1
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Trentham-Dietz A, Chapman CH, Jayasekera J, Lowry KP, Heckman-Stoddard BM, Hampton JM, Caswell-Jin JL, Gangnon RE, Lu Y, Huang H, Stein S, Sun L, Gil Quessep EJ, Yang Y, Lu Y, Song J, Muñoz DF, Li Y, Kurian AW, Kerlikowske K, O'Meara ES, Sprague BL, Tosteson ANA, Feuer EJ, Berry D, Plevritis SK, Huang X, de Koning HJ, van Ravesteyn NT, Lee SJ, Alagoz O, Schechter CB, Stout NK, Miglioretti DL, Mandelblatt JS. Collaborative Modeling to Compare Different Breast Cancer Screening Strategies: A Decision Analysis for the US Preventive Services Task Force. JAMA 2024; 331:1947-1960. [PMID: 38687505 DOI: 10.1001/jama.2023.24766] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Importance The effects of breast cancer incidence changes and advances in screening and treatment on outcomes of different screening strategies are not well known. Objective To estimate outcomes of various mammography screening strategies. Design, Setting, and Population Comparison of outcomes using 6 Cancer Intervention and Surveillance Modeling Network (CISNET) models and national data on breast cancer incidence, mammography performance, treatment effects, and other-cause mortality in US women without previous cancer diagnoses. Exposures Thirty-six screening strategies with varying start ages (40, 45, 50 years) and stop ages (74, 79 years) with digital mammography or digital breast tomosynthesis (DBT) annually, biennially, or a combination of intervals. Strategies were evaluated for all women and for Black women, assuming 100% screening adherence and "real-world" treatment. Main Outcomes and Measures Estimated lifetime benefits (breast cancer deaths averted, percent reduction in breast cancer mortality, life-years gained), harms (false-positive recalls, benign biopsies, overdiagnosis), and number of mammograms per 1000 women. Results Biennial screening with DBT starting at age 40, 45, or 50 years until age 74 years averted a median of 8.2, 7.5, or 6.7 breast cancer deaths per 1000 women screened, respectively, vs no screening. Biennial DBT screening at age 40 to 74 years (vs no screening) was associated with a 30.0% breast cancer mortality reduction, 1376 false-positive recalls, and 14 overdiagnosed cases per 1000 women screened. Digital mammography screening benefits were similar to those for DBT but had more false-positive recalls. Annual screening increased benefits but resulted in more false-positive recalls and overdiagnosed cases. Benefit-to-harm ratios of continuing screening until age 79 years were similar or superior to stopping at age 74. In all strategies, women with higher-than-average breast cancer risk, higher breast density, and lower comorbidity level experienced greater screening benefits than other groups. Annual screening of Black women from age 40 to 49 years with biennial screening thereafter reduced breast cancer mortality disparities while maintaining similar benefit-to-harm trade-offs as for all women. Conclusions This modeling analysis suggests that biennial mammography screening starting at age 40 years reduces breast cancer mortality and increases life-years gained per mammogram. More intensive screening for women with greater risk of breast cancer diagnosis or death can maintain similar benefit-to-harm trade-offs and reduce mortality disparities.
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Affiliation(s)
- Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Christina Hunter Chapman
- Department of Radiation Oncology and Center for Innovations in Quality, Safety, and Effectiveness, Baylor College of Medicine, Houston, Texas
| | - Jinani Jayasekera
- Health Equity and Decision Sciences (HEADS) Research Laboratory, Division of Intramural Research at the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | | | - Brandy M Heckman-Stoddard
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - John M Hampton
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison
| | | | - Ronald E Gangnon
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Ying Lu
- Stanford University, Stanford, California
| | - Hui Huang
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sarah Stein
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Liyang Sun
- Stanford University, Stanford, California
| | | | | | - Yifan Lu
- Department of Industrial and Systems Engineering and Carbone Cancer Center, University of Wisconsin-Madison
| | - Juhee Song
- University of Texas MD Anderson Cancer Center, Houston
| | | | - Yisheng Li
- University of Texas MD Anderson Cancer Center, Houston
| | - Allison W Kurian
- Departments of Medicine and Epidemiology and Population Health, Stanford University, Stanford, California
| | - Karla Kerlikowske
- Departments of Medicine and Epidemiology and Biostatistics, University of California San Francisco
| | - Ellen S O'Meara
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | | | - Anna N A Tosteson
- Dartmouth Institute for Health Policy and Clinical Practice and Departments of Medicine and Community and Family Medicine, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| | - Eric J Feuer
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Donald Berry
- University of Texas MD Anderson Cancer Center, Houston
| | - Sylvia K Plevritis
- Departments of Biomedical Data Science and Radiology, Stanford University, Stanford, California
| | - Xuelin Huang
- University of Texas MD Anderson Cancer Center, Houston
| | | | | | - Sandra J Lee
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Oguzhan Alagoz
- Department of Industrial and Systems Engineering and Carbone Cancer Center, University of Wisconsin-Madison
| | | | - Natasha K Stout
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Diana L Miglioretti
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
- Department of Public Health Sciences, University of California Davis
| | - Jeanne S Mandelblatt
- Departments of Oncology and Medicine, Georgetown University Medical Center, and Georgetown Lombardi Comprehensive Institute for Cancer and Aging Research at Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC
