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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="2024-11-23T13:00:00.000">November 23, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Health Equity & Access Weekly Roundup: November 23, 2024</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/giuliana-grossi">Giuliana Grossi</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="Health Equity & Access Weekly Roundup: November 23, 2024" 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" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" 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2px; } audio { height: 40px; } .rhap_container { width: 300px !important; border-radius: 100px !important; height: 40px !important; box-shadow: 0px 0px 2px 2px rgba(0,0,0,0.1); } .rhap_progress-section { width: 150px; margin-left: 35px; } .rhap_controls-section { position: relative; bottom: .75rem; } .rhap_time { font-size: 12px; color: rgb(0,55,103); } .rhap_progress-bar { color: rgb(0,55,103) !important; } .rhap_progress-filled { background-color: rgb(0,55,103) !important; } .rhap_progress-indicator { height: 15px; width: 5px; top: -5px; margin-left: 1px; background-color: rgb(0,55,103) !important; } .rhap_repeat-button { display: none; } .rhap_volume-bar, rhap_volume-button, .rhap_volume-indicator { background: rgb(0,55,103) !important; } .rhap_volume-bar { height: 2px; width: 35px; position: relative; left: 22px; bottom: 21px; } .rhap_volume-button { // width: 5px; // height: 5px; flex: 0 0 26px; position: relative; left: 22px; bottom: 21px; } .rhap_volume-button svg { height: 18px; width: 18px; } .rhap_volume-indicator { height: 8px; width: 8px; top: -2.75px } .rhap_button-clear { color: rgb(0,55,103) !important; } .rhap_play-pause-button { color: rgb(0,55,103) !important; font-size: 30px !important; width: 30px !important; height: 30px !important; position: relative; right: 90px; bottom: 22px; } .rhap_main-controls button { color: rgb(0,55,103) !important; } audio::-webkit-media-controls-play-button, video::-webkit-media-controls-play-button { -webkit-appearance: media-play-button; color: #b8dcf6; } audio::-webkit-media-controls-panel { background-color: white !important; color: #000; } audio::-webkit-media-controls-current-time-display, audio::-webkit-media-controls-time-remaining-display { font-size: 12px; } </style></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">Americans are underinsured, even with employer-based health plans; a thorough critique of the lack of representation among Black patients in clinical trials showcases a persistent theme; systemic barriers in cardiology, breast cancer, and patent systems are examined.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><h3 class="text-xl pb-4 pt-2"><a target="_blank" href="https://www.ajmc.com/view/despite-record-aca-enrollment-report-reveals-underinsured-americans-are-in-crisis"><strong>Despite Record ACA Enrollment, Report Reveals Underinsured Americans Are in Crisis</strong></a></h3><p class="pb-2">Despite significant progress under the Affordable Care Act (ACA), millions of Americans still face critical gaps in health insurance coverage and affordability. As of 2023, 8% of the population, or 26 million people, remained uninsured, while nearly a quarter of working-age adults were underinsured, struggling with high deductibles and out-of-pocket costs that prevent timely care. A report from The Commonwealth Fund highlights alarming trends: 57% of underinsured adults avoided necessary care due to cost, nearly 30% carried medical debt, and 41% reported worsened health from delaying care. While ACA reforms improved coverage access and protections, gaps persist, particularly among those with employer-sponsored insurance, which increasingly includes higher cost-sharing requirements. The report calls for policy changes to enhance affordability and coverage, such as permanent tax credits, closing the Medicaid gap, reducing out-of-pocket costs, and addressing the root causes of high health care prices. These steps are essential to sustaining progress and ensuring equitable access to care.</p><p class="pb-2"></p><h3 class="text-xl pb-4 pt-2"><a target="_blank" href="https://www.ajmc.com/view/as-myeloma-trials-tackle-frontline-treatment-where-are-the-black-patients-"><strong>As Myeloma Trials Tackle Frontline Treatment, Where Are the Black Patients?</strong></a></h3><p class="pb-2"><strong><em>This featured content is available for free when you enter your basic information.