Because so many Black people die young — with many years of life ahead of them — their higher mortality rate from 1999 to 2020 resulted in a cumulative loss of more than 80 million years of life compared with the white population, the study showed.

Although the nation made progress in closing the gap between white and Black mortality rates from 1999 to 2011, that advance stalled from 2011 to 2019. In 2020, the enormous number of deaths from covid-19 — which hit Black Americans particularly hard — erased two decades of progress.

Authors of the study describe it as a call to action to improve the health of Black Americans, whose early deaths are fueled by higher rates of heart disease, cancer, and infant mortality.

“The study is hugely important for about 1.63 million reasons,” said Herman Taylor, an author of the study and director of the cardiovascular research institute at the Morehouse School of Medicine.

“Real lives are being lost. Real families are missing parents and grandparents,” Taylor said. “Babies and their mothers are dying. We have been screaming this message for decades.”

High mortality rates among Black people have less to do with genetics than with the country’s long history of discrimination, which has undermined educational, housing, and job opportunities for generations of Black people, said Clyde Yancy, an author of the study and chief of cardiology at Northwestern University’s Feinberg School of Medicine.

Black neighborhoods that were redlined in the 1930s — designated too “high risk” for mortgages and other investments — remain poorer and sicker today, Yancy said. Formerly redlined ZIP codes also had higher rates of covid infection and death. “It’s very clear that we have an uneven distribution of health,” Yancy said. “We’re talking about the freedom to be healthy.”

A companion study estimates that racial and ethnic inequities cost the U.S. at least $421 billion in 2018, based on medical expenses, lost productivity, and premature death.

In 2021, non-Hispanic white Americans had a life expectancy at birth of 76 years, while non-Hispanic Black Americans could expect to live only to 71. Much of that disparity is explained by the fact that non-Hispanic Black newborns are 2½ times as likely to die before their 1st birthdays as non-Hispanic whites. Non-Hispanic Black mothers are more than 3 times as likely as non-Hispanic white mothers to die from a pregnancy-related complication. (Hispanic people can be of any race or combination of races.)

Racial disparities in health are so entrenched that even education and wealth don’t fully erase them, said Tonia Branche, a neonatal-perinatal medicine fellow at Lurie Children’s Hospital of Chicago who was not involved in the JAMA study.

Black women with a college degree are more likely to die from pregnancy complications than white women without a high school diploma. Although researchers can’t fully explain this disparity, Branche said it’s possible that stress, including from systemic racism, takes a greater toll on the health of Black mothers than previously recognized.

Death creates ripples of grief throughout communities. Research has found that every death leaves an average of nine people in mourning.

Black people shoulder a great burden of grief, which can undermine their mental and physical health, said Khaliah Johnson, chief of pediatric palliative care at Children’s Healthcare of Atlanta. Given the high mortality rates throughout the life span, Black people are more likely than white people to be grieving the death of a close family member at any point in their lives.

“We as Black people all have some legacy of unjust, unwarranted loss and death that compounds with each new loss,” said Johnson, who was not involved with the new study. “It affects not only how we move through the world, but how we live in relationship with others and how we endure future losses.”

Johnson’s parents lost two sons — one who died a few days after birth and another who died as a toddler. In an essay published last year, Johnson recalled, “My parents asked themselves on numerous occasions, ‘Would the outcomes for our sons have been different, might they have received different care and lived, had they not been Black?’”

Johnson said she hopes the new study gives people greater understanding of all that’s lost when Black people die prematurely. “When we lose these lives young, when we lose that potential, that has an impact on all of society,” she said.

And in the Black community, “our pain is real and deep and profound, and it deserves attention and validation,” Johnson said. “It often feels like people just pass it over, telling you to stop complaining. But the expectation can’t be that we just endure these things and bounce back.”

Teleah Scott-Moore said she struggles with the death of her 16-year-old son, Timothy, an athlete who hoped to attend Boston College and study sports medicine. He died of sudden cardiac arrest in 2011, a rare condition that kills about 100 young athletes a year. Research shows that an underlying heart condition that can lead to sudden cardiac death, hypertrophic cardiomyopathy, often goes unrecognized in Black patients.

Scott-Moore still wonders if she should have recognized warning signs. She also has blamed herself for failing to protect her two younger sons, who found Timothy’s body after he collapsed.

At times, Scott-Moore said, she wanted to give up.

Instead, she said, the family created a foundation to promote education and health screenings to prevent such deaths. She hears from families all over the world, and supporting them has helped heal her pain.

“My grief comes back in waves, it comes back when I least expect it,” said Scott-Moore, of Baltimore County, Maryland. “Life goes on, but it’s a pain that never goes away.”

The post Study Reveals Staggering Toll of Being Black in America: 1.6M Excess Deaths Over 22 Years appeared first on Medika Life.