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Singh Ospina N, Diaz-Thomas A, McDonnell ME, Demay MB, Pittas AG, York E, Corrigan MD, Lash RW, Brito JP, Murad MH, McCartney CR. Navigating Complexities: Vitamin D, Skin Pigmentation, and Race. J Clin Endocrinol Metab 2024:dgae314. [PMID: 38828960 DOI: 10.1210/clinem/dgae314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Indexed: 06/05/2024]
Abstract
Vitamin D plays a critical role in many physiological functions, including calcium metabolism and musculoskeletal health. This commentary aims to explore the intricate relationships among skin complexion, race, and 25-hydroxyvitamin D (25[OH]D) levels, focusing on challenges the Endocrine Society encountered during clinical practice guideline development. Given that increased melanin content reduces 25(OH)D production in the skin in response to UV light, the guideline development panel addressed the potential role for 25(OH)D screening in individuals with dark skin complexion. The panel discovered that no randomized clinical trials have directly assessed vitamin D related patient-important outcomes based on participants' skin pigmentation, although race and ethnicity often served as presumed proxies for skin pigmentation in the literature. In their deliberations, guideline panel members and selected Endocrine Society leaders underscored the critical need to distinguish between skin pigmentation as a biological variable and race and ethnicity as socially determined constructs. This differentiation is vital to maximize scientific rigor and, thus, the validity of resulting recommendations. Lessons learned from the guideline development process emphasize the necessity of clarity when incorporating race and ethnicity into clinical guidelines. Such clarity is an essential step toward improving health outcomes and ensuring equitable healthcare practices.
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Affiliation(s)
- Naykky Singh Ospina
- Division of Endocrinology, University of Florida, Gainesville, FL 32610, USA
| | - Alicia Diaz-Thomas
- Division of Pediatric Endocrinology, Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Marie E McDonnell
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Marie B Demay
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA 02111, USA
| | | | | | | | - Juan P Brito
- Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - M Hassan Murad
- Mayo Clinic, Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Christopher R McCartney
- Division of Endocrinology and Metabolism, Department of Medicine, West Virginia University, Morgantown, WV 26506, USA
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3
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Benda N, Woode S, Niño de Rivera S, Kalish RB, Riley LE, Hermann A, Masterson Creber R, Costa Pimentel E, Ancker JS. Understanding Symptom Self-Monitoring Needs Among Postpartum Black Patients: Qualitative Interview Study. J Med Internet Res 2024; 26:e47484. [PMID: 38669066 PMCID: PMC11087860 DOI: 10.2196/47484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pregnancy-related death is on the rise in the United States, and there are significant disparities in outcomes for Black patients. Most solutions that address pregnancy-related death are hospital based, which rely on patients recognizing symptoms and seeking care from a health system, an area where many Black patients have reported experiencing bias. There is a need for patient-centered solutions that support and encourage postpartum people to seek care for severe symptoms. OBJECTIVE We aimed to determine the design needs for a mobile health (mHealth) patient-reported outcomes and decision-support system to assist Black patients in assessing when to seek medical care for severe postpartum symptoms. These findings may also support different perinatal populations and minoritized groups in other clinical settings. METHODS We conducted semistructured interviews with 36 participants-15 (42%) obstetric health professionals, 10 (28%) mental health professionals, and 11 (31%) postpartum Black patients. The interview questions included the following: current practices for symptom monitoring, barriers to and facilitators of effective monitoring, and design requirements for an mHealth system that supports monitoring for severe symptoms. Interviews were audio recorded and transcribed. We analyzed transcripts using directed content analysis and the constant comparative process. We adopted a thematic analysis approach, eliciting themes deductively using conceptual frameworks from health behavior and human information processing, while also allowing new themes to inductively arise from the data. Our team involved multiple coders to promote reliability through a consensus process. RESULTS Our findings revealed considerations related to relevant symptom inputs for postpartum support, the drivers that may affect symptom processing, and the design needs for symptom self-monitoring and patient decision-support interventions. First, participants viewed both somatic and psychological symptom inputs as important to capture. Second, self-perception; previous experience; sociocultural, financial, environmental, and health systems-level factors were all perceived to impact how patients processed, made decisions about, and acted upon their symptoms. Third, participants provided recommendations for system design that involved allowing for user control and freedom. They also stressed the importance of careful wording of decision-support messages, such that messages that recommend them to seek care convey urgency but do not provoke anxiety. Alternatively, messages that recommend they may not need care should make the patient feel heard and reassured. CONCLUSIONS Future solutions for postpartum symptom monitoring should include both somatic and psychological symptoms, which may require combining existing measures to elicit symptoms in a nuanced manner. Solutions should allow for varied, safe interactions to suit individual needs. While mHealth or other apps may not be able to address all the social or financial needs of a person, they may at least provide information, so that patients can easily access other supportive resources.
