programs are largely worthwhile, but not because they have played a powerful role in preventing suicide. A few budget numbers on the size of the safety net would have strengthened your piece and signaled to readers that you appreciate our country\u2019s major investment in safety net programs.<\/p>\n

Obviously, your piece stimulated me, which is a good thing.<\/p>\n

\u2014 John D. Graham; Bloomington, Indiana<\/em><\/p>\n

Single-Payer vs. All-Payer<\/strong><\/p>\n

I\u2019m curious why Xavier Becerra \u2014 or any of the other California gubernatorial candidates, for that matter \u2014 aren\u2019t talking about an \u201call-payer\u201d model, similar to what was in place in Maryland (\u201cIn California Governor Race, Single-Payer Is a Litmus Test. There\u2019s Still No Way To Pay for It<\/a>,\u201d May 8). There are many reasons a single-payer model wouldn\u2019t work in one state, only one of which is the difficulties in figuring out reimbursement for people who travel out of state and receive healthcare while traveling. The all-payer model, which is being replaced by the AHEAD (Achieving Healthcare Efficiency through Accountable Design) model from the Centers for Medicare & Medicaid Services, is something worth considering in California. With the sheer size of the population, having unified billing, coding, and metrics across all payers could save millions in administrative costs.<\/p>\n

We need to start with ideas that are feasible and then work our way toward something bigger. Let\u2019s at least have a conversation about something that is possible to do.<\/p>\n

\u2014 Kathryn Peisert; San Rafael, California<\/em><\/p>\n

Bolstering the Home Care Workforce<\/strong><\/p>\n

This is another instance of money not being used wisely. In the article \u201cKids Keep Getting Stuck in Hospitals, Even After Being Cleared for Discharge<\/a>\u201d (May 18), pediatrician Elaine Lin noted a shortage of home care aides. In some states, private businesses provide home care services. Due to a profit incentive, these businesses often pay home care aides low wages.<\/p>\n

This is one of the factors driving worker shortages. Why not try transferring a portion of the money now spent on high-cost hospital stays to better-trained and better-paid home care aides? Of course, each state has its own laws, regulations, and funding sources to navigate. However, it seems the willpower to collaborate is a necessary piece to solve this problem.<\/p>\n

Some children could benefit from receiving care in a group home setting or at home with family members. If money can be better spent, let\u2019s start with creating a system to increase the pay of better-trained and better-paid home care aides \u2014 a system that should increase the quality of services at reduced costs.<\/p>\n

\u2014 Russell Anthony; Nashville, Tennessee<\/em><\/p>\n

Essential Help While We Age<\/strong><\/p>\n

Your recent article \u201cThe Help That Many Older Americans Need Most<\/a>\u201d (April 27) captures something the healthcare system has been slow to accept: What happens to older Americans\u2019 health is determined less by what happens in the clinic than by what happens at home, in the neighborhood, and at the kitchen table.<\/p>\n

The evidence is stark. Nearly 1 in 10<\/a> older adults live in poverty, and many face<\/a> persistent food insecurity. These challenges reinforce one another in a devastating cycle: Loneliness worsens food insecurity, food insecurity accelerates functional decline, and functional decline deepens isolation.<\/p>\n

Community health workers are doing essential work to interrupt these cycles. But too much of that work remains invisible. Providers refer patients to community resources with no way of knowing whether anyone followed up. Community organizations serve people without a consistent way to report back. The result is a system that means well but cannot learn from itself, and older adults, especially those in rural areas, are left to navigate the challenges alone.<\/p>\n

Technology can change that. Leaders nationwide are turning to closed-loop referral networks that enable community health workers and clinical providers to connect individuals with food assistance, transportation, housing support, behavioral health services, and other essential resources. Importantly, technology helps them track whether those services are actually received.<\/p>\n

Beyond the initial referral, these networks monitor improvements in specific health metrics, like A1c levels and hospital readmissions. By identifying unmet needs early and coordinating timely support, they help prevent health crises and alleviate burdens on caregivers.<\/a><\/p>\n

Both Oregon and Missouri offer strong examples of what this looks like at scale. In Oregon, statewide closed-loop referral technology, available across all 36 counties, served more than 80,000 clients<\/a>. It also delivered $29 million in health-related social needs (HRSN) benefits to 15,000 Medicaid clients under Medicaid\u2019s 1115 waiver last year alone.<\/p>\n

In Missouri, the ToRCH program<\/a> has seen its participating hospitals and clinics achieve a 19.6% increase in individuals with controlled blood pressure and an 18% increase in behavioral health follow-up after visits to the emergency department.<\/p>\n

The Rural Health Transformation Program offers a concrete opportunity to build on this model. Policymakers should seize the opportunity to invest in infrastructure that makes social care coordination real: not just referrals sent, but services confirmed, outcomes tracked, and communities strengthened.<\/p>\n

For an older adult in rural America, the difference between knowing where to turn and not knowing can be the difference between staying home and ending up in the emergency room. That\u2019s the gap these systems can close.<\/p>\n

\u2014 Halima Ahmadi-Montecalvo, vice president of research and evaluation for Unite Us; Washington, D.C.<\/em><\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n

This <a target=”_blank” href=”https:\/\/kffhealthnews.org\/letter-to-the-editor\/readers-drugged-driving-suicide-prevention-worker-shortages-single-payer-may-2026\/”>article<\/a&gt<\/a>; first appeared on <a target=”_blank” href=”https:\/\/kffhealthnews.org”>KFF<\/a> Health News<\/a> and is republished here under a <a target=”_blank” href=”https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/”>Creative<\/a> Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<img src=”https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/8\/2023\/04\/kffhealthnews-icon.png?w=150&quot<\/a>; style=”width:1em;height:1em;margin-left:10px;”><\/p>\n

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Letters to the Editor\u00a0is a periodic feature. We\u00a0welcome all comments\u00a0and will publish a selection. We edit for length and clarity and require full names. On the Road To Find Out Your article \u201cEfforts To Understand the Nation\u2019s Drugged Driving Problem Stall Under Trump\u201d (May 19) missed the mark. There is a real lack of data…<\/p>\n","protected":false},"author":0,"featured_media":13527,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-13526","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/13526"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=13526"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/13526\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/13527"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=13526"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=13526"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=13526"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}