MCLEAN, Va., & BEDFORD, Mass.–(BUSINESS WIRE)–A new MITRE-Harris Poll Survey on Patient Experience finds 52 percent of individuals in the United States feel their symptoms are “ignored, dismissed, or not believed” when seeking medical treatment. That number rises to 6-in-10 within the Hispanic community.

“And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

The polling also revealed that more than half of Blacks and Hispanics feel the “healthcare provider is biased against me based on their attitude, words, or actions,” contributing to a 4-in-10 average across all demographics. Fifty percent (50%) of respondents also reported “a healthcare provider assuming something about me without asking me.”

Additionally, the results indicate that several groups are all much more likely to experience bias, doubt, or language barriers when seeking treatment. These include individuals identifying as a person with a disability or having a chronic health condition, those responsible for managing access to healthcare for a family member or friend, and members of the LGBTQ+ community.

“These findings confirm unacceptable disparities in patient experience along racial and ethnic lines, for the LGBTQ+ community, and for those who are managing chronic health conditions or navigating the world with disabilities,” said Juliette Forstenzer Espinosa, senior Medicare, Medicaid, and Affordable Care Act Marketplace strategist, MITRE. “And these categories are, of course, intersectional. There’s no question there is work to do to better serve all populations at the point-of-care.”

Rob Jekielek, managing director, The Harris Poll, said, “With the evolution of online patient portals and digital support tools, we have seen stronger usage among those who need to navigate the system the most—individuals with a chronic illness or disability and those who manage the healthcare needs of others. However, this has not translated to substantially lower frustration with the healthcare system, including understanding of coverage and claims. Confusion and uncertainty are even higher among the majority of Americans who use the system sporadically, or only when specific needs arise.”

Additional key findings from the MITRE-Harris Poll Survey include:

• When consumers have a concern or question about a bill, they struggle with whom to call.
  Fifty-four percent (54%) of insured individuals in the United States say they don’t know whom to contact if they have an issue with a bill or claim. Individuals self-identifying as disabled or dealing with chronic illness, caregivers, Hispanics, and younger generations are more likely to say they do know whom to contact if they have issues.
• Prevalence of unexpected medical bills decreases slightly.
  Forty-three percent (43%) of insured Americans report receiving an unexpected bill because their insurance did not cover as much as expected – a decrease from a 2021 MITRE-Harris Poll Survey when 47 percent reported a billing surprise.
• Patients are overwhelmingly using portals.
  Nearly 9-in-10 insured individuals use online patient portals more often for test results (70%), appointments (64%), and medical records (63%) than for other applications, such as finding a healthcare provider (58%), reviewing insurance benefits (54%), managing prescriptions (54%), or filing a health insurance claim (37%). Insured Black, Indigenous, and people of color (BIPOC) groups are more likely than white individuals to use patient portals to find a healthcare provider or file a claim.
• Patients seeking some specialists may wait two months or more for a visit.
  While most Americans can schedule an imaging appointment or a visit with their primary care provider or general practitioner in less than two weeks, 1-in-5 say it can take two months or more to meet with specialized professionals such as mental health providers, specialty physicians, dentists, or optometrists.

Methodology

This survey was conducted online within the United States, September 27-29, 2022, among 2,047 adults (ages 18 and over) by The Harris Poll on behalf of MITRE via the Harris On Demand omnibus product.

Editor’s Notes:

• Survey findings and commentary slide presentation is available by request to media@mitre.org.
• Health Insurance Marketplace open enrollment runs from November 1, 2022 to January 15, 2023.

About The Harris Poll

The Harris Poll is one of the longest-running surveys in the U.S. tracking public opinion, motivations, and social sentiment since 1963, and is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times. We work with clients in three primary areas: building twenty-first-century corporate reputation, crafting brand strategy and performance tracking, and earning organic media through public relations research. Our mission is to provide insights and guidance to help leaders make the best decisions possible. To learn more, please visit www.theharrispoll.com.

About MITRE

MITRE’s mission-driven teams are dedicated to solving problems for a safer world. Through our public-private partnerships and federally funded R&D centers, we work across government and in partnership with industry to tackle challenges to the safety, stability, and well-being of our nation. Learn more at mitre.org.

©2022 MITRE #22-4132 12-15-2022

Contacts

Media
Mike Murphy, external communications principal, MITRE media@mitre.org.

The post MITRE-Harris Poll Survey Finds Half of Patients in the US Feel Ignored or Doubted When Seeking Medical Treatment appeared first on Medika Life.

Significant change is needed. But what change? Lowering drug costs will not lower total spending on health so long as pharmacy benefit managers (PBMs) continue to profit from the “spread.” Access to care will not improve so long as we ponder the future of essential telehealth services. Patient adherence will not be supported if formularies can call upon “non-medical switching” as a go-to negotiating tool. The US percentage of GDP will not align with other developed nations’ investments in health if we don’t redirect effort to emotional and physical preventive and value-based care. Fixing one piece of the healthcare puzzle is helpful – but is it transformational?

