Military Health System Highlights Research Submissions and Disease Prevention Advances for Week of March 23-27

• A new study from Project Viva shows that replacing 30 minutes of daily sitting time with exercise significantly lowers type 2 diabetes risk in teens aged around 13. • Researchers analyzed data from over 800 adolescents in Eastern Massachusetts who wore movement trackers and kept sleep logs for up to 10 days. • Results exceeded expectations, highlighting small lifestyle changes' strong protective effects against future diabetes in youth.

• International medical graduates play a vital role in addressing the U.S. physician shortage projected at 86,000 by 2036, particularly for Medicare patients and underserved communities. • The American Medical Association's March 27, 2026 National Advocacy Update calls on representatives to co-sponsor H.R. legislation to support these essential workers. • This effort aims to ensure adequate healthcare workforce amid growing demands from aging populations and expanded coverage.

• Health plans' reliance on downcoding programs to cut physician reimbursements prompts state-level reforms highlighted in AMA's March 27, 2026 State Advocacy Update. • These practices harm doctors' earnings and patient care quality, leading policymakers to intervene for fairer payment systems. • The update covers top advocacy stories from March 2026, emphasizing protections for physicians amid ongoing reimbursement battles.

• New York City logged 743 tuberculosis cases in 2025, down 11% from 2024, though numbers stay high compared to prior years, per Health Department data released March 24, 2026. • The department offers a new 1-month short-course regimen for latent TB, reducing visits from 3-9 months; 337 patients started it in 2025, with 75% completing by mid-February 2026. • On World TB Day March 27, NYC co-hosts a conference with updates; Commissioner Dr. Alister Martin notes TB killed more globally last year than COVID-19 or HIV.

• U.S. hospitals face escalating financial pressures as expenses rise over twice as fast as prices, with specialty margins varying widely amid ongoing challenges. • Ophthalmology leads with 17.5% margins, followed by genetics at 12.8%, hematology at 12.2%, cancer at 10.6%, and pulmonology at 2.4%. • Dipping overall margins signal need for cost controls as systems grapple with climbing operational expenses.

• The Trump administration is pressuring hospitals nationwide to shut down gender-affirming care programs for minors by threatening to withhold federal funding, described as 'unprecedented' by GLAD Law's Jennifer Levi. • Providers like Boston Medical Center, Boston Children's Hospital, and Mass General Brigham face a stark choice: discontinue medications for transgender youth or risk losing critical federal support that could shut them down. • In Massachusetts, state health leaders and smaller providers like Transhealth, serving 600-700 patients under 18, vow to continue care despite risks, with CEO Jo Erwin hiring more staff in anticipation of increased demand.

• A measles outbreak in Washtenaw County, southeast Michigan, now includes 7 cases under investigation involving unvaccinated children and adults, with potential exposure at Trinity Health Ann Arbor Hospital's ER on March 21. • The latest case concerns a young child treated in Ypsilanti, raising concerns that ER visitors may have been exposed to the highly contagious virus. • All confirmed and suspected cases are among unvaccinated individuals, highlighting ongoing vaccination gaps amid the outbreak's growth reported on March 25.

• Patients and providers in Colorado reported rising health care costs due to Trump administration policies including H.R.1 Medicaid requirements and ended ACA tax credits, discussed at a March 25 virtual roundtable with Sen. John Hickenlooper. • Nearly 250,000 Coloradans risk losing Medicaid coverage, exacerbating rural health care deserts where 82% of hospitals operate on unsustainable margins, per Craig Memorial Regional Health CEO Jennifer Riley. • Uninsured patients will seek emergency care at the highest cost level, straining providers and worsening access, especially for women's health services.

• HHS through the National Cancer Institute announced a $200 million public-private partnership to fund clinical trials for cancer vaccines targeting high-risk recurrence patients. • The initiative supports mRNA and other vaccine types, aiming to accelerate development with private sector involvement including venture capital. • 'Nothing of this scale has been attempted in cancer vaccines before,' said Stacey Adam, VP of science partnerships for the Foundation for the National Institutes of Health.

• Thousands of CDC employees have been laid off over the past year, leaving the agency in chaos amid funding cuts and the aftermath of a deadly shooting at its Atlanta headquarters last summer. • Insiders express concerns that the incoming Trump-nominated director will further erode trust in the agency as measles outbreaks escalate and vaccine policies face resistance. • The nominee is expected to be announced on Truth Social by Wednesday, inheriting a hollowed-out leadership structure marked by yearlong turmoil.

• Dr. Casey Means' nomination for U.S. surgeon general is stalled after senators from both parties questioned her vaccine views and limited medical experience during a confirmation hearing last month. • The 38-year-old Stanford-educated physician, who left her surgical residency, faces scrutiny for her alignment with Health Secretary Robert F. Kennedy Jr.'s vaccine rollback efforts. • Despite White House and activist support, Means needs full Republican backing on the Senate HELP Committee, but two GOP senators remain opposed amid legal setbacks for Kennedy's agenda.