</em></strong></p><p class="pb-2">The recent FDA approval of isatuximab (Sarclisa) for newly diagnosed, transplant-ineligible multiple myeloma highlights a persistent issue in clinical research: the underrepresentation of Black patients in clinical trials. Despite Black individuals constituting 20% of newly diagnosed multiple myeloma cases in the US, only 0.9% of participants in the phase 3 IMROZ trial were Black. This disparity is not unique, as other trials, such as PERSEUS and CEPHEUS, also report similarly low Black enrollment. These gaps hinder understanding of treatment effects across populations, contributing to inequities in care and outcomes. While advances in multiple myeloma therapy have significantly improved survival rates over 2 decades, the lack of diversity in trials raises questions about the safety and efficacy of treatments for Black patients, who experience the disease at disproportionately higher rates. The FDA has introduced draft guidelines requiring "diversity action plans" for pivotal trials, aiming to address these disparities. However, structural barriers like restrictive eligibility criteria and trial site locations remain challenges. Advocates and researchers stress the need for inclusive clinical research to ensure equitable access to life-saving therapies.</p><p class="pb-2"></p><h3 class="text-xl pb-4 pt-2"><a target="_blank" href="https://www.ajmc.com/view/proposed-new-cardiology-board-could-reshape-the-system-aha-2024"><strong>Proposed New Cardiology Board Could "Reshape" the System: AHA 2024</strong></a></h3><p class="pb-2">The proposed creation of an American Board of Cardiovascular Medicine aims to address evolving complexities in cardiovascular care, enhance certification processes, and improve patient outcomes. At the recent <a target="_blank" href="https://www.ajmc.com/conference/aha">American Heart Association (AHA) conference</a>, Cathie Biga, MSN, president of the American College of Cardiology, highlighted the need for a dedicated certifying board to ensure ongoing competence in this specialized field and address workforce shortages. The board could streamline skill validation, identify knowledge gaps, and personalize education for cardiologists while focusing on underserved populations and health equity. An official decision from the American Board of Medical Specialties is expected in February.</p><p class="pb-2"></p><h3 class="text-xl pb-4 pt-2"><a target="_blank" href="https://www.ajmc.com/view/racial-inequities-in-guideline-adherent-breast-cancer-care-and-timely-treatment"><strong>Racial Inequities in Guideline-Adherent Breast Cancer Care and Timely Treatment</strong></a></h3><p class="pb-2">A new study highlights significant racial disparities in breast cancer care among older adults, with non-Hispanic Black patients facing increased odds of not receiving guideline-concordant care or timely treatment compared with non-Hispanic White patients. Analysis of National Cancer Database data revealed that non-Hispanic Black women were as likely to be diagnosed with breast cancer but had a 40% higher mortality rate, partly due to delays in treatment initiation and reduced access to multimodality therapy. Even after adjusting for clinical and demographic variables, non-Hispanic Black patients showed a higher risk of all-cause mortality, underscoring the need for equitable and timely care.</p><p class="pb-2"></p><h3 class="text-xl pb-4 pt-2"><a target="_blank" href="https://www.ajmc.com/view/addressing-patent-hurdles-payer-barriers-and-interchangeability"><strong>Addressing Patent Hurdles, Payer Barriers, and Interchangeability</strong></a></h3><p class="pb-2">Global Biosimilars Week, held November 11–15 by the International Generics and Biosimilars Association, highlighted key challenges in biosimilar adoption, including patent system complexities, payer and pharmacy benefit manager (PBM) policies, and interchangeability designations. The Biologics Price Competition and Innovation Act's "patent dance" framework has facilitated biosimilar development but faces criticism for its complexity and potential to delay market entry. Issues such as product hopping and patent exclusivity also hinder competition. Payers and PBMs influence biosimilar access through reimbursement strategies favoring higher-priced reference drugs, often resulting in higher patient costs and unexpected treatment changes. Panelists at the event proposed policy reforms to enhance biosimilar adoption, including increasing PBM transparency, revising reimbursement strategies, and encouraging fair competition to reduce costs and improve access for patients.</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" style="scroll-snap-align:center;text-decoration:none" 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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/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/7928afa87272891a1211f02ab685217dc119fc12-5694x3800.jpg?fit=crop&auto=format" alt="Welcome to Vermont road sign | Image credit: rabbit75_fot – 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent">How Did Vermont Get the Best Maternal Health Score in the US?</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/hayden-e-klein">Hayden E. Klein</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">State-level maternal health scores varied greatly in the 2024 March of Dimes report card, with Vermont getting the only A grade on preterm birth rates.</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-wellness-way?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">November 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/frameworks-for-advancing-health-equity-wellness-way?utm_source=www.ajmc.com&utm_medium=relatedContent">Frameworks for Advancing Health Equity: Wellness Way</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-wellness-way?