As 2013 nears to a close, the year's top health news story -- the fumbled debut of the Affordable Care Act, often dubbed Obamacare -- continues to grab headlines.
The Obama administration had high hopes for its health-care reform package, but technical glitches on the federal government's HealthCare.gov portal put the brakes on all that. Out of the millions of uninsured who stood to benefit from wider access to health insurance coverage, just six were able to sign up for such benefits on the day of the website's Oct. 1 launch, according to a government memo obtained by the Associated Press.
Those numbers didn't rise much higher until far into November, when technical crews went to work on the troubled site, often shutting it down for hours for repairs. Republicans opposed to the Affordable Care Act pounced on the debacle, and a month after the launch Health and Human Services secretary Kathleen Sebelius told Americans, "You deserve better, I apologize."
Also apologizing was President Barack Obama, who in November said he was "sorry" to hear that some Americans were being dropped from their health plans due to the advent of reforms -- even though he had repeatedly promised that this would not happen.
However, by year's end the situation began to look a bit rosier for backers of health-care reform. By Dec. 11, Health and Human Services announced that nearly 365,000 consumers had successfully selected a health plan through the federal- and state-run online "exchanges," although that number was still far below initial projections.
And a report issued the same day found that one new tenet of the reform package -- allowing young adults under 26 to be covered by their parents' plans -- has led to a significant jump in coverage for people in that age group.
Another story dominating health news headlines in the first half of the year was the announcement by film star Angelina Jolie in May that she carried the BRCA breast cancer gene mutation and had opted for a double mastectomy to lessen her cancer risk. In an op-ed piece in The New York Times, Jolie said her mother's early death from BRCA-linked ovarian cancer had played a big role in her decision.
The article immediately sparked discussion on the BRCA mutations, whether or not women should be tested for these anomalies, and whether preventive mastectomy was warranted if they tested positive. A Harris Interactive/HealthDay poll conducted in August found that, following Jolie's announcement, 5 percent of respondents -- equivalent to about 6 million U.S. women -- said they would now seek medical advice on the issue.
Americans also struggled with the psychological impact of two acts of horrific violence -- the December 2012 Newtown, Conn., school massacre that left 20 children and six adults dead and the bombing of the Boston Marathon in April of this year. Both tragedies left deep wounds on the hearts and minds of people at the scenes, as well as the tens of millions of Americans who watched the carnage through the media.
Indeed, a study released in December suggested that people who had spent hours each day tracking coverage of the Boston bombing had stress levels that were often higher than some people actually on the scene.
Major changes to the way doctors are advised to care for patients' hearts also spurred controversy in 2013. In November, a panel from the American Heart Association and the American College of Cardiology issued guidelines that could greatly expand the number of Americans taking cholesterol-lowering statin drugs.
One month later, an independent panel of experts issued its own recommendations on the control of high blood pressure -- guidelines that might shrink the number of people who take blood pressure drugs. Both recommendations ignited controversy as to their validity, and debate on these issues is likely to continue, experts say.
Contraception is another medical issue that's no stranger to controversy. In June, the U.S. Food and Drug Administration sparked both applause and outrage when it moved the Plan B "morning after" pill to over-the-counter status, with no age restrictions in place. The move came after protracted legal battles, led by the Obama administration, to prevent such access.
Other stories making headlines in 2013 included:
- Higher numbers of children diagnosed and treated for ADHD. One in every 10 U.S. children is now diagnosed with attention-deficit/hyperactivity disorder, the U.S. Centers for Disease Control and Prevention announced in November, although the agency also said the years-long rise in cases has begun to slow. And while some experts say better diagnosis of ADHD is long overdue, many Americans worry that children are being "overmedicated" for psychological issues.
- The ongoing epidemic of prescription painkiller abuse. Early in 2013, a federal government report found that abuse of prescription painkillers such as OxyContin and Vicodin now trails only marijuana use as a form of drug abuse, and 22 million Americans have abused a prescription painkiller since 2002. Reacting to the crisis, the FDA in October announced tighter restrictions on Vicodin and painkillers like it.
- Pro football and head injuries. The 2012 suicide of retired National Football League star linebacker Junior Seau, followed by the 2013 death of former Michigan college quarterback Cullen Finnerty -- both of whom had suffered concussion-linked brain damage -- helped spark a national debate on the dangers of head injury in amateur and professional sports. By year's end, the NFL announced that it was partnering with the U.S. National Institutes of Health on a major study into the long-term effects of repeat head injuries and better concussion diagnosis.
- CDC anti-smoking campaign beat expectations. Perhaps one of the most positive health stories of the year was the success of the CDC's hard-hitting "Tips From Former Smokers" ad campaign. The ads often focused on the difficulties in breathing or managing everyday tasks faced by people ravaged by smoking-induced disease. CDC officials said the campaign spurred a 75 percent jump in calls to a stop-smoking hotline and a 38-fold rise in visits to the campaign's website.
- A new focus on "friendly" tummy bugs. A number of high-profile studies were published in 2013 highlighting the role of "helpful" microbes living in the trillions in the human digestive tract. New research is suggesting that the human-microbe relationship may have a big impact on conditions ranging from infant colic to obesity. Successful "fecal transplants" were also described, which allow patients sickened by dangerous gut bugs to import disease-fighting microbial communities from healthy donors.