There are changes afoot that we need to make happen sooner rather than later by moving minds, systems and behaviors so that life-sustaining and life-saving approaches to patient care may eventually tip the scale of human survival toward health and wellness. However, we see data through the lens of a human perspective – sometimes self-interests or emotional needs for control.

Here are 10 possibilities that are not dreams – they can happen – if the health ecosystem leaders think beyond cost, reimbursement or authoritative voice and focus on people’s healthy longevity:

1. Artificial Intelligence (AI) — A future of engagement and collaboration:

AI has been around since the Gutenberg Bible! In 1899, medicine made a giant leap into AI by publishing the Merck Manual — a handbook that collected all known medical advice and gave physicians a compendium of diagnoses and treatments. No expert can remember the vast canon of medical information within their specialty, and books became a source of “augmented knowledge.”

Too many health systems and physicians view AI as “novel.” Addressing the obstacles to implementation within their health systems is critical to enhanced decision-making benefits offered by AI. Concerns about cybersecurity and training are valid! However, the value of implementing artificial intelligence is not about embracing technology — it’s about amplifying human wisdom to address patient urgencies effectively.

Human intelligence can be augmented by uniting data, patient files and other health professionals’ patient-care experiences, channeled through this technology platform. We must now rally to address questions about data quality, emotional resistance to change and cybersecurity. As innovation theorist, John Nosta writes about the emerging importance of aligning IQ and EQ with TQ (technology quotient).

“The battle of man versus machine might be ending where cooperative engagement provides transformative solutions to a wide variety of problems and opportunities.”

2. Behavioral Health — America does not lack a supply chain to manufacture chronically ill citizens:

We are killing ourselves slowly…with poor nutrition. We continue to add belt notches to our waistlines. The added weight also increases risks for heart disease, diabetes, cancer, mental health stressors, and more. Who pays those sickness bills? Employers foot a large percentage of the nation’s workforce health insurance. It’s time to look beyond providing an expected workplace benefit. Physicians, employers, payers and the people they seek to help must reduce the waistlines of people tipping toward the obesity border! Helping consumers shed unnecessary pounds and meeting their corresponding medical priorities offers immediate life-saving and personalized health benefits.

The best option for corporations footing a large part of the health bill is to intervene with payers and recognize benign neglect in tackling the obesity epidemic only adds to suffering and expense. Louis J. Aronne, M.D., who founded the breakthrough patient-centered health-tech Intellihealth along with Weill Cornell Medicine physician colleague Katherine Saunders, MD, notes:

“Obesity is a very complex chronic disease with a number of causes from diet to underlying medical conditions, medications and genetics. “Through our extensive research and applied medical model, we have incorporated all of our practice methodologies into a single software platform, which delivers a blueprint for treating obesity with supervision and continued oversight. Evaluation of our approach demonstrates 3x the number of patients reaching the key outcome measure of 5% or greater weight loss compared to programs that incorporate behavioral interventions alone.”

3. Decentralized Clinical Trials — Democratize drug development:

Even before COVID-19 appeared, traditional clinical trial recruitment models were being reconsidered. Drug development was almost sidelined during the pandemic, and clinical research organizations (CROs) recognized that they needed to reinvent patient recruitment. Operation Warp Speed showed how to put the pedal to the metal for COVID-19 vaccines; systems developed now can be applied to other high-priority, clinical urgencies such as treatments for rare diseases and often-fatal cancers.

Collaboration to advance the process is working. Science and research pioneers such as Amir Kalali, MD, and Craig Lipset, who co-lead the industry-wide DTRA.org group, show the sector’s readiness to change direction collectively. Innovators like Michelle Longmire, MD, CEO of Medable, and Irfan Khan, MD, CEO of Circuit Clinical, demonstrate that an industry known to advance new medications from bench to bedside can innovate how and where patients are invited to participate in urgently needed therapeutic discoveries. Innovation is based on finding new paths to address unmet needs.

To accelerate drug discovery and development possibilities, biopharma and medical device companies need to find a new set of allies – patient advocacy organizations and their communities; primary care centers with access to people in rural and inner-city communities. They must recognize that in working with government, sector companies, and those that seek to serve – people with health needs – they can go farther, faster.

4. Digital Health — Physicians and patients need coverage clarity:

Food and Drug Administration approval for life-sustaining innovations does not necessarily sway payer access decisions. “Claim denied” is the all-to-often refrain when physicians and their patients seek access to a 510 K-approved medical device or digital therapeutic.

Payers may have sufficient justification to deny coverage. But what are the criteria for those “dead-on-arrival” reimbursement decisions? What are the guidelines to secure formulary approval? If more data are needed to ensure access for patients — insurance customers — payers must become partners in the sector’s and patient-care success. Adding bricks to the walls patients must circumvent to secure care for themselves and their families does little to improve care or customer relationships.