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The Wellness Way facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.</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/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f1f12e9d502c73f75e8062c6dd726c422c8aff78-4320x3473.jpg?fit=crop&auto=format" alt="FDA Approval | image credit: gomixer - 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent">FDA Approves Imatinib Oral Solution for Treatment of Various Cancers</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/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The FDA approval marks the first oral solution indicated for patients with different forms of leukemia. </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/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?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" 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">October 29th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent">Breaking the Cycle: The Importance of Early Intervention in Hidradenitis Suppurativa</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/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.</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/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/fd59c15f823c569d6a35b26efa98794998e60211-6720x4480.jpg?fit=crop&auto=format" alt="Patients with treatment-resistant central centrifugal cicatricial alopeciasaw improvement in symptoms and gene expression, suggesting the potential of metforminas a new treatment option. | Image Credit: Prostock-studio - 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent">Metformin Improves Symptoms and Gene Expression in Central Centrifugal Cicatricial Alopecia</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/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Patients with treatment-resistant central centrifugal cicatricial alopecia saw improvement in symptoms and gene expression, suggesting the potential of metformin as a new treatment option.</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/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/2daed33e29a1e4264b7784effa59ab6a7f33a5b2-4500x3000.jpg?fit=crop&auto=format" alt="Cardiovascular health | Image Credit: BillionPhotos.com - 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">November 25th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent">Unfavorable Health-Related Social Needs Associated With Lower Cardiovascular Health Scores</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></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Adults with more unfavorable health-related social needs, such as unemployment or food insecurity, had a higher prevalence of low cardiovascular health, highlighting the importance of addressing social determinants to improve population health.</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/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/7928afa87272891a1211f02ab685217dc119fc12-5694x3800.jpg?fit=crop&auto=format" alt="Welcome to Vermont road sign | Image credit: rabbit75_fot – 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent">How Did Vermont Get the Best Maternal Health Score in the US?</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/hayden-e-klein">Hayden E. Klein</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/how-did-vermont-get-the-best-maternal-health-score-in-the-us-?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">State-level maternal health scores varied greatly in the 2024 March of Dimes report card, with Vermont getting the only A grade on preterm birth rates.</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-wellness-way?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">November 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/frameworks-for-advancing-health-equity-wellness-way?utm_source=www.ajmc.com&utm_medium=relatedContent">Frameworks for Advancing Health Equity: Wellness Way</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-wellness-way?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The Wellness Way facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.</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/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f1f12e9d502c73f75e8062c6dd726c422c8aff78-4320x3473.jpg?fit=crop&auto=format" alt="FDA Approval | image credit: gomixer - 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent">FDA Approves Imatinib Oral Solution for Treatment of Various Cancers</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/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/fda-approves-imatinib-oral-solution-for-treatment-of-various-cancers?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The FDA approval marks the first oral solution indicated for patients with different forms of leukemia. </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/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?