Trump Administration Scraps Research Into Health Disparities

2025/08/15 Leave a comment

Another example of wilful ignorance:

The federal government has for decades invested vigorously in research aimed at narrowing the health gaps between racial and socioeconomic groups, pouring billions of dollars into understanding why minority and low-income Americans have shorter lives and suffer higher rates of illnesses like cancer and heart disease.

Spending on so-called health disparities rose even during the Trump administration’s first term. But in its second, much of the funding has come to a sudden halt.

Following a series of executive orders prohibiting diversity, equity and inclusion policies at every level of the federal government, the National Institutes of Health this year began terminating initiatives that officials said smacked of identity politics and offered dubious benefits.

“Spending billions on divisive, politically driven D.E.I. initiatives that don’t deliver results is not just bad health policy — it’s bad government,” said a spokeswoman for the Department of Health and Human Services.

The N.I.H will invest in projects that support “all vulnerable populations,” and expand participation “based on clinical need — not identity,” she added. She declined to be identified.

In letters from the N.I.H., scientists were told that their projects were canceled because they “harm the health of Americans,” “provide a low return on investment,” or “do not enhance health, lengthen life, or reduce illness.”

“The communication is very clear: We do not value health equity, we do not value a focus on underserved and under-treated populations, we do not consider these to be a priority,” said Dr. Kemi Doll, a cancer specialist at the University of Washington School of Medicine, who coaches younger researchers from minority backgrounds.

In interviews, many scientists whose work depends on N.I.H. grants described the terminations as harrowing and bewildering. Many felt their research was not evaluated on its merits, but nixed because words like “race” or “gender” were in the project’s title or description.

According to an analysis of federal data by The New York Times, as of mid-June the N.I.H. had terminated at least 616 projects focused on closing the health divide between Black and white, and rich and poor, Americans….

Source: Trump Administration Scraps Research Into Health Disparities

Filed under Multiculturalism Tagged with , ,

U.S. maternal deaths keep rising. Here’s who is most at risk

2023/07/06 Leave a comment

Likely similar variations in Canada although hopefully there has not been a comparable increase:

The number of people dying in the U.S. from pregnancy-related causes has more than doubled in the last 20 years, according to a new study, published in JAMA, the Journal of the American Medical Association.

And while the study found mortality rates remain “unacceptably high among all racial and ethnic groups across the U.S.,” the worst outcomes were among Black women, Native American and Alaska Native people.

The study looks at state-by-state data from 2009 to 2019. Co-author Dr. Allison Bryant, an obstetrician at Massachusetts General Hospital in Boston, says maternal death rates in the U.S. just keep getting worse.

“And that is exacerbated in populations that have been historically underserved or for whom structural racism affects them greatly,” she says.

Maternal death rates have consistently been the highest among Black women, and those high rates more than doubled over the last twenty years. For Native American and Alaska Native people, the rates have tripled.

Dr. Gregory Roth, at the University of Washington, also co-authored the paper. He says efforts to stop pregnancy deaths have not only stalled in areas like the South, where the rates have typically been high. “We’re showing that they are worsening in places that are thought of as having better health,” he says.

Places like New York and New Jersey saw an increase in deaths among Black and Latina mothers. Wyoming and Montana saw more Asian mothers die. And while maternal mortality is lower for white women, it is also increasing in some parts of the country.

“We see that for white women, maternal mortality is also increasing throughout the South, in parts of New England and throughout parts of the Midwest and Northern Mountain States,” he says.

The steady increase in maternal mortality in the U.S. is in contrast to other high-income countries which have seen their much lower rates decline even further.

“There’s this crystal clear graph that’s been out there that’s very striking,” Bryant says. With countries like the Netherlands, Austria and Japan with a clear decrease. “And then there is the U.S. that is far above all of them and going in the opposite direction,” she says.

Most maternal deaths are deemed preventable by state review committees. Dr. Catherine Spong, at the University of Texas Southwestern Medical Center, says pregnancy-related deaths can be caused by different things. The biggest risk factors are conditions like cardiovascular disease, severe pre-eclampsia, maternal cardiac disease and hemorrhage, she says.

Continuing heart problems and mental health conditions can also contribute to the death of a new mother.

The researchers say doctors would have a better chance of dealing with these health conditions, if more women had access to healthcare after their babies were born.

About half the births in the U.S. are paid for by Medicaid and “the majority of the deaths are in the immediate postpartum period,” Roth says. “If you don’t have easy access to health care in this period, you’re at very high risk.”

For those who get their healthcare through Medicaid, medical coverage lasts at least two months after the birth of a child. Since 2021, states have had the option to extend that coverage for a year. So far, 36 states and Washington D.C. have done so. States like Alabama and Mississippi, which saw some of the highest maternal death increases, did not.

Source: U.S. maternal deaths keep rising. Here’s who is most at risk

Filed under Multiculturalism Tagged with , ,

Black men were likely underdiagnosed with lung problems because of bias in software, study suggests

2023/06/03 Leave a comment

Of note (I have done the pulmonary function test as part of my cancer treatments but was completely unaware of the algorithms involved but I could sense the difference between two tests about a year apart):

Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests. 

As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software was changed, the study said. 

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are “exciting” to see published but it’s also “what we’d expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors’ decisions about patient care.

For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people’s lungs were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity. 

One example beyond lung function is a heart failure risk-scoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care. Another is an equation used in determining kidney function that creates estimates of higher kidney function in Black patients.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It’s often done using a spirometer — a device with a mouthpiece connected to a small machine. 

After the test, doctors get a report that has been run through computer software and scores the patient’s ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure. 

Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for medical procedures or even lung transplants, Vyas said.

While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, “especially when patients are borderline,” said Dr. Albert Rizzo, the chief medical officer at the American Lung Association. 

The new study looked at more than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm.

Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm.

Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.

Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for pregnant women that predicts risks of vaginal delivery if the mom previously had a cesarean section.

Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software. 

Source: Black men were likely underdiagnosed with lung problems because of bias in software, study suggests

Filed under Multiculturalism Tagged with , , ,