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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-09-05T20:08:47.501">September 5, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Patients With Vitiligo Experience Poorer Quality of Life but Greater Health Care Access, Utilization</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/brooke-mccormick">Brooke McCormick</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Patients With Vitiligo Experience Poorer Quality of Life but Greater Health Care Access, Utilization" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" 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background: #7F7F7F; color: white; padding: 2px; border-radius: 100%; } </style></div></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><p class="py-2 mb-2 text-sm italic text-gray-600">Compared with those without vitiligo, patients with vitiligo have higher health care access and utilization but report a lower quality of life.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Patients with <a target="_blank" href="https://www.ajmc.com/compendium/dermatology">vitiligo</a> are more likely to report worse quality of life but greater health care access and utilization than those without vitiligo, according to a study published in <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346581/"><em>Archives of Dermatological Research</em></a>.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">The researchers explained that patients with vitiligo are more likely to experience negative psychosocial effects, like depression, anxiety, and poorer quality of life. Patients with vitiligo may also have limited health care access; past research <a rel="nofollow noreferrer noopener" target="_blank" href="https://link.springer.com/article/10.1007/s13555-023-00983-3">found</a> that about half of those analyzed received no treatment during their first year after diagnosis.<sup class="text-inherit">2</sup></p><p class="pb-2"></p><p class="pb-2">Therefore, the researchers conducted a study to explore health care access and utilization among patients with vitiligo; they also analyzed vitiligo’s disease burden on patients.<sup class="text-inherit">1</sup> The researchers aimed to investigate whether these outcomes may be mediated by socioeconomic status, race and ethnicity, or related health conditions.</p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%276000%27%20height=%274000%27/%3e"/></span><img alt="hands of a patient with vitiligo | Image Credit: Rabizo Anatolii - stock.adobe.com" title="hands of a patient with vitiligo | Image Credit: Rabizo Anatolii - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="hands of a patient with vitiligo | Image Credit: Rabizo Anatolii - stock.adobe.com" title="hands of a patient with vitiligo | Image Credit: Rabizo Anatolii - stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Ff53568d965f39ad0d3caf6c8d81140e75eecebb1-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Ff53568d965f39ad0d3caf6c8d81140e75eecebb1-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Compared with those without vitiligo, patients with vitiligo have higher health care access and utilization but report a lower quality of life. | Image Credit: Rabizo Anatolii - stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f53568d965f39ad0d3caf6c8d81140e75eecebb1-6000x4000.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">They conducted their study using survey data from “All of Us,” a research program from the National Institutes of Health that provides a large, longitudinal dataset on US patients.<sup class="text-inherit">3</sup> The researchers identified patients with vitiligo in the program based on relevant <em>International Classification of Diseases, Ninth Revision, Clinical Modification</em> (<em>ICD-9-CM</em>), <em>ICD-10-CM</em>, and Systematized Nomenclature of Medicine diagnosis codes in their electronic health records.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">The study assessed quality of life, health care access, and health care utilization. To assess quality of life, the researchers used responses to a question from the “Overall Health” survey, which asked patients to rate their overall quality of life on a 5-point scale: excellent, very good, good, fair, or poor. The researchers then placed responses into 2 categories: worse (fair or poor) or better (good, very good, or excellent) quality of life.</p><p class="pb-2"></p><p class="pb-2">Similarly, they assessed health care access by using responses to a question from the “Healthcare Access & Utilization” survey, which asked patients if they experienced delayed care during the past calendar year due to various obstacles, including no transportation or the inability to afford the copay. The researchers considered patients to have delayed care if they reported it to be so for any reason.</p><p class="pb-2"></p><p class="pb-2">Lastly, health care utilization was determined based on another “Overall Health” survey response. The researchers designated health care utilization as “yes” if the patient indicated they visited a doctor within the past year.</p><p class="pb-2"></p><p class="pb-2">There were 409,218 patients with available data in the All of Us program as of September 2023, 1094 (0.3%) with vitiligo. However, the researchers only analyzed those who completed the “Overall Health” and “Healthcare Access & Utilization” surveys; this included 190,209 participants, 573 with vitiligo (52% of the vitiligo population). </p><p class="pb-2"></p><p class="pb-2">Among these patients, those with vitiligo reported having a fair or poor quality of life more often than those without vitiligo (14% vs 11%; <em>P</em> = .037). Conversely, a lower number of patients with vitiligo reported delayed care during the past year due to obstacles (31% vs 36%; <em>P</em> = .020) or not seeing a doctor in the past year (6% vs 11%; <em>P</em> < .001).</p><p class="pb-2"></p><p class="pb-2">Within the vitiligo population, non-Caucasian patients with vitiligo were more likely to report a fair or poor quality of life (24% vs 7%; <em>P</em> < .001) and delayed care due to obstacles (42% vs 26%; <em>P</em> < .001) than Caucasian patients without vitiligo.</p><p class="pb-2"></p><p class="pb-2">Similarly, most demographic and socioeconomic characteristics examined were significantly associated with quality of life, delayed care due to obstacles, and not seeing a doctor. Compared with Caucasian patients with vitiligo, Black patients (OR, 1.08; 95% CI, 1.03-1.13), Hispanic patients (OR, 1.09; 95% CI, 1.04-1.15), and those of other racial/ethnic groups (OR, 1.31; 95% CI, 1.22-1.40) were more likely to report a fair or poor quality of life.</p><p class="pb-2"></p><p class="pb-2">Additionally, Black patients (OR, 1.27; 95% Ci, 1.21-1.33), Hispanic patients (OR, 1.44; 95% CI, 1.38-1.51), and patients of other racial/ethnic groups (OR, 1.32; 95% CI, 1.25-1.39) were more likely to report not seeing a doctor in the past year. Lastly, patients of other racial/ethnic groups were significantly more likely to report delayed care due to obstacles (OR, 1.07; 95% CI, 1.25-1.39), and Black patients were less likely to report delayed care (OR, 0.95; 95% CI, 0.92-0.98).</p><p class="pb-2"></p><p class="pb-2">After adjusting for patient characteristics, the relationships between vitiligo and having a fair or poor quality of life (OR, 1.28; 95% CI, 0.98-1.66), delayed care due to obstacles (OR, 1.04; 95% CI, 0.86-1.26), or not seeing a doctor in the past year (OR, 0.71; 95% CI, 0.50-1.01) were not statistically significant.</p><p class="pb-2"></p><p class="pb-2">The researchers acknowledged their limitations, one being that many vitiligo cases go undiagnosed. Therefore, not all vitiligo cases may be reflected in the All of Us cohort. Despite their limitations, the researchers expressed confidence in their findings.</p><p class="pb-2"></p><p class="pb-2">“These results indicate that while all individuals with vitiligo are affected by their disease, individuals who identify as non-Caucasian may experience an increased impact on quality of life and challenges in health care access and utilization,” the authors concluded. “Incorporating special considerations for these subpopulations in health care practice may lead to improved quality of life outcomes.”</p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><p class="pb-2">1. Crummer E, Cohen JT, Rosmarin D, Lin PJ. Impact on quality of life, health care access, and health care utilization of individuals with vitiligo: an analysis of the All of Us research program. <em>Arch Dermatol Res</em>. 2024;316(8):554. doi:10.1007/s00403-024-03275-8</p><p class="pb-2">2. Rosmarin D, Soliman AM, Li C. Real-World Treatment Patterns in Patients with Vitiligo in the United States. <em>Dermatol Ther (Heidelb)</em>. 2023;13(9):2079-2091. doi:10.1007/s13555-023-00983-3</p><p class="pb-2">3. All of Us Research Program. National Institutes of Health. December 31, 2021. Accessed September 5, 2024. <a rel="nofollow noreferrer noopener" target="_blank" href="https://allofus.nih.gov/sites/default/files/All%20of%20Us%20Research%20Program%20Operational%20Protocol%202022.pdf">https://allofus.nih.gov/sites/default/files/All%20of%20Us%20Research%20Program%20Operational%20Protocol%202022.pdf</a></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" 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loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a></div></div><div class="relative block sm:hidden"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9f5ebb7c99d79d5bab3a92b62039a58829d9f6cf-6720x4480.jpg?fit=crop&auto=format" alt="Inpatient dermatology. | Image Credit: Seventyfour - stock.adobe.com " width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent">Redesigning Inpatient Dermatology to Address Costs, Improve Access</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/cameron-santoro">Cameron Santoro</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The clinical and financial implications of inpatient dermatology were examined, highlighting the need for systemic changes to improve care, reduce costs, and address health equity for patients with skin diseases. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/unlocking-access-exploring-mental-health-care-among-medicaid-managed-care-enrollees?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 23rd 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/unlocking-access-exploring-mental-health-care-among-medicaid-managed-care-enrollees?utm_source=www.ajmc.com&utm_medium=relatedContent">Unlocking Access: Exploring Mental Health Care Among Medicaid Managed Care Enrollees</a></p><div class="jsx-ad50481d5ee26850 authors 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Access Amid Medicaid Transition and Policy Reversals: Molly Dean</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/molly-dean-msw">Molly Dean, MSW</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/adapting-aca-access-amid-medicaid-transition-and-policy-reversals-molly-dean?