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" 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">October 29th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent">Breaking the Cycle: The Importance of Early Intervention in Hidradenitis Suppurativa</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/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.</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/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/fd59c15f823c569d6a35b26efa98794998e60211-6720x4480.jpg?fit=crop&auto=format" alt="Patients with treatment-resistant central centrifugal cicatricial alopeciasaw improvement in symptoms and gene expression, suggesting the potential of metforminas a new treatment option. | Image Credit: Prostock-studio - 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">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent">Metformin Improves Symptoms and Gene Expression in Central Centrifugal Cicatricial Alopecia</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/metformin-improves-symptoms-and-gene-expression-in-central-centrifugal-cicatricial-alopecia?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Patients with treatment-resistant central centrifugal cicatricial alopecia saw improvement in symptoms and gene expression, suggesting the potential of metformin as a new treatment option.</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/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/2daed33e29a1e4264b7784effa59ab6a7f33a5b2-4500x3000.jpg?fit=crop&auto=format" alt="Cardiovascular health | Image Credit: BillionPhotos.com - 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">November 25th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent">Unfavorable Health-Related Social Needs Associated With Lower Cardiovascular Health Scores</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></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/unfavorable-health-related-social-needs-associated-with-lower-cardiovascular-health-scores?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Adults with more unfavorable health-related social needs, such as unemployment or food insecurity, had a higher prevalence of low cardiovascular health, highlighting the importance of addressing social determinants to improve population health.</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":"Health Equity & Access Weekly Roundup: November 23, 2024","datePublished":"2024-11-23T13:00:00.000Z","dateModified":"2024-11-22T21:41:26Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/health-equity-access-weekly-roundup-november-23-2024"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"health equity,health care access","articleBody":"Despite Record ACA Enrollment, Report Reveals Underinsured Americans Are in Crisis\n\nDespite significant progress under the Affordable Care Act (ACA), millions of Americans still face critical gaps in health insurance coverage and affordability. As of 2023, 8% of the population, or 26 million people, remained uninsured, while nearly a quarter of working-age adults were underinsured, struggling with high deductibles and out-of-pocket costs that prevent timely care. A report from The Commonwealth Fund highlights alarming trends: 57% of underinsured adults avoided necessary care due to cost, nearly 30% carried medical debt, and 41% reported worsened health from delaying care. While ACA reforms improved coverage access and protections, gaps persist, particularly among those with employer-sponsored insurance, which increasingly includes higher cost-sharing requirements. The report calls for policy changes to enhance affordability and coverage, such as permanent tax credits, closing the Medicaid gap, reducing out-of-pocket costs, and addressing the root causes of high health care prices. These steps are essential to sustaining progress and ensuring equitable access to care.\n\n\n\nAs Myeloma Trials Tackle Frontline Treatment, Where Are the Black Patients?\n\nThis featured content is available for free when you enter your basic information.\n\nThe recent FDA approval of isatuximab (Sarclisa) for newly diagnosed, transplant-ineligible multiple myeloma highlights a persistent issue in clinical research: the underrepresentation of Black patients in clinical trials. Despite Black individuals constituting 20% of newly diagnosed multiple myeloma cases in the US, only 0.9% of participants in the phase 3 IMROZ trial were Black. This disparity is not unique, as other trials, such as PERSEUS and CEPHEUS, also report similarly low Black enrollment. These gaps hinder understanding of treatment effects across populations, contributing to inequities in care and outcomes. While advances in multiple myeloma therapy have significantly improved survival rates over 2 decades, the lack of diversity in trials raises questions about the safety and efficacy of treatments for Black patients, who experience the disease at disproportionately higher rates. The FDA has introduced draft guidelines requiring \"diversity action plans\" for pivotal trials, aiming to address these disparities. However, structural barriers like restrictive eligibility criteria and trial site locations remain challenges. Advocates and researchers stress the need for inclusive clinical research to ensure equitable access to life-saving therapies.