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Affiliation(s)
- Natalie Benda
- School of Nursing, Columbia University, New York, NY, United States
| | - Sydney Woode
- Department of Radiology, Early Lung and Cardiac Action Program, The Mount Sinai Health System, New York, NY, United States
| | | | - Robin B Kalish
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Alison Hermann
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | | | - Eric Costa Pimentel
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
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4
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Barry MJ, Li L. USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents-Reply. JAMA 2023; 330:2024-2025. [PMID: 38015221 DOI: 10.1001/jama.2023.20452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
| | - Li Li
- University of Virginia, Charlottesville
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5
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Doubeni CA, Bailey ZD, Winn RA. Commentary: Health disparities across the cancer care continuum and implications for microsimulation modeling. J Natl Cancer Inst Monogr 2023; 2023:173-177. [PMID: 37947331 PMCID: PMC11009501 DOI: 10.1093/jncimonographs/lgad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Chyke A Doubeni
- Department of Family and Community Medicine, The Ohio State University College of Medicine, Ohio State University Comprehensive Cancer Center, Wexner Medical Center, Columbus, OH, USA
| | - Zinzi D Bailey
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Robert A Winn
- Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
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6
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Nicholson W, Barry MJ, Mangione CM. Aligning Prevention Evidence Gaps With Prevention Research. JAMA 2023; 330:1623-1624. [PMID: 37934214 DOI: 10.1001/jama.2023.20879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
This Viewpoint describes the development of tools to communicate actionable steps to address research needs and gaps for USPSTF recommendations that have insufficient evidence to make definitive guidance.
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Affiliation(s)
- Wanda Nicholson
- Prevention and Community Health, George Washington Milken Institute of Public Health, Washington, DC
| | - Michael J Barry
- Division of General Internal Medicine and the Informed Medical Decisions Program in the Health Decision Sciences Center, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Carol M Mangione
- Department of Medicine, David Geffen School of Medicine and Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, Los Angeles
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7
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Abstract
In this Viewpoint, the authors urge the USPSTF to undertake a comprehensive effort to ensure its recommendations systematically consider the effects of ableism and structural ableism on individuals with disability.
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Affiliation(s)
- Dimitri A Christakis
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
- Chief health officer, Special Olympics International, Washington, DC
| | - Lisa I Iezzoni
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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8
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Britz JB, O'Loughlin KM, Henry TL, Richards A, Sabo RT, Saunders HG, Tong ST, Brooks EM, Lowe J, Harrell A, Bethune C, Moeller FG, Krist AH. Rising Racial Disparities in Opioid Mortality and Undertreatment of Opioid Use Disorder and Mental Health Comorbidities in Virginia. AJPM FOCUS 2023; 2:100102. [PMID: 37790667 PMCID: PMC10546578 DOI: 10.1016/j.focus.2023.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction There were more than 100,000 fatal drug overdoses in the U.S. in 2021 alone. In recent years, there has been a shift in opioid mortality from predominantly White rural communities to Black urban communities. This study aimed to identify the Virginia communities disproportionately affected by the overdose crisis and to better understand the systemic factors contributing to disparities in opioid mortality. Methods Using the state all-payer claims database, state mortality records, and census data, we created a multivariate model to examine the community-level factors contributing to racial disparities in opioid mortality. We used generalized linear mixed models to examine the associations between socioecologic factors and fatal opioid overdoses, opioid use disorder diagnoses, opioid-related emergency department visits, and mental health diagnoses. Results Between 2015 and 2020, racial disparities in mortality widened. In 2020, Black males were 1.5 times more likely to die of an opioid overdose than White males (47.3 vs 31.6 per 100,000; p<0.001). The rate of mental health disorders strongly correlated with mortality (β=0.53, p<0.001). Black individuals are not more likely to be diagnosed with opioid use disorder (β=0.01, p=0.002) or with mental health disorders (β= -0.12, p<0.001), despite higher fatal opioid overdoses. Conclusions There are widening racial disparities in opioid mortality. Untreated mental health disorders are a major risk factor for opioid mortality. Findings show pathways to address inequities, including early linkage to care for mental health and opioid use disorders. This analysis shows the use of comprehensive socioecologic data to identify the precursors to fatal overdoses, which could allow earlier intervention and reallocation of resources in high-risk communities.