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">As enrollment shifts to the Affordable Care Act (ACA) marketplace following the unwinding of Medicaid and the Trump administration begins to implement health policy changes, Molly Dean, MSW, Siftwell's policy advisor, shares insight on how to adapt.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9f5ebb7c99d79d5bab3a92b62039a58829d9f6cf-6720x4480.jpg?fit=crop&auto=format" alt="Inpatient dermatology. | Image Credit: Seventyfour - stock.adobe.com " width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent">Redesigning Inpatient Dermatology to Address Costs, Improve Access</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/cameron-santoro">Cameron Santoro</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/redesigning-inpatient-dermatology-to-address-costs-improve-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The clinical and financial implications of inpatient dermatology were examined, highlighting the need for systemic changes to improve care, reduce costs, and address health equity for patients with skin diseases. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/unlocking-access-exploring-mental-health-care-among-medicaid-managed-care-enrollees?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 23rd 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/unlocking-access-exploring-mental-health-care-among-medicaid-managed-care-enrollees?utm_source=www.ajmc.com&utm_medium=relatedContent">Unlocking Access: Exploring Mental Health Care Among Medicaid Managed Care Enrollees</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/ju-chen-hu-phd">Ju-Chen Hu, PhD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/unlocking-access-exploring-mental-health-care-among-medicaid-managed-care-enrollees?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with the author of a study published in the January 2025 issue of The American Journal of Managed Care® to examine the association between quantitative network adequacy standards and mental health care access among adult Medicaid enrollees.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/abortion-in-2025-access-fertility-and-infant-mortality-updates?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/0a1ac834af1e53b8cc045bb074cc7b4ce4ac0f0c-5874x3916.jpg?fit=crop&auto=format" alt="Doctor examines hologram of female uterus | Image Credit: WS Studio 1985 - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/abortion-in-2025-access-fertility-and-infant-mortality-updates?utm_source=www.ajmc.com&utm_medium=relatedContent">Abortion in 2025: Access, Fertility, and Infant Mortality Updates</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/abortion-in-2025-access-fertility-and-infant-mortality-updates?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">While Republican state-led efforts aim to increase restrictions to abortion care and access to mifepristone and misoprostol in 2025, JAMA authors join the conversation with their published research and commentary.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/frameworks-for-advancing-health-equity-accessing-ketamine-assisted-therapy?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a1728e6a06fccde8af20d2308f860344f9776b8f-800x400.jpg?fit=crop&auto=format" alt="Managed Care Cast" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 14th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/frameworks-for-advancing-health-equity-accessing-ketamine-assisted-therapy?utm_source=www.ajmc.com&utm_medium=relatedContent">Frameworks for Advancing Health Equity: Accessing Ketamine-Assisted Therapy</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/frameworks-for-advancing-health-equity-accessing-ketamine-assisted-therapy?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Jessica Tracy, head of Growth and Partnerships at Enthea, shares how employers and unions can support mental health and address access barriers to evidence-based ketamine treatments.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4b1e70c0107d954ccd83281363addeca769a16bd-4992x3328.jpg?fit=crop&auto=format" alt="Patient talking with doctor | Image credit: Monkey Business - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent">Cancer Mortality Rates Still High Among Black Patients, Despite Overall Decline</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Black individuals had a 2-fold risk of cancer death related to prostate, myeloma, and stomach cancers compared with White individuals.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/adapting-aca-access-amid-medicaid-transition-and-policy-reversals-molly-dean?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a471c373ad790308f1c732a5c09f38d20d818a84-959x530.png?fit=crop&auto=format" alt="Molly Dean, MSW, Siftwell" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 19th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/adapting-aca-access-amid-medicaid-transition-and-policy-reversals-molly-dean?utm_source=www.ajmc.com&utm_medium=relatedContent">Adapting ACA Access Amid Medicaid Transition and Policy Reversals: Molly Dean</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/molly-dean-msw">Molly Dean, MSW</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/adapting-aca-access-amid-medicaid-transition-and-policy-reversals-molly-dean?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">As enrollment shifts to the Affordable Care Act (ACA) marketplace following the unwinding of Medicaid and the Trump administration begins to implement health policy changes, Molly Dean, MSW, Siftwell's policy advisor, shares insight on how to adapt.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Patients With Vitiligo Experience Poorer Quality of Life but Greater Health Care Access, Utilization","datePublished":"2024-09-05T20:08:47.501Z","dateModified":"2024-09-05T20:08:53Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/f53568d965f39ad0d3caf6c8d81140e75eecebb1-6000x4000.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/patients-with-vitiligo-experience-poorer-quality-of-life-but-greater-health-care-access-utilization"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"dermatology,vitiligo,quality of life,health care access,health care utilization","articleBody":"Patients with vitiligo are more likely to report worse quality of life but greater health care access and utilization than those without vitiligo, according to a study published in Archives of Dermatological Research.1\n\n\n\nThe researchers explained that patients with vitiligo are more likely to experience negative psychosocial effects, like depression, anxiety, and poorer quality of life. Patients with vitiligo may also have limited health care access; past research found that about half of those analyzed received no treatment during their first year after diagnosis.2\n\n\n\nTherefore, the researchers conducted a study to explore health care access and utilization among patients with vitiligo; they also analyzed vitiligo’s disease burden on patients.1 The researchers aimed to investigate whether these outcomes may be mediated by socioeconomic status, race and ethnicity, or related health conditions.\n\n\n\nThey conducted their study using survey data from “All of Us,” a research program from the National Institutes of Health that provides a large, longitudinal dataset on US patients.3 The researchers identified patients with vitiligo in the program based on relevant International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), ICD-10-CM, and Systematized Nomenclature of Medicine diagnosis codes in their electronic health records.1\n\n\n\nThe study assessed quality of life, health care access, and health care utilization. To assess quality of life, the researchers used responses to a question from the “Overall Health” survey, which asked patients to rate their overall quality of life on a 5-point scale: excellent, very good, good, fair, or poor. The researchers then placed responses into 2 categories: worse (fair or poor) or better (good, very good, or excellent) quality of life.\n\n\n\nSimilarly, they assessed health care access by using responses to a question from the “Healthcare Access & Utilization” survey, which asked patients if they experienced delayed care during the past calendar year due to various obstacles, including no transportation or the inability to afford the copay. The researchers considered patients to have delayed care if they reported it to be so for any reason.\n\n\n\nLastly, health care utilization was determined based on another “Overall Health” survey response. The researchers designated health care utilization as “yes” if the patient indicated they visited a doctor within the past year.\n\n\n\nThere were 409,218 patients with available data in the All of Us program as of September 2023, 1094 (0.3%) with vitiligo. However, the researchers only analyzed those who completed the “Overall Health” and “Healthcare Access & Utilization” surveys; this included 190,209 participants, 573 with vitiligo (52% of the vitiligo population). \n\n\n\nAmong these patients, those with vitiligo reported having a fair or poor quality of life more often than those without vitiligo (14% vs 11%; P = .037). Conversely, a lower number of patients with vitiligo reported delayed care during the past year due to obstacles (31% vs 36%; P = .020) or not seeing a doctor in the past year (6% vs 11%; P < .001).\n\n\n\nWithin the vitiligo population, non-Caucasian patients with vitiligo were more likely to report a fair or poor quality of life (24% vs 7%; P < .001) and delayed care due to obstacles (42% vs 26%; P < .001) than Caucasian patients without vitiligo.\n\n\n\nSimilarly, most demographic and socioeconomic characteristics examined were significantly associated with quality of life, delayed care due to obstacles, and not seeing a doctor. Compared with Caucasian patients with vitiligo, Black patients (OR, 1.08; 95% CI, 1.03-1.13), Hispanic patients (OR, 1.09; 95% CI, 1.04-1.15), and those of other racial/ethnic groups (OR, 1.31; 95% CI, 1.22-1.40) were more likely to report a fair or poor quality of life.\n\n\n\nAdditionally, Black patients (OR, 1.27; 95% Ci, 1.21-1.33), Hispanic patients (OR, 1.44; 95% CI, 1.38-1.51), and patients of other racial/ethnic groups (OR, 1.32; 95% CI, 1.25-1.39) were more likely to report not seeing a doctor in the past year. Lastly, patients of other racial/ethnic groups were significantly more likely to report delayed care due to obstacles (OR, 1.07; 95% CI, 1.25-1.39), and Black patients were less likely to report delayed care (OR, 0.95; 95% CI, 0.92-0.98).\n\n\n\nAfter adjusting for patient characteristics, the relationships between vitiligo and having a fair or poor quality of life (OR, 1.28; 95% CI, 0.98-1.66), delayed care due to obstacles (OR, 1.04; 95% CI, 0.86-1.26), or not seeing a doctor in the past year (OR, 0.71; 95% CI, 0.50-1.01) were not statistically significant.