\n\n\n\nProposed New Cardiology Board Could \"Reshape\" the System: AHA 2024\n\nThe proposed creation of an American Board of Cardiovascular Medicine aims to address evolving complexities in cardiovascular care, enhance certification processes, and improve patient outcomes. At the recent American Heart Association (AHA) conference, Cathie Biga, MSN, president of the American College of Cardiology, highlighted the need for a dedicated certifying board to ensure ongoing competence in this specialized field and address workforce shortages. The board could streamline skill validation, identify knowledge gaps, and personalize education for cardiologists while focusing on underserved populations and health equity. An official decision from the American Board of Medical Specialties is expected in February.\n\n\n\nRacial Inequities in Guideline-Adherent Breast Cancer Care and Timely Treatment\n\nA new study highlights significant racial disparities in breast cancer care among older adults, with non-Hispanic Black patients facing increased odds of not receiving guideline-concordant care or timely treatment compared with non-Hispanic White patients. Analysis of National Cancer Database data revealed that non-Hispanic Black women were as likely to be diagnosed with breast cancer but had a 40% higher mortality rate, partly due to delays in treatment initiation and reduced access to multimodality therapy. Even after adjusting for clinical and demographic variables, non-Hispanic Black patients showed a higher risk of all-cause mortality, underscoring the need for equitable and timely care.\n\n\n\nAddressing Patent Hurdles, Payer Barriers, and Interchangeability\n\nGlobal Biosimilars Week, held November 11–15 by the International Generics and Biosimilars Association, highlighted key challenges in biosimilar adoption, including patent system complexities, payer and pharmacy benefit manager (PBM) policies, and interchangeability designations. The Biologics Price Competition and Innovation Act's \"patent dance\" framework has facilitated biosimilar development but faces criticism for its complexity and potential to delay market entry. Issues such as product hopping and patent exclusivity also hinder competition. Payers and PBMs influence biosimilar access through reimbursement strategies favoring higher-priced reference drugs, often resulting in higher patient costs and unexpected treatment changes. Panelists at the event proposed policy reforms to enhance biosimilar adoption, including increasing PBM transparency, revising reimbursement strategies, and encouraging fair competition to reduce costs and improve access for patients.","description":"Americans are underinsured, even with employer-based health plans; a thorough critique of the lack of representation among Black patients in clinical trials showcases a persistent theme; systemic barriers in cardiology, breast cancer, and patent systems are examined.","author":[{"@type":"Person","name":"Giuliana Grossi"}]}</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 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Klein","url":"hayden-e-klein"}],"documentGroupMapping":null,"contentCategory":{"_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z"},"audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.ajmc.com/2c70d335-62fa-4d32-80f9-c0cc4ff2f8c5_1732656420857.b681575b-aa4a-4345-a82e-7ecaa9908a4f.mp3","articleType":"News","body":[{"markDefs":[{"_key":"03e093aec7c2","nofollow":true,"blank":true,"_type":"link","href":"https://www.marchofdimes.org/peristats/reports/vermont/report-card"}],"children":[{"_type":"span","marks":[],"text":"Vermont emerged as a leader in maternal and infant health in the latest ","_key":"75b7c20fac040"},{"_type":"span","marks":["03e093aec7c2"],"text":"March of Dimes report card","_key":"75b7c20fac041"},{"_key":"75b7c20fac042","_type":"span","marks":[],"text":", achieving the best scores—and the only A—in the country."},{"marks":["superscript"],"text":"1","_key":"cea17ad94dc7","_type":"span"}],"_type":"block","style":"normal","_key":"c38c1594ddd5"},{"children":[{"_key":"10c5c7a7d8f30","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"f29f67736beb","markDefs":[]},{"markDefs":[{"href":"https://www.ajmc.com/view/us-earns-another-low-grade-on-maternal-health","_key":"b23ab706a685","blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"The March of Dimes 2024 report card included all 50 states; Washington, DC; and Puerto Rico in the report and gave the country ","_key":"3fcc731bdb490"},{"text":"overall a D+","_key":"3fcc731bdb491","_type":"span","marks":["b23ab706a685"]},{"_key":"3fcc731bdb492","_type":"span","marks":[],"text":" for its 2023 preterm birth rate."