Digital health analyst and author Artur Olesch outlines a challenge for the coming year in a question many more should be asking:

The COVID-19 pandemic has accelerated the implementation of telecare and telemedicine. Individuals are increasingly using mobile health apps. What can be done not to waste this potential?

5. Ecohealth — We need a healthy planet or else:

Where you live impacts how long and how well you live. Thousands of U.S. communities are ticking time bombs. The harsh reality is that 26% of Black Americans and 29% of Hispanic Americans live within three miles of a toxic landfill site, exposing these communities of color to dangerous levels of lead and other heavy metals and chemicals. We must face the harsh reality that while planet earth can do just fine without humanity; humanity needs a healthy planet. This was the striking call-to-action by Meharry Medical College President and CEO Dr. James E.K. Hildreth.

The longer we wait, the harder it will be to course-correct. The shift to a healthier world requires other innovative superpowers — courage and collaboration. According to Bob Martineau, senior partner FINN Partners, a former Federal and State government official focusing on environment issues: 

Though we breathe, eat and live in the environment, we often forget just how interconnected all aspects of our health are with the world around us. Exposure to dangerous levels of air, soil and groundwater pollution is proven to cause a cascade of life-threatening woes that include cancers, nervous system disorders, respiratory diseases, and premature births.

6. Tackle older patients’ care and adherence challenges:

When people are diagnosed with a chronic or severe medical condition, we must ensure that the patient-physician relationship guides care and that the medical ecosystem prioritizes medication adherence. The National Health Institute reports that 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. We don’t need to invent or create new care challenges. Let physicians already seeking to do good oversee clinical-care decisions.

Age discrimination and comfort with using technology to access the health system are barriers to access and understanding medication use and adherence. Age bias is often attached to health conditions often experienced in older persons. While older Americans often are the health system’s most significant customers, they face continued discrimination. We must see continued innovation in earlier detection of illnesses that impact seniors, such as loneliness, Alzheimer’s and even sexually transmitted diseases.

7. Health disparities — The most vulnerable need access to care now:

Decades of racism place people of color in harm’s way from COVID-19 more than any other community. Blacks are dying at a rate of 50.3 per 100,000 people, compared with 20.7 for whites. In New York City, the most densely populated place in America, 19% of residents, many people of color, live in poverty, while 17% live in overcrowded conditions. We seem unable to come to grips with the reality that health disparities cause multiple public health disasters and cost lives and dollars.

We must reach the communities that seek information in ways that speak to their interests and needs. What groups such as Hip Hop Public Health creatively use the power of music with health-specific messages to mobilize and change mindsets.

America is among the few developed nations that deny good healthcare services to those most in need. Neglect and racism are morally counter to the health mission of medical leaders. The changes of senior citizens to access health networks easily must be addressed. Policymakers, corporate leaders and citizens must raise their voices to enact change. A cultural shift is needed to rally communities for awareness and education. According to Yele Aluko, MD, MBA, chief medical officer at EY:

The current conversation going on nationally about societal justice, about health equity, drives a moral imperative. This conversation is going on across health systems, big business, government, and philanthropic organizations. Everybody’s talking about how we need to fix this wrong, so the time is now. We have a convergence of goodwill that drives my optimism. But we must seize the moment and translate it into actionable solutions.

8. Metaverse — Smart technologies channel our imagination toward curative possibilities:

Do you have an imagination? Put it to work to heal. After all, medical engineering is a pioneering effort that connects people’s ideas with human biology to overcome sickness. We entered the “Matrix” the first time we imaged a therapeutic stent, LVAD and 3D-printed artificial limb; complex operations became possible when expert hands drew upon technology to realize new concepts.

Rafael Grossman, MD, FACS, has been tapping technology to improve patient-centered medical care. Always ready to explore the disruptive power of technology in medicine, Dr. Grossman has been at the forefront of using smart glasses, augmented, virtual and mixed reality to change the way we practice and teach medicine.

Grossman and medical compatriots such as Daniel Kraft, MD, don’t see the metaverse as sci-fi. Artificial reality, virtual reality and wearables are used by leading-edge practitioners to advance patient outcomes.

9. Remote Patient Monitoring and Telehealth — Remote care after COVID-19:

Digital systems are built into beds, furniture and watches. Medical wearables make hospital stays more customer-friendly by delivering patient information straight to providers’ smartphones and central monitoring stations. At the height of the pandemic, there was a dramatic uptick in telehealth and remote care. As reimbursement rates shift, patients worry they will lose the benefits of remote care.

Ever so often, Congress, the Centers for Medicare and Medicaid Services and private payers pump the brakes on continued remote access with life-saving services such as telemedicine. We need to change the culture of conservatism when it comes to remote advancements and access. Groups like the American Telemedicine Association are essential voices for access and a sensible hybrid approach to care.

