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Health Equity and Access Weekly Roundup: February 24, 2024

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This week's news from the Center on Health Equity and Access discusses racial disparities in prostate cancer outcomes, the impact of access to cancer care on racial gaps in CLL/SLL outcomes, the effects of 340B programs on drug pricing and health care disparities, the role of mental illness in maternal mortality rates, and racial bias and diagnosis disparities in bipolar disorder.

Dr Jun Gong: Improved Access Closes the Gaps Between Black, White Men With Prostate Cancer

Jun Gong, MD, discusses disparities in prostate cancer outcomes between Black and White men, citing socioeconomic and biological factors. Historical data show higher incidence and mortality rates among Black men, with recent research highlighting the impact of socioeconomic status and genetic differences on treatment response. Gong emphasizes the need for increased Black male representation in clinical trials to address these disparities systematically. Despite efforts, progress in trial diversity remains gradual, underscoring the ongoing necessity for tailored interventions to mitigate the gap in prostate cancer outcomes.

Access to Cancer Care Alleviates Racial Disparities in CLL/SLL

A study in the American Journal of Hematology found that equal access to cancer care reduces racial disparities in outcomes between Black and White patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Despite initial differences in disease stage and time to treatment, when Black patients were treated with advanced therapies, such as small module inhibitors, their overall survival matched that of White patients. However, access disparities persist, highlighting the need for interventions to improve overall access to care.

Part 2: Dr James Robinson on the Impact of 340B Programs and Drug Pricing Policies

In a study published in The New England Journal of Medicine, James Robinson, PhD, MPH, and his team analyze insurer drug expenditures on infused drugs and their impact on hospital price markups, especially focusing on 340B Drug Pricing Program–eligible hospitals. Robinson highlights how these markups exacerbate health care disparities, particularly affecting patients requiring expensive therapies. He discusses the inefficiency of the pharmaceutical supply chain and emphasizes how insurance plans with high cost sharing disproportionately disadvantage patients in need, often impacting lower-income individuals with limited coverage options.

Mental Health Plays Pivotal Role in US Maternal Mortality Rates

New research in JAMA Psychiatry underscores the crucial role of mental illness in maternal mortality rates, emphasizing the necessity for comprehensive strategies during the perinatal period. The study reveals a high prevalence of perinatal psychiatric disorders linked to severe morbidity and mortality during delivery and postpartum, exacerbated by access limitations to care, particularly in regions lacking adequate clinicians. Maternal stress and trauma during pregnancy are associated with adverse outcomes, highlighting the importance of addressing these issues. The study stresses the need for interdisciplinary clinical training, improved insurance coverage parity, and integration of health care with community services to enhance prenatal care and outcomes, advocating for a coordinated effort to mitigate mental illness's impact on maternal mortality.

Dr Leesha Ellis-Cox Confronts Racial Bias, Diagnosis Disparities in Mental Health Care

Psychiatrist Leesha Ellis-Cox, MD, MPH, discusses the ongoing disparities in bipolar disorder diagnosis rates among Black Americans in an interview with The American Journal of Managed Care®. She attributes these disparities to racial bias in health care and social stigma, exacerbated by the underrepresentation of Black health care providers. Ellis-Cox emphasizes the need for providers to confront biases, advocate for cultural humility training, and eliminate stigma to ensure equitable mental health care for all communities.

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