Tomorrow, Americans will gather with family and friends to celebrate Thanksgiving. In 1863, during the Civil War, President Lincoln declared Thanksgiving an official holiday—a uniquely American day set aside to thank God for His gracious gifts and the blessings we receive. Gratitude is a central tenet of most major religions.
We live in a time of amazing prosperity and one of the great gifts surrounds vocation. One of my new favorite country artists is Jordan Davis, and he has a line in his song “Buy Dirt” that resonates with me: “Do what you love but call it work.” Reflecting on that, I realized the amazing good fortune I have had to lead Paragon and the work of such a talented team committed to improving public policy and Americans’ lives.
As much as I love my job, the real meaning in life comes from relationships. Thanksgiving offers the opportunity to mend fences, share experiences, and grow in relationships with our families, friends, and communities. To bring it back to health policy, there are profound positive health benefits from positive social connection and friendship. As we highlight below, there are also positive health effects from having a spirit of gratitude.
I have two items for the newsletter this morning prepared by Paragon’s research assistants: Rushil Knagaram with a note on how gratitude is good for our health and Emma Brookshire Gallutia with a summary of Dr. Joel Zinberg’s new piece on telehealth.
Power of Gratitude
Practicing gratitude can significantly improve both mental and physical well-being. Research shows that practicing gratitude for just 15 minutes a day, five days a week, for at least six weeks can lead to meaningful improvements in mental health. Notably, gratitude benefits not only individuals with strong mental health but also those facing challenges.
For example, a study involving college students seeking mental health counseling found that participants who wrote gratitude letters experienced significantly better mental health 4 and 12 weeks after their writing exercises ended, compared to those who wrote about negative experiences or only received counseling. Gratitude also serves as an effective tool for managing anxiety by redirecting focus from negative thought patterns to the present moment, fostering a calmer and more centered mindset.
The advantages of gratitude extend beyond mental health. A review revealed that keeping a gratitude journal can significantly lower diastolic blood pressure, demonstrating its potential to support heart health. This finding underscores how a grateful mindset not only reduces symptoms of depression and anxiety but also contributes to better overall physical health.
Telehealth’s Uncertain Effect on Health
Dr. Joel Zinberg authored an article in National Review that highlights his recent study of telehealth expansion during the COVID-19 pandemic and recommends Congress proceed with caution when considering an extension of soon-to-expire regulatory flexibilities within Medicare for telehealth services. While telehealth is promoted as an effort to increase access to care for patients in rural and underserved areas, improve quality of care, and decrease costs of care compared to in-person care, Joel’s study found little evidence to support these claims.
Joel found that telehealth’s initial rapid rise in utilization at the start of the pandemic dropped across most fields of medicine, except for mental and behavioral health including substance abuse services. In-person visits quickly returned to near pre-COVID levels, suggesting that most patients and providers do not find telehealth as attractive as in-person care – except for mental and behavioral health. A sustained increase in mental and behavioral telehealth usage, including substance abuse care, resulted in total telehealth utilization remaining above pre-pandemic levels.
Contrary to expectation, telehealth was used more in urban areas than rural areas and there is limited evidence that the service delivers the same quality of care as in-person visits. Joel discusses potential antibiotic overprescription and limitations with virtual physical exams. Joel also suggests that the overall increased utilization of telehealth services increases health care spending, as telehealth supplements in-person care rather than fully replacing it.
Since much is still unknown about telehealth’s cost-effectiveness and care quality, Joel suggests that, rather than authorize a permanent expansion of telehealth, Congress should consider temporary extensions of flexibilities in fee-for-service Medicare paired with requirements to conduct much-needed research on telehealth’s long-term impacts.
All the best,
Brian Blase
President
Paragon Health Institute