},{"marks":["superscript"],"text":"2","_key":"8d14343a2de9","_type":"span"},{"_type":"span","marks":[],"text":" Vermont was the only state to receive an A grade for its low preterm rate, with just 6 other states falling close behind with B ratings.","_key":"6bed3b77c0bb"},{"_type":"span","marks":["superscript"],"text":"1","_key":"3aba8982424c"},{"_type":"span","marks":[],"text":" Meanwhile, 20 states landed in the C category and 16 in the D category, while 8 states and Puerto Rico received Fs.","_key":"401036883815"}],"_type":"block","style":"normal","_key":"11ab60873531"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"86455b0d6cfe0"}],"_type":"block","style":"normal","_key":"b7f3e011a1cf"},{"markDefs":[],"children":[{"_key":"758a3b5c929e0","_type":"span","marks":[],"text":"How Did Vermont Jump From a B Rating to an A in 1 Year?"}],"_type":"block","style":"h3","_key":"2a09f63caadb"},{"children":[{"_key":"d4ec70c7c6660","_type":"span","marks":[],"text":"The state reported a preterm birth rate of 7.7% in 2023, which improved from the prior year when it was 8.8%—the highest it was since 2013—and is notably lower than the national average of 10.4%. Breaking it down by county, Chittenden, Franklin, Rutland, Windham, and Windsor all saw improvements, while the rate in Washington county worsened compared with last year’s report. Additionally, half these counties got Bs, with Rutland county having the highest rate of 9.1%."}],"_type":"block","style":"normal","_key":"e17a41c4cf1e","markDefs":[]},{"_type":"block","style":"normal","_key":"103822ab6bec","markDefs":[],"children":[{"text":"","_key":"f1afdc82fb560","_type":"span","marks":[]}]},{"_type":"block","style":"normal","_key":"2a98f2795d63","markDefs":[],"children":[{"_key":"11b31e281e870","_type":"span","marks":[],"text":"There are a few factors that play into Vermont’s low preterm birth rate. First, the percentage of women having low-risk cesarean births in Vermont was 23.7%, comparable to the country-wide rate of 26.6%. Additionally, only 6.2% of birthing people were receiving inadequate prenatal care, much lower than the 15.7% rate across the US. These factors underline the importance of improving nationwide access to comprehensive maternal care."}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a077f75e18d20"}],"_type":"block","style":"normal","_key":"ee6246de4339"},{"alt":"Welcome to Vermont road sign | Image credit: rabbit75_fot – stock.adobe.com","_key":"fa9dab67f41c","disableTextWrap":false,"disableLightBox":true,"imgcaption":[{"markDefs":[],"children":[{"marks":[],"text":"Vermont had the lowest preterm birth rate in the US in 2023 | Image credit: rabbit75_fot – stock.adobe.com","_key":"852f8e890861","_type":"span"}],"_type":"block","style":"normal","_key":"f7c6dd52bee1"}],"_type":"figure","alignment":"right","widthP":35,"asset":{"_ref":"image-7928afa87272891a1211f02ab685217dc119fc12-5694x3800-jpg","_type":"reference"}},{"style":"normal","_key":"e13c0a625fda","markDefs":[{"_type":"link","href":"https://www.commonwealthfund.org/publications/scorecard/2024/jul/2024-state-scorecard-womens-health-and-reproductive-care","_key":"703201b25ce8","nofollow":true,"blank":true}],"children":[{"_type":"span","marks":[],"text":"Vermont is also one of the few ","_key":"0bb616cd5f0b0"},{"_type":"span","marks":["703201b25ce8"],"text":"top-performing states","_key":"0bb616cd5f0b1"},{"_type":"span","marks":[],"text":" in terms of women’s overall health.","_key":"0bb616cd5f0b2"},{"_type":"span","marks":["superscript"],"text":"3","_key":"d4f54cd29a81"},{"text":" According to the 2024 State Scorecard on Women’s Health and Reproductive Care, Vermont has the lowest all-cause mortality rate among women of reproductive age (15 to 44 years) and the lowest maternal mortality.","_key":"3ebeea4f932d","_type":"span","marks":[]}],"_type":"block"},{"_type":"block","style":"normal","_key":"d9f35a7e1917","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7e1ac9d7e2a20"}]},{"_key":"80bb43a5ed71","markDefs":[],"children":[{"_type":"span","marks":[],"text":"According to The Commonwealth Fund, this is largely due to the state increasing its number of maternity care providers and reducing the number of women lacking prenatal care, postpartum checkups, and insurance.","_key":"f82eda337ed50"},{"_type":"span","marks":["superscript"],"text":"3","_key":"1f9e57b99691"},{"_type":"span","marks":[],"text":" Expanding Medicaid to include more individuals with lower household incomes is linked to reduced maternal mortality rates, improved infant health outcomes, and increased access to reproductive health services, and Vermont is among the states that have adopted Medicaid expansion.","_key":"7cb096efbccf"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"c15f10d41d26","markDefs":[],"children":[{"text":"","_key":"5e3e9cafea590","_type":"span","marks":[]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"However, the maternal mortality rate nearly doubled between 2018 and 2022, increasing the most for Black and American Indian and Alaska Native women, though the role of the COVID-19 pandemic during this timeframe should be examined closer as there was a clear spike in 2021 that has since dropped.","_key":"c975f938521e0"},{"_type":"span","marks":["superscript"],"text":"1","_key":"b32e7c9f6244"}],"_type":"block","style":"normal","_key":"56fff3fd9bf3"},{"_key":"0e7f43dce952","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"724da5094ffe0"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"Despite