Medicine is a culture where patients are not yet seen as customers. Cancer survivor, caregiver and health professional Stacy Hurt, a HIMSS Digital Health Influencer and recent participant in a VyTrac-sponsored webinar on remote patient monitoring, writes on the importance of a hybrid approach:

Patients ultimately want two things: hope and options. We’re finally to a point where telemedicine is an option. It for sure shouldn’t replace the in-person encounter and relationship between the healthcare provider and patient, but it is an option we need to preserve.

10. Self-Care — Our health system keeps us alive — it doesn’t keep us well:

Our health system is not built around sustaining “health.” We have invested mightily in national illness management, a sick-care structure that offers no return on investment regarding a better path to healthy longevity. Value-based and preventive care to keep the illness at bay is a big win-win-win for households, companies and governments that now foot the nation’s health insurance bill. Employers and payers will find that incentivizing self-care and illness prevention is a more innovative business model.

WebMD Chief Medical Officer John Whyte, MD, an author on bestsellers with life-saving tips to reduce cancer and diabetes risks, writes:

The biggest myth has been that (cancer) is primarily caused by genetics or just bad luck and there is nothing that you can do about it. The reality is only about 30% of cancer is caused by what we would say are inherited mutations or family history. The rest is primarily influenced by lifestyle. I know, although nothing is 100% preventable, we have learned through science that you can reduce your risk by deciding what you eat, how much you exercise, your level of stress, the quality of your sleep. These are all things you have control over.

If this roster of innovations in hand tells us anything, it’s time we put health-system mindset change front and center. There are plenty of great reasons to say, “this won’t work” or “let’s not do it; it adds to costs.” It is understandable that new products, services and approaches take time to implement and cost money. But when we look at people’s well-being, adding complexity to people’s lives that separates them from access to the best quality of care has never been medicine’s intended mission.

We look to changes such as Amazon purchasing One Medical as a pathway to fix that which is broken. We have an abundance of innovative, readily and inexpensive (often generic) medicines. We often can speak with a skilled health professional through our smartphones and tablets. Perhaps the change so sorely needed isn’t another billion-dollar acquisition and “roll-up,” it’s addressing the challenges of collaboration and transparency?

Health providers are at the forefront of confronting our significant societal challenges. They have risen to the task heroically. Health disparities between the haves and have-nots and developed and developing nations have opened our eyes and hearts. Innovation combined with our determination must open the door to fundamental system change.

The post Health Possibilities We Can’t Afford to Block appeared first on Medika Life.

Finding enough people to fill trials is one of the highest hurdles in research; nearly eight out of ten trials don’t meet enrollment deadlines. But it’s not only a challenge to find enough participants, it’s also extremely difficult to assemble a truly representative group, meaning that therapeutics are too often developed for a smaller, less diverse patient population – rather than for *all* the patients who need and will use these new medicines.

Drug developers are well aware of this critical shortcoming. And while their commitment to making trials more inclusive is increasingly expressed, what may not always be clear is the path forward with concrete, achievable steps that lead to making inclusivity a reality.

Ultimately, driving inclusivity is dependent on reimagining research infrastructure. Before we can bring a greater and more representative number of patients into the system, we need to fortify the system with new avenues of access and engagement. Clinical trials 2.0 must be about increasing access for both the physicians and patients in the communities most likely to be excluded from research today.

A recent STAT article highlights health tech startups – including Acclinate, Power, and Trial Library – that are taking important early steps to drive better engagement and community partnerships. Their efforts should be encouraging and exciting to all of us who work in clinical research or depend upon it. We are all pursuing the same mission; viewing likeminded organizations as competitors is an outmoded way of thinking and will hold back the acceleration of clinical development. The challenge of bringing more  opportunity for participation in clinical trials to historically underrepresented groups is big enough that we need all players with good ideas to share best practices and collaborate on behalf of patients.

The need for multiple approaches is laid bare in the statistics. Considering that 50 percent of clinical trials are conducted in only two percent of US zip codes, technologies that bring trials to patients, rather than patients to trials, have the potential to make clinical research more accessible to a pool of participants with greater geographic, economic, ethnic, and racial diversity. This is critical, as recently developed drugs can have a different effect on patients, depending on their race and ethnicity.

It is worth noting that if history is a teacher, technology alone won’t solve for inclusivity on a large scale; even with the apps, smart devices, and internet access that make patient participation easier, we *still* need to find these patients in the first place and engage with them in high trust environments. Successfully engaging, listening, and educating these potential participants is where our current system fails us.

The equation for successfully reimagining clinical trials – making them more representative for researchers and more accessible for patients as a care option – must put community engagement and awareness building at the center of efforts. This requires authentic, long-term investment in communities, and, importantly, increasing exponentially the number of community-based physicians and clinics participating in research as investigators and trial sites.