\n\n\n\nThe researchers acknowledged their limitations, one being that many vitiligo cases go undiagnosed. Therefore, not all vitiligo cases may be reflected in the All of Us cohort. Despite their limitations, the researchers expressed confidence in their findings.\n\n\n\n“These results indicate that while all individuals with vitiligo are affected by their disease, individuals who identify as non-Caucasian may experience an increased impact on quality of life and challenges in health care access and utilization,” the authors concluded. “Incorporating special considerations for these subpopulations in health care practice may lead to improved quality of life outcomes.”\n\n\n\nReferences\n\n1. Crummer E, Cohen JT, Rosmarin D, Lin PJ. Impact on quality of life, health care access, and health care utilization of individuals with vitiligo: an analysis of the All of Us research program. Arch Dermatol Res. 2024;316(8):554. doi:10.1007/s00403-024-03275-8\n\n2. Rosmarin D, Soliman AM, Li C. Real-World Treatment Patterns in Patients with Vitiligo in the United States. Dermatol Ther (Heidelb). 2023;13(9):2079-2091. doi:10.1007/s13555-023-00983-3\n\n3. All of Us Research Program. National Institutes of Health. December 31, 2021. Accessed September 5, 2024. https://allofus.nih.gov/sites/default/files/All%20of%20Us%20Research%20Program%20Operational%20Protocol%202022.pdf","description":"Compared with those without vitiligo, patients with vitiligo have higher health care access and utilization but report a lower quality of life.","author":[{"@type":"Person","name":"Brooke McCormick"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] py-12 pl-auto"><div class="xxl:w-[75%] 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Patients with vitiligo may also have limited health care access; past research ","_key":"f4871e4a2c0b0"},{"marks":["0250ed2c0fe1"],"text":"found","_key":"63395c56540e","_type":"span"},{"_type":"span","marks":[],"text":" that about half of those analyzed received no treatment during their first year after diagnosis.","_key":"89153b41d2c1"},{"_type":"span","marks":["superscript"],"text":"2","_key":"8013242a633c"}],"upload_doc":null,"uploadAudio":null,"medias":null},{"style":"normal","_key":"7017c6afbf34","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"4ecb2f2c333d0"}],"_type":"block"},{"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Therefore, the researchers conducted a study to explore health care access and utilization among patients with vitiligo; they also analyzed vitiligo’s disease burden on patients.","_key":"76f0caf5546b0"},{"text":"1","_key":"2c9cd46cbe93","_type":"span","marks":["superscript"]},{"marks":[],"text":" The researchers aimed to investigate whether these outcomes may be mediated by socioeconomic status, race and ethnicity, or related health conditions.","_key":"afc0aa04c1e3","_type":"span"}],"_type":"block","style":"normal","_key":"6b59d02b36f6","upload_doc":null,"uploadAudio":null},{"asset":{"_ref":"image-f53568d965f39ad0d3caf6c8d81140e75eecebb1-6000x4000-jpg","_type":"reference"},"disableLightBox":true,"alt":"hands of a patient with vitiligo | Image Credit: Rabizo Anatolii - stock.adobe.com","_key":"198a96a98321","_type":"figure","upload_doc":null,"uploadAudio":null,"medias":null,"alignment":"right","widthP":40,"disableTextWrap":false,"imgcaption":[{"_key":"971389c6cfac","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Compared with those without vitiligo, patients with vitiligo have higher health care access and utilization but report a lower quality of life. | Image Credit: Rabizo Anatolii - stock.adobe.com","_key":"6b6b0b6b03e0"}],"_type":"block","style":"normal"}]},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"They conducted their study using survey data from “All of Us,” a research program from the National Institutes of Health that provides a large, longitudinal dataset on US patients.","_key":"a1fe10de619e0"},{"_type":"span","marks":["superscript"],"text":"3","_key":"6ee9997e6219"},{"marks":[],"text":" The researchers identified patients with vitiligo in the program based on relevant ","_key":"3e503289f57d","_type":"span"},{"_key":"36b9e384720b","_type":"span","marks":["em"],"text":"International Classification of Diseases, Ninth Revision, Clinical Modification"},{"_type":"span","marks":[],"text":" (","_key":"c2c070772cbf"},{"_type":"span","marks":["em"],"text":"ICD-9-CM","_key":"6ed9ef654f64"},{"_type":"span","marks":[],"text":"), ","_key":"f31e5aae93b2"},{"_type":"span","marks":["em"],"text":"ICD-10-CM","_key":"0e75d854db29"},{"_type":"span","marks":[],"text":", and Systematized Nomenclature of Medicine diagnosis codes in their electronic health records.","_key":"3d949421a1ab"},{"_type":"span","marks":["superscript"],"text":"1","_key":"5bab3b9989b5"}],"_type":"block","style":"normal","_key":"5f10c2958656","markDefs":[],"upload_doc":null},{"_type":"block","style":"normal","_key":"e72cc612ab43","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"13b1f3d0cee10"}],"upload_doc":null,"uploadAudio":null,"medias":null},{"_key":"620aed5b23ca","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The study assessed quality of life, health care access, and health care utilization. To assess quality of life, the researchers used responses to a question from the “Overall Health” survey, which asked patients to rate their overall quality of life on a 5-point scale: excellent, very good, good, fair, or poor. The researchers then placed responses into 2 categories: worse (fair or poor) or better (good, very good, or excellent) quality of life.","_key":"a9db2fe61a610"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null},{"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_key":"e529c6b5729c0","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"cc3d5c48730e","upload_doc":null},{"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Similarly, they assessed health care access by using responses to a question from the “Healthcare Access \u0026 Utilization” survey, which asked patients if they experienced delayed care during the past calendar year due to various obstacles, including no transportation or the inability to afford the copay. The researchers considered patients to have delayed care if they reported it to be so for any reason.","_key":"e6cc53b795800"}],"_type":"block","style":"normal","_key":"4a72902c6f23","upload_doc":null},{"children":[{"_type":"span","marks":[],"text":"","_key":"f9af967e05b50"}],"_type":"block","style":"normal","_key":"97d15e74aeac","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"Lastly, health care utilization was determined based on another “Overall Health” survey response. The researchers designated health care utilization as “yes” if the patient indicated they visited a doctor within the past year.","_key":"5dd75b5154700"}],"_type":"block","style":"normal","_key":"7c0fcd70330a","markDefs":[],"upload_doc":null},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ca991bb5adce0"}],"_type":"block","style":"normal","_key":"abda5fcc5861","upload_doc":null,"uploadAudio":null,"medias":null},{"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"There were 409,218 patients with available data in the All of Us program as of September 2023, 1094 (0.3%) with vitiligo. However, the researchers only analyzed those who completed the “Overall Health” and “Healthcare Access \u0026 Utilization” surveys; this included 190,209 participants, 573 with vitiligo (52% of the vitiligo population). 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Conversely, a lower number of patients with vitiligo reported delayed care during the past year due to obstacles (31% vs 36%; ","_key":"cf38bff01f8c","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"P","_key":"887d158387d1"},{"_type":"span","marks":[],"text":" = .020) or not seeing a doctor in the past year (6% vs 11%; ","_key":"e7dc651af93e"},{"_type":"span","marks":["em"],"text":"P","_key":"dace721bb8b0"},{"marks":[],"text":" \u003c .001).","_key":"3e2a54be15d7","_type":"span"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"aa879ad0719f","markDefs":[]},{"style":"normal","_key":"3616263e7513","markDefs":[],"children":[{"marks":[],"text":"","_key":"26ec5a7b53f40","_type":"span"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block"},{"_key":"bc5083acabc9","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"Within the vitiligo population, non-Caucasian patients with vitiligo were more likely to report a fair or poor quality of life (24% vs 7%; ","_key":"9c83f00d715a0"},{"_type":"span","marks":["em"],"text":"P","_key":"8859238d7a0b"},{"_type":"span","marks":[],"text":" \u003c .001) and delayed care due to obstacles (42% vs 26%; ","_key":"df9c4fa466fa"},{"_type":"span","marks":["em"],"text":"P","_key":"fd8f69d5e198"},{"marks":[],"text":" \u003c .001) than Caucasian patients without vitiligo.","_key":"607c48816adc","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"f91536e369ef0"}],"_type":"block","style":"normal","_key":"3aef88368c26"},{"medias":null,"_type":"block","style":"normal","_key":"125d1207387a","markDefs":[],"children":[{"text":"Similarly, most demographic and socioeconomic characteristics examined were significantly associated with quality of life, delayed care due to obstacles, and not seeing a doctor. Compared with Caucasian patients with vitiligo, Black patients (OR, 1.08; 95% CI, 1.03-1.13), Hispanic patients (OR, 1.09; 95% CI, 1.04-1.15), and those of other racial/ethnic groups (OR, 1.31; 95% CI, 1.22-1.40) were more likely to report a fair or poor quality of life.","_key":"046d07a70fee0","_type":"span","marks":[]}],"upload_doc":null,"uploadAudio":null},{"_key":"dd43db774730","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bc939ed171110"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal"},{"style":"normal","_key":"2e48d91ecad3","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"Additionally, Black patients (OR, 1.27; 95% Ci, 1.21-1.33), Hispanic patients (OR, 1.44; 95% CI, 1.38-1.51), and patients of other racial/ethnic groups (OR, 1.32; 95% CI, 1.25-1.39) were more likely to report not seeing a doctor in the past year. Lastly, patients of other racial/ethnic groups were significantly more likely to report delayed care due to obstacles (OR, 1.07; 95% CI, 1.25-1.39), and Black patients were less likely to report delayed care (OR, 0.95; 95% CI, 0.92-0.98).","_key":"a7b70fb6a8b20"}],"_type":"block"},{"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"cdb8cae2fb3e0"}],"_type":"block","style":"normal","_key":"08c707e76132","upload_doc":null,"uploadAudio":null},{"upload_doc":null,"uploadAudio":null,"medias":null,"_key":"cc6def77c21f","markDefs":[],"children":[{"text":"After adjusting for patient characteristics, the relationships between vitiligo and having a fair or poor quality of life (OR, 1.28; 95% CI, 0.98-1.66), delayed care due to obstacles (OR, 1.04; 95% CI, 0.86-1.26), or not seeing a doctor in the past year (OR, 0.71; 95% CI, 0.50-1.01) were not statistically