“Despite the convenience and value of telehealth, many states have rolled back COVID-19 pandemic–era flexibilities and reimposed strict licensure requirements for telemedicine. Thus, as it was prepandemic, so it is again that a physician, duly licensed in their home state, is prohibited from consulting or following up with an out-of-state patient via video or phone unless they are also licensed in the patient’s state. Penalties for doing so without that license can amount to tens of thousands of dollars in fines and potential imprisonment. Despite growing pressure to respond to patient preferences and widespread evidence of the benefits of interstate … Read More
All posts in Equity
“Why would more screening in both Black and white Americans reduce the mortality disparity between the two groups? What’s more, cancer screening actually stands out for its lack of racial disparity. The proportion of Black and white women having mammograms has been virtually identical for the past three decades (in fact, Black women currently have the test at slightly higher rates). Yet deaths from breast cancer are about one-third higher in Black women. For the past two decades, a similar pattern has been seen in colorectal cancer screening — equal rates among Black and white Americans — yet colorectal cancer … Read More
“Landeiro and colleagues computed the economic burden of four diseases (cancer, coronary heart disease [CHD], dementia, and stroke) in England using consistent methodology and a broad definition of disease burden. This analysis is an important advance that will allow policy makers, researchers, and other stakeholders to assess the absolute and relative burden of these diseases in a meaningful way. The Global Burden of Disease also uses a consistent methodology for estimating the burden of many diseases across countries. However, its methodology focuses only on mortality and morbidity, which are evaluated comprehensively, but does not account for many other costs included … Read More
“Colonoscopy is the dominant approach to colorectal cancer screening in the United States. Among people who are screened, two thirds get a colonoscopy. This fact is easy to miss in Halpern and colleagues’ 2021 data, which included 9.2 million people reporting colonoscopy and 9.8 million reporting fecal immunochemical testing (FIT). That ambiguity is explained by the distinct screening intervals (every 10 years for colonoscopy and annually for FIT), whereas there is no ambiguity about the difference in the resources required each year: $24 billion for colonoscopy versus $0.6 billion for FIT. Colonoscopy is clearly overused in the United States. It … Read More
“Over the years, medical schools have made some progress in diversifying their student bodies, with numbers ticking up. But just like undergraduate admissions, wealth and connections continue to play a determining role in who is accepted. More than half of medical students come from families in the top 20 percent of income, while only 4 percent come from those in the bottom 20 percent, according to data from the Association of American Medical Colleges. There is also a family dynamic. Children of doctors are 24 times more likely to become doctors than their peers, according to the American Medical Association. … Read More
“At a 1992 conference on birth control, an official on the F.D.A.’s fertility and maternal health drugs advisory committee, Philip Corfman, noted that the birth control pill is safer than aspirin, which is available over the counter. The F.D.A. subsequently announced plans to convene a hearing to consider moving oral contraceptives over-the-counter. It was believed that this would greatly expand access to birth control by bypassing doctors, to whom millions of Americans then — as still now — had little access. But, as the historian Heather Munro Prescott has recounted, the hearing was canceled at least partly because of criticism from … Read More
“We used Elevance Health’s in-network pricing data and medical claims data. We focused on in-network prices because these are the prices negotiated by the payer, and out-of-network providers represent a small percentage of use for planned procedures. The formatting of the released data files follows the specifications provided by CMS. We limited our analysis to one state, Colorado, and one month, August 2022, to illustrate the concepts. [..] We split the prices into two components, the professional price and the facility price. Notably, these two components may not be the only costs associated with a procedure as there are often other … Read More
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
“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
“For fifty years, Roe protected providers from legal risks like the ones taken on by the Jane Collective, an underground network of women in Chicago. Collective members arranged more than eleven thousand illegal abortions in the late nineteen-sixties and early seventies, until a team of detectives raided their makeshift clinic and charged them with multiple counts of “conspiracy to commit abortion.” (Just before their cases went to trial, the Supreme Court legalized abortion.) Arguably, providers face greater legal dangers now than they did before Roe. Carole Joffe, a sociologist who has written about the history of abortion, told me that … Read More