With End of Affirmative Action, a Push for a New Tool: Adversity Scores

“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

Providing Birth Control Over the Counter Should Be Just the Beginning

“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

Using Publicly Available Health Plan Pricing Data For Research And App Development

“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

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

The Problem with Planned Parenthood

“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

How a 2019 Florida Law Catalyzed a Hospital-Building Boom

Excerpt – Florida is among the states that have abandoned a decades-old regulation meant to keep medical costs in check. The requirement, used nearly nationwide until the 1980s, allowed new hospital construction only if a state issued a “Certificate of Need,” or CON. The process involves would-be hospital builders applying to the state and the state government evaluating need based on criteria such as population growth and existing hospital capacity. About two-thirds of states still require a CON. But several, including Georgia, Kentucky, and South Carolina, have this year debated whether to scrap or loosen restrictions. West Virginia relaxed its … Read More

Black Smokers at Center of New York Fight to Ban Menthol Cigarettes

“Well intentioned as the [proposed menthol-flavored cigarette] ban may be, it has angered some Black leaders, including a group of ministers who have rallied against Ms. Hochul’s proposal because they worry it could increase encounters between Black people and the police if menthol cigarettes were to go underground and authorities crack down on sellers. Other Black opponents of the ban suggest it may be discriminatory, a heavy-handed crackdown on the preferred nicotine fix of Black smokers, even if African American men have the highest rates of lung cancer, according to the Centers for Disease Control and Prevention. Some smokers said that if the … Read More

Addressing Health-Related Social Needs in the Clinical, Community, and Policy Domains

“The effects of social determinants of health (SDOH) on health outcomes have been extensively evaluated and described. Efforts to elucidate the impact of specific unmet health-related social needs (HRSN), such as food insecurity and lack of transportation, on specific outcome measures can help pinpoint necessary interventions and policy changes. [..] In recent years, the Centers for Medicare &Medicaid Services (CMS) have placed higher priority on addressing health equity, including directly addressing unmet HRSN and accounting for social risk in Medicare payments. For payments, a growing body of literature has demonstrated that health care systems caring for patients with higher social … Read More

Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults

“The concept of cardiovascular health (CVH) was proposed by the American Heart Association (AHA) in 2010 and is composed of both lifestyle factors and biological metrics. The original algorithm for evaluating CVH was the Life’s Simple 7 (LS7) score. In 2022, the AHA published the new algorithm for evaluating CVH, the Life’s Essential 8 (LE8) score, on the basis of feedback on the LS7 score and new evidence. The LE8 score adopts a new scoring algorithm and incorporates sleep health into CVH.8 Intriguingly, previous studies have shown that having a higher CVH level was not only associated with a lower … Read More