Misdiagnoses cost the U.S. 800,000 deaths and serious disabilities every year, study finds

“Analyzing the nature of misdiagnoses also provides significant opportunities for solutions: The errors are many, but they are quite concentrated. According to the study, 15 diseases account for about half the misdiagnoses, and five diseases alone — stroke, sepsis, pneumonia, venous thromboembolism, and lung cancer — caused 300,000 serious harms, or almost 40% of the total, because clinicians failed to identify them in patients. “That’s a lot that you could accomplish if you cut those harms by 50% for just those five diseases — that would be 150,000 prevented serious permanent disabilities or death,” said [lead author of the BMJ … Read More

The Problem With How the Census Classifies White People

“Like people of Middle Eastern and North African origins, millions of other Americans have been funneled into one side of our country’s enduring binary of whiteness or the other. According to today’s census forms, Greeks, Irish, Italians, Slavs (who were systematically excluded for a century), and Jews—who are still the target of white-supremacist violence—are indistinct from people with Mayflower backgrounds. Being an unspecified “white” person has allowed many of us to blend in, when the most unifying thing we might do in this era of identity-driven polarization is acknowledge all the ways we are different. Today’s nationalist identity politics are … Read More

Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020

“Introduction Epidemiological research on chronic pain (pain lasting ≥3 months) and high-impact chronic pain (HICP) (chronic pain associated with substantial restrictions in life activities, including work, social, and self-care activities) in the US has increased substantially since the release of the Institute of Medicine (currently the National Academy of Medicine) report on pain in 2011 and the Department of Health and Human Services National Pain Strategy (NPS) in 2016. [..] we used data from the 2019-2020 National Health Interview Survey (NHIS) Longitudinal Cohort (NHIS-LC) to determine the IRs [incidence rates] of chronic pain across demographic groups to refine our understanding of … Read More

The Economic Burden of Racial, Ethnic, and Educational Health Inequities in the US

“Introduction During the last half of the 2010s, life expectancy for college-educated persons continued to increase, while life expectancy for adults without a college education decreased. This crisis in the health of adults who do not have a college degree rose to national attention due largely to the opioid crisis. Initially, the opioid crisis devastated predominantly White communities in the midwestern and north-central states of the US, but eventually spread to other communities and currently disproportionately affects Black and Latino populations. However, a closer analysis reveals that mortality rates for adults who were not college-educated increased for many causes of … Read More

Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020

“Introduction In 1985, the US Department of Health and Human Services (HHS) Secretary Margaret M. Heckler issued the Report of the Secretary’s Task Force on Black and Minority Health, also known as the Heckler Report. The landmark report found that the Black population had strikingly higher mortality rates than the White population, resulting in almost 60 000 excess deaths a year relative to the White population. Race offers no intrinsic biological reason for those categorized as Black individuals to have worse outcomes than White individuals, indicating therefore that these disparities are driven by the burden of acquired risk factors, influence of … Read More

The System That Failed Jordan Neely

What a subway killing reveals about New York City’s revolving-door approach to mental illness and homelessness. “There are more than two hundred thousand residents of New York City living with severe mental illness; roughly five per cent of them are homeless. That’s thirteen thousand people with schizophrenia, major depressive and bipolar disorders, or other significant mental- or behavioral-health diagnoses, all of whom regularly spend the night at a shelter, in the subway, on the street. They’re the ones you recognize—the people whom, for the past fifty years, every mayor has either tried to help, harass, or hide from view. Rudy … Read More

Structural Racism and Long-term Disparities in Youth Exposure to Firearm Violence

“Exposure to firearm violence is associated with lasting consequences for youth and their loved ones. Indirect exposure (eg, witnessing violence) and direct exposure (eg, surviving an assault) can influence mental and physical health outcomes over the life course. In a subset of individuals, exposure is associated with the future enactment of firearm violence, feeding cycles of firearm violence at the community level. [..] At the same time, efforts must directly target the systemic inequities that concentrate firearm violence exposure among Black and Hispanic youth. Racial and ethnic disparities in these outcomes are profound and longstanding. In the study by Lanfear … Read More

Cardiometabolic multimorbidity, lifestyle behaviours, and cognitive function: a multicohort study

An excerpt: Introduction [..] Although an increasing number of studies have focused on the impact of single cardiometabolic diseases on cognitive aging, only a few have considered the associations between their frequent co-occurrence and the loss of cognitive health. Additionally, previous studies of cardiometabolic multimorbidity and cognitive ageing have been limited to only examining individuals from European regions. These countries have a lower prevalence of individuals with cardiometabolic diseases than some countries in Asia, which could potentially lead to different effect estimations regarding the associations between these types of disease and cognitive ageing. [..] Methods This pooled multicohort study utilised data … Read More

Why Americans Feel More Pain

“Tens of millions of Americans are suffering pain. But chronic pain is not just a result of car accidents and workplace injuries but is also linked to troubled childhoods, loneliness, job insecurity and a hundred other pressures on working families. [..] [..] cluster of tightly woven problems that hold back our people and our country: childhood trauma, educational failure, addiction, mental health issues, homelessness, loneliness, family breakdown, unemployment — and, we increasingly recognize, physical pain. “People’s lives are coming apart, and this leads to huge increases in physical pain,” said Angus Deaton, a Nobel Prize winner in economics who with … Read More

Patients and Their Physician’s Perspectives About Oral Anticoagulation in Patients With Atrial Fibrillation Not Receiving an Anticoagulant

“Oral anticoagulation reduces thromboembolic events in patients with nonvalvular atrial fibrillation (AF); however, underuse of anticoagulation is a major issue in treating patients with nonvalvular AF at high stroke risk. Prior data from the American College of Cardiology’s (ACC) Practice Innovation and Clinical Excellence Registry (PINNACLE Registry) has found approximately 40% of patients are not receiving anticoagulants, with little change over time, despite the availability of the nonvitamin K antagonists. Studies examining the reasons for nonuse are sparse. Because underuse may relate to both physician prescribing and patient factors, some studies have looked at physician assessment of the risk of bleeding … Read More