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Affiliation(s)
- Jacqueline B. Britz
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Kristen M. O'Loughlin
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Tracey L. Henry
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Alicia Richards
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Roy T. Sabo
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Heather G. Saunders
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Sebastian T. Tong
- Department of Family Medicine, University of Washington, Seattle, Washington
| | - E. Marshall Brooks
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Jason Lowe
- Division of Behavioral Health, Virginia Department of Medical Assistance (DMAS), Richmond, Virginia
| | - Ashley Harrell
- Division of Behavioral Health, Virginia Department of Medical Assistance (DMAS), Richmond, Virginia
| | - Christine Bethune
- Division of Behavioral Health, Virginia Department of Medical Assistance (DMAS), Richmond, Virginia
| | - F. Gerard Moeller
- C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
| | - Alex H. Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
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Farrell TW, Hung WW, Unroe KT, Brown TR, Furman CD, Jih J, Karani R, Mulhausen P, Nápoles AM, Nnodim JO, Upchurch G, Whittaker CF, Kim A, Lundebjerg NE, Rhodes RL. Exploring the intersection of structural racism and ageism in healthcare. J Am Geriatr Soc 2022; 70:3366-3377. [PMID: 36260413 PMCID: PMC9886231 DOI: 10.1111/jgs.18105] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 02/01/2023]
Abstract
The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought to the forefront of the collective public consciousness at different points throughout history. The COVID-19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID-19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well-documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism.
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Affiliation(s)
- Timothy W. Farrell
- Division of Geriatrics, Spencer Fox Eccles School of
Medicine, University of Utah, Salt Lake City, Utah, USA
- VA Salt Lake City Geriatric Research, Education, and
Clinical Center, Salt Lake City, Utah, USA
| | - William W. Hung
- Department of Geriatrics and Palliative Medicine, Icahn
School of Medicine at Mount Sinai, New York New York, USA
- Geriatric Research, Education and Clinical Center, James J
Peters VA Medical Center, New York New York, USA
| | - Kathleen T. Unroe
- Department of Medicine, Indiana University, Indianapolis,
Indiana, USA
- Regenstrief Institute, Indiana University Center for Aging
Research Indianapolis, Indianapolis, Indiana, USA
| | - Teneille R. Brown
- Center for Law and Biomedical Sciences, University of Utah
S.J. Quinney College of Law, Salt Lake City, Utah, USA
| | - Christian D. Furman
- Department of Geriatric Medicine, Department of Geriatric
and Palliative Medicine, Trager Institute/Optimal Aging Clinic, University of
Louisville, Louisville, Kentucky, USA
| | - Jane Jih
- Division of General Internal Medicine, Multiethnic Health
Equity Research Center, Asian American Research Center on Health, University of
California, San Francisco, San Francisco, California, USA
| | - Reena Karani
- Department of Medical Education, Department of Medicine,
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine
at Mount Sinai, New York New York, USA
| | | | - Anna María Nápoles
- Division of Intramural Research, National Institute on
Minority Health and Health Disparities, National Institutes of Health, Bethesda,
Maryland, USA
| | - Joseph O. Nnodim
- Division of Geriatric and Palliative Medicine, Department
of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gina Upchurch
- Senior PharmAssist, Durham, North Carolina, USA
- Eshelman School of Pharmacy, Department of Public Health
Leadership, Gillings School of Global Public Health, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chanel F. Whittaker
- Department of Practice, Sciences, and Health Outcomes
Research (P-SHOR), The Peter Lamy Center on Drug Therapy and Aging, University of
Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Anna Kim
- American Geriatrics Society, New York New York, USA
| | | | - Ramona L. Rhodes
- Central Arkansas Veterans Healthcare System, Geriatric
Research Education and Clinical Center, North Little Rock, Arkansas, USA
- Department of Geriatrics, University of Arkansas for
Medical Sciences, Little Rock, Arkansas, USA
- Division of Geriatric Medicine, University of Texas
Southwestern Medical Center, Dallas, Texas, USA
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10