significant.","_key":"15088adea8c70","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"medias":null,"_key":"8aa8cf1664d5","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"578ef96434b60"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null},{"children":[{"_type":"span","marks":[],"text":"The researchers acknowledged their limitations, one being that many vitiligo cases go undiagnosed. Therefore, not all vitiligo cases may be reflected in the All of Us cohort. Despite their limitations, the researchers expressed confidence in their findings.","_key":"449f5c8cd3f70"}],"_type":"block","style":"normal","_key":"fa2797d099f6","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[]},{"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal","_key":"07d77a448ab6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"730aa3b62ef80"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“These results indicate that while all individuals with vitiligo are affected by their disease, individuals who identify as non-Caucasian may experience an increased impact on quality of life and challenges in health care access and utilization,” the authors concluded. “Incorporating special considerations for these subpopulations in health care practice may lead to improved quality of life outcomes.”","_key":"1da29f04bf3c0"}],"_type":"block","style":"normal","_key":"6e3a1c72382e","upload_doc":null,"uploadAudio":null,"medias":null},{"_type":"block","style":"normal","_key":"0047e7650d57","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1f687a60532f0"}]},{"uploadAudio":null,"medias":null,"style":"normal","_key":"fc511e1b3521","markDefs":[],"children":[{"marks":["strong"],"text":"References","_key":"c978ea3aeab30","_type":"span"}],"_type":"block","upload_doc":null},{"children":[{"text":"1. Crummer E, Cohen JT, Rosmarin D, Lin PJ. Impact on quality of life, health care access, and health care utilization of individuals with vitiligo: an analysis of the All of Us research program. ","_key":"29c0dc463268","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Arch Dermatol Res","_key":"efbc1f58657e"},{"_type":"span","marks":[],"text":". 2024;316(8):554. doi:10.1007/s00403-024-03275-8","_key":"a123a75f1b94"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal","_key":"8567f2c8f1e7","markDefs":[]},{"children":[{"text":"2. Rosmarin D, Soliman AM, Li C. Real-World Treatment Patterns in Patients with Vitiligo in the United States. 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Dermatologic consultation has potential to diagnose and treat over 60% of these patients, improving outcomes. Inpatient skin care costs over $5 billion yearly, making up about 0.5% of total inpatient health care spending.","_key":"00eeaeb818ec","_type":"span"}],"_type":"block","style":"normal","_key":"693843c719a4"},{"markDefs":[],"children":[{"text":"","_key":"dacb81049f4a","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"4e4702b09f97"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Hospitalizations for skin diseases average $7949, the authors explained, but the cost nearly doubles to $15,967 when patients have comorbidities, which also lengthen stays (7.3 vs 4.6 days). This review examines inpatient dermatology's clinical and financial implications by synthesizing literature on its utilization, trends, and impact, noting how changing reimbursement and the shift to hospitalist care have altered its model.","_key":"b1a55124d975"}],"_type":"block","style":"normal","_key":"fe284a6239ec"},{"style":"normal","_key":"7074211b4514","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c3d3b63794fc"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["underline","strong"],"text":"Economic Impact of Dermatologic Conditions","_key":"f488fda0733a"}],"_type":"block","style":"h4","_key":"64dd5864f2e1"},{"markDefs":[],"children":[{"_key":"f13e6e6bc0f1","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"8f344b8461ed"},{"_type":"block","style":"normal","_key":"68680f3c7ea2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Dermatologic hospitalizations strain the health care system, and better care continuity between hospitalists and dermatologists could help mitigate this strain. Annual per-person health care costs for patients with atopic dermatitis reach $10,474 per person per year (PPPY), mainly due to outpatient and pharmacy expenses, one study found.","_key":"7d290a15b8d4"},{"marks":["sup"],"text":"2 ","_key":"96401e12fe10","_type":"span"},{"_type":"span","marks":[],"text":"For example, atopic dermatitis medication costs $1168 PPPY, with topical therapies at $254 and systemic therapies at $914.","_key":"5c08019b46ea"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"369fa38102bd"}],"_type":"block","style":"normal","_key":"91b2d67c13e1"},{"children":[{"_type":"span","marks":[],"text":"A 2014 study found skin disease hospitalizations cost $5.04 billion, led by bacterial infections ($7024 per admission), ulcers ($12,984 per admission), and connective tissue disorders ($15,577 per admission).","_key":"4cfe4b589089"},{"_type":"span","marks":["sup"],"text":"1","_key":"5dc7457b0eba"},{"text":" A 2012 pediatric study found costs of $379.8 million that year, with cutaneous lymphomas ($58,294), congenital skin abnormalities ($24,186), and ulcers ($17,064) driving costs. These figures highlight the need for better outpatient dermatologic care access and a restructured consultative model for comprehensive inpatient dermatologic care.","_key":"431c47c0c705","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"384e46647885","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"763821f6b275"}],"_type":"block","style":"normal","_key":"88b28039d148"},{"_key":"92b9b9f4679f","markDefs":[],"children":[{"marks":[],"text":"Patients with severe skin disease may benefit from an expanded care team, including primary inpatient dermatologists and palliative care specialists. The researchers estimated a 0.47% mortality rate for primarily dermatologic hospitalizations.","_key":"fa6335626cb4","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"80d503883179","markDefs":[],"children":[{"_key":"9fdb5b4187c4","_type":"span","marks":[],"text":""}]},{"_type":"block","style":"normal","_key":"375788aa0c07","markDefs":[],"children":[{"_type":"span","marks":[],"text":"High costs and readmission rates suggest implementing primary admitting inpatient dermatologists, rather than consulting dermatologists, would improve treatment and outcomes.","_key":"a0ffc24538a0"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"a4334a6feb06"}],"_type":"block","style":"normal","_key":"0789c0d8a8bd","markDefs":[]},{"_key":"0c7de2c1d22c","markDefs":[],"children":[{"marks":["underline","strong"],"text":"Expanding Inpatient Dermatology Services","_key":"4b654eb7222d","_type":"span"}],"_type":"block","style":"h4"},{"_type":"block","style":"normal","_key":"bcd658f5cb2d","markDefs":[],"children":[{"_key":"f05a89456c3e","_type":"span","marks":[],"text":""}]},{"_type":"block","style":"normal","_key":"dbe8cf86d7c4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"In 2017, dermatologists consulted in only 4.6% of Medicare skin-related hospitalizations (8867 annual consultations), saving Medicare $19 million to $38.3 million, the study authors noted. Based on these findings, a 10% consultation rate could save $41.3 million to $83.3 million.","_key":"7b15c603d559"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"214385a102de"}],"_type":"block","style":"normal","_key":"34fe3a6e82ff","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"“To increase this rate to 10%, we would need to conduct an additional 10,402 consultations annually, bringing the total to about 19,269,” the authors wrote. \"To reach 20%, an additional 29,671 consultations would be necessary, totaling 38,538 per year. In terms of staffing, we estimate that one dermatologist can handle about 500 inpatient consultations annually (2-3 consults per workday excluding weekends, holidays, and vacation days). To meet the 10% target, this would require 21 additional dermatologists. To reach 20%, about 60 more dermatologists would be needed.”","_key":"045f39940336"}],"_type":"block","style":"normal","_key":"d4b90fe1bc3d","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"","_key":"a3b5ad48fb30"}],"_type":"block","style":"normal","_key":"469c12b23e22","markDefs":[]},{"_key":"09975de3fff8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"While expanding inpatient consultations may reduce outpatient availability, involving residents and fellows can distribute the workload and maintain both inpatient and outpatient services, the authors noted. Inpatient dermatology exposure may also increase resident interest in the subspecialty, addressing the physician shortage.","_key":"6254e180ce8a"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a4bca269737c"}],"_type":"block","style":"normal","_key":"582e8c7138e6"},{"children":[{"_type":"span","marks":[],"text":"Improved financial incentives could encourage more dermatologists to provide this care. Professional organizations can conduct additional advocacy efforts, and lobbying for Medicare and Medicaid reimbursement changes can pave the way for higher payments. Additionally, inpatient dermatology addresses the median 2-day lag time between hospitalization and consultation associated with the consultative model.","_key":"87d2b3fc71a1"}],"_type":"block","style":"normal","_key":"cf35c4e36316","markDefs":[]},{"_type":"block","style":"normal","_key":"c4e5d327c0f9","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"5098ed419f80"}]},{"children":[{"_type":"span","marks":[],"text":"“Expanding upon such data-driven research demonstrating the value of inpatient dermatology, can further bolster advocacy efforts for reimbursement,” study authors stated.","_key":"a0c6c12f55f6"}],"_type":"block","style":"normal","_key":"d1aec964aafc","markDefs":[]},{"_key":"5c1c48f826bf","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"cbf498e88338"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":["strong","underline"],"text":"Optimizing Teledermatology Services","_key":"afc2db149851"}],"_type":"block","style":"h4","_key":"fe62600304f3","markDefs":[]},{"markDefs":[],"children":[{"_key":"24be6009da5b","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"c9716d76fcd9"},{"style":"normal","_key":"746568c69990","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Inpatient teledermatology can expand dermatologists' reach and consultation availability without bedside presence. Studies confirm its diagnostic accuracy and improved patient outcomes, the authors explained. Teledermatology has also proven effective in emergency departments and underserved areas with limited dermatologist access. Since most dermatology clinics are off-site, teledermatology eliminates travel delays and enables timely interventions.","_key":"f2d8ef7f4c0f"}],"_type":"block"},{"_type":"block","style":"normal","_key":"cf6c1c2f6847","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ee9fa321677c"}]},{"children":[{"_type":"span","marks":[],"text":"However, barriers to widespread implementation remain, including nonstandardized reimbursement, limited televisit reimbursement (exacerbated by Medicare reductions), and increased costs. Teledermatology can drastically reduce time to diagnosis from 137.5 days with usual care to just 50 days, enabling earlier interventions and potentially improving prognoses.","_key":"8b894ca82e59"}],"_type":"block","style":"normal","_key":"de6c934024f9","markDefs":[]},{"_key":"00069edff7ed","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"4de91f32b36c"}],"_type":"block","style":"normal"},{"_key":"6774b2893522","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Pre-pandemic teledermatology use was limited, but post-pandemic adoption rose to 77.8%. 