progress in reducing preterm births, Vermont has also seen a slight increase in infant mortality over the past decade, with 26 babies dying before their first birthday in 2022. Interestingly, the infant mortality rate among Black babies was 20% lower than the state average, highlighting nuanced trends in outcomes.","_key":"d1217dce06ee0"}],"_type":"block","style":"normal","_key":"2350a02d254c","markDefs":[]},{"style":"normal","_key":"6ed4d8ddd5ca","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ae230c62c1560"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"6cbaffb21d9a0","_type":"span","marks":["strong"],"text":"Racial Gaps in Preterm Birth Rates"}],"_type":"block","style":"h3","_key":"c8f8728286ed"},{"children":[{"_type":"span","marks":[],"text":"Disparities remain as the preterm birth rate varied by race and ethnicity. The preterm birth rate among babies born to Hispanic birthing people was 1.3 times higher than among all other groups in 2023, similar to the gap between Black birthing people and other groups across the country as a whole.","_key":"03649279c02b0"}],"_type":"block","style":"normal","_key":"edbb0509f210","markDefs":[]},{"_type":"block","style":"normal","_key":"6430815c38ed","markDefs":[],"children":[{"text":"","_key":"c118090966590","_type":"span","marks":[]}]},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.census.gov/quickfacts/VT#qf-headnote-b","_key":"17676e233da0"},{"blank":true,"_type":"link","href":"https://usafacts.org/data/topics/people-society/population-and-demographics/our-changing-population/state/vermont/","_key":"31abd550b23f","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"According to the report, Hispanic people in Vermont have a 52% higher preterm birth rate relative to Asian people, with rates of 10% and 6.6%, respectively. 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However, there was 1 patient who experienced subsequentregression 3 months after metformin discontinuation.","_key":"55ee920698070"}],"_type":"block","style":"normal","_key":"09f1313d0133"},{"style":"normal","_key":"c3ead5e5146f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"44e31b88b5ba0"}],"_type":"block"},{"style":"normal","_key":"1a15fc5d2c05","markDefs":[],"children":[{"_type":"span","marks":[],"text":"A differential gene expression analysis was conducted to compare pre- and postmetformin samples, accounting for false discovery rates. 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Metformin treatment was associated with increased expression of an AMPK signaling gene set and a gene set comprising all keratin-associated proteins.","_key":"126309902c0f0","_type":"span","marks":[]}]},{"_key":"0ce160effb61","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"4575db2c606f0"}],"_type":"block","style":"normal"},{"_key":"bc38cea7dad5","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Study limitations include a small sample size, retrospective design, lack of a placebo control group, and a single-center setting, which may limit the generalizability of the findings. The absence of a validated activity or severity scale for central centrifugal cicatricial alopecia hindered precise assessment of disease progression. 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The study utilized data from the National Health and Nutrition Examination Survey, examining associations between HRSNs and the American Heart Association's Life’s Essential 8 metrics. Results indicated that higher HRSNs correlated with lower CVH scores. Despite limitations, the study suggests multipronged approaches to improve CVH through community interventions and policies.","body":[{"markDefs":[{"blank":true,"_type":"link","href":"https://www.ahajournals.org/doi/full/10.1161/JAHA.124.035863","_key":"b1029b44f14c","nofollow":true},{"_type":"link","href":"https://www.ajmc.com/compendium/cardiovascular","_key":"6715b7decdaf","nofollow":false,"blank":true}],"children":[{"text":"Adults with more unfavorable health-related social needs (HRSNs) had a graded positive association with low ","_key":"361b184258160","_type":"span","marks":[]},{"_key":"9cdb3c7f13f8","_type":"span","marks":["6715b7decdaf"],"text":"cardiovascular health (CVH)"},{"_key":"2f50309bbbe4","_type":"span","marks":[],"text":" and an adverse association with high CVH, according to a study published in "},{"_type":"span","marks":["b1029b44f14c","em"],"text":"Journal of the American Heart Association","_key":"361b184258161"},{"_type":"span","marks":["em"],"text":".","_key":"361b184258162"},{"marks":["superscript"],"text":"1","_key":"bc9db284aa34","_type":"span"}],"_type":"block","style":"normal","_key":"d258cc122f28"},{"style":"normal","_key":"bb0191ee6a9b","markDefs":[],"children":[{"text":"","_key":"7ebfcf5fad660","_type":"span","marks":[]}],"_type":"block"},{"_key":"2eab991bd28c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"HRSNs include social and economic factors that impact an individual’s ability to maintain their health and well-being, such as unemployment, food insecurity, financial barriers, and educational attainment. The researchers emphasized that understanding factors