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IntroductionThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic. As of July 31, 2020 when our team completed the state case reports for this project, COVID-19 had caused 154,093 deaths in the United States (U.S.), ('JHU COVID-19 Tracking Map,' 2020) and that number exceeded 400,000 by January 30, 2021, when this article was completed ('JHU COVID-19 Tracking Map,' 2020; The New York Times, 2020). A disproportionate number of cases, hospitalizations, and deaths in the United States occurred among Black, Latinx, and American Indian or Alaskan Native popu-

Objectives: The palliative and hospice care movement has expanded significantly in the United States since the 1960s. Neonatal end of life care, in particular, is a developing area of practice requiring healthcare providers to support terminally ill newborns and their families, to minimize suffering at the end of the neonate’s life. This paper seeks to systematically summarize healthcare providers’ perspectives related to end of life, in order to identify needs and inform future directions. Methods: Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically reviewed the literature discussing healthcare provider perspectives of neonatal end of life care ranging from year 2009 to 2020. To be included in the review, articles had to explicitly focus on perspectives of healthcare providers toward neonatal end of life care, be published in academic peer-reviewed sources, and focus on care in the United States. Results: Thirty-three articles were identified meeting all inclusion criteria. The literature covers, broadly, provider personal attitudes, experiences delivering care, practice approaches and barriers, and education and training needs. The experiences of physicians, physician assistants, nurse practitioners, and nurses are highlighted, while less is discussed of other providers involved with this work (e.g., social work, physical therapy). Conclusion: Future research should focus on developing and testing interventions aimed at training and supporting healthcare providers working with neonates at end of life, as well as addressing barriers to the development and implementation of neonatal palliative teams and guidelines across institutions.

AimsTo determine whether, in the United States, higher opioid overdose‐related mortality rates (OOMR) in Affordable Care Act (ACA) Medicaid expansion states relative to mortality rates in non‐expansion states have been mediated by increased prescription opioid availability.DesignSeparate mixed‐effect regression models examined difference‐in‐difference effects of time and expansion status on Medicaid‐reimbursed opioids measured in morphine milligram (mg) equivalents on all OOMR and on prescription OOMR. We used generalized structural equation models to test whether increases in Medicaid‐reimbursed prescription opioid availability mediated OOMR post‐Medicaid expansion.Setting and participantsThis study used national, serial, cross‐sectional data for Medicaid‐reimbursed prescription opioids, Medicaid enrollment information and annual OOMR for any opioids and for prescription opioids from 49 states and the DC pre‐ (2008–13) and post‐ACA Medicaid expansion (2014–16).MeasurementsThe outcome measures were OOOMR and Medicaid‐reimbursed prescription opioid availability. The main input variables were time and ACA Medicaid expansion status.FindingsMedicaid expansion states had larger increases in prescription opioid availability (b = 480, 357.8, P = 0.001) compared with non‐expansion states. However, the largest increases in prescription opioid availability in expansion states were between 2009 and 2011, well before the ACA Medicaid expansion. Whereas expansion states also had higher any OOMR compared with non‐expansion states (b = 3.6, P = 0.011), significant differences in prescription OOMR between expansion and non‐expansion states did not emerge until 2015 (b = 1.4, P = 0.014) and 2016 (b = 4.0, P = 0.004), and Medicaid‐reimbursed prescription opioid availability was not a significant mediator.ConclusionsIncreases in Medicaid‐reimbursed prescription opioid availability in Affordable Care Act Medicaid expansion states in the United States do not appear to have mediated post‐Affordable Care Act Medicaid expansion mortality rate differences, but there is still a possibility of lagged effects.