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Inpatient dermatologic care, particularly consultations, offers lower financial incentives. Dermatologists also acknowledge that reimbursement rates have not kept pace with inflation.","_key":"30472e01de29"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"9f4190f3bcd9"}],"_type":"block","style":"normal","_key":"76a508b80575"},{"children":[{"_type":"span","marks":["underline","strong"],"text":"Recommendations and Strategies to Improve Inpatient Dermatology","_key":"117afb781a34"}],"_type":"block","style":"h4","_key":"9dd22aacf4d3","markDefs":[]},{"children":[{"text":"","_key":"eb479363f96f","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"4d5c3dd5acd3","markDefs":[]},{"style":"normal","_key":"589c45e6301b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Systemic changes in government and healthcare protocols must implement dermatologists as primary admitting teams and standardize telehealth in low-resource areas, the authors wrote. 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Inpatient teledermatology integration into residency training may also benefit institutions with limited in-person capacity and no primary dermatology admitting service.","_key":"8b082e37f0c0","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"42f27dac4e14","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0f38d65e2219"}]},{"_type":"block","style":"normal","_key":"99af03f43325","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Underlying issues include the current dermatologist deficit for basic services, let alone inpatient consultations, the authors noted. 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Abortion bans in the wake of the "},{"_type":"span","marks":["em"],"text":"Dobbs v Jackson ","_key":"b03e778c2446"},{"_type":"span","marks":[],"text":"Supreme Court decision in 2022 and the preceding Texas Senate Bill 8 (SB8) in 2021 have introduced legal and ethical dilemmas, prompting a nationwide conversation including various perspectives among physicians, authors, and lawmakers.","_key":"5796cc75ba3f"}],"_type":"block"},{"_type":"block","style":"normal","_key":"c8f27ca56f72","markDefs":[],"children":[{"_key":"55e859a445a0","_type":"span","marks":[],"text":""}]},{"style":"normal","_key":"81f4293470c5","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Abortion access continues to be one of the most contentious issues in US health care, according to ","_key":"3bb31b6ce2cd"},{"_type":"span","marks":["em"],"text":"JAMA Health Forum’s","_key":"c7858834ec80"},{"_type":"span","marks":[],"text":" editor in chief, Sandro Galea, MD, DrPh, who emphasized the role of academic medical journals in publishing rigorous research while fostering informed discussion on complex and politically charged topics.","_key":"113d97d42bce"},{"text":"1","_key":"c64c743efd96","_type":"span","marks":["sup"]}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"6ab68bcb37a9","_type":"span"}],"_type":"block","style":"normal","_key":"fea8276dd648"},{"style":"normal","_key":"2831846fc907","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“This becomes both particularly important—and particularly difficult—when dealing with issues that are of enormous contemporary consequence and of heated public debate,” he wrote in an editorial published in ","_key":"58cb0905c188"},{"_type":"span","marks":["em"],"text":"JAMA Health Forum","_key":"6b1dd8a521c6"},{"_type":"span","marks":[],"text":".","_key":"1d2007e487dd"}],"_type":"block"},{"style":"normal","_key":"525f14392093","markDefs":[],"children":[{"marks":[],"text":"","_key":"72e94bb2d7e2","_type":"span"}],"_type":"block"},{"_key":"c1d35de29846","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The topic of abortion restrictions and related impacts were addressed in multiple articles published by ","_key":"f037c84645d7"},{"_key":"1e90dd8074c7","_type":"span","marks":["em"],"text":"JAMA"},{"text":" this week, including a pair of investigations Galea highlighted that examined the real-world effects of abortion bans.","_key":"69023cc3452e","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"c2b047cd0ae6","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"ded03e187f40"},{"children":[{"_key":"533a8c20cb80","_type":"span","marks":[],"text":"The first study analyzed US national vital statistics data from 2012 to 2023 and found a significant rise in infant mortality following state-level abortion restrictions that translated to an estimated 478 excess infant deaths during the months affected by the bans."},{"marks":["sup"],"text":"2","_key":"480e8d065c3f","_type":"span"},{"marks":[],"text":" Across the 14 states with bans, the observed infant mortality rate was 6.26 per 1000 live births compared with an expected rate of 5.93, resulting in an absolute increase of 0.33 (95% credible interval [CrI], 0.14-0.51) and a relative increase of 5.60% (95% Crl, 2.43%-8.73%). Gemmill et al found the impact was particularly severe among Black individuals, those in Southern states, and infants with congenital anomalies.","_key":"613b26120e93","_type":"span"}],"_type":"block","style":"normal","_key":"fd86976e88fd","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1d230476c916"}],"_type":"block","style":"normal","_key":"a11224e30c80"},{"_type":"block","style":"normal","_key":"637eca10a152","markDefs":[],"children":[{"_type":"span","marks":[],"text":"An analogous pattern of disparities was exhibited in the second study by Bell et al; more than 20,000 excess births occurred after abortion bans based on an analysis of US Census and birth certificate data.","_key":"381a8e72be7e"},{"_type":"span","marks":["sup"],"text":"3","_key":"ddfabfadb40e"},{"marks":[],"text":" The findings demonstrated disproportionate effects on Medicaid beneficiaries (2.41%), racially diverse communities (≈ 2.0%), individuals younger than 35 years (≈ 2.0%), those without college degrees (high school diploma, 2.36%; 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These abortion laws have been “recognized as some of the most restrictive antiabortion regulations in the country” and have affected the landscape of reproductive rights and health beyond Texas borders, as observed in 13 additional states with near-total abortion bans.","_key":"c9ac55ffd33b","_type":"span"}]},{"style":"normal","_key":"9182dc4b1944","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"982ef68da214"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"6a1f9b3685eb","_type":"span","marks":[],"text":"The state first criminalized abortion in 1854 and again in 1925, only for these laws to be overridden by "},{"text":"Roe v Wade","_key":"677cf4672744","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" in 1973. However, Texas lawmakers persisted with regulations that included transvaginal ultrasound requirements, mandatory waiting periods, fetal remains burial mandates, and state-mandated counseling that Ivey says includes inaccurate medical information. These laws have steadily eroded access to abortion, culminating in SB8, which not only bans abortion after 6 weeks but also allows private citizens to sue anyone they believe has helped someone obtain an abortion, according to the article.","_key":"0bd05fcf6e52"}],"_type":"block","style":"normal","_key":"790e1718739c"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f61b90abbb70"}],"_type":"block","style":"normal","_key":"c013a8180a86"},{"_type":"block","style":"normal","_key":"708a7414f090","markDefs":[],"children":[{"marks":[],"text":"Polling has indicated most Texans support legal abortion in some circumstances. However, Texas’ current ban offers no exceptions for rape, incest, fetal anomalies, or lethal chromosomal conditions. The only exceptions are ectopic pregnancies and cases where the mother’s life is in danger—though vague legal wording leaves many physicians uncertain about what is legally permissible.","_key":"0570d18e4898","_type":"span"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"cfe0e1fa23e8"}],"_type":"block","style":"normal","_key":"49f2d5a4cee7","markDefs":[]},{"_key":"3adc36cb41d1","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Under Texas law SB8, physicians face severe penalties for violating abortion laws. A ruling from the Texas Supreme Court offered some guidance but lacked legal force, leaving doctors hesitant. Recent cases, such as ","_key":"00b366d26e4a"},{"_type":"span","marks":["em"],"text":"Zurawski v Texas","_key":"8015ce458ce1"},{"_type":"span","marks":[],"text":", show the consequences, with patients suffering from severe complications due to denied abortions, potentially leading to increased maternal fatalities, the article stated.","_key":"a5ee149418b9"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"b1b78f305f9a"}],"_type":"block","style":"normal","_key":"24e5b709ee93","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Make no mistake—the design of these laws is intentional,” Ivey wrote. “The vague wording of the law with detailed, severe penalties for physicians is deliberate. The chilling effect in health care is the desired outcome. The culture of fear among patients and physicians is real. This confusion led the Texas Supreme Court to request clarification from the state medical board. The board opined that the threat to maternal life need not be imminent, but a medical board cannot change law.”","_key":"43894ccf27f8"}],"_type":"block","style":"normal","_key":"4234f2844d38"},{"style":"normal","_key":"93ec045dc8c5","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bf45f321cba0"}],"_type":"block"},{"_type":"block","style":"h3","_key":"c9313c20834e","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Consequences of “Legislative Intrusion” in Medicine","_key":"2866967d7018"}]},{"style":"normal","_key":"bdaa25ccddd7","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/view/new-report-shows-worsening-health-outcomes-for-women-in-states-with-abortion-bans","_key":"99b4b83d73f5"}],"children":[{"_type":"span","marks":[],"text":"Of all US women of reproductive age, 10% reside in Texas.","_key":"9d0a293f333a"},{"text":"6","_key":"5d488aaae73e","_type":"span","marks":["sup"]},{"text":" This subpopulation is also the most uninsured, with Texas ","_key":"2cfab7b14b6a","_type":"span","marks":[]},{"text":"ranking lowest","_key":"4727fbf1b612","_type":"span","marks":["99b4b83d73f5"]},{"_type":"span","marks":[],"text":" across