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What We’re Reading: Paying to Quit Substance Use; Census Undercounts; Global COVID-19 Toll


A new opinion indicates paying those with substance use disorder to stay clean could be legal; the 2020 Census undercounted some racial minorities; the true global COVID-19 death toll could be 3 times higher than the official tally.

Program Incentivizes Quitting Substance Use

A new opinion from the Biden administration looks to permit increased use of a harm reduction technique that would pay individuals addicted to drugs for staying clean, otherwise known as contingency management, The Washington Post reports. The process is supported by decades of research that shows that small payments for meeting recovery goals help people remain sober. Prior to the new opinion, the program was underused due to concern it would violate a federal law barring kickbacks to patients. An HHS assistant inspector general said in the opinion that one company already employing the technique would not face criminal or civil penalties.

Over-, Undercounts Reported in 2020 Census

According to a new report from the Census Bureau, the 2020 count undercounted Black individuals, Hispanics, and Native Americans while overcounting White and Asian people, Politico reports. Mistakes such as these can impact voting districts, congressional representation, and allocation of federal funds. Despite the quality of the most recent count being similar to those in the past, the Census Bureau director said these under- and overcounts present limitations. The 2020 Census was already carried out in tumultuous times—during an election year and the early months of the COVID-19 pandemic.

COVID-19 Death Toll May Be Much Higher Than Reported

The global death toll from COVID-19 may have been 3 times worse than previously reported, according to CNN, with researchers estimating there have been 18 million more deaths than typically expected over the past 2 years. Officially, reports show that through the end of 2021, less than 6 million people have died from COVID-19. Lack of diagnostic or reporting resources likely contributed to the undercount. Indirect costs of the pandemic including restricted access to health care, economic downturns, or behavior changes in lockdowns could have also played a role. All-cause mortality was assessed in 187 countries; India, the United States, Russia, Mexico, Brazil, Indonesia, and Pakistan accounted for more than half of all excess deaths.

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