This week, we spotlight state-level action to better measure the impact of equity programs, other health equity initiatives across the nation, and new global and national research that underscores the urgency of these issues. Protect Our Care is committed to making health care a right for every American.
Addressing systemic racial, ethnic, and other inequities in health care is among the most pressing issues in America. The causes of these inequities, and the corresponding actions needed to tackle them head on, are multi-faceted. As it stands, marginalized communities, including people of color, rural Americans, LGBTQ+ people, and people with disabilities, face worse access to quality, affordable health coverage, which contributes to dangerous health outcomes.
INITIATIVES
Bloomberg: New York to Require Data on Health Equity From Insurers. “Adrienne A. Harris, superintendent of the Department of Financial Services, has issued a mandatory request for information to health insurers to gauge the impact of programs aimed at reducing health disparities, according to New York State DFS Wednesday. Information on race/ethnicity and language data collection efforts, health equity programs, and workforce initiative has been requested, said the department. This RFI plans to identify programs and best practices to address the industry-wide issue, DFS said.” [Bloomberg, 11/30/22]
Delaware Business Times: With NIH Grant, DSU to Open Up New Health Equity Research Center. “The National Institutes of Health (NIH) has awarded DSU with a $18.36 million research grant over the course of five years, which will aid in bringing researchers to the HBCU to study health disparities in the state, particularly on underserved populations. Identified research projects include: how social determinants impact sleep health; integrating low-cost immunotherapeutics to treat triple negative Breast Cancer; and machine learning-based imaging biomarkers for metabolic and age-related diseases.” [Delaware Business Times, 12/1/22]
Pittsburgh Business Times: UPMC Hillman Cancer Center Increases Focus on Addressing Health Equity. “Researchers continue to make significant advancements in the arenas of cancer prevention, early detection and treatment. Unfortunately, social and economic factors still play a big role in determining the access patients have to such innovations. UPMC Hillman Cancer Center is expanding its focus on health equity. The organization recently hired a leading researcher in the field, Monica Baskin, Ph.D., to serve as associate director of community outreach and engagement and associate director for health equity. She spent two decades leading a nationally recognized research program at the University of Alabama at Birmingham that developed programs to reduce racial and geographic disparities associated with cancer.” [Pittsburgh Business Times, 11/28/22]
WBOC: Worcester County Health Department Awarded Grant from Maryland to Address COVID-Related Health Disparities. “The health department said that during the pandemic, routine preventive health screenings and care were often delayed. The goal of this new project is to increase access to and participation in health screenings, education programs, and the adoption of healthy lifestyles. The project will address social determinants of health which are the environmental conditions where people are born, live, learn, work, play, worship that affect health outcomes. This includes factors like socioeconomic status, education, physical environment, employment, social support networks, and access to care.” [WBOC, 11/30/22]
Akron Beacon Journal: Local Clinic Helping to Significantly Reduce Racial Health Disparities. “The ICARE program, which stands for Integrating Clinical and Resource Evaluations, is funded through donations at Akron General. It is part of a larger campaign called Neighbor to Neighbor, which was launched in 2020 by Akron General President Brian Harte to specifically address health disparities in Summit County. So far, more than $2 million has been raised for the program, which includes efforts to address infant mortality and the Center for Family Medicine, which addresses health disparities and chronic diseases at its clinic. The goal of Akron General’s new program is to have someone, and hopefully eventually a larger team, helping patients through the “complex fragmented health care ecosystem,” which often has gaps that people fall through and to close those gaps, Harte said. Harte hopes Neighbor to Neighbor and programs such as ICARE can be a model for similar program at other Cleveland Clinic locations as well as other area health systems.” [Akron Beacon Journal, 12/2/22]
CHALLENGES
World Health Organization: Release of the Global report on Health Equity for Persons with Disabilities. “An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. [T]he WHO Global report on health equity for persons with disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself.” [WHO, 12/2/22]