all 50 states for health care coverage and affordability in The Commonwealth Fund’s 2024 State Scorecard on Women’s Health and Reproductive Care.","_key":"af8a6423301f"},{"marks":["sup"],"text":"7","_key":"703566984416","_type":"span"},{"marks":[],"text":" In 2022, 27% of Texas women went without needed care due to access issues.","_key":"02a3ce78e750","_type":"span"},{"_type":"span","marks":["sup"],"text":"6","_key":"bee0df368ce6"},{"_type":"span","marks":[],"text":" The state only recently extended postpartum Medicaid coverage to 1 year—far later than many other states.","_key":"1a3e3973718c"}],"_type":"block"},{"_key":"458d6d17f314","markDefs":[],"children":[{"marks":[],"text":"","_key":"ea0ab07021bd","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"Adding to the crisis is a worsening provider shortage, Ivey explained. Nearly half (48%) of practicing obstetrician-gynecologists (ob-gyns) nationwide are older than 55 years and expected to retire in the next decade. Texas is already seeing a decline in ob-gyn residency applications, with 57% of residents reporting that abortion laws are influencing their decision to leave the state after training. This exodus could have dire consequences, particularly in the 47% of Texas counties that are classified as maternity deserts; 17 rural labor and delivery units have closed in the last decade.","_key":"7ab04c9de839","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"1dc16380c343"},{"markDefs":[],"children":[{"text":"","_key":"3d569c8bb7b7","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"cf93b2d208b1"},{"style":"normal","_key":"a9f37b57e633","markDefs":[],"children":[{"_key":"e87760af48a2","_type":"span","marks":[],"text":"The "},{"text":"Dobbs","_key":"cf96f15ba9f6","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" decision set forth a ripple effect of trigger laws and abortion bans that impacted the entire country, with restrictions imposed in some states while other states simultaneously aimed to fill those access gaps. However, it hasn't decreased the occurrence of abortion nationwide—possibly even moving the needle slightly in the opposite direction, as speculated in the Society of Family Planning report.","_key":"95d4d106977f"},{"_type":"span","marks":["sup"],"text":"5","_key":"6424813c79a0"}],"_type":"block"},{"_key":"ed10535672d3","markDefs":[],"children":[{"_key":"4a13dd3ea97c","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Reproductive Restrictions 2025: Current Policy Conversations","_key":"08131714422c"}],"_type":"block","style":"h3","_key":"bc462ada3bbd"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Texas isn’t the only state setting trends in restricting abortion; key legislative efforts in Republican-led states to classify mifepristone and misoprostol as controlled dangerous substances have gained traction.","_key":"0612f0edc2f6"},{"_type":"span","marks":["sup"],"text":"8","_key":"8b55a1808155"},{"_type":"span","marks":[],"text":" Measures have been introduced in various states, including Idaho, Oklahoma, Tennessee, and Texas, aiming to replicate Louisiana, the first state to reclassify the medications as Schedule IV controlled substances under the state’s Controlled Dangerous Substances Law. ","_key":"6b496dcc8bc2"}],"_type":"block","style":"normal","_key":"088813ba90e1"},{"style":"normal","_key":"901d18f101ff","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a8934894e6ad"}],"_type":"block"},{"markDefs":[{"href":"https://jamanetwork.com/journals/jama/fullarticle/2830292","_key":"8ffd233454bc","nofollow":true,"blank":true,"_type":"link"}],"children":[{"text":"This move, enabled through Senate Bill 276, places these widely used reproductive health medications under the same regulatory framework as sedatives and barbiturates—despite clear scientific evidence that they do not pose a risk for addiction or abuse, according to ","_key":"36fb00bb63bb","_type":"span","marks":[]},{"_type":"span","marks":["8ffd233454bc"],"text":"another ","_key":"e059d7f48aae"},{"_type":"span","marks":["8ffd233454bc","em"],"text":"JAMA","_key":"8a160a6630c8"},{"_type":"span","marks":["8ffd233454bc"],"text":" Viewpoint article","_key":"60b4b2998d62"},{"_key":"0313e4b21e4a","_type":"span","marks":[],"text":"."},{"_type":"span","marks":["sup"],"text":"9","_key":"8689720197a6"}],"_type":"block","style":"normal","_key":"07ddf7769ca5"},{"style":"normal","_key":"f3c8acf711ee","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"847ce836b964"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Scientific data overwhelmingly confirm that mifepristone and misoprostol do not have addictive properties, these authors note. Neither drug affects the brain’s reward system, nor do they produce euphoria or withdrawal symptoms. Mifepristone, a progesterone receptor antagonist, is approved by the FDA for medication abortion and for managing hyperglycemia in patients with Cushing disease. Misoprostol, a prostaglandin E1 analog, is widely used in obstetrics and gynecology for labor induction, miscarriage management, and postpartum hemorrhage—one of the leading causes of maternal death.","_key":"d453bd9e41a3"}],"_type":"block","style":"normal","_key":"de86ad93c318"},{"_key":"47611fe0486a","markDefs":[],"children":[{"_key":"2ca5a39acac1","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"While some attempts have already stalled in Indiana and Mississippi, experts state that even if these bills do not pass, their repeated introduction could help normalize restrictions on abortion medication.","_key":"bc3afd99a115"},{"marks":["sup"],"text":"8,9","_key":"b87962968fab","_type":"span"},{"_type":"span","marks":[],"text":" Louisiana’s legislation “was not designed to make care safer or to improve health outcomes—rather, it increases barriers to health care and raises unnecessary fear around prescribing and dispensing these medications.”","_key":"123d1998e9f2"},{"_type":"span","marks":["sup"],"text":"9","_key":"8c768bb2c67f"}],"_type":"block","style":"normal","_key":"16b3fec484df","markDefs":[]},{"_key":"592aae93245d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f6fdab1062df"}],"_type":"block","style":"normal"},{"_key":"7235059b64e9","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The debate on abortion access will continue, as will disagreements on the role of government in health care policy.","_key":"2ac789999c70"},{"marks":["sup"],"text":"6","_key":"653d5cbb5062","_type":"span"},{"_type":"span","marks":[],"text":" Yet, Ivey argues that ongoing legislative interference in medical decision-making is inappropriate and impacts the health and well-being of patients and physicians. Specifically, he calls out harmful \"laws that require physicians to give, withhold, or restrict information that can be shared with patients; laws that mandate tests, procedures, or treatments; laws that criminalize evidence-based care; or laws that create content-specific informed consent.\"","_key":"a53f73b3c1c6"}],"_type":"block","style":"normal"},{"style":"normal","_key":"539fc810157a","markDefs":[],"children":[{"_key":"50ca5bdb7ab4","_type":"span","marks":[],"text":""}],"_type":"block"},{"_key":"2c723e249c86","markDefs":[],"children":[{"_type":"span","marks":[],"text":"\"Health care policy determined by ideology is nothing short of dangerous,\" he concluded.","_key":"b6227e425d5c"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"6a85e81a0440"}],"_type":"block","style":"normal","_key":"f409114096a7","markDefs":[]},{"_key":"76baded918c8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Galea reinforced the power of complementing thorough peer-reviewed data with thoughtful commentary published in academic journals.","_key":"952376db3163"},{"_type":"span","marks":["sup"],"text":"1","_key":"ce0bfda29e5e"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"339dfbfd724b"}],"_type":"block","style":"normal","_key":"f3fb60eb7f46"},{"style":"normal","_key":"11c78c7160ee","markDefs":[],"children":[{"marks":[],"text":"\"There is plenty of evidence about the gap between data and implementation and between the generation of evidence and policy change,\" he wrote. \"However, this is exactly how a knowledge base is built, and how we can create a scaffold of ideas that inform public debate, and eventually change policy.”","_key":"3e9be714cdb6","_type":"span"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"","_key":"2f14b9fa619c"}],"_type":"block","style":"normal","_key":"2b0965327e9e","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a315cd158bf0"}],"_type":"block","style":"normal","_key":"5dbce8f19858"},{"_key":"8c4d28fabb19","markDefs":[],"children":[{"_key":"94350e8f364c","_type":"span","marks":["strong"],"text":"References"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"1. Galea S. Research on difficult social issues—the consequences of abortion bans. ","_key":"976289d7fb95","_type":"span"},{"_key":"9a8dfffef94d","_type":"span","marks":["em"],"text":"JAMA Health Forum."},{"marks":[],"text":" 2025;6(2):e250087. doi:10.1001/jamahealthforum.2025.0087","_key":"49409088642a","_type":"span"}],"_type":"block","style":"normal","_key":"9a897cee30ba"},{"markDefs":[{"_type":"link","href":"https://www.ajmc.com/view/abortion-bans-linked-to-higher-infant-mortality-disproportionately-impact-black-infants","_key":"22214593fb6c"}],"children":[{"marks":[],"text":"2. Steinzor P. Abortion bans linked to higher infant mortality, disproportionately impact Black infants. ","_key":"56be59176172","_type":"span"},{"text":"AJMC","_key":"16d83729b9e4","_type":"span","marks":["em"]},{"_key":"aaa9e37d57a3","_type":"span","marks":["sup"],"text":"®"},{"_type":"span","marks":[],"text":". February 13, 2025. Accessed February 13, 2025. ","_key":"06443b269f8e"},{"marks":["22214593fb6c"],"text":"https://www.ajmc.com/view/abortion-bans-linked-to-higher-infant-mortality-disproportionately-impact-black-infants","_key":"a6a9d597a913","_type":"span"}],"_type":"block","style":"normal","_key":"491ee6848866"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"3. Bell SO, Franks AM, Arbour D, et al. US abortion bans and fertility. ","_key":"1fb05dc28852"},{"_key":"3e92e6d42bd2","_type":"span","marks":["em"],"text":"JAMA."