Racial inequities in clinical performance diminish overall health care system performance; however, quality assessments have rarely incorporated reliable measures of racial inequities. We studied care for more than one million Medicare fee-for-service beneficiaries with cancer to assess the feasibility of calculating reliable practice-level measures of racial inequities in chemotherapy-associated emergency department (ED) visits and hospitalizations. Specifically, we used hierarchical models to estimate adjusted practice-level Black-White differences in these events and described differences across practices. We calculated reliable inequity measures for 426 and 322 practices, depending on the measure. These practices reflected fewer than 10 percent of practices treating Medicare beneficiaries with chemotherapy, but they treated approximately half of all White and Black Medicare beneficiaries receiving chemotherapy and two-thirds of Black Medicare beneficiaries receiving chemotherapy. Black patients experienced chemotherapy-associated ED visits and hospitalizations at higher rates (54.2 percent and 35.8 percent, respectively) than White patients (45.7 percent and 31.9 percent, respectively). The median within-practice Black-White difference was 8.1 percentage points for chemotherapy-associated ED visits and 2.7 percentage points for chemotherapy-associated hospitalizations. Additional research is needed to identify other reliable measures of racial inequities in health care quality, measure care inequities in smaller practices, and assess whether providing practice-level feedback could improve equity.
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http://dx.doi.org/10.1377/hlthaff.2021.01594 | DOI Listing |
Public Health Res (Southampt)
September 2024
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Background: Sex workers' risk of violence and ill-health is shaped by their work environments, community and structural factors, including criminalisation.
Aim: We evaluated the impact of removing police enforcement on sex workers' safety, health and access to services.
Design: Mixed-methods participatory study comprising qualitative research, a prospective cohort study, mathematical modelling and routine data collation.
Nurse Educ Pract
December 2024
University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address:
Aim: This review explores the provider perspectives regarding cultural competency to pinpoint common themes that emerge from the existing literature.
Background: Cultural competency is vital in healthcare and remains a burgeoning area of interest in the healthcare landscape. Nevertheless, achieving mastery of these competencies remains challenging as health inequities persist that affect the care received by minority populations.
J Med Virol
December 2024
School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
Racialized and Indigenous communities have been disproportionately affected by COVID-19 infections and mortality, driven by systemic socioeconomic inequalities. However, how these factors specifically influence COVID-19 vaccine uptake is not documented among racialized individuals in Canada. The present study aims to examine COVID-19 vaccine uptake rates and related factors among racialized and Indigenous communities compared to White people in Canada.
View Article and Find Full Text PDFBMC Oral Health
December 2024
Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA.
Background: Oral diseases remain a significant public health problem worldwide, with growing gaps in oral health status among various socioeconomic groups. The objective of the current study is to analyze the impact of different social determinants of health (SDOH) on oral health outcomes (frequency of dental visits, self-reported oral health status, embarrassment because of oral health status, and tooth loss) among a representative sample of United States (U.S.
View Article and Find Full Text PDFJ Public Health Manag Pract
December 2024
Author Affiliations: Prevention Research Center, Brown School, Washington University in St Louis, St Louis, Missouri (Crenshaw and Allen); School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (Fifolt and Erwin); Public Health Accreditation Board, Alexandria, Virginia (Lang and Belflower Thomas); and Prevention Research Center, Brown School; Alvin J. Siteman Cancer Center and Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine; Washington University in St Louis, St Louis, Missouri (Brownson).
Objective: This article focuses on supports and challenges to health equity that small local health departments (LHDs) experienced while working toward national reaccreditation or Pathways Recognition with the Public Health Accreditation Board's Standards & Measures Version 2022 (PHAB S&M v2022).
Design: The study team conducted 22 qualitative interview sessions with members of health department leadership teams.
Setting: In the spring of 2024, participants from 4 small LHDs in the western and midwestern regions of the United States participated in individual remote interview sessions.
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