Strikingly, less than five percent of US cancer patients have participated in a clinical trial, despite more than 7o percent of patients expressing their willingness. A big part of the problem in accessing trials is that patients simply never find out about them, and the source with the greatest potential to convey opportunities to patients is physicians.

After some initial exposure in medical school, most physicians never take part in a clinical trial again. This means that there’s a shortage of doctors doing research, further reinforcing the concentration of clinical trials at existing sites. By identifying and enlisting the participation of physicians in communities that have been shut out of research and would benefit from it, we have the opportunity to put clinical research into the offerings of standard medical care. This enables more people from more diverse backgrounds to hear about trials and helps make it possible for them to participate.

We need a new generation of physicians to help conduct clinical research and reach patients who are willing to take part – and a new, integrated approach to research as a care option.  Existing trial sites are not numerous or accessible enough to meet existing research needs, limiting patient access and causing a dangerous chokepoint in the development of new, much-needed therapeutics. But, through a synthesis of digital remote technologies, data, and targeted community and physician outreach, we can create a network of additional clinical trial sites. These range from doctor’s offices to patients’ homes to local pharmacies and urgent care facilities, expanding the number, diversity, and location of patients in research.

Building the necessary trust across the drug development ecosystem to allow for new investigators, new sites, and new participants to access and participate in clinical trials will not be easy, but it can be done and we are already seeing signs this is happening. Embracing new site infrastructure that opens up clinical trial participation to everyone holds the promise of solving the crisis of people waiting for the development of life-saving drugs. It is worth the effort to evolve our process and broaden our circle of inclusion; partnering with these physicians, patients, and their communities to accomplish our shared goals of improving and extending lives looks to be the next great innovation in clinical trials.

The post Increase Inclusivity in Research by Reimagining Clinical Trials appeared first on Medika Life.

How was Salk’s vaccine received? Researchers said it was “junk science” and tended to dismiss it, favoring the live virus from Sabin’s lab. Not only was Salk’s vaccine safer, but it was also quickly manufactured and readily available to the public. But the dueling virus controversy lasted until the 1990s when Sabin’s vaccine was discontinued because it could infect others.

The Salk vaccine was involved in an unprecedented 1.8 million children in a human experiment to test its effectiveness. Salk had already tested the vaccine on himself and his family, and none developed polio.

The problem with the notable presence of the polio virus in NYC wastewater is that other countries worldwide still use the Sabin vaccine. Traveling and being vaccinated abroad means the virus has carriers that, unwittingly, bring the virus back to the US. Once here, it quickly enters the wastewater system and can spread the virus to the unvaccinated.

How many know about the 1949 polio epidemic that swept the nation and placed infants in iron lungs? The huge tubes, in short supply, were airlifted from location to location as the virus spread with unprecedented speed, striking the nation’s young. A complete explanation of the virus and how it attacks the body can be viewed here.

From 1916–1919, over two thousand people in New York City, primarily in Brooklyn, died from polio infection, which, thanks to the Industrial Revolution, drove people to cities where they were packed into poor living situations, a lack of nutrition led to disease and sewage quickly carried the virus into homes.

Does that sound familiar? Is wastewater carrying the virus throughout apartment buildings and into homes? Yes, it can last up to one week in those situations. Infection is as close as your sewer system. Other viruses can still live on surfaces, including clothing and towels.

What other virus is being discovered anew in the sewage systems of the US and abroad? Yes, it’s Covid-19, and just like polio, the human waste in the sewage systems carries the virus to distant areas from its origin in someone’s home. As I write, New York state has to combat both polio and Covid-19 in its wastewater.

Up to 30 percent of those infected have no symptoms, and therein lies the main problem. If someone isn’t sick, they don’t think they need to be vaccinated or take steps to protect others by keeping a safe distance or wearing a mask.

The Covid-19 virus has mutated as all viruses do, and the new iterations present new challenges. These mutations have managed to either disguise themselves or, in other ways, avoid the body’s immune system protection and the vaccines that depend on this for our safety.

To ward off the iterations, new innoculations will continue to be needed and, conceivably, into the future. Each fall will bring a new-and-improved vaccine for the still mutating viruses. Viruses don’t stop mutating.

Those who have received misinformation about vaccines and refuse to be vaccinated will continue to present agreeable hosts for the viruses while endangering others.

Politics and business have failed to adequately address this enduring danger in a wish to reassure the general public and get all of us back to business. In my opinion, the CDC’s efforts have been poor, and a shuffling of management has already begun.

The post Polio/Covid Planning, the Poor, Life and Mobility appeared first on Medika Life.

We serve no worthwhile purpose when we slander anyone, least of those sworn to protect us. Yes, I know I may be accused of being too pro-police because I have many law enforcement relatives, but I am a citizen who views the problems from a professional standpoint. I hope I can be unbiased, and I have tried my best, as all of us, to try to clarify some factors contributing to this bloodshed.