},{"marks":[],"text":" Published online February 13, 2025. doi:10.1001/jama.2024.28527","_key":"d4a953454fb5","_type":"span"}],"_type":"block","style":"normal","_key":"5f486f100c96"},{"markDefs":[{"_type":"link","href":"https://www.nytimes.com/2025/02/13/health/abortion-bans-infant-mortality.html","_key":"068ffaf522d7"}],"children":[{"_type":"span","marks":[],"text":"4. Belluck P. After abortion bans, infant mortality and births increase, research finds. The New York Times. February 13, 2025. Accessed February 18, 2025. ","_key":"3d39aecf58c5"},{"marks":["068ffaf522d7"],"text":"https://www.nytimes.com/2025/02/13/health/abortion-bans-infant-mortality.html","_key":"bc7e01fbd39e","_type":"span"}],"_type":"block","style":"normal","_key":"9f0898dc742e"},{"children":[{"_type":"span","marks":[],"text":"5. WeCount report. Society of Family Planning; October 22, 2024. doi:10.46621/728122kflzwf","_key":"97b5fc59c967"}],"_type":"block","style":"normal","_key":"ba86d78d3190","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"6. Ivey RT. The consequences of legislative regulation in medicine. ","_key":"2d46da1422d0"},{"_type":"span","marks":["em"],"text":"JAMA.","_key":"d96a8a2453ed"},{"_key":"a6c4aee37e96","_type":"span","marks":[],"text":" Published online February 13, 2025. doi:10.1001/jama.2025.0381"}],"_type":"block","style":"normal","_key":"6aa436a7c6f0"},{"_type":"block","style":"normal","_key":"6d6c766fc232","markDefs":[{"_type":"link","href":"https://www.ajmc.com/view/new-report-shows-worsening-health-outcomes-for-women-in-states-with-abortion-bans","_key":"d25b6324f35f"}],"children":[{"_key":"36295fb37c3b","_type":"span","marks":[],"text":"7. Grossi G. New report shows worsening health outcomes for women in states with abortion bans. "},{"marks":["em"],"text":"AJMC","_key":"ae42c1be46bc","_type":"span"},{"_key":"bb1ed079ffb2","_type":"span","marks":[],"text":". July 18, 2024. Accessed February 14, 2025. "},{"_type":"span","marks":["d25b6324f35f"],"text":"https://www.ajmc.com/view/new-report-shows-worsening-health-outcomes-for-women-in-states-with-abortion-bans","_key":"b27f4e956307"}]},{"markDefs":[{"_type":"link","href":"https://www.pbs.org/newshour/nation/what-to-know-about-state-proposals-to-ban-abortion-pills-and-punish-women-who-seek-to-end-pregnancies","_key":"5020ae1bf494"}],"children":[{"marks":[],"text":"8. Mulvihill G. What to know about state proposals to ban abortion pills and punish women who seek to end pregnancies. PBS. February 11, 2025. Accessed February 16, 2025. ","_key":"5ab87bae2075","_type":"span"},{"text":"https://www.pbs.org/newshour/nation/what-to-know-about-state-proposals-to-ban-abortion-pills-and-punish-women-who-seek-to-end-pregnancies","_key":"d02cfd01fdb4","_type":"span","marks":["5020ae1bf494"]}],"_type":"block","style":"normal","_key":"b6398322ba2f"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"9. Tasset J, Scarsi KK, Edelman A. Regulation of controlled substances and reproductive health. 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The Coalition’s service area includes the Philadelphia five-county region (Philadelphia, Bucks, Montgomery, Chester, and Delaware Counties), the State of Delaware, and Southern New Jersey (Camden, Burlington, Gloucester, Salem, Cumberland, Atlantic and Cape May Counties). GPBCH also offers affiliate memberships to organizations that do not participate as employers but have an interest in supporting GPBCH’s mission.","_key":"c04149f0c6250"}]},{"style":"normal","_key":"0bd3c445442d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2fb0623af5680"}],"_type":"block"},{"_type":"block","style":"normal","_key":"1e58b06cc89b","markDefs":[{"_type":"link","href":"https://protect-us.mimecast.com/s/6UYCC0RBmBHJVqnBHwrBnh?domain=gpbch.org/","_key":"e8532f1ac25a"}],"children":[{"_key":"cf810944fc3c0","_type":"span","marks":[],"text":"Our mission is to increase the value of health benefit spending for the region’s employers. We do this by improving workforce and community health, increasing healthcare quality and safety, and reducing healthcare costs. The Coalition represents employer interests in working with health plans, healthcare providers, benefits consultants, suppliers and other system stakeholders to address population health priorities and to ensure that when healthcare is needed it is accessible, affordable, equitable, high-quality, and safe. 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Data used for the report were the most recent available in the databases.","_key":"7f1eafa2e494"}],"_type":"block"},{"_key":"60994c6bde8f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"9d5cbe7429a3"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The authors found that there will be an estimated 248,470 diagnoses and 73,240 deaths related to cancer in Black individuals, accounting for the second leading cause of death in Black individuals in 2025. Overall, the mortality rate associated with cancer declined from 49% in 1991 to 33% in 2022. Black men experienced the highest decline in mortality related to cancer compared with Black women, White men, and White women, with a 65% to 67% drop among Black men aged 40 to 59 years.","_key":"a93b85323095"}],"_type":"block","style":"normal","_key":"43299e24caf1"},{"asset":{"_ref":"image-4b1e70c0107d954ccd83281363addeca769a16bd-4992x3328-jpg","_type":"reference"},"_key":"4009f2e78ad8","widthP":40,"disableLightBox":true,"_type":"figure","disableTextWrap":false,"imgcaption":[{"style":"normal","_key":"ab0328b11fe5","markDefs":[],"children":[{"_key":"b098725d2b27","_type":"span","marks":[],"text":"Black individuals had worse mortality outcomes related to cancer compared with other population groups | Image credit: Monkey Business - stock.adobe.com"}],"_type":"block"}],"alt":"Black individuals had worse mortality outcomes related to cancer compared with other population groups | Image credit: Monkey Business - stock.adobe.com","alignment":"left"},{"style":"normal","_key":"3adad0b4f574","markDefs":[],"children":[{"_type":"span","marks":[],"text":"However, the risk of cancer death was still high among Black individuals. Myeloma, prostate, endometrial, and stomach cancers had a risk of cancer death in Black individuals that was 2-fold higher compared with White individuals. Colorectal, breast, cervical, and liver cancers all had a 40% to 50% higher risk of death in Black individuals.","_key":"455b35dce1c8"}],"_type":"block"},{"_type":"block","style":"normal","_key":"e23cba8e1bc7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1a154bbb2875"}]},{"_key":"e6951ccec4c8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The most reported cancers diagnosed in Black individuals were prostate (44% in men), breast (34% in women), lung (10%), and colorectal (8%) cancers . These cancers also made up 58% of all new diagnoses. The likelihood of dying from breast cancer was 38% higher in Black women compared with White women, while the likelihood of being diagnosed with breast cancer was 5% lower in Black women. The incidence rate of prostate cancer was also 67% higher in Black men compared with White men, with Black men twice as likely to die. The incidence of endometrial cancer also increased in Black women by 2% each year.","_key":"bebeef0bca7d"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"d5a692eae008"}],"_type":"block","style":"normal","_key":"9178d7061d91"},{"children":[{"_type":"span","marks":[],"text":"“Overall declines in cancer mortality rates in Black people largely reflect behavioral changes, such as historical declines in cigarette smoking among Black teens, as well as advances in treatment and earlier detection for some cancers. Yet, this population persistently experiences a much higher mortality burden than other racial and ethnic groups for many cancers. We must reverse course,” said Rebecca Siegel, MPH, senior scientific director, surveillance research at the American Cancer Society and senior author of the report, in a statement.","_key":"b8a7ee2c1cae"},{"_type":"span","marks":["sup"],"text":"1","_key":"a927d15f0885"}],"_type":"block","style":"normal","_key":"33262444679c","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bfa9350df402"}],"_type":"block","style":"normal","_key":"c3dcc9c991b4"},{"children":[{"_type":"span","marks":[],"text":"These results are in line with past research that has found a continuing disparity in both diagnoses and health care related to health care in Black individuals. Researchers have found that Black women are less likely to receive care according to guidelines when compared with White women and an increased mortality in Black women due to these care disparities.","_key":"8b51ee392c64"},{"_type":"span","marks":["sup"],"text":"2","_key":"05cd6bb5cfc0"},{"text":" Racial discrimination has also been a source of disparities in outcomes among Black individuals, with most participants of a study published by the ","_key":"31cae70ee917","_type":"span","marks":[]},{"marks":["em"],"text":"Journal of the National Cancer Institute","_key":"ffba9c63da83","_type":"span"},{"_type":"span","marks":[],"text":" reporting that they had experienced racial discrimination when accessing health care related to cancer.","_key":"cd5b5ba4284a"},{"_type":"span","marks":["sup"],"text":"3","_key":"e7ea32dacbc8"}],"_type":"block","style":"normal","_key":"e308c401b4a6","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"189fe2053753"}],"_type":"block","style":"normal","_key":"d7797d9c7449"},{"style":"normal","_key":"ee2c3d7b21b0","markDefs":[],"children":[{"_key":"138ab81ba58a","_type":"span","marks":[],"text":"\"This report highlights the disparities the Black community has faced for decades. While the decline in cancer mortality rates is encouraging, the stark inequities in incidence and survival for many cancers underscore the urgent need for targeted research and interventions,” said Dr. Wayne A. I. Frederick, interim chief executive officer of the American Cancer Society and the American Cancer Society Cancer Action Network."},{"_key":"12dce5148da4","_type":"span","marks":["sup"],"text":"1"}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"76195ae143e8","_type":"span"}],"_type":"block","style":"normal","_key":"248c74c08029"},{"style":"normal","_key":"2f80e0f548de","markDefs":[],"children":[{"marks":[],"text":"","_key":"a72e1206de6e","_type":"span"}],"_type":"block"},{"children":[{"text":"","_key":"f7c11366089e","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"4e04f76a00cf","markDefs":[]},{"_type":"block","style":"normal","_key":"d24762e8a6df","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"References","_key":"577444586665"}]},{"children":[{"text":"New ACS study shows cancer mortality rates among black people declining, but remain higher than other racial and ethnic groups. News release. American Cancer Society. ","_key":"c7be583058e3","_type":"span","marks":[]},{"text":"https://www.newswise.com/articles/new-acs-study-shows-cancer-mortality-rates-among-black-people-declining-but-remain-higher-than-other-racial-and-ethnic-groups/","_key":"bb868b156fe8","_type":"span","marks":["141f46f02109"]}],"level":1,"_type":"block","style":"normal","_key":"a05dbd4f417e","listItem":"number","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.newswise.com/articles/new-acs-study-shows-cancer-mortality-rates-among-black-people-declining-but-remain-higher-than-other-racial-and-ethnic-groups/","_key":"141f46f02109"}]},{"style":"normal","_key":"293313a074d6","listItem":"number","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/view/racial-inequities-in-guideline-adherent-breast-cancer-care-and-timely-treatment","_key":"4c24796bbf4b"}],"children":[{"_type":"span","marks":[],"text":"Santoro C. Racial inequities in guideline-adherent breast cancer care and timely treatment. ","_key":"65f12faae767"},{"text":"AJMC","_key":"3bda46bc48a0","_type":"span","marks":["em"]},{"text":"®","_key":"809bd700ed77","_type":"span","marks":["sup"]},{"_type":"span","marks":[],"text":". November 19, 2024. Accessed February 19, 2025. ","_key":"ab9a8001f14a"},{"_type":"span","marks":["4c24796bbf4b"],"text":"https://www.ajmc.com/view/racial-inequities-in-guideline-adherent-breast-cancer-care-and-timely-treatment","_key":"d5fdb1b9ab9e"}],"level":1,"_type":"block"},{"style":"normal","_key":"ba2040d9eb14","listItem":"number","markDefs":[{"blank":true,"_type":"link","href":"https://www.ajmc.com/view/racial-discrimination-in-cancer-care-has-long-term-impact-on-patients-study-shows","_key":"cb0ac9dab587","nofollow":false}],"children":[{"_type":"span","marks":[],"text":"Grossi G. Racial discrimination in cancer care has long-term impact on patients, study shows. ","_key":"fd42d9f485c0"},{"marks":["em"],"text":"AJMC","_key":"cacdb5b8bbb6","_type":"span"},{"text":". November 14, 2023. Accessed February 19, 2025. ","_key":"9e57877f22b2","_type":"span","marks":[]},{"_type":"span","marks":["cb0ac9dab587"],"text":"https://www.ajmc.com/view/racial-discrimination-in-cancer-care-has-long-term-impact-on-patients-study-shows","_key":"b2f4631b8abf"}],"level":1,"_type":"block"}],"_updatedAt":"2025-02-20T14:38:36Z","gptTakeaways":"• Black individuals face higher cancer mortality rates despite overall declines, with significant disparities in incidence and outcomes compared to other racial groups.