Examining Political Determinants of Health
Social determinants of health (SDoH), characteristics like race, ethnicity, socioeconomic status, geographical location, and housing status, have been increasingly recognized as contributing to health outcomes. However, another set of factors affecting health outcomes are political determinants of health, policies that affect population health in a given community or locale.
FDA Defends Decades-Old Abortion Pill Approval Decision Against Conservative Challengers
A group of conservatives called the Alliance for Hippocratic Medicine challenging the approval of mifepristone, a pill used for safe abortions, has met resistance from the US Food and Drug Administration (FDA). The group and other far-right activists claim the agency rushed the drug’s approval and claim that the agency declared pregnancy an illness in the decision.
Increasing Access to New Medications for Patients Across Africa
Africa deals with a disproportionate disease burden but patients throughout the continent have less access to new therapeutics than their peers in wealthy western nations. In a new IQVIA article, Mridu Bhutani discusses some of the underlying causes of this health inequity and covers ways that African nations can and are addressing them.
Black and Latino Medicaid Recipients Less Likely to Receive New Epilepsy Drugs
A recently published study in Neurology Clinical Practice found that Medicaid patients were less likely to be prescribed newer third-generation antiseizure medications (ASMs) if they were Black, Latino, Pacific Islander, or Native Hawaiian. These drugs tend to perform better and have less side effects, but are underutilized in the aforementioned populations compared to white Medicaid recipients.
Improving Data Quality to Target Social Determinants of Health
Although increasing efforts have been made to address social determinants of health (SDoH) to improve health equity, poor or inconsistent data sources get in the way of progress. The American Medical Association (AMA) has put forward several initiatives to help address SDoH data standards that encourage interoperability.
Real-World Data Study Finds Black and Hispanic Patients Receive Less Opioids During End-of-Life Care
A recently published study in the Journal of Clinical Oncology found that Black and Hispanic patients with cancer were significantly less likely to receive opioids during end-of-life care. In addition, the results, which came from nearly 320,000 Medicare patients 65 and older, also showed that Black and Hispanic patients were more likely to be urine screened for drug use.
CMS Lets States Cover Nonmedical Services for Medicaid Beneficiaries
Social determinants of health (SDoH) like housing instability and food insecurity dramatically impact patient health outcomes. To address these factors, the US Centers for Medicare and Medicaid Services (CMS) has issued a new guidance that allows states to offer benefits for nonmedical services, under the classification of “in lieu of services and settings.”
Racial Medicare Access Disparities Worsen Health Outcomes for Black Enrollees
Research early last year found that Black patients are routinely offered less high-quality Medicare Advantage plans compared to their white counterparts. A new study builds on this, finding that the decreased access to 5-star plans has measure effects on outcomes for Black enrollees. The researchers looked at hospitalizations that would be avoidable with disease management and outpatient care covered by better plans.
Fluctuating Income as a Social Determinant of Health
A freshly-published study has identified fluctuating income as a social determinant of health (SDoH) that negatively impacts health outcomes. The paper, published in the Journal of Applied Psychology, surveyed gig workers, servers, delivery drivers, and other workers whose daily income is not steady. These workers faced health disparities in several key areas of health.
Improving Recruiting of Black and Rural Patients
In the US, Black and rural residents are often significantly underrepresented in clinical trials. This negatively impacts these populations and decreases the clinical potential of new therapeutics. In a recent Clinical Leader article, Chief Editor Ed Miseta discusses the underlying causes of clinical trial under-representation and insights from two studies on how to address it.
Modern Segregation in US Worsens Cancer Outcomes
In a newly published JAMA Oncology paper, researchers find that people living in US counties with higher levels of racial and socioeconomic segregation face a 20% increase in mortality rates. This effect was more pronounced in lung cancer, with mortality rates spiking by 50% in the most segregated counties.
Hitting the Books: Exploring Education Status as a Key Social Determinants of Health
Educational status is being increasingly recognized as a pivotal social determinant of health (SDoH) a social factor that affects health outcomes. In a new primer by Sara Heath, learn more about education as an SDoH and how it interacts with other key SDoH like race, ethnicity, etc.
NEJM Perspective: How Hospitals Can Act On Health Equity Data
In a recent announcement, the US Centers for Medicare and Medicaid Services (CMS) added three measures to the Hospital Inpatient Quality Reporting program that are intended to promote health equity efforts. These measures will rate hospitals on the degree to which they prioritize health equity, how they collect sociodemographic information and health-related social needs (HSRNs), the percentage of patients screened for HSRNs, and more.
GAO Report Finds Certain Demographics Underrepresented in Cancer Drug Trials
A newly released report from the US Government Accountability Office finds that, despite years of health equity efforts, several key demographics are routinely underrepresented in clinical trials for new cancer therapeutics. This includes people with lower-incomes, rural residents, teens, older adults, and women. In addition, people from certain ethnic and racial backgrounds are also underrepresented.
Unaffordable Medical Expenses Are a Key Social Determinant of Health
Race, ethnicity, socioeconomic status, and geographical location are all widely recognized as primary social determinants of health (SDoH). However, unaffordable medical bills are often overlooked as a critical SDoH. A recently published paper in JAMA Network Open explored this concept and found that ~20% of US households have medical debt.
High Deductibles Discourage Follow-Up Testing After Abnormal Mammogram Results
A recent study found that 20% of women who receive abnormal results from a mammogram will not seek additional screening if their deductible is too high. 932 patients who received mammograms at Boston Medical Center were surveyed. The results showed that ~60% of respondents who had to pay a deductible would still go in for testing, while another 20% were undecided. Social determinants of health (SDoH) like low income, Hispanic ethnicity, and uninsured status were associated with decreased follow-up testing
Childhood Cancer Survivors on Public Insurance Face Barriers to Care
A recent study found that childhood cancer survivors face significant barriers of access to care when insured on public plans. The study followed patients who received care for cancer at a pediatric cancer center between the ages of 15-19. The risk of follow-up effects after transitioning to adult care are dependent on a variety of factors, so researchers employed a Transition Readiness Inventory (TRI).
Improving Health Outcomes for Hispanic Populations by Recognizing Their Diversity
Although often lumped together into one homogenous group, Hispanic people are incredibly diverse, coming from a wide range of backgrounds. Unfortunately, this impairs data collection efforts that could identify the unique health concerns faced by different groups within Hispanic populations. By improving data collection practices, public health officials could target known health disparities and discover new ones in need of addressing.
Making Clinical Trials Populations Better Represent Patients
Clinical trial participants are often not representative of the patient populations. People from marginalized backgrounds are often overlooked, leaving lingering safety and efficacy questions remaining for those already facing barriers to access. In a new PM Live, article, Paul Chew of Phesi discusses diversity in clinical trials and why it is critical in improving health equity efforts.
Addressing Structural Stigma to Improve Health Equity
Structural stigma refers to forms of stigma reinforced by systems that exert some degree of control or influence over one’s lives, often through legal institutions. In a new Health Affairs brief, authors discuss the ramifications of structural stigma on health disparities through the lens of people living with substance use disorder (SUD). The laws surrounding substance use and the ramifications of their enforcement play an important role in negative health outcomes for people with SUD.
Connecticut Shelter Targets Health Disparities by Addressing Housing Insecurity
Housing insecurity is just one of many social determinants of health (SDoH) that negatively impact health outcomes. A shelter in Milford, CT, US, is attempting to improve health outcomes for people facing housing insecurity by promoting co-living arrangements with older adults. Participants pay a reduced rent, while the older adults have an individual nearby in case of emergency.
Insurance Coverage Reduces Cigarette Use in People Living with Mental Illness and Substance Use Disorders
An article recently published in Addiction found that insurance coverage is associated with reduced cigarette use in people living with mental illness or substance use disorder. People within this demographic are at increased risk of cigarette use, especially when they are under- or uninsured. The study examined data from nearly 450,000 respondents of the US National Survey of Drug Use and Health Surveys from 2009-2019.
Community Care Hubs as an Avenue to Improve Health Outcomes
The US Department of Health and Human Services (HHS) has prioritized the need to address social determinants of health to improve health outcomes for marginalized people. In this month’s issue of Health Affairs¸ authors discuss the use of community care hubs to help improve community health outcomes.
Interview with Nasim Asfar, Chief Health Officer of Oracle Health
Chief Healthcare Executive has published a new interview with Nasim Asfar, Oracle Health’s Chief Health Officer. Asfar is spearheading efforts to target health disparities to support health equity efforts and how Oracle Health is using tech to do so. She starts by touching on the outsized importance of social determinants of health (SDoH).
Study Highlights Barriers to Care for Disabled People in US Healthcare System
A newly published study in Health Affairs further characterizes significant physical and structural barriers to care. The survey found that many physicians felt uncomfortable taking on disabled patients, often denying care. Furthermore, many care delivery locations are not ADA compliant and inaccessible to some disabled people.