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Takeda K, Risley C, Kousar A, Briley KP, Prenshaw K, Talluri R, Geisinger KR, Rebellato LM. Post‐kidney transplant cancers: Racial and ethnic differences in sun‐exposed skin versus non‐sun‐exposed anogenital skin. Cancer Med 2022; 12:7348-7355. [PMID: 36373513 PMCID: PMC10067113 DOI: 10.1002/cam4.5431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Transplant recipients have a 2- to 4-fold increased risk of developing malignancies over the general population. Cancer is the second most common cause of death for recipients. The magnitude of the risk depends on the cancer type and increases in viral-related malignancies. Skin cancer is the most common. However, data in most cancer registries is limited to cutaneous melanomas, thereby limiting the epidemiologic examination of cancer risk in non-melanoma skin cancer. Our goal was to evaluate post-kidney transplant cancer cases and sites in our population to guide screening recommendations. METHODS Between 2009 and 2015, a retrospective study of adult kidney recipients transplanted at East Carolina University was conducted. The first cancer diagnosis after transplant through February 18, 2020, was captured and analyzed. Patient demographics, cancer sites, and histological diagnoses were analyzed and compared. p16 immunohistochemistry was used as a surrogate marker for high-risk human papillomavirus (HPV) infection. RESULTS Retrospectively, kidney transplant recipients were analyzed (N = 439), the majority were non-Hispanic Black (NHB) individuals, 312 (71.1%), and 127 (28.9%) were non-Hispanic White (NHW) individuals. Of these, 59 (13.4%) developed a posttransplant malignancy, with the majority on sun-exposed skin found in NHW. NHB had all anogenital/mucosa skin cancers on non-sun-exposed skin. Of these detected in NHB, all were squamous cell carcinomas, with five out of six (83.3%) being positive for p16. CONCLUSIONS Posttransplant malignancy differed significantly by race, site, and potential source of etiology. The majority of malignancies are likely explained by acceleration of precursor lesions from prior exposure to ultraviolet rays or HPV.
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Affiliation(s)
- Kotaro Takeda
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Carolann Risley
- Department of Cell and Molecular Biology, and Cancer Center and Research Institute University of Mississippi Medical Center, School of Nursing, School of Medicine Jackson Mississippi USA
| | - Aisha Kousar
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Kimberly P. Briley
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Karyn Prenshaw
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Rajesh Talluri
- Department of Data Science, School of Population Health University of Mississippi Medical Center Jackson Mississippi USA
| | - Kim R. Geisinger
- Walter Reed Military Medical Center The Joint Pathology Center Silver Springs Maryland USA
| | - Lorita M. Rebellato
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
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Mangione CM, Nicholson W, Davidson KW. Addressing Gaps in Research to Reduce Disparities and Advance Health Equity: The USPSTF Incorporation of the NASEM Taxonomy on Closing Evidence Gaps in Clinical Prevention. JAMA 2022; 328:1803-1804. [PMID: 36251304 DOI: 10.1001/jama.2022.19154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint reviews the evidence gaps reported to Congress by the US Preventive Services Task Force (USPSTF) in 2021 on improving health inequities in prevention and uses the 3 taxonomies provided by National Academies of Sciences, Engineering, and Medicine (NASEM) to classify these gaps.
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Affiliation(s)
- Carol M Mangione
- University of California, Los Angeles
- Chair, US Preventive Services Task Force
| | - Wanda Nicholson
- University of North Carolina, Chapel Hill
- Vice chair, US Preventive Services Task Force
| | - Karina W Davidson
- Feinstein Institutes for Medical Research, Northwell Health, New York, New York
- Immediate past chair, US Preventive Services Task Force
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12
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Davidson KW. Lessons From Implementation of the U.S. Preventive Services Task Force Recommendations for Lung Cancer Screening. Ann Intern Med 2022; 175:1608-1609. [PMID: 36215711 DOI: 10.7326/m22-2886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Karina W Davidson
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, New York, New York
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13
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Burns RB, Mangione CM, Weinberg DS, Kanjee Z. How Would You Screen This Patient for Colorectal Cancer? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med 2022; 175:1452-1461. [PMID: 36215708 DOI: 10.7326/m22-1961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer death for men and women in the United States, with an estimated 52 580 people expected to die in 2022. Most frequently, CRC is diagnosed among persons aged 65 to 74 years. However, among persons younger than 50 years, incidence rates have been increasing since the mid-1990s. In 2021, partially because of the rising incidence, the U.S. Preventive Services Task Force (USPSTF) recommended CRC screening for adults aged 45 to 49 years (Grade B recommendation). Options for CRC screening include stool-based and direct visualization tests. The USPSTF did not recommend a specific screening test; rather, its guidance was to select a test after a discussion with the patient. Here, a primary care physician and a gastroenterologist discuss the recommendation to begin CRC screening at age 45, review options for CRC screening, and discuss how to choose among the available options.