associated with low CVH may help to identify and address potential barriers, ultimately improving population health.","_key":"ff0a65d5bb82"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"96435a6debe5","_type":"span"}],"_type":"block","style":"normal","_key":"995678f42953"},{"_type":"block","style":"normal","_key":"0f4b1a90fb9f","markDefs":[{"_key":"9f89145e49c5","nofollow":true,"blank":true,"_type":"link","href":"https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.192703?url_ver=Z39.88-2003\u0026rfr_id=ori:rid:crossref.org\u0026rfr_dat=cr_pub%20%200pubmed"},{"href":"https://www.ahajournals.org/doi/10.1161/CIR.0000000000001078","_key":"15bd9b76cd84","nofollow":true,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"In 2010, the American Heart Association (AHA) ","_key":"bae5c9b4db61"},{"_type":"span","marks":["9f89145e49c5"],"text":"released","_key":"320bcb749a09"},{"_type":"span","marks":[],"text":" Life’s Simple 7, a set of 7 metrics designed to improve CVH among all Americans by 20%.","_key":"2fbeac0757f1"},{"_type":"span","marks":["superscript"],"text":"2","_key":"cb3502f25570"},{"_type":"span","marks":[],"text":" These metrics included body mass index (BMI), physical activity, smoking, dietary intake, blood pressure, total cholesterol, and fasting glucose. 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Given these gaps, the researchers aimed to evaluate the associations between HRSNs and LE8, both individually and collectively, among US adults aged 20 and older.","_key":"c38093a461300"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"ac350e4bccf0","_type":"span"}],"_type":"block","style":"normal","_key":"43897839ebce"},{"alt":"cardiovascular health | Image Credit: BillionPhotos.com - stock.adobe.com","_key":"4b17090b1197","alignment":"right","disableLightBox":true,"_type":"figure","disableTextWrap":false,"asset":{"_ref":"image-2daed33e29a1e4264b7784effa59ab6a7f33a5b2-4500x3000-jpg","_type":"reference"},"imgcaption":[{"style":"normal","_key":"526a176cf8d2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Adults with more unfavorable health-related social needs, such as unemployment or food insecurity, had a higher prevalence of low cardiovascular health. | Image Credit: BillionPhotos.com - stock.adobe.com","_key":"e98247f607d8"}],"_type":"block"}],"widthP":40},{"_key":"be3452b2a963","markDefs":[],"children":[{"_type":"span","marks":[],"text":"They used data from the January 2011 to March 2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey that assessed the nutrition and health status of the US population. Those selected underwent an in-person interview at home, followed by an examination at the NHANES Mobile Examination Center.","_key":"44e9f4713d1c0"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"00ab8f02731b","markDefs":[],"children":[{"_key":"5d62f19aa98a0","_type":"span","marks":[],"text":""}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Healthy People 2030 group social determinants of health (SDOH) into 5 domains: economic stability, health care access and quality, education access and quality, neighborhood and built environment, and social and community context. Based on these, the researchers identified 8 HRSN components: employment status, family poverty-to-income ratio, education level, food security, health care access, health insurance status, home ownership, and marriage status.","_key":"1fae3a9629fb0"}],"_type":"block","style":"normal","_key":"8be881a42988"},{"children":[{"_type":"span","marks":[],"text":"","_key":"deaec2e402eb0"}],"_type":"block","style":"normal","_key":"297e4abf159e","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"For each participant, they summed the number of HRSNs, ranging from 0 to 8; higher numbers indicated more unfavorable HRSNs. The researchers categorized unfavorable HRSNs as none, 1 to 2, 3 to 4, and 5 or more.","_key":"8b8aa41a61a90"}],"_type":"block","style":"normal","_key":"492c82351754"},{"_key":"7a0db100b777","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"39bae8c059480"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"7d2a8166d348","markDefs":[],"children":[{"_key":"2ea4643140780","_type":"span","marks":[],"text":"Additionally, each LE8 metric score ranged from 0 to 100, with a higher score indicating better health. The overall LE8 score was the mean of the 8 metric components and was categorized as low (\u003c 50), moderate (50-79), and high (≥ 80) CVH. After calculating both scores, the researchers used multivariable linear and multinomial logistic regression models to examine the association between HRSNs and CVH."}]},{"_key":"35e5df2afa86","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"cb5806928cd20"}],"_type":"block","style":"normal"},{"style":"normal","_key":"fa1ea3bf4232","markDefs":[],"children":[{"_type":"span","marks":[],"text":"They analyzed 14,947 NHANES participants, who had a mean (SE) age of 46.4 (0.35) years. About half of the participants (49.3%) were male, and nearly two-thirds were non-Hispanic White (66.3%). Additionally, the mean number of unfavorable HRSNs was 1.79 (0.04). 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