ACCESS TO CARE
Cancer death rates decline, but income is a factor in survival
Sujata Srinivasan, Connecticut Health I-Team, March 27
In the nation’s poorest counties, the cancer mortality rate is 20 percent higher than in the most affluent counties, and the difference is much larger for cancers that are the most preventable: cervical, colorectal and lung. Oncologists are familiar with the socioeconomics of cancer, which include patients worrying about taking time off work to get biopsies and being unable to afford treatment. “Patients are choosing less than the treatment they need, and the consequence could be that they could die,” said Dr. Kristen Zarfos, breast surgeon at Middlesex Health, in Middletown.
HEALTH EQUITY
African Americans more likely to be misdiagnosed with schizophrenia, study finds
Aneri Pattani, Philadelphia Inquirer, March 27
African-Americans with severe depression are more likely to be misdiagnosed as having schizophrenia than white patients, a new study from Rutgers University found. The finding builds on years of evidence that clinicians’ racial biases — whether conscious or unconscious — affect the types of mental-health diagnoses African-American patients receive. From teens being underdiagnosed for depression to adults being overdiagnosed for schizophrenia, research has demonstrated a persistent trend of misdiagnosis for this community. “This is rampant and widespread,” said Alfiee Breland-Noble, a professor of psychiatry at Georgetown University Medical Center. “It is a pervasive problem in the health-care system.”
PRECISION MEDICINE
Asthma takes a hard toll on African-Americans. Can precision medicine ease the burden?
John McQuaid, STAT, March 26
Asthma hits African-Americans particularly hard, and the health care system often fails them. Overall, African-Americans are nearly three times as likely to die from asthma as white people. Researchers have found one surprising explanation for these disparities: A set of genetic mutations found mostly in people of African ancestry may make them less likely to respond to albuterol, the most-prescribed asthma drug in the world. The new research raises the possibility that a cheap genetic test could one day be developed to help identify patients who are resistant to albuterol and could benefit from alternative treatments.
Genetic research has a white bias and it may be hurting everyone’s health
Vicky Stein, PBS NewsHour, March 21
As of last year, 78 percent of the people included in the most prominent form of genomic research were of European ancestry — a group that makes up just 12 percent of the world’s population. Researchers warn that heavily biased genetic databases can lead doctors to diagnose conditions or prescribe treatments that might be relevant to people with European genes, but not for people from other backgrounds. For example, algorithms that help doctors prescribe the right amount of warfarin work fairly well for people with European genes, but are far less accurate for African-Americans. One study of African-Americans found a genotype-guided algorithm consistently prescribed too much medication, resulting in a high risk of uncontrolled bleeding.
FIRST PERSON
My friend’s cancer taught me about a hole in our health system
Aaron E. Carroll, The New York Times, March 25
Americans spend so much time debating so many aspects of health care, including insurance and access. Almost none of that covers the actual impossibility and hardship faced by the many millions of friends and family members who are caregivers. It’s hugely disrupting and expensive. There’s no system for it. It’s a gaping hole.