\n\n• Black men experienced the highest decline in cancer mortality, yet remain at higher risk for cancers like myeloma and prostate cancer.\n\n• Behavioral changes, treatment advances, and early detection have contributed to mortality declines, but racial discrimination and healthcare disparities persist.\n\n• Targeted research and interventions are urgently needed to address the stark inequities in cancer incidence and survival among Black individuals.","gptSummary":"Despite a decline in cancer mortality rates among Black individuals, they still face higher mortality compared to other racial groups. The American Cancer Society's report highlights significant disparities in cancer incidence and outcomes, with Black men experiencing the highest decline in mortality. However, Black individuals remain at a higher risk for certain cancers, such as myeloma and prostate cancer. Behavioral changes, treatment advances, and early detection have contributed to mortality declines, but racial discrimination and healthcare disparities continue to impact outcomes, necessitating targeted research and interventions.","authors":[{"displayName":"Julia Bonavitacola","url":"julia-bonavitacola"}],"targeting":{"content_placement":["news","topic/center-on-health-equity-and-access","compendium/oncology"],"document_url":["cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"Disease Activity, Safety Remain Following Switch From Infliximab Biosimilar to Originator in IBD","url":{"current":"disease-activity-safety-remain-following-switch-from-infliximab-biosimilar-to-originator-in-ibd","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Image credit: Chinnapong - stock.adobe.com","asset":{"_ref":"image-c47d1001b06db553ad12b402fa8d787f080c3245-3600x2057-jpg","_type":"reference"}},"published":"2025-02-20T21:24:50.268Z"},{"title":"First Insulin Aspart Biosimilar Receives FDA Approval","url":{"current":"first-insulin-aspart-biosimilar-receives-fda-approval","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"FDA Approved. | Image Credit: Nirusmee - 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Trump, which ","_key":"24b5a1511201"},{"_key":"683e0c998ea8","_type":"span","marks":["6d4b92ce49f3"],"text":"brought changes"},{"_key":"0a4afcc13845","_type":"span","marks":[],"text":" to health policy."},{"_type":"span","marks":["sup"],"text":"3","_key":"f947b840bb90"},{"_type":"span","marks":[],"text":" While the administration was ordered to ","_key":"50a650d022b1"},{"_key":"c7411da3ccb7","_type":"span","marks":["f7af914332e3"],"text":"reverse course"},{"text":" on a move that raised alarms for jeopardizing coverage for nearly 80 million Americans enrolled in Medicaid and rescinded the directive that had ordered federal agencies to freeze trillions in financial assistance, enrollees still face barriers in accessing the platform and uncertainty surrounding the future of health assistance.","_key":"a372be81bd11","_type":"span","marks":[]},{"_key":"8864a3c54852","_type":"span","marks":["sup"],"text":"3,4"}]},{"markDefs":[],"children":[{"text":"","_key":"93ec4fe93d41","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"0dcead9a867f"},{"markDefs":[],"children":[{"text":"Molly Dean, MSW, policy advisor at Siftwell, joined ","_key":"308eef7f8749","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"The American Journal of Care","_key":"05eae64ace84"},{"_type":"span","marks":["sup"],"text":"®","_key":"a215cd72976e"},{"marks":[],"text":" (","_key":"c7c20b1f519c","_type":"span"},{"_key":"e0ef69d9ea30","_type":"span","marks":["em"],"text":"AJMC"},{"marks":["sup"],"text":"®","_key":"809c5acac54d","_type":"span"},{"text":") to draw attention to potential challenges that may arise and highlight areas that health centers and public entities can focus on to best support individuals during these shifts.","_key":"20339acbfeb2","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"401a9eb44128"},{"_type":"block","style":"normal","_key":"8c1852e51308","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"04605423f56f"}]},{"_key":"d6a6419f8992","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited; captions were auto-generated.","_key":"25622d9bb9c3"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"15112a67e30c"}],"_type":"block","style":"normal","_key":"81caaa92329e","markDefs":[]},{"children":[{"_type":"span","marks":["strong"],"text":"Given recent changes in ACA enrollment and the new presidential administration, what are the biggest policy challenges ahead for Medicare and Medicaid programs?","_key":"c315db298287"}],"_type":"block","style":"normal","_key":"d64933eeca61","markDefs":[]},{"style":"normal","_key":"50ba88e5e754","markDefs":[],"children":[{"_key":"93f4d6aa5c17","_type":"span","marks":[],"text":"I think the reality of current state really is going to force states and programs to look at how they maintain providing care and coverage, frankly, to Americans and to the members that they currently provide coverage to. I think at the suspension of the public health emergency, you saw a tremendous amount of Americans coming off Medicaid rolls. Some needed to, right? They were no longer eligible. Some, unfortunately, due to administrative issues, if you will, or who were unable to reach them and contact them, came off the rolls and have lost coverage. "}],"_type":"block"},{"_key":"c411e0bb8f9d","markDefs":[],"children":[{"_key":"60fffe217ce8","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"We really need to ensure that public entities that support individuals can maintain access to care whether they maintain Medicaid coverage or not. And so I think it's understanding who is providing care to underinsured and uninsured people in communities, and ensuring that those entities have funds to be stable. Traditionally, that is through Medicaid. I think about your federally qualified health centers, the pivotal role they play in covering and, more importantly, providing care to individuals. A lot of those entities are funded through braided funding streams, much of which is Medicaid funds. And when there is a threat—or kind of a restriction, both of coverage and those funds—you land in a place where your safety net is going away. So I think that is going to be a critical, critical opportunity that has to be seized here quickly to ensure the safety net is stable. ","_key":"72b35e5f2fc9"}],"_type":"block","style":"normal","_key":"14dad6191433"},{"children":[{"_type":"span","marks":[],"text":"","_key":"781bca6f7312"}],"_type":"block","style":"normal","_key":"13ea621e314d","markDefs":[]},{"markDefs":[],"children":[{"_key":"43981c42a21b","_type":"span","marks":[],"text":"What that's going to do is require a shift. There has been a tremendous amount of focus over the last 4 years on workforce and developing workforce and developing pipeline to ensure that there are enough people to care for the demand, but I think we're going to see an immediate shift towards just shoring up these entities to ensure they can pay their bills. And I think that's one of the biggest quick impacts we're going to see with the loss of coverage. Loss of coverage because of people losing coverage on the other side of the public health emergency. And then, with the potential kind of restructuring of Medicaid, we're seeing waving in the wind right now with a new administration, that's going to be critical."}],"_type":"block","style":"normal","_key":"f95e30ffd195"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"c0c8640d3e37","_type":"span"}],"_type":"block","style":"normal","_key":"d2d51dbfab6d"},{"_key":"1b158ab78b58","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"References","_key":"e4988518431d"}],"_type":"block","style":"normal"},{"style":"normal","_key":"5fcc7bee4fdb","markDefs":[{"href":"https://www.ajmc.com/view/lessons-learned-from-medicaid-unwinding-as-states-tackle-eligibility-checks","_key":"42a5b27cda82","nofollow":false,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"1. Grossi G. Lessons learned from Medicaid unwinding as states tackle eligibility checks. ","_key":"728ae00c540f"},{"text":"AJMC","_key":"19ae3d6d8664","_type":"span","marks":["em"]},{"text":". November 7, 2024. Accessed February 19, 2025. ","_key":"234e2cd4fe49","_type":"span","marks":[]},{"_type":"span","marks":["42a5b27cda82"],"text":"https://www.ajmc.com/view/lessons-learned-from-medicaid-unwinding-as-states-tackle-eligibility-checks","_key":"89c1b6c52fbc"}],"_type":"block"},{"_key":"405b2c77fedc","markDefs":[{"blank":true,"_type":"link","href":"https://www.ajmc.com/view/medicaid-unwinding-left-thousands-of-pediatric-patients-uninsured","_key":"806c434a0e6d","nofollow":false}],"children":[{"_key":"b0b1741e6205","_type":"span","marks":[],"text":"2. McCormick B. Medicaid unwinding left thousands of pediatric patients uninsured. "},{"marks":["em"],"text":"AJMC","_key":"647e349177d3","_type":"span"},{"text":". February 7, 2025. Accessed February 19, 2025. ","_key":"edf1f670fd1e","_type":"span","marks":[]},{"_type":"span","marks":["806c434a0e6d"],"text":"https://www.ajmc.com/view/medicaid-unwinding-left-thousands-of-pediatric-patients-uninsured","_key":"32857b1f4cf8"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"d35c013e62cd","markDefs":[{"_key":"c5238b21bdf1","nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/view/trump-s-federal-grant-freeze-threatens-medicaid-funding"}],"children":[{"_key":"b405436ff730","_type":"span","marks":[],"text":"3. Klein H. Trump's federal grant freeze threatens Medicaid funding. "},{"text":"AJMC","_key":"cd2ea8026085","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". January 28, 2025. Accessed February 19, 2025. 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