Health care needs of aging veterans. The number of aging veterans treated in the U.S. Veterans Health Administration system increased considerably from 1996 to 2011, according to the Federal Interagency Forum on Aging-Related Statistics. But not all veterans have easy access to health care, especially as they age; as of 2011 the proportion of those enrolled in the Department of Veterans Affairs (VA) system who were older than 65 and living in rural or highly rural areas had increased to about 47%. As part of the solution to meeting the health care needs of increasing numbers of aging veterans, the VA's Office of Geriatrics and Extended Care is rolling out several pilot programs that focus on home care-based alternatives to long-term care. Other solutions include services like transportation, outreach, telehealth, and mobile health clinics staffed by NPs to provide primary care closer to home.
U.S. drug shortages. Reports of shortages of cancer agents and surgical anesthetics, among other drugs, have increased over the past three years, according to the Food and Drug Administration (http://1.usa.gov/1BNmS2). The situation spurred the agency's Center for Drug Evaluation and Research to create an action plan at the end of October. Whether the plan is effective should become clear in 2014.
Vaccine development. Although a promising HIV vaccine failed in a recent trial, research toward the development of one that's effective will continue, and advances in immunology and worldwide collective research efforts in other areas still hold promise. For example, recent results of research in cellular immune responses published in the October 2013 Nature Medicine may herald the development of a universal flu vaccine, and progress toward a malaria vaccine is also accelerating, according to the PATH Malaria Vaccine Initiative (http://bit.ly/1dUaAhD). Malaria cases reached a 40-year high in the United States last year, which may further impel development of such a vaccine.
Women's reproductive choices. Issues surrounding contraception access, choices, and availability for women were all hot issues in 2013 as the Patient Protection and Affordable Care Act went through its implementation woes. Those issues are likely to stay hot in 2014, as demonstrated by the end-of-the-year flip-flop in the legal status of abortion access in Texas, an issue that received attention when state senator Wendy Davis filibustered to prevent legislation that would restrict women's access to abortion in the state. The law was passed anyway but was overturned by a federal judge-only to be reinstated by the U.S. Court of Appeals for the Fifth District shortly afterward. The court battles will likely continue into this year and perhaps beyond.-Gail M. Pfeifer, MA, RN, news director