I can’t imagine what it must be like to be a POC in this country and have teenage boys in the family who, indeed, must feel targeted for arrest or worse for nothing more than a broken taillight on a car or jogging on a road in broad daylight.

The questions of mental illness and auditory hallucinations are not at issue here because neither was involved in the killing of Ahmaud Arbery. His death was precipitated by his jogging in an area where there had been recent criminal activity. If a neighbor were thinking “citizen’s arrest,” would he have needed the firepower he carried with him? In this death, the police were not involved.

The town where I live asked me to provide a few classes for their officers regarding dealing with persons with mental illness. I quickly discovered that the police officers were similar to the security personnel at a psychiatric hospital where I had worked; they bought into the myths about mental illness.

Many of you have probably heard the myth about how powerful someone with such an illness can be and how dangerous. It is endemic in our culture, and we need to address it because people are endangered by it. Studies have shown that a lack of training and procedures can result in a self-fulfilling prophesy of mental illness and dangerousness.

“…departments lack written policies and procedures for management of persons with mental illness. The lack of education, training, policies, and procedures has a tendency to cause line officers to respond improperly. Instead of approaching the call as a person with an illness, oftentimes police officers will approach as though the patient is a dangerous felon.” When we combine all the myths, especially those where people believe the mentally ill have super strength, the result can be a tragedy.

I recall a young, immature, and almost seven-feet-tall patient on a unit where I worked. He thought it was great fun to tell tall tales about hiding alcohol on the grounds. Unfortunately, he “acted up” on the unit, and the security team was called in. These men have previously worked in law enforcement locally or in the military. Four men jumped on top of him and pulled him to the ground, where the skirmish resulted in one officer having a broken finger and another a severely sprained wrist.

They put shackles and handcuffs on him and pushed him into a grounds’ car to take him to the police station, where they pressed charges of assault against him. He was a young kid who laughed through the entire “fight,” viewing it as fun rather than fear on their part. He hadn’t attacked them; it was the other way around, but he was charged.

Another factor that may play a significant role in irrational police actions of any type may be the stress of the job, which can lead to depression and affect their work. But, along with the stress comes preexisting bias and racism; we cannot deny that.

Police culture has also played a role in how the officers respond to a situation involving a mentally ill person. We have already seen that there may be inadequate training regarding these interactions, but how much has been researched regarding the inherent fear of officers?

The stigma in the culture of the police workplace prohibits any display of what may be seen as fear. But aren’t all of us vulnerable to fear, especially when placed in a perceived life-and-death situation? Doesn’t our adrenaline kick in when danger is apparent?

Police officers are not immune to this natural, biological response. Their ability to control the reaction determines the situation’s outcome. But how many are willing to tell others of their fear? They are also victims of stigma, but here it is of appearing fearful in any situation.

The work of the police is essential, but their humanity must also be important. Just as the military has had to deal with mental health issues, such as PTSD, anxiety, and depression, police officers must be seen in this enlightened light.

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Dallas tried to do the right thing with Covid vaccine distribution, but Texas state officials blocked the effort.

Republican Commissioner J.J. Koch proposed prioritizing vaccine distribution in the zip codes with the highest number of Covid cases. The Dallas County Commissioners Court approved the plan until state officials from the Department of State Health Services pushed back. Texas DSHS officials vetoed the plan and threatened to reduce the number of doses delivered to the county.

Dallas County released vaccination data broken down by ZIP code showing the majority of vaccines were going to white, affluent areas. While the new Covid case data did not include racial demographics, it demonstrated 11 local zip codes with high Covid prevalence rates.

These zip codes include areas with large communities of people of color. The Dallas County health department attempted to prioritize vaccinating the predominately Black and Latinx neighborhoods at its Fair Park vaccination hub.

The Texas Tribune reports Texas state officials threatened to reduce vaccine distribution to Dallas Country unless it reversed the policy. Faced with the threat of losing crucial vaccine supply, Dallas County officials relented and changed course.

DSHS Associate Commissioner Imelda Garcia issued an attempted explanation stating, “While we ask hub providers to ensure vaccine reaches the hardest-hit areas and populations, solely vaccinating people who live in those areas is not in line with the agreement to be a hub provider.”

It is important to note the Dallas Country strategy never proposed vaccinating only the residents in the 11 zip codes. Increasing the vaccine supply in the Fair Park location would have only simply increased the vaccine supply in areas geographically closer to the affected neighborhoods.

The CDC has continued to report data showing an almost five times higher risk of severe disease and hospitalization in people of color. Dallas County attempted to focus the vaccine strategy to help these communities.

Dallas had a chance to prioritize vaccinating the communities that need it the most.

Can someone explain why Texas said no?

The post Texas Blocks Dallas Efforts to Vaccinate Communities of Color appeared first on Medika Life.

Both organizations will work together to bridge racial disparities impacting pregnant women across the country.