Montgomery Advertiser: 50 Years on, Racial Health Disparities Still Remain Due to the Unethical “Tuskegee Syphilis Study.” “Fifty years after officials halted one of the most unethical public health studies in United States history, the societal effects of the Tuskegee Syphilis Study and the health injustices it represents remain prevalent in the area, according to new research from Tulane University and Auburn University. From 1932 until 1972, doctors from the U.S. Public Health Service ran a study in Macon County that included 600 Black men, many of whom were sharecroppers and had never been to a doctor’s office. Of that number, 399 of the men had the bacterial infection syphilis, and the remaining 201 men did not. Doctors told all of them that they were being treated for “bad blood.” About 11 years into the study, penicillin became the widely available treatment for syphilis. However, the doctors in Tuskegee opted not to provide effective care to the participants, instead watching them suffer from severe side effects from their untreated infection with the goal of tracking syphilis’ progression to death. In a summary of his work, Chae states that almost half of the Black population living in rural areas across the country resides in high-poverty counties, whereas about 10% of the rural white population lives in high-poverty counties. This proves true when comparing Macon County to surrounding counties. In the summary of the study’s findings, Chae states that some residents were “understandably skeptical of participating in this work.” He attributes the skepticism in part to the lingering impact of the Tuskegee Syphilis Study. Its effects have played out in more ways than one, including contributing to the mistrust of the COVID vaccine among Black Americans. Still, Chae said residents were committed to making their communities healthier.” [Montgomery Advertiser, 11/27/22]
Stanford Institute for Economic Policy Research: Inequalities in U.S. Infant and Maternal Mortality Rates Point to Access Issues Due to Structural Racism. “Newly released research from Stanford’s Petra Persson and Maya Rossin-Slater finds that… Black mothers and their newborns of all income levels do significantly worse, health-wise, than their white counterparts. The disparities identified in the study of California births are so large, in fact, that Black women and their infants of the highest-income households fare worse on average than the lowest-income white mothers and their infants.That Black mothers and their newborns at all income levels are worse off than whites is one of several remarkable insights from the study about inequality in infant and maternal health. The study, released this week by the National Bureau of Economic Research, also compares the patterns in California to those found in Sweden, a country known for its universal health care system and high performance on international health rankings. The researchers find that even the richest mothers and newborns in California fare worse along multiple measures of health than the poorest mothers and newborns in Sweden.” [SIEPR, 11/28/22]
USA Today: Children of Color Less Likely to Receive Elective Pediatric Surgery. “Latino, Black and Asian children are less likely to undergo elective surgeries compared with white children, according to a recent study. The study, published in the Journal of Pediatric Surgery, analyzed data on more than 200,000 children from a national health survey of parents. Roughly 10,000 of those children reportedly had surgery. Between 40% and 60% fewer surgeries were reported by parents of Black, Asian and Latino children, and Latino children were more likely to have emergency surgery. The research shows children of color could be suffering amid delays in important surgical interventions, experts say.” [USA Today, 12/2/22]
Forbes: AI Used in Health Care Often Leave Minority Patients Behind. “[T]he desire to see data and AI used to transform the way we receive healthcare remains high [but] research from the University of Michigan reminds us that such an approach is only as strong as the data behind it, and that this could freeze out minority patients and lead to growing health inequalities. This is because the data that is used to train AI systems is either not representative of the diverse population or reflects what is already unequal care.” [Forbes, 12/2/22]
Fierce BioTech: Lung Cancer Racial Disparities Start at the Research Level. “Although it is well documented that Black smokers develop lung cancer at younger ages than white smokers even when they smoke fewer cigarettes, the guidelines that doctors use to recommend patients for screening have been slow to reflect the disparity. But screening is only part of the issue, said experts who evaluate what happens both before and after a person is checked for signs of cancer. Researchers are concerned about the lack of diverse representation in the clinical studies on which the screening recommendations are based. For example, about 13% of the U.S population is Black but Black people made up just 4.4% of participants in the National Lung Screening Trial, a large, multiyear study in the early 2000s that looked at whether screening with low-dose CT scans could reduce mortality from lung cancer. But a 2019 study published in JAMA Oncology found that under those parameters, 68% of Black smokers would have been ineligible for screening at the time of their lung cancer diagnosis, compared with 44 percent of white smokers. In 2021, the U.S. Preventive Services Task Force lowered the recommended screening age for lung cancer to 50 and reduced the number of pack years to 20.” [Fierce BioTech, 12/1/22]