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Affiliation(s)
- Risa B Burns
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (R.B.B., Z.K.)
| | - Carol M Mangione
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, California (C.M.M.)
| | | | - Zahir Kanjee
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (R.B.B., Z.K.)
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14
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Gilliam CA, Lindo EG, Cannon S, Kennedy L, Jewell TE, Tieder JS. Use of Race in Pediatric Clinical Practice Guidelines: A Systematic Review. JAMA Pediatr 2022; 176:804-810. [PMID: 35666494 DOI: 10.1001/jamapediatrics.2022.1641] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE National clinical practice guidelines (CPGs) guide medical practice. The use of race in CPGs has the potential to positively or negatively affect structural racism and health inequities. OBJECTIVE To review the use of race in published pediatric CPGs. EVIDENCE REVIEW A literature search of PubMed, Medscape, Emergency Care Research Institute Guidelines Trust, and MetaLib.gov was performed for English-language clinical guidelines addressing patients younger than 19 years of age from January 1, 2016, to April 30, 2021. The study team systematically identified and evaluated all articles that used race and ethnicity terms and then used a critical race theory framework to classify each use according to the potential to either positively or negatively affect structural racism and racial inequities in health care. FINDINGS Of 414 identified pediatric clinical practice guidelines, 126 (30%) met criteria for full review because of the use of race or ethnicity terms and 288 (70%) did not use race or ethnicity terms. The use of a race term occurred 175 times in either background, clinical recommendations, or future directions. A use of race with a potential negative effect occurred 87 times (49.7%) across 73 CPGs and a positive effect 50 times (28.6%) across 45 CPGs. CONCLUSIONS AND RELEVANCE In this systematic review of US-based pediatric CPGs, race was frequently used in ways that could negatively affect health care inequities. Many opportunities exist for national medical organizations to improve the use of race in CPGs to positively affect health care, particularly for racial and ethnic minoritized communities.
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Affiliation(s)
- Courtney A Gilliam
- Division of Hospital Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle
| | - Edwin G Lindo
- Department of Family Medicine, University of Washington School of Medicine, Seattle
| | - Shannon Cannon
- Division of Pediatric Urology, Department of Urology, University of Wisconsin School of Medicine & Public Health, Madison
| | | | | | - Joel S Tieder
- Division of Hospital Medicine, Department of Pediatrics, Seattle Children's and the University of Washington School of Medicine, Seattle
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15
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Mangione CM, Barry MJ, Nicholson WK, Cabana M, Coker TR, Davidson KW, Davis EM, Donahue KE, Jaén CR, Kubik M, Li L, Ogedegbe G, Pbert L, Ruiz JM, Stevermer J, Wong JB. Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Disease Risk Factors: US Preventive Services Task Force Recommendation Statement. JAMA 2022; 328:367-374. [PMID: 35881115 DOI: 10.1001/jama.2022.10951] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and stroke, is the leading cause of death in the US. A large proportion of CVD cases can be prevented by addressing modifiable risk factors, including smoking, obesity, diabetes, elevated blood pressure or hypertension, dyslipidemia, lack of physical activity, and unhealthy diet. Adults who adhere to national guidelines for a healthy diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not; however, most US adults do not consume healthy diets or engage in physical activity at recommended levels. OBJECTIVE To update its 2017 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the benefits and harms of behavioral counseling interventions to promote healthy behaviors in adults without CVD risk factors. POPULATION Adults 18 years or older without known CVD risk factors, which include hypertension or elevated blood pressure, dyslipidemia, impaired fasting glucose or glucose tolerance, or mixed or multiple risk factors such as metabolic syndrome or an estimated 10-year CVD risk of 7.5% or greater. EVIDENCE ASSESSMENT The USPSTF concludes with moderate certainty that behavioral counseling interventions have a small net benefit on CVD risk in adults without CVD risk factors. RECOMMENDATION The USPSTF recommends that clinicians individualize the decision to offer or refer adults without CVD risk factors to behavioral counseling interventions to promote a healthy diet and physical activity. (C recommendation).
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Affiliation(s)
| | | | | | | | | | | | - Karina W Davidson
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York
| | - Esa M Davis
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | - Li Li
- University of Virginia, Charlottesville
| | | | - Lori Pbert
- University of Massachusetts Medical School, Worcester
| | | | | | - John B Wong
- Tufts University School of Medicine, Boston, Massachusetts
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16
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Community engagement education in academic health centers, colleges, and universities. J Clin Transl Sci 2022; 6:e109. [PMID: 36285015 PMCID: PMC9549477 DOI: 10.1017/cts.2022.424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/08/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023] Open
Abstract
Community engagement (CE) is critical for advancing health equity and a key approach for promoting inclusive clinical and translational science. However, it requires a workforce trained to effectively design, implement, and evaluate health promotion and improvement strategies through meaningful collaboration with community members. This paper presents an approach for designing CE curricula for research, education, clinical care, and public health learners. A general pedagogical framework is presented to support curriculum development with the inclusion of community members as facilitators or faculty. The overall goal of the curriculum is envisioned as enabling learners to effectively demonstrate the principles of CE in working with community members on issues of concern to communities to promote health and well-being. We highlight transformations needed for the commonly used critical service-learning model and the importance of faculty well-versed in CE. Courses may include didactics and practicums with well-defined objectives and evaluation components. Because of the importance of building and maintaining relationships in CE, a preparatory phase is recommended prior to experiential learning, which should be guided and designed to include debriefing and reflective learning. Depending on the scope of the course, evaluation should include community perspectives on the experience.
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17
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Krieger N. Breaking Through and Backlash: Advancing Awareness About Racism, Sexism, Social Class, and the People's Health. Am J Prev Med 2022; 62:807-813. [PMID: 35597562 DOI: 10.1016/j.amepre.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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18
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Affiliation(s)
- Olakunle B Akintemi
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
| | - Kenneth B Roberts
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
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19
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Kleinwechter H, Demandt N, Nolte A. Screening auf Gestationsdiabetes mellitus (GDM) – Welchen Weg weisen die neuen Studien? Übersicht und Kommentar. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1784-6160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDas Screening auf Gestationsdiabetes mellitus (GDM) wird international nicht einheitlich durchgeführt. In Deutschland wird allen Schwangeren ein zweizeitiges Screening angeboten, zunächst ein 50-g Vortest (nicht nüchtern), im positiven Fall gefolgt von einem 75-g oralen Gluksetoleranztest (oGTT) über 2 h (nüchtern). Im Jahr 2021 sind zwei randomisierte Screeningstudien publiziert worden, in denen einzeitiges Screenen ohne Vortest mit dem zweizeitigen Screenen verglichen wurde. Einzeitiges Screenen erhöht die GDM-Prävalenz um das 2,3-fache ohne Vorteile für klinisch relevante Endpunkte von Müttern und Neugeborenen und um den Preis unnötiger Pharmakotherapie sowie Belastung der Ressourcen bei den Betreuern. Beim zweizeitigen Screening benötigen nur 20% der Frauen einen oGTT. Darüber hinaus wird die zweizeitige Strategie von den Frauen präferiert.
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Affiliation(s)
- Helmut Kleinwechter
- Diabetes-Schwerpunktpraxis und Schulungszentrum, diabetolgikum kiel, Kiel, Germany
| | - Norbert Demandt
- Diabetes-Schwerpunktpraxis und Schulungszentrum, diabetolgikum kiel, Kiel, Germany
| | - Andreas Nolte
- Diabetes-Schwerpunktpraxis und Schulungszentrum, diabetolgikum kiel, Kiel, Germany
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20
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Davidson KW, Mangione C, Ogedegbe G. US Preventive Services Task Force Recommendation Statement on Screening for Atrial Fibrillation-Reply. JAMA 2022; 327:2022. [PMID: 35608587 DOI: 10.1001/jama.2022.5207] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Karina W Davidson
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York
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21
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Rutter CM, May FP, Coronado GD, Pujol TA, Thomas EG, Cabreros I. Racism Is a Modifiable Risk Factor: Relationships Among Race, Ethnicity, and Colorectal Cancer Outcomes. Gastroenterology 2022; 162:1053-1055. [PMID: 34942173 DOI: 10.1053/j.gastro.2021.12.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 01/16/2023]
Affiliation(s)
| | - Folasade P May
- David Geffen School of Medicine and UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California
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22
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Hill-Briggs F, Ephraim PL, Vrany EA, Davidson KW, Pekmezaris R, Salas-Lopez D, Alfano CM, Gary-Webb TL. Social Determinants of Health, Race, and Diabetes Population Health Improvement: Black/African Americans as a Population Exemplar. Curr Diab Rep 2022; 22:117-128. [PMID: 35239086 PMCID: PMC8891426 DOI: 10.1007/s11892-022-01454-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW To summarize evidence of impact of social determinants of health (SDOH) on diabetes risk, morbidity, and mortality and to illustrate this impact in a population context. RECENT FINDINGS Key findings from the American Diabetes Association's scientific review of five SDOH domains (socioeconomic status, neighborhood and physical environment, food environment, health care, social context) are highlighted. Population-based data on Black/African American adults illustrate persisting diabetes disparities and inequities in the SDOH conditions in which this population is born, grows, lives, and ages, with historical contributors. SDOH recommendations from US national committees largely address a health sector response, including health professional education, SDOH measurement, and patient referral to services for social needs. Fewer recommendations address solutions for systemic racism and socioeconomic discrimination as root causes. SDOH are systemic, population-based, cyclical, and intergenerational, requiring extension beyond health care solutions to multi-sector and multi-policy approaches to achieve future population health improvement.
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Affiliation(s)
- Felicia Hill-Briggs
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
| | - Patti L. Ephraim
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
| | - Elizabeth A. Vrany
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
| | - Karina W. Davidson
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
| | - Renee Pekmezaris
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
| | - Debbie Salas-Lopez
- grid.416477.70000 0001 2168 3646Department of Community and Population Health at Northwell Health, Manhasset, NY USA
| | - Catherine M. Alfano
- grid.250903.d0000 0000 9566 0634Institute of Health System Science, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 USA
- grid.250903.d0000 0000 9566 0634Institute of Cancer Research, Feinstein Institutes for Medical Research at Northwell Health, NY Manhasset, USA
| | - Tiffany L. Gary-Webb
- grid.21925.3d0000 0004 1936 9000Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA USA
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23
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Borrell LN, Williams DR. Racism and oral health equity in the United States: Identifying its effects and providing future directions. J Public Health Dent 2022; 82 Suppl 1:8-11. [PMID: 35088413 PMCID: PMC9541355 DOI: 10.1111/jphd.12501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
Abstract
While racial/ethnic oral health inequities have been documented for many years in the United States, the potential role of racism has not been examined until recently. In fact, the common practice has been to attribute racial/ethnic disparities in oral health to low socioeconomic position and/or the lack of access to care. In contrast, racism is considered a fundamental cause of a broad range of adverse health outcomes for racial/ethnic minorities. Emerging evidence on oral health suggests that racism can affect access to oral health and clinical decision-making by acting as a social determinant of health (SDoH). Specifically, SDoHs may affect access to quality dental care due to the lack of dental insurance, low dentist-population ratio in racial/ethnic minority communities and the lack of diversity in the dental profession. We describe potential mechanisms through which racism can affect important SDoHs that are essential to oral health equity, outline recommendations to mitigate its existing negative effects and propose interventions to minimize pathogenic effects of racism on oral health outcomes in the population.
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Affiliation(s)
- Luisa N. Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health PolicyCity University of New YorkNew YorkNew YorkUSA
| | - David R. Williams
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public HealthHarvard UniversityBostonMassachusettsUSA
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24
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Doubeni CA, Corley DA, Zhao W, Lau Y, Jensen CD, Levin TR. Association between Improved Colorectal Screening and Racial Disparities. N Engl J Med 2022; 386:796-798. [PMID: 35196434 DOI: 10.1056/nejmc2112409] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Wei Zhao
- Kaiser Permanente Medical Center, Walnut Creek, CA
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25
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Siddique SM, May FP. Race-Based Clinical Recommendations in Gastroenterology. Gastroenterology 2022; 162:408-414.e2. [PMID: 34890599 PMCID: PMC10115149 DOI: 10.1053/j.gastro.2021.12.234] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Shazia Mehmood Siddique
- Division of Gastroenterology, Leonard Davis Institute for Health Economics, University of Pennsylvania, Center for Evidence-Based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Folasade P May
- Vatche & Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Division of Gastroenterology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
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26
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Doubeni CA, Corley DA, Peek RM. Advancing Diversity, Equity, and Inclusion in Scientific Publishing. Gastroenterology 2022; 162:59-62.e1. [PMID: 34740579 DOI: 10.1053/j.gastro.2021.10.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Douglas A Corley
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Richard M Peek
- Vanderbilt University Medical Center, Nashville, Tennessee
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27
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Affiliation(s)
- Phil B Fontanarosa
- Dr Fontanarosa is Interim Editor in Chief and Dr Golub is Executive Deputy Editor, JAMA
| | - Robert M Golub
- Dr Fontanarosa is Interim Editor in Chief and Dr Golub is Executive Deputy Editor, JAMA
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