DATE OF RELEASE: Aug, 10, 2020

ARLINGTON, Va. /PRNewswire/ — March of Dimes, the leader in the fight for the health of all moms and babies, and longtime partner Anthem Foundation, the philanthropic arm of Anthem, Inc., today announced a $1.1 million grant with their latest plans to tackle America’s maternal and infant health crisis, which is particularly devastating for communities of color. The partnership aims to close the health equity gap by addressing the racial disparities and social determinants of health that have disproportionally impacted Black mothers who are more likely to die from pregnancy-related causes and have premature babies compared to all other women.

The new grant will support programs in 16 states and Washington D.C with a core component of the grant focusing on health equity partnerships with more than 20 hospitals, which includes Breaking Through Implicit Bias in Maternal Healthcare training. According to the 2003 National Academies for Science, Engineering and Medicine, “racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients’ insurance status and income, are controlled.” In response, March of Dimes developed this training, in collaboration with Quality Interactions, to improve patient-provider communications and treatment decisions, contributing to improved quality of care at a critical intervention point. The course provides an overview of implicit bias, its impact on the maternal infant health crisis, history of structural racism in the United States, strategies for providers to both mitigate racial bias in maternity care and to commit to a culture of equity.

The grant will also support programs for moms and babies, such as Supportive Pregnancy Care and interconception care.  Through Supportive Pregnancy Care, pregnant women receive their clinical care, share support with other women at a similar stage in pregnancy, and gain knowledge and skills related to pregnancy, childbirth, and parenting. Interconception care programs help new moms to get information and services that promote birth spacing, smoking cessation, and mental health.

“The U.S. is in the midst of a maternal and infant health crisis, which is particularly devastating to women and babies of color. Data show that the U.S. remains among the most dangerous developed nations in the world for childbirth,” said Dr. Rahul Gupta, Chief Medical and Health Officer, Senior Vice President and Interim Chief Scientific Officer at March of Dimes. “Roughly every 12 hours a woman dies from pregnancy-related causes, and the CDC reports that 60 percent are preventable.  Programs like these, supported by the Anthem Foundation, are invaluable in making a positive impact for moms and babies.”

In the U.S. Black women are three times more likely to die from pregnancy-related causesⁱ and Black babies are twice as likely to die before their first birthdaysⁱⁱ compared to their White counterparts. Systemic racial injustice has affected not only health care, but also social determinants of health, such as  access to food, education, housing and jobs. These factors, together with the direct experience of racial discrimination and unequal treatment, have built a health equity gap that is directly and negatively impacting moms and babies of color.

“Anthem and its Foundation continue to lead with our commitment to improving lives and communities across our nation,” said Razia Hashmi, MD, MPH, Vice President for Commercial Clinical Operations at Anthem. “For over 10 years, our partnership with March of Dimes has provided over 47,000 individuals with access to care. We are working tirelessly to create enduring change in communities across the country, and addressing the factors driving disparities in our health system and in society as a whole.”

Over the past decade, Anthem Foundation has contributed close to $8 million to support March of Dimes programs aimed at reducing premature birth across the country. These programs have had a significant impact with only 7.3 percent of participants in group prenatal care delivering prematurely, compared to a national average of 10 percent.

About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs and provide education and advocacy so that every baby can have the best possible start. Building on a successful 80-year legacy of impact and innovation, we empower every mom and every family. Visit marchofdimes.org or nacersano.org for more information. Visit shareyourstory.org for comfort and support. Find us on Facebook and follow us on Instagram and Twitter.

About Anthem Foundation
The Anthem Foundation is the philanthropic arm of Anthem, Inc. and through charitable contributions and programs, the Foundation promotes the organization’s commitment to improving lives and communities. Through strategic partnerships and programs, the Foundation addresses the social drivers that will help create a healthier generation of Americans in communities that Anthem, Inc. and its affiliated health plans serve.  The Foundation focuses its funding on critical initiatives that make up its Healthy Generations Program, a multi-generational initiative that targets: maternal health, diabetes prevention, cancer prevention, heart health and healthy, active lifestyles, behavioral health efforts and programs that benefit people with disabilities. The Foundation also coordinates the company’s year-round Dollars for Dollars program which provides a 100 percent match of associates’ donations, as well as its Volunteer Time Off and Dollars for Doers community service programs. To learn more about the Anthem Foundation, please visit http://www.anthem.foundation and its blog at https://medium.com/anthemfoundation.

ⁱ [Petersen EE, Davis NL, Goodman D, et al. Racial/Ethnic Disparities in Pregnancy-Related Deaths-United States, 2007-2016. MMWR Morb Mortal Wkly Rep 2019;68(35):762–765.]↩
ⁱⁱ [Ely DM, Driscoll AK. Infant mortality in the United States, 2017: Data from the period linked birth/infant death file. National Vital Statistics Reports, vol 68 no 10. Hyattsville, MD: National Center for Health Statistics. 2019.]↩

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