How tech can shrink racial disparities in medicine
Kosali Simon, Tradeoffs, March 26
A new paper suggests technology has the potential to correct inequities. Researchers examined how clinical decision support systems (CDSS) impacted the rates of amputations for diabetics. CDSS are digital programs that analyze data from an electronic health record to provide physicians and nurses with set protocols and checklists which standardize decision making in hopes of reducing subjective assessments. Existing research shows that Black patients are more likely to have limbs amputated, while white patients are more likely to undergo revascularization procedures that can save their limbs. The researchers found that CDSS adoption reduced the amputation disparity by more than half. The authors found the decreased rates of amputations in Black patients were likely due to specialists getting involved more often, thanks to the standardized steps laid out in the CDSS.
With demand for community health workers rising, so does need for sustainable funding
Cara Rosner, Connecticut Health I-Team, March 29
As COVID-19 laid bare Connecticut’s health care deserts, it now highlights the efforts of community health workers (CHWs) who labored in forgotten neighborhoods for years. In many ways, they have become a key factor in the state’s public health response for marginalized communities during the pandemic. “We need an army of CHWs. The capacity is just overwhelming right now,” said Giselle Carlotta-McDonald, executive director of Project Access-New Haven, which employs CHWs in a partnership with Yale New Haven Hospital. But the pandemic has raised serious concerns about whether their work is sustainable in the long run. CHWs typically are funded by grant money, which advocates say is not sustainable.
Dialysis clinics to start offering COVID-19 vaccines
Yuki Noguchi, NPR, March 30
About half of dialysis patients in the U.S. are Black or Latino, people whose vulnerability to both kidney disease and COVID-19 are both made worse by lower access to health care. Last week, the Biden administration said it would distribute vaccines directly to dialysis clinics as part of its broader effort to expand vaccination in high-risk communities. Experts say vaccinating at dialysis centers is an elegant solution to many thorny problems. It’s a step “that will lead to health equity,” says Joseph Vassalotti, chief medical officer for the National Kidney Foundation.
A user’s guide: How to talk to those hesitant about the Covid-19 vaccine
Usha Lee McFarling, STAT, March 26
As the COVID vaccine supply increases throughout the U.S., the next hurdle to reaching herd immunity will be convincing those who are hesitant about vaccines to receive their shots. Experts say the best way to tackle vaccine hesitancy is for people to have conversations with those they trust, whether a doctor, pastor, family member, or friend. So STAT spoke with a number of experts on the frontlines to create this guide on how best to handle these sometimes difficult conversations. Their suggestions may surprise you.
Racial disparities have been found in screening for postpartum mood disorders
Priya Iyer, Scientific American, March 30
Racial disparities are well documented in the diagnosis and treatment of maternal mental health issues, and a new study found racial gaps in postpartum screening. After accounting for other factors associated with postpartum depression screening—such as depression diagnosis prior to birth and income level—researchers still found racial disparities. Compared with white women, Asian women were 19 percent less likely to be screened. African-American women were 36 percent less likely, and Native American, Hawaiian, Alaska Native and multiracial women were 56 percent less likely. The findings are concerning because those who need postpartum